As a public health nurse home visitor with the Philadelphia Nurse-Family Partnership (NFP) and a lawyer with HELP: MLP working in a nursing-legal partnership, we see firsthand how housing conditions impact the health, well-being, and stability of our clients and their children. We are thrilled that Pennsylvania legislators voted to invest in children and families by passing the Whole-Home Repairs Act in July. This legislation will have a direct impact on many families we served, including “Alicia’s” (name changed).
A lifelong Germantown resident, “Alicia” lives with her infant son and elderly mother in her childhood home. She is proud of her home and her family’s multigenerational homeownership. But even with a full-time job as a childcare worker and no monthly mortgage payments, Alicia cannot afford the repairs her old home needs, and she worries that her son’s health will suffer as a result.
The bathtub in Alicia’s sole bathroom leaks into the kitchen when the faucet is on, so she and her mother have not been able to shower in their home for over a year. She hired a contractor, but he took her money and disappeared before finishing the work. Another plumber recently quoted her over $7,000 for only the most necessary repairs. “I just want to be able to let my son play in the bath,” Alicia says.
Roof repairs similarly went unfinished, and parts of the home’s subflooring have rotted, making the floor unstable and threatening to make the only toilet un-useable. Alicia worries about mold and she knows that a house as old as theirs is likely to have a legacy of lead paint, for which remediation efforts are very expensive. She has struggled to pay crushing heat bills, sometimes going without heat in the winter. Her son will start crawling soon, and she fears she won’t be able to keep him safe in their home.
Alicia is not alone. Pennsylvania is home to some of the oldest housing stock in the country, with approximately 95% of housing stock built before 1978 and 40% built before 1950. Even families who can afford their mortgage payments or rent often find costly maintenance and repair work – particularly of older homes – out of reach financially. According to the most recent American Housing Survey, an estimated 280,000 occupied units across Pennsylvania have moderate to severe deficiencies, such as a leaky roof or window, exposed wiring, unreliable heat, or a non-working toilet. Longstanding home repair programs often exclude homes with extensive deficiencies, leaving families like Alicia’s with no assistance to undertake basic, urgently needed repairs. This is frequently compounded by escalating utility bills, because these homes often cannot be efficiently heated or cooled.
Living in a home that feels unsafe, lacks sufficient heat, or has reduced capacity for sanitation creates enormous stress on families, negatively impacting their well-being and ability to regulate their children’s stress. Environmental and safety hazards in the home can have numerous health consequences for children before they are even born and well beyond childhood. In utero exposure to mold and lead during pregnancy can increase the risk of premature birth and low birthweight. Childhood exposure to these hazards can lead to allergies, asthma, and serious neurological problems with lifelong cognitive and developmental impacts. Poor housing conditions keep children from playing, learning, and feeling safe in their homes, the very place where they should find comfort and security.
Making home maintenance and repairs more affordable and accessible directly protects children’s health – and the Whole-Home Repairs Act aims to help families like Alicia’s do just that. Introduced in by State Senator Nikil Saval (D-Philadelphia) and widely supported by Pennsylvanians on both sides of the aisle, this legislation provides $125 million in funding for families to complete major home repairs, in turn making them eligible for additional resources through existing, smaller-scale home maintenance programs. The Act also funds support staff to help homeowners and property owners access the appropriate programs for them in a sequence that maximizes the resources available to address their individual home repair needs. Finally, the legislation encourages training and retention in our state’s existing home repair and weatherization training programs, ensuring more skilled workers to help families get the home repairs they need to stay safe in their homes.
Because the Whole-Home Repairs Act has become law, Alicia will be able to ensure that her son can play in the bath and thrive growing up in their family’s treasured house, just as she did. And countless Pennsylvania families like theirs will be able to live more safely and affordably in their homes for years to come.
Joselle Palacios, BSN, RN is a Public Health Nurse Home Visitor with the Philadelphia Nurse-Family Partnership at the National Nurse-Led Care Consortium.