As asthma rates rise in the United States, researchers and policymakers are looking at the impact housing quality has on adverse health outcomes. A new healthy homes module released with US Department of Housing and Urban Development’s American Housing Survey allows us to analyze the relationship between children with asthma and conditions in their homes.

A new Urban Institute report reveals that childhood asthma disproportionally affects renters, particularly publicly assisted renters, and causes higher emergency room use.

Asthma prevalence is closely related to environmental, genetic, and demographic factors, such as income and ethnicity. We found that childhood asthma disproportionally affects low-income families, black families, and families with female household heads. But even when we controlled for some of these factors, we found that renters are more likely than owners to have school-age children with asthma. 

So, what makes renters more vulnerable?

Renters are exposed to more in-home asthma triggers

Asthma prevalence is often influenced by exposure to indoor allergens. We studied monthly exposure to smoke, musty smells, and roaches and rodents, as well as exposure to plumbing leaks, roof leaks, and mold.

On average, renters had higher exposure to every asthma trigger we studied. Plumbing leaks, roof leaks, and inadequate ventilation typically contribute to mold formation. We found that 21.6 percent of renters reported leaks in their homes, compared with 18.5 percent of owners.

The share of renters with mold, smoke, or pest exposure in their homes is more than double that of owners. Assisted renters face even more of an uphill battle: assisted renters with at least one child with asthma are exposed to asthma triggers twice as often as unassisted renters.

Renters are also exposed to more triggers than owners, on average. Nearly half of renters have one or two triggers in the home (45.6 percent). But only 32.8 percent of owner-occupied homes have one or more triggers.

These findings point to a serious concern about the quality of the rental housing stock. Renters typically have less flexibility in making changes to their homes than owners do because of lease restrictions. And if these conditions are present in the entire building, renters likely have no control over the long and expensive remediation process the building would need to undergo.

How can we address this problem?

As rental demand rises, policymakers need to address the disparate health outcomes that renters and owners face. Building codes and health and safety inspections are typically conducted by local governments but don’t focus on asthma triggers.

Landlords and tenants also need education about potential health effects from these triggers. They should ensure awareness about potential health consequences related to leaks, smoke, and other triggers, especially for households with children. 

Costs beyond the rent must also be considered. According to the Centers for Disease Control and Prevention, asthma costs the United States $56 billion a year. The conditions in which many American renter families live need to be raised to a new standard, given what we know about the health risks connected to housing conditions.