Program helps create safer and healthier homes for NC residents

This article was written for our sponsor, North Carolina Community Action Association.

In North Carolina, 9,000 people face homelessness on any given night and 1.5 million people are living in poverty. Our homes are more than just places where we live — they also have a significant impact on our lives, health and overall wellbeing.

"The condition of a home and the health and safety of the occupants are directly correlated," said Melissa Soto, executive director of Watauga, Avery, Mitchell and Yancey Community Action.

North Carolina Community Action Agencies are nonprofit organizations that provide life-changing services to help low-income individuals, families, children and other vulnerable populations "create pathways to self-sufficiency."

There are 34 local agencies in North Carolina serving communities across the state.

"If a person has asthma for example, it doesn't matter how many times they are treated or how much medication they take when they live in a home full of 20-year-old carpet, no air conditioning, and mold — they are just exacerbating the problem. If a senior has arthritis and is unsteady on their feet, living in a home with soft or uneven flooring is an accident waiting to happen," continued Soto. "Many of the families in the mountains heat with wood and, unless maintained properly, a woodstove is a huge health hazard for those with any type of breathing problem. It can also pose a fire hazard if the chimney is not cleaned or maintained."

Living conditions are but one of many social determinants of health. As Soto explained, the conditions of a person's home can affect or pose risks to their existing health and/or preexisting issues.

"When something isn't right in your home, that just adds so much stress. You might be afraid that you're going to lose it or you're afraid that it's not up to code. And you're also stressed out about it because you don't have the money to do the work," said Joel Groce, the director of finance and administration at NCCAA.

Data reveals that most Americans spend around 60 percent of their time in their homes. With the pandemic still in full swing, many people are spending even more time at home as businesses, schools, and churches have closed or temporarily altered their normal operating hours. In rural and impoverished communities, people also tend to spend more time at home, especially when they are without adequate transportation or access to services.

Soto explained that rural communities often lack the resources that bigger cities and more urban areas have access to. To serve the largest number of people, many funders and grantmakers focus their giving on areas that are densely populated.

"That is important; however, every person living in poverty matters. In rural areas, our poverty is just as prevalent, sometimes even more so — it just looks different," said Soto.

One way that NCCAA is addressing this gap is through its Healthy Homes Initiative. The Healthy Homes Initiative is a partnership between local North Carolina Community Action Agencies and Blue Cross and Blue Shield of North Carolina. The Healthy Homes Initiative, "provides families with the crucial home repairs that they need to improve their health.

Through this program, NCCAA will help to remedy the unsuspecting causes of illnesses hidden in the homes of vulnerable North Carolinians across 56 counties. Each participant is eligible to receive up to $2,500 in home health and safety repairs."

"This could involve measures that improve the air quality, the accessibility of the home, or the overall safety of the dwelling," said Soto. "Examples include the removal of carpeting and the installation of hard surface flooring to improve air quality, building ramps or widening doors for wheelchair accessibility, or repairing unsafe flooring to prevent falls."

Services provided through the Healthy Homes Initiative include:

• A Healthy Home Assessment​​
• Accessibility/fall prevention in the interior of the home
• Replacement of carpet with hard surface flooring
• Deep cleaning of the home
• Interior pest control
• Moisture control (basement and crawl space sealing)​
• Air filter change-out (plus four additional replacements)
• Provided air purifiers
• Installation and/or battery change out of carbon monoxide and smoke detectors

Sophie McMillian, a community and diversity engagement program manager at Blue Cross N.C., said that a few years ago Blue Cross N.C. made a commitment to reinvest $50 million into North Carolina communities, specifically regarding social drivers (determinants) of health. With a background in nonprofit housing, McMillian understands the connection between health and housing and suggested Blue Cross NC invest in housing.

"I knew of the work that the NCCAA was doing across the state to improve the quality of housing – including their weatherization program. Together, we crafted this investment to be flexible enough to close the gaps of other funding and provide critical repairs with a focus on improving health. We originally invested $2 million to help repair 800 houses across North Carolina in 2018. Earlier this year, we were able to invest an additional $1 million to help even more North Carolinians in rural areas," said McMillian.

According to a Healthy Homes Initiative first quarter report for 2020, 59 percent of the homes receiving Healthy Homes services were occupied by Black/African-American families, 38 percent by white/Caucasian families, 2 percent by Hispanic families, and 1 percent by Native American families. Seventy-four percent of the homes receiving services were occupied by seniors over the age of 60 and 16 percent of the homes assisted had children under the age of 18 living in them. Fifty-nine percent of participant homes had chronic health conditions present such as arthritis, diabetes, heart disease, mental health, or musculoskeletal disorders.

Groce emphasized that the Healthy Homes Initiative is unique in that the funding is flexible to address an array of safety concerns that they may come across. For example, one family was using a kerosene heater to cook their meals since their stove stopped working. A local Community Action Agency was able to replace the stove. While not technically a "home repair", the service did address a safety concern as cooking off the heater was a fire hazard. The flexibility has allowed NCCAA to address as many gaps as possible without unnecessary red tape.

"The partnership between NCCAA and Blue Cross N.C. brings a critical resource to an area where it is urgently needed," added Soto. "In our four-county area, over 84 percent of the homes are more than 40 years old. When these homes are occupied by a low-income person, especially a senior, home repairs get pushed to the back burner for more basic needs such as food and medicine. The funding through the Healthy Homes Initiative has allowed WAMY to help many seniors live more safely and stay in their homes longer."

For Soto, Groce and McMillian, several touching stories of the individuals and families that have been helped through the Healthy Homes Initiative come to mind.

Soto relayed a story of a man who had severe mental health issues and a very limited income.

"He told us that he didn't feel worthy to ask for help but realized that he didn't have a choice. His water pump was not working, and he had gone without water for three months. He had been going to friends’ homes to shower, wash clothes and use the bathroom. He was carrying jugs of water back and forth and trying to make do. Thanks to the funding through Healthy Homes, we were able to install a new well pump and restore running water to his home for the first time in three months," said Soto.

During another occasion, WAMY helped an 80-year-old woman who could not drive or physically take her trash to the dumpster. There was trash piled up throughout her home and she was so embarrassed about the situation that she cried. Healthy Homes helped remove 4.5 dump truck loads of trash from her house and deep cleaned her home and she was finally able to use her kitchen and bathroom again.

"There was a woman in Chatham County, she was in her seventies and had COPD, and was going to the emergency room four or five times a year. We took out all of the carpet and she actually had beautiful hardwoods underneath. We cleaned those up, did some sealant in the crawl space. And with that, she told me that she hadn't gone to the emergency room at all within a year and had gone down from three different inhalers to only one," added McMillian.

Groce includes a lot of details about families, their physical conditions, and the state of their homes in his official progress reports. In one, he described helping an elderly couple.

These kinds of stories are but a few in a long list of people whose lives were changed thanks to this program. While COVID-19 impacted NCCAA's ability to provide some of its services during Q2, it has since implemented safety protocols and is continuing to create healthier homes and communities for those in need.

"We want to thank Blue Cross N.C., our other partners, and the community at-large for their continued support as together we change the lives of North Carolina families facing the daily challenges of living in poverty," said Groce.

This article was written for our sponsor, North Carolina Community Action Association.