Environmental conditions in low-income urban housing: clustering and associations with self-reported health

Am J Public Health. 2014 Sep;104(9):1650-6. doi: 10.2105/AJPH.2013.301253. Epub 2013 Sep 12.


Objectives: 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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Air Pollution, Indoor / analysis
  • Air Pollution, Indoor / statistics & numerical data
  • Animals
  • Boston / epidemiology
  • Cluster Analysis
  • Environmental Exposure / analysis*
  • Female
  • Fungi
  • Health Status*
  • Housing / statistics & numerical data*
  • Humans
  • Insecta
  • Male
  • Middle Aged
  • Pesticides
  • Poverty / statistics & numerical data*
  • Prevalence
  • Rodentia
  • Socioeconomic Factors
  • Urban Population / statistics & numerical data*
  • Ventilation
  • Young Adult


  • Pesticides