Housing, Health and the Environment 2006 NEHA Sabbatical Exchange Alberta, Canada Michele Morrone, Ph.D., R.S. Associate Professor Ohio University
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Housing, Health and the Environment
2006 NEHA Sabbatical Exchange
Alberta, Canada
Michele Morrone, Ph.D., R.S.
Associate Professor
Ohio University
Sabbatical Goal
The main goal of my sabbatical experience is to enhance the undergraduate course that I
teach called “Shelter Environments.” In order to accomplish this goal, I developed an experience
that provided me with exposure to a variety of housing and environmental health issues in
Alberta, Canada.
Overview of Public Health in Canada and Alberta
Canada has universal health care under the Canada Health Act: “the aim of Canada's
health care system is to ensure that all residents of Canada have reasonable access to medically
necessary insured services without direct charges.” Health Canada is the main federal agency
responsible for developing policies and enforcing the requirements of the Health Act.
Health Canada is lead by the Minister of Health and is divided into 6 regions, 7
branches, and several agencies, commissions and boards. An organizational chart of Health
Canada can be found in Appendix A. One of Health Canada’s key roles in public health has to do
with addressing the needs of the First Nations who are the native people in Canada.
In September of 2004 the government of Canada announced the creation of a new
national agency known as the Public Health Agency of Canada. The major foci of this agency
are emergency response, infectious disease control, and injury prevention. The press releases
announcing the establishment of the Public Health Agency note that it will collaborate with
Health Canada and contribute to a national health network.
Similar to the U.S., many of the core public health functions are the responsibility of
provinces. The provincial governments, in turn, pass the responsibility onto local health regions
or districts. Not all provinces organize public health practice the same way since each province
has its own public health legislation. The most common organizational scheme involves the
creation of regional authorities to oversee delivery of public health services in the provinces. 1
The Regional Health Authorities Act divided Alberta into 9 health regions as shown in
Figure 1. Each region is tasked with the broad goals of: 1) promoting health; 2) responding to
regional needs; and 3) reporting on performance. Each region has a health board consisting of 11
– 13 people. The health regions in Alberta include both primary care and public health
professionals.
1
For a discussion of public health in Canada refer to The Role and Organization of Public Health at:
http://www.phac-aspc.gc.ca/publicat/sars-sras/naylor/3_e.html#s3b . This document also offers a comparison of
Canada’s public health system to the U.S. system.
Figure 1. Health Regions in Alberta, Canada
Environmental Health and Housing in Alberta
In July 1999, Alberta enacted the Minimum Housing and Health Standards 2 for the
purpose of protecting health of the public who live in and near rental housing. The standards are
different than building codes in that they focus on ensuring that occupants are provided with safe
and healthy housing and they are enforced by public health inspectors rather than through
permits and code compliance.
The major requirements of the standards are related to the condition of the housing,
equipment and furnishings, and sanitation. Specifically, the standards require:
1) The housing premises must be structurally sound and must be maintained in a
waterproof, windproof and weatherproof condition;
2) Occupants of a housing premises must be supplied with adequate heat, potable water,
sanitary facilities, cooking facilities, and adequate space for sleeping; and
3) All rooms including other areas used in common by the occupants of housing
premises must be maintained in a clean and sanitary condition.
In order to accomplish these requirements, there are both specific and general elements in
the standards. An example of a specific element is that there must be a window that can open in
sleeping areas and this window must be at least 3.8 ft2 (0.35m2) in area. An example of a more
general element of the housing standards is that the basement must be structurally sound. The
public health inspector is responsible for inspecting the premises and may call for assistance
from a building or electrical inspector for the elements that require more judgment.
The standards are clear that the owner of the property is responsible for maintaining the
housing in compliance with the standards. The Minimum Housing and Health Standards were
adopted by the Alberta government in September 1999 through Alberta Regulation 173/99 which
is a section of the Public Health Act related to housing. 3
Edmonton, Alberta
Edmonton is located in the Capital Health Region as shown in Figure 2 as Region 6 and
in Figure 3 in more detail. This region encompasses several major cities, including Edmonton,
and serves more than 1 million people in central Alberta.
2
http://www.health.gov.ab.ca/resources/publications/housing99.pdf
3
http://www.qp.gov.ab.ca/Documents/REGS/1999_173.CFM
Figure 2. Capital Health Region
Housing and health has been a public health priority since the early 1990s in Edmonton
when a study was completed that identified the magnitude of the problem with the city’s housing
stock. 4 This study indicated that more than 2,000 household were living in inadequate housing
conditions. Furthermore, this appeared to be an environmental justice issue, as most of these
households were identified as low income.
In 1992, Edmonton created a Safe Housing Committee which included inspectors from a
variety of city departments and sought input from builders, realtors and contractors in the city.
The committee conducted a project to demonstrate how substandard housing could be upgraded
in a cost effective way in order to ensure that public health is protected.
During the sabbatical I met with the Director of Housing Services, Jay Freeman and the
Senior Safety Codes Officer, Hal Wright. They explained that the safe housing program in
Edmonton is a proactive approach to ensuring adequate housing. The program involves
coordination among several departments in the city including fire, planning, building, and health.
Prior to the safe housing committee and the 1990 study, properties were handled by complaint
only, now there are opportunities to address housing conditions before a complaint is made.
4
For more information about the history of safe housing in Edmonton see: http://www.cmhc-
schl.gc.ca/en/inpr/imhoaf/afhoid/pore/mobuco/mobuco_006.cfm
Safe Housing Inspection
I was able to observe an inspection by one of the safe housing teams which is depicted in
Figures 3- 5.
Figure 3. Edmonton Safe Housing Team
From left: Ken Dong, Environmental Health
Officer, Executive Officer and Senior Advisor,
Capital Health; Howard Schultz, Safety codes
Officer, City of Edmonton; Russell Croome,
Fire Inspector; Don Scott; Electrical Inspector
Figure 4. Rooming House Being Figure 5. Environmental Health
Inspected by Safe Housing Team Officer Collecting Drinking Water
Sample
The safe housing team is a true partnership among several agencies and departments with
a common goal of ensuring that conditions are safe and healthy in rental units. The team
conducts the inspection simultaneously which is a benefit to the owner because it is not
necessary to coordinate several different inspections; all of the necessary inspections for
occupancy are conducted at one time. This is also an efficient way for government to complete
the required inspections because of the immediate communication among the departments.
Complaint Investigation
Although Edmonton is an innovator when it comes to safe housing and health, a majority
of the housing-related activities in Capital Health still involve responding to complaints. During
the sabbatical I was able to observe several complaint-related inspections. As Figures 6-9 show,
one of the major violations with the Minimum Housing Standards in many of these homes is
related to structural soundness of the house as well as means of egress. An example of the EH
response to a complaint is found in Appendix B.
Figure 6. Wojciech Drobina, Environmental Health Officer,
Executive Officer, Preparing Notes for Violation Summary
Figure 7. Example of Structural Violation
Figure 8. Example of Egress Violation
Special Investigations
The City of Edmonton has a dedicated police officer who serves as a derelict housing
investigator. Specifically, this officer responds to complaints and tips related to illegal drug
activity in the City’s housing. Figure 9 is a picture of this police officer preparing to enter a
housing unit with the environmental health officer. This situation shows a strong commitment on
the part of the City to work with public health to address critical housing issues and is further
evidence of the exceptional coordination in the city.
Figure 9. Environmental Health Officer Drobina and Constable Chris Hayduk
Preparing to Enter a Suspicious Property
Rural Properties
Capital Health is also responsible for responding to complaints in rural areas. Rural rental
properties must comply with the housing standards and regulation. Karen Emde, a Senior
Advisor and Water Quality Specialist provided me the opportunity to visit a rural property that
was required to upgrade its drinking water system. Although the residence, depicted in Figure
10, is owner-occupied, there is a rental unit the basement of the home. Therefore, the owner must
comply with the standards. Earlier tests conducted by Capital Health on this property indicated
that the drinking water quality was unsafe. The owner addressed this issue by installing several
cisterns (Figure 11) that will provide a reliable source of safe drinking water into the home.
A plumbing inspector accompanied Capital Health to the property to ensure that the
plumbing connections were adequate. While on the property, another potential issue with the
wastewater treatment system was noted (Figure 12), which may require additional follow up with
this property owner.Figure 10. Rural Property Being Inspected for Drinking
Water Quality
Figure 11. Cisterns Located in GarageFigure 12. Location of Septic Tank on Rural Property Under Investigation
Calgary, Alberta
The Calgary Health Region is located in southern and southwest Alberta (Figure 13). It
covers a broad region encompassing a variety of geographic areas including a major urban area
with the City of Calgary, smaller rural and suburban areas surrounding Calgary, and the tourist
resort area of Banff in the Rocky Mountains.
The major housing issues that I was exposed to during my time with Calgary were: 1)
illegal marijuana growing operations (“grow-ops”) and 2) housing for temporary workers in the
Banff (“staff accommodations”).
Grow-ops
One public health inspector in the health region’s environmental health office is a team
member of public officials responsible for enforcing laws against illegal drug cultivation in
homes. In addition to the public health inspector, other team members include law enforcement,
hazardous materials management personnel, and fire safety officials. The main role of the health
inspector is to condemn houses that have been seriously damaged due to the circumstances under
which the illegal drugs are grown.Figure 13. Calgary Health Region
Although I was not able to participate in an inspection involving an illegal grow-op, I did
have the opportunity to listen to a presentation about the health region’s role. The health
inspector assigned these duties spoke to a group of realtors about the public health implications
of grow-ops. Realtors are very interested in this topic, especially in terms of the housing
conditions that can result from the excess moisture and high temperature need to cultivate the
plants. An example of the mold that can result from an illegal grow-up is shown in Figure 14.
Figure 14. Mold Growth Resulting from Illegal Marijuana
Growing Operation
(Photo courtesy of Calgary Health Region)Staff Accommodations
The town of Banff is a major tourist destination in Alberta’s Rocky Mountains and
surrounded by the Banff National Park. There are world-class hotels and ski resorts in the area
and it is promoted as a summer destination location as well. It is about 90 minutes from Calgary.
The resorts and ski slopes are staffed largely by young men and women who travel from all over
the world for the seasonal work. The resorts, in turn, provide low cost housing for their staff.
Although the staff accommodations vary in quality, the Banff office of the Calgary Health
Region recently became aware of poor housing conditions in these units (Figures 15 and 16).
Figure 15. Public Health Inspector Kori Woodard Outside of
Staff Accommodation in Banff
Figure 16. Inside of Staff Accommodation in Banff
(Left: sleeping area; right: kitchen in same unit)A serious issue in the staff accommodations is the presence of bed bugs. Figure 17 is a
bedroom in one of the staff accommodation buildings that was seriously infested with bed bugs.
As this figure shows, a major challenge in eradicating these pests is the log cabin structure which
allows the bed bugs to move from easily from unit to unit. Figure 18 shows bed bug bites on
staff. A fact sheet that was developed by Calgary health related to bed bugs can be found in
Appendix C.
Figure 17. Staff Accommodation Unit with Bed Bug Problem
Figure 18. Bed Bug Bites on Arm of Resident in Staff Accommodation
(Photo courtesy of Calgary Health Region)In addition to bed bugs, the staff accommodations have moisture and mold problems
associated with inadequate ventilation; general sanitation issues that are associated with housing
for a young, relatively transient population; and crowding that could contribute to the efficient
spread of infectious diseases.
Calgary Health Region is working with the owners of the staff accommodations to
upgrade many of the units. Some of these upgrades include pest control, new windows for better
egress and ventilation, improved toilet facilities, and fire safety measures. An example of the
results of a public health inspection in one of the staff accommodation buildings is found in
Appendix D.
First Nations
Alberta is the home of several native, or First Nations, reserves which house bands
(tribes). Public health issues on the reserves are addressed by Health Canada which is the federal
health agency, rather than health regions. While in Calgary, I had the opportunity to spend one
day on the Tsuu T'ina reserve. The band provides housing to band members, however, when a
member has a complaint about the housing, they can contact Health Canada with their concerns.
Pierre Denault (Figure 19) is the Environmental Health Officer in the region responsible for
public health issues on a vast area of First Nations land including the Tsuu T’ina reserve.
Figure 19. Pierre Denault, Environmental Health Officer with First Nations and Inuit Health
Branch, Health Canada, Near a Dump on Reserve Land
The housing conditions I observed on the reserve contain some of the same issues that
can be seen with the rural poor. For example, a major issue has to do with general sanitation. As
figure 20 shows, sanitation near the houses I visited is an obvious problem.Figure 20. Outside of Home on First Nations Reserve
One of the major complaints that residents have is with mold and moisture problems.
Many of the moisture problems are related to inadequate ventilation or poor window and door
construction/installation. Health Canada’s involvement on the reserve in housing issues involves
responding to complaints and informing the band leadership of the findings of their inspections.
The response from the leadership can take a great amount of time especially if there is not an
imminent health hazard. In one case, while I was with the EH officer, he observed a
disconnected heating duct that was releasing carbon monoxide into the home and he was able to
get maintenance personnel to address this problem relatively quickly.
Presentation to Public Health Inspectors
Once a month, the health inspectors have the opportunity to participate in a distance
learning event called “info share.” Numerous locations are linked electronically to a meeting that
includes presentations. I was invited to make a presentation about housing and health while I was
in Edmonton. The slides from this presentation are found in Appendix E.
Conclusion/ Next Steps
The sabbatical was an invaluable experience and provide me the opportunity to focus on
specific steps to take to enhance the undergraduate course at Ohio University. As a result of the
sabbatical, I have revised my outline for the class to include a focus on cultural awareness and
interpersonal communication skills.All of the public health inspectors I met and observed in Alberta are very knowledgeable
about the environmental health aspects of housing. However, the major skill that emerged as the
most important is the ability to communicate interpersonally with a wide range of people. It is
not uncommon for health inspectors working in housing to have to condemn a house and discuss
the condemnation with the occupants who may be on site. I am more convinced than ever that
undergraduate environmental health students need to be provided with ample opportunities to
enhance their interpersonal communication skills, so I intend to make this an emphasis of the
shelter environments class.
In addition to the interpersonal communication, it is extremely important for
environmental health students to increase their understanding of different cultures. Visiting the
First Nations reserve in Canada has underscored the importance of this knowledge. With this in
mind, I will attempt to include opportunities for exposure to different cultures and their housing
situations into the class as well.
The major next step is to begin work on a book related to housing and health. While in
Canada, I developed the following chapter outline of this book:
– Section 1: Specific EH housing issues
» indoor air quality
» drinking water
» solid waste
» household hazardous waste
» wastewater
– Section 2: housing and society
» Housing law and policy
» Housing and SES
» Housing and children’s health
» Lead
» Housing and cultural awarenessYou can also read
