Moving the needle on home health: Reconceptualizing social problems in a multi-stakeholder system

Despite significant evidence that housing quality plays a key role in the overall health of the population, health risks that originate at home have failed to garner direct policy attention or intervention commensurate with their impact. Drawing on the sociology of social problems, we identify how causal and political responsibility for risks in the United States context is complicated when these environmental health risks are embedded in private homes. We argue that changing how home health is addressed by health and building practitioners requires a reconceptualization of home health whereby the multiple responsible parties and sources of exposure become leverage points for future research and interventions. This reframing includes identifying housing as an arena of health, representing a class of risks tied to place. We also contend that health is an essential element of homes as systems and must be embedded in how those in building science, construction, property management, and code design approach housing. Finally, we suggest the need for specialists to navigate home health issues, drawing on the hospitalist model of health provision. These proposals illustrate multiple points at which residents, researchers, and health and building professionals may intervene and home health risks can be addressed.