This document was produced by Omaha Healthy Kids Alliance to help demonstrate the need for our community to invest in healthy housing for our children.

1. 5006 Underwood Ave | 402-934-9700 | www.omahahealthykids.org
For references visit www.omahahealthykids.org
2013 OHKA CASE FOR SUPPORT
C A S E F O R S U P P O R T

2. CONTENTS
02 WHO WE ARE
04 UNHEALTHY HOMES
06 LEAD
10 ASTHMA
14 IN THE HOME
20 OUR WORK
567children in Omaha had high lead levels in 2012
8.7% of school-age children in Omaha currently have asthma
20.9% of children with asthma in Omaha missed
three or more school days in the past year due to their asthma
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3. WHO WE ARE
Omaha Healthy Kids Alliance is a nonprofit organization that works to create a safe and healthy environment for
all families in Omaha. Our main goal is to bring awareness and education to families in the city about
environmental hazards, green and healthy homes, and lead poisoning. We believe that education is
fundamental for empowering people and creating change.
The betterment of all communities in Omaha is what moves our daily work. We strive to create environmental
equality in Omaha for all by offering education on health hazards in the home, tenant legal rights, environmental
testing, and information on the community resources available in the city. Through our services, we intend to
empower people and give them voice, knowledge, and power to strive for change in their own homes and
communities.
WHY HEALTHY HOMES
We believe that a healthy home contributes not only to the health of the family, but to the health of the entire
community. A healthy home means fewer school days missed due to asthma attacks, or fewer lead-poisoned kids
placed in special education. It also means reduced costs for special education, emergency room visits, utility bills
and overall health care.
WHO WE ARE
3

4. UNHEALTHY HOMES
UNHEALTHY HOMES
Poor people, children, racial minorities, the elderly,
and disabled people are at a higher risk of living
in substandard housing where they are greatly
exposed to lead, pests, air pollutants,
contaminants, and social risks
70%
With people spending an average of
70% of their time inside their homes,
poor air quality, humidity, structural problems,
and exposure to contaminants inside
put families at a greater risk of
developing illnesses
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5. • Learning Disabilities
• Lowered IQ
• Mental Retardation
• Attention Deficit Disorder
• Behavioral Problems
• Dental Cavities
• Hyperactivity
• Developmental Delays
WHAT HAPPENS WHEN A CHILD IS LEAD-POISONED?
LEAD
WHAT IS LEAD?
Lead is a heavy metal which is highly toxic for humans. It is a neurotoxin and does not play any healthy role in our
bodies.
The main source of lead is substandard housing. Old paint that is peeling and chipping creates lead dust. Lead
dust is heavy, so it settles quickly and is difficult to clean. Younger children are usually exposed to lead through
hand to mouth activities. Lead dust is often on floors, window sills, and toys, so it is more accessible to small
children.
African American children
are 5x more likely to be
lead poisoned than
Caucasian children
THE LIKELIHOOD OF BEING LEAD POISONED
• Autism-like Symptoms
• Asperger-like Symptoms
• Sensory Integration Disorder
• Hearing Loss
• Impulsivity
• Stunted Neuron Growth
• Altered Brain Plasticity
Poor children are 8x
more likely to be
poisoned than upper
income children
African
American
children
Caucasian
children
Upper income
children
Poor
children
Lead poisoning is the #1 environmental hazard to children
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6. Blood lead concentrations between 1 and 10 µg/dL result in an average of a 7.4 IQ points lost.
A lowered IQ in children increases the need for enrollment in special education services, reduces the likelihood
of high school and college graduation, lowers lifetime earnings, and greatly increases propensity to engage in
violent criminal activity.
CHILDREN POISONED BY LEAD ARE:
LEAD COSTS
During a 6 year period, the cost for lead poisoning is the sum of the costs for medical treatment ($11-$53 million),
lost earnings ($165-$233 billion), tax revenue ($25-$35 billion), special education ($30-$146 million), lead-linked
ADHD cases ($267 million), and criminal activity ($1.7 billion), for a total of $192-$270 billion.
The net benefit of lead paint hazard control ranges from $181 to $269 billion, resulting in a return of $17-$221
for each dollar invested in lead hazard control.
LEAD COSTS
In 2012, Omaha spent $126,477 to treat lead-poisoned children.
If we focus on preventing lead poisoning rather than on treating poisoned kids, for every dollar spent on
controlling lead hazards, $17-$221 would be returned in health benefits, increased IQ, higher lifetime earnings,
tax revenue, reduced spending on special education, and reduced criminal activity.
$1 in lead
hazard control
$17 to $221
in return
Lead
poisoned
children
No lead
in blood
Lead
poisoned
children
No lead
in blood
7x more likely to
drop out of school
6x more likely to be
involved in the
criminal justice system
457 children had blood lead levels between 5-9.5 µg/dL
62 had blood lead levels between 9.5-14 µg/dL
50 between 15-25 µg/dL
7 between 25-45 µg/dL
HOW MANY CHILDREN IN OMAHA?
During 2012 in Omaha, 567 children had lead levels over 5
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7. ASTHMA
ASTHMA
1 in 7 children have life time asthma
1 in 3 children with asthma are poor
90% of children with asthma can attribute their asthma attacks to items found in the home
14 million absences from school are because of asthma
ABSENT
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8. OMAHA CAN’T BREATHE
8.7% of school-age children in Omaha currently have asthma
Asthma prevalence in Omaha is particularly high in:
• African American children (25.9%)
• Northeast Omaha (19.4%)
AMONG CHILDREN AND ADOLESCENTS WITH ASTHMA:
12.2% had 3 or more urgent/emergency care visits in the
past year due to asthma
11.8% had 2 overnight hospitalizations due to asthma
16.7% do not have an asthma action plan in place
In Omaha, a total of 20.9% of children with asthma missed
3 or more school days in the past year due to their asthma
34.6% of parents with asthmatic children missed at least
1 day of work in the past year because of the child’s asthma
ASTHMA COSTS
The annual cost of asthma is approximately
56 billion dollars
Asthma has a direct health care cost of $3,259 per person per year.
The overall expenditure in asthma related cases in Omaha was $14,284,197 during 2012 .
$56,000,000,000
Without Asthma With Asthma
Without Asthma
Without Asthma
With Asthma
With Asthma
Without Asthma With Asthma
A child with asthma spends 50 cents more for
every $1 that a child without asthma spends in health care
A child with asthma spends 4 times more on
medicine than a child without asthma
An emergency visit costs 40% more when a child
has asthma
$0.50
$0.50
$0.50
$0.50
$0.50
12.2%
11.8%
16.7%
20.9%
34.6%
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9. INDOOR AIR QUALITY
Radon is the second leading cause of lung
cancer
8 million homes have radon levels above the
EPA’s recommended action level of 4.0pCi/L
21,000 cases of lung cancer annually are due to
radon exposure in non-smokers with a cost of
$1.1 million per person
Installing a radon mitigation system ranges from
$750 to $2,850 dollars per house
Carbon monoxide is the leading cause of
accidental deaths in the country
Carbon monoxide deaths cost the U.S. $500
million a year
Carbon monoxide kills nearly 500 people a year
and sends 15,000 to the emergency room
3,400 people
with lung cancer die
annually due to
exposure to
secondhand smoke
The average cost of
secondhand smoke is
$10 billion
46,000 people
die annually from heart
disease due to second-
hand smoke exposure
Secondhand smoke expo-
sure costs $5 billion a
year in direct medical costs
and $5 billion a year
in indirect costs
IN THE HOME
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10. RADON IN OMAHA
Omaha is a red zone for radon. The natural composition of the soil in Nebraska makes our community more
vulnerable to radon exposure.
Radon can enter the home through cracks and exposed soil in basements.
Douglas County is among the 8 counties in Nebraska where levels of radon between 86 to 204pCi/L were found.
In Douglas County, between 6,561 to 10,332 houses were tested for radon prior to 2011. Testing is increasing,
but still many more homes need to be tested.
CARBON MONOXIDE IN
NEBRASKA
Nebraska is the state with the highest mortality rate
from carbon monoxide
In 2011, the Nebraska Poison Control Center received
268 calls related to carbon monoxide
In 2012, Omaha Healthy Kids Alliance visited 350
homes; only around 25% of the houses had a carbon
monoxide detector
INJURY
Falls are the leading cause of non-fatal injuries for all
children ages 0 to 19
Every day, approximately 8,000 children are treated
in U.S. emergency rooms for fall-related injuries. This
adds up to almost 2.8 million children each year
In Omaha, unintentional injury is the leading cause
of death of children and adolescents
In Omaha, a total of 15.1% of children were
seriously injured enough to require treatment at
some point in the past year. Among these children,
22.6% were seriously injured more than once
Homes visited
Other households’
energy cost
Low income
families’
energy cost
Average of houses
tested for radon
Total housing
units
Homes
with a carbon
monoxide
detector
Unintentional injuries have a total societal cost of
$217 billion
$3.5%
$14%
=
Unintentional injuries Societal cost
ENERGY EFFICIENCY
Low income families usually spend 14% of their total income on energy cost; other households only pay 3.5%.
When energy efficiency upgrades are done correctly it can improve ventilation, reduce moisture and condensation,
increase safety, improve comfort, and improve the general and respiratory health of occupants in homes.
Correct energy retrofit upgrades result in fewer missed days from school and work and fewer visits to the doctor’s office.
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11. OVERALL COST
If we take only the numbers we have so far, and make a rough estimation of how much unhealthy homes cost us:
HOW AN UNHEALTHY
HOUSE AFFECTS
EDUCATION
$30
million
An unhealthy home means more lead poisoned
children and more children with asthma. These two
diseases are responsible for learning disabilities,
special education placement, and missed school days.
Lead causes learning disabilities, attention deficit
disorder, lowered IQ, behavioral problems,
hyperactivity, ADHD, hearing loss and impulsivity.
Blood lead concentrations of 1 to 10 µg per deciliter
cause a 7.4 loss in IQ points.
Lead levels below 10 µg/dL affect the reading
readiness of children at kindergarten entry.
Lower children’s IQ:
• Increases the need for enrollment in
special education services
• Reduces the likelihood of high school
and college graduation
• Lowers lifetime earnings
• Greatly increases their propensity to
engage in violent criminal activity
Children poisoned by lead are seven times more
likelytodropoutof school and sixtimesmorelikelyto
be involved in the criminal justice system
The cost of special education related to lead
poisoning ranges from $30 to $146 million dollars
The cost of ADHD cases related to lead poisoning is
around $267 million dollars
Asthma causes 14 million absences from school
every year
A total of 8.7% of school-age children in Omaha
currently have asthma
A total of 20.9% of children with asthma missed three
or more school days in the past year due to their
asthma
$146
million
$38.5 billion (Lead Poisoning)
$56 billion (Asthma)
$23.1 billion (Radon)
$217 billion (Unintentional Home Injuries)
$10 billion (Secondhand Smoke)
$0.5 billion (Carbon Monoxide Deaths)
= $345.1 billion dollars a year
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12. Healthy Home Assessments
Using our assessment tools, our trained Healthy
Home Specialists are able to triage potential health
hazards in the home
Community-ide Education
We provide education about lead poisoning and
green and healthy home issues. Our program “The
Lead Detectives” helps teach children how to look for
lead hazards in their own home. We also conduct
outreach in homes, clinics and schools for all
communities in Omaha
Training
We are a certified training firm for the EPA RRP
(Renovation, Repair and Painting). Training is also
provided on Healthy Homes to community groups
and organizations
OUR WORK
Healthy Housing for Everyone
We advocate for housing standards that protect
children and families in Omaha. These standards
ensure that homes are safe, affordable, healthy and
energy efficient
Keeping Kids Safe
Our work ensures that children are kept safe from
environmental hazards. We work to keep children
safe from issues like mold, asthma triggers like dust,
lead hazards and toxins that can significantly impact a
child’s development, education and overall health
Hazard Remediation
For qualifying homes, we are often able to provide
assistance to help fix issues in the home, or we can
refer to one of our community partners for help
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13. Deprived and highly medicated, Divad struggled daily at school.
Although Maria took Divad to various therapists and physicians, it
was Divad’s older sister that got the family referred to Omaha
Healthy Kids Alliance.
Divad’s older sister was seventeen years old and also suffered from
asthma. Maria took her daughter to OneWorld Community Health
Centers because she was constantly crying and wouldn’t tell Maria
why. “I thought she was depressed, suicidal,” said Maria. When
Maria’s daughter spoke to the staff at One World, she revealed that
she didn’t want to move because she would miss her friends. Maria
explained the situation to One World, who suggested that Omaha
Healthy Kids Alliance conduct a healthy home assessment to be
sure that it was the house that was making Divad sick.
When Shannon and Ariana, both Healthy Home Specialists with
Omaha Healthy Kids Alliance first entered Maria’s home, they were
shocked by the state of decay. “There were holes in the floor, and
some weak spots where I thought we would just fall straight
through,” said Shannon. “The walls were buckling, there was a
smell—it was overwhelming. The house was simply unlivable.”
Ariana and Shannon knew immediately that the house had a bad
water intrusion problem. The conditions of all the walls exposed
high humidity in the house and most probably mold behind the
walls. Ariana explained to Maria that mold is an asthma trigger and
that she should move out of the house, because unless the entire
house has mold remediation work done, Divad’s asthma would not
disappear. Ariana explained to Maria her rights as a tenant, and
gave her a landlord/tenant manual, created by Legal Aid of
Nebraska, in Spanish, so she could know the steps to take in order
to talk to her landlord.
“When we first met her, we could tell that she was incredibly
stressed. Now that they’re out of that house, she’s so much more
relaxed and confident” Ariana said. Smiling, Maria said, “Now I
know I am not powerless. Once they told me I could fight for my
family, a huge weight lifted off my shoulders.” Maria continues,
“They showed me the way out and gave me the language to tell my
landlord why I was leaving that terrible house.”
Today, Divad rarely takes medication and only uses his inhaler
when he needs it, which is also rare. He has stopped visiting the ER
and missing school. In fact, all of Maria’s children are much
healthier now.
FROM THE FIELD...
“They showed me the way out”
Maria had rented the house for five years with her husband, Cesar, and their three children. The oldest child, a
seventeen-year old girl, had suffered from asthma her entire life. The youngest, a four-year old boy, was just
beginning to develop asthma when Omaha Healthy Kids Alliance representatives visited the home. But their
middle child, a seven-year old named Divad, was struggling for his life.
Maria knew that the house was making Divad sick. Divad’s persistent cough, trouble breathing, and asthma
attacks were most noticeable when in their home. Whenever she took him to the doctor’s office, he did not
cough. But inside the crumbling house, he coughed so hard that his face went red and the veins of his neck
stood out.
Eventually one of the doctors suggested taking Divad out of the house and seeing how his health fared. The
family made a trip to Kansas to visit Maria’s sister, and, in spite of the cats in the house, Divad had no trouble
breathing in his aunt’s home. It was then that Maria decided they must try to leave the house.
The landlords did not provide a Spanish translation of the lease, and used the Spanish-English language barrier
to trap Maria’s family into the home for five years.
Over their five-year residency, Maria had appealed to the owners, asking them to make repairs. Problems like
pieces of dry wall falling into the seventeen year old daughter’s room, an unstable foundation, and rotten
floorboards were enough reason to vacate the deteriorating home. None of the windows opened; the whole
home should have been condemned. Even though Maria cleaned the carpets and walls daily, the condition of
the house was so poor that a leaky roof, buckling walls, and a moldy ceiling were only a small indicator of the
massive water intrusion inside the home. And no matter how much she cleaned, the mold growing behind walls
and on ceilings was killing Divad.
One of the owners made repairs to the leaking roof, but did not provide new insulation and left Maria’s family
with a growing mold problem. Other owners had a different way of dealing with Maria’s pleas. “We would ask
them to replace the carpet, and they promised us new carpet in a month,” an OHKA staff member translates.
Maria sits up straight in her new kitchen, and a gleam of anger enters her eyes. “Then a month later, there would
be a note that we had a new owner.”
In the mean time, Divad’s asthma was worsening. He was not only missing weeks at a time of school days, but
Maria was starting to have problems with school personnel, doctors and therapists. They all started to suggest to
her that Divad was not that sick but that he was pretending to be sick, and that she was allowing him to continue
with the farce. Divad was taking approximately twelve pills a day, a nebulizer every night and allergy shots every
week. He was rushed to the emergency room from 3 to 4 nights a week because he could not breathe.
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14. THE COST
It costs us 150 dollars to help one family
150 dollars that allows us to give education to the families, do environmental testing in the home, and help
with paint stabilization
150 dollars that creates healthy families and healthier homes
150 dollars preventing the expenditure of thousands of dollars in asthma related emergency health
care costs
150 dollars that keeps one more child out of special education because he or she is not lead poisoned
150 dollars that creates better, healthier and more equitable communities
$25 Provides a carbon monoxide detector to a family
$75 Provides a child with mattress covers, pillow protectors and furnace filters
$150 Covers the cost for one Green and Healthy Home Assessment
$250 Provides a lead risk assessment for one home
$750 Paints the interior of one house
$1500 What OHKA currently spends to make a house 30% healthier, safer and more energy efficient
WAYS EVERYONE CAN GET INVOLVED
Donate through our IndieGogo campaigns to help specific families
Donate directly to us through our website (www.omahahealthykids.org)
Volunteer with us and help us fix houses for families in Omaha
Donate supplies and materials to make homes healthier
Partner with us to help create a greener, safer, healthier Omaha
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