Inner-city residents are taking a hands-on approach to public health issues that affect their lives. Since 1996, I have had the honor of being part of a team of researchers from Tufts University School of Medicine (where I am an assistant professor) and the Harvard and Boston University Schools of Public Health, which joined forces with residents of public housing and local community groups to address housing conditions and health in the Boston area.

From the onset, resident participation was at the center of our work. Beginning at the West Broadway housing development (WB) in South Boston and moving to the Franklin Hill Housing (FH) in North Dorchester, Boston University's Patricia Hynes and I first worked with teams of residents to tailor an epidemiologic survey to their housing conditions and to train them to administer the questionnaire to their neighbors. We were joined in the endeavor by the Public Health Initiative at the South Boston Community Health Center, by the Committee for Boston Public Housing's Action Against Asthma program at FH, and, in 1998, by Jack Spengler, Akira Yamaguchi Professor of Environmental Health and Human Habitation at the Harvard School of Public Health.

Over the course of these collaborations, we met resident leaders like Lilly Berry of WB and Patricia Terry of FH, who not only quickly learned what we had to teach them but also offered us invaluable lessons about how to work effectively in their communities. Without their guidance and support, it is doubtful that many residents would have opened their doors to us, let alone been willing to take the 45-minute survey.

In the end, the residents' questionnaires documented high rates of overheated apartments, which alternated with periods of tenants resorting to the use of gas ovens for warmth. They also found widespread water damage, mold growth, and pest infestation. When combined with the extremely high rates of asthma reported by tenants, the results suggest that these housing conditions are negatively affecting resident health.

In the immediate aftermath of the surveys, the residents, the health center, and the university partners developed follow-up programs, including efforts to install window guards and to reduce parental smoking around children at WB and a pilot asthma intervention program that was just completed at FH, whose field work was led by Jose Vallarino, research specialist at the Harvard School of Public Health.

Given the limited scope of our efforts to address housing conditions so far and the huge costs associated with upgrading housing, important questions remain: What will effectively alleviate such adverse conditions? And where will the money come from to make the needed repairs? These questions have led us to form a broader consortium that includes energy experts, the housing authority, and public health commission of the City of Boston to try to find practical answers and, in the process, continue our work with residents to bring about healthy homes in public housing.

Doug Brugge
M.A.'87, Ph.D.'87, S.M.'88