Interest in the intersection between health and housing is rising within both sectors as they work together to prevent asthma attacks and reduce related emergency room (ER) and hospital use. Initiatives to reduce asthma triggers in the home—including mold, pests, and tobacco smoke—are under way across the country, from home remediation to new regulations (e.g., a public housing smoking ban).
Understanding the relationship between asthma, ER and urgent care visits, and housing-related triggers is difficult, but the 2015 American Housing Survey includes a special module with questions on asthma and triggers in the home. This dataset helped us explore variations in asthma prevalence and asthma-related ER use among school-age children (ages 5 to 17) by a wide array of housing and household characteristics.
Our study produced the following findings:

• Asthma prevalence. Households with kids are more likely to have at least one with asthma when they also reported exposure to smoke, mold, and leaks in their home.
• Emergency room and urgent care visits. Smoking inside the home and mold in the bedroom were associated with more ER and urgent care visits among households with an asthmatic child.
• Housing tenure. Renters with kids are more likely to have asthma triggers in their homes than owners and are more likely to have at least one child with asthma.
• Rental assistance. Assisted renters have higher exposure to certain indoor asthma triggers—smoke and mold—than other low- income renters not receiving any government rental assistance and are more likely to have at least one child with asthma in the household.

Policy Implications
That certain housing and household characteristics, including the presence of asthma triggers, influence asthma rates suggests several policy implications to explore.

• Current policies and programs may be missing certain asthma triggers, and building and housing inspections may overlook less visible but threatening hazards, such as smoke, mold, and leaks. Dealing with these hazards requires a different approach, but few programs and resources train inspectors to look for more comprehensive problems or to help property owners directly resolve these issues.
• Renters are particularly vulnerable. Because of lease restrictions or building-wide problems, they have fewer means to address certain asthma triggers (mold, leaks, and smoke) on their own. Action by the US Department of Housing and Urban Development, private landlord education, and legal aid for tenants may be required.
• Reduced exposure to tobacco smoke may be key to reducing asthma-related ER and urgent care visits. Promising practices include smoking cessation programs or referrals for parents and other adult household members. The public housing ban on smoking may reduce asthma exacerbations, but its effects and enforceability remain to be seen.