Ubiquitous mold, a particular problem in bathrooms, kitchens, and basements, can trigger asthma attacks, the eighth most common chronic condition suffered by Americans, affecting nearly 25 million people, a third of whom are children under 18 years of age, according to the American Lung Association.

After decades of success eliminating lead-based paint hazards in American homes, nearly half a million children still have blood-lead levels high enough to harm their intelligence, behavior, and development, according to the U.S. Centers for Disease Control and Prevention.

Asthma and lead poisoning are just two of the many chronic health conditions significantly tied to the way housing is designed, built, and maintained, according to "Healthy Homes, Healthy Families" a new white paper by the National Center For Healthy Housing and The Enterprise Foundation(EF).

While the housing industry generally is moving toward healthier home building techniques and technology, the affordable housing industry could use an extra push.

"For far too long in this country we have had too narrow an understanding of 'affordable housing,' confined to the intersection of building costs and family incomes. As such, we have neglected the important benefits that affordable housing provides for families -- especially healthier children and more sustainable communities," the white paper says.

To that end, the EF, along with environmental group Natural Resources Defense Council (NRDC), the American Institute of Architects, the American Planning Association, and philanthropic groups has already launched the Green Communities Initiative -- a five-year, $550 million program designed to build 8,500 environmentally friendly affordable homes nationwide.

"For many families, asthma, injuries, and lead poisoning are just symptoms of the underlying problem," says Dr. Megan Sandel, a Boston University School of Medicine expert on housing's impact on children's health.

"Inadequate housing is the real disease. Safe, decent, affordable housing is the best preventive medicine low-income families can get. This initiative will ensure that thousands of homes and the children that reside in them are safer and healthier," Sandel said.

Written by former associate editor of the Miami Herald, Tony Proscio, now a consultant to foundations and civic organizations and an independent urban affairs writer, the white paper hopes to help propel programs like the Environmental Protection Agency's (EPA) experimental "Air+" program.

Air+ is modeled on the existing Energy Star program for approaches to energy efficiency, including less power hungry appliances.

Air+ focuses on building to a higher standard of clean indoor air. An Air+ label would assure consumers that the air in their homes will be significantly cleaner than homes built with codes not up to par with the Air+ standard. That could lead to both the builder and the buyer, should there be any added expense from the higher standard, earning increased market value in the home.

The national lead abatement program, for example, has proved a cost saver and value booster, but lead poisoning prevention has also shown how difficult it can be to introduce new practices that raise the "first cost" of building, renovating, or maintaining a home.

The white paper says it's necessary to over come the psychological "first costs" barrier to get developers to think about long term savings in home maintenance, repair, reduced liability, improved quality of life, health, and developmental benefits for children, instead of knee-jerk reacting to only the initial expenditures necessary to create sustainable and safe housing and to make repairs.

"In the case of lead poisoning, this kind of long-term reckoning is becoming increasingly common, and public policy has shifted accordingly. Yet even now, after nearly 30 years of advocacy and successful policy development, lead poisoning rates are alarmingly high in many of the country's poorest communities. And disputes over first costs still complicate many efforts at further improvement," the white paper says.

Proscio's paper also says a movement for healthier affordable homes must also come from the grassroots non-profit housing development area, which has, and should continue to demonstrate the appeal and affordability of housing designed for a healthier indoor and outdoor environments.

Positive steps include the Asthma Regional Council of New England group, in cooperation with the building industry, working to develop detailed guidelines for healthy construction. Those guidelines are increasingly part of the eligibility criteria for the allocation of public housing dollars in New England.

"There are sound, affordable methods of construction and maintenance, that can make housing healthier for those who live there. Yet these methods are not well understood among housing developers and policy experts. And even when they are better understood, many builders and property owners still sometimes overestimate the cost of healthier practices, neglecting to factor in the long-term economies associated with energy efficiency, reduced costs of maintenance and repair, reduced liability, and better lives for the residents," Proscio writes.

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