title: Environmental conditions in low-income urban housing: clustering and associations with self-reported health.
abstract: OBJECTIVE
  We explored prevalence and clustering of key environmental conditions in low-income housing and associations with self-reported health.
  
  
  METHODS
  The Health in Common Study, conducted between 2005 and 2009, recruited participants (n = 828) from 20 low-income housing developments in the Boston area. We interviewed 1 participant per household and conducted a brief inspection of the unit (apartment). We created binary indexes and a summed index for household exposures: mold, combustion by-products, secondhand smoke, chemicals, pests, and inadequate ventilation. We used multivariable logistic regression to examine the associations between each index and household characteristics and between each index and self-reported health.
  
  
  RESULTS
  Environmental problems were common; more than half of homes had 3 or more exposure-related problems (median summed index = 3). After adjustment for household-level demographics, we found clustering of problems in site (P < .01) for pests, combustion byproducts, mold, and ventilation. Higher summed index values were associated with higher adjusted odds of reporting fair-poor health (odds ratio = 2.7 for highest category; P < .008 for trend).
  
  
  CONCLUSIONS
  We found evidence that indoor environmental conditions in multifamily housing cluster by site and that cumulative exposures may be associated with poor health.
authors.affiliation: Gary Adamkiewicz and John D. Spengler are with the Department of Environmental Health and Glorian Sorensen is with the Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA. Amy E. Harley is with the Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee. Anne Stoddard and May Yang are with the New England Research Institutes, Watertown, MA. Marty Alvarez-Reeves is with the Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA.
authors.forename: Gary
authors.initials: G
authors.lastname: Adamkiewicz
authors.forename: John D
authors.initials: JD
authors.lastname: Spengler
authors.forename: Amy E
authors.initials: AE
authors.lastname: Harley
authors.forename: Anne
authors.initials: A
authors.lastname: Stoddard
authors.forename: May
authors.initials: M
authors.lastname: Yang
authors.forename: Marty
authors.initials: M
authors.lastname: Alvarez-Reeves
authors.forename: Glorian
authors.initials: G
authors.lastname: Sorensen
mesh_terms: D000293:Adolescent; D000328:Adult; D016902:Air Pollution, Indoor / Q000032:analysis / Q000706:statistics & numerical data; D000818:Animals; D001900:Boston / Q000453:epidemiology; D016000:Cluster Analysis; D004781:Environmental Exposure / Q000032:analysis*; D005260:Female; D005658:Fungi; D006304:Health Status; D006798:Housing / Q000706:statistics & numerical data*; D006801:Humans; D007313:Insecta; D008297:Male; D008875:Middle Aged; D010575:Pesticides; D011203:Poverty / Q000706:statistics & numerical data*; D015995:Prevalence; D012377:Rodentia; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data*; D014691:Ventilation; D055815:Young Adult
chemical_list: D010575:Pesticides
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