Ellen Tohn Makes the Case for Adding Health to the Home Equation
By Susan Valenti Corliss
In 2000, the Environmental Protection Agency (EPA), University of Tulsa and myself produced a conference on asthma and allergies that was supposed to break down barriers between the medical community and the indoor environmental industry. It was thought that if we brought all the stakeholders to one event we’d be able to work together in solving consumer’s indoor health issues where they live, work and play. Sure, we seemed to have a lock on public health officials working on the issues in their small way–house by house– but the key though was getting the doctors to hop on board the train to play a role. We needed them to think about the buildings and homes in a new way and ask the consumer how they felt in those areas.
Fast forward 18 years, consultant and researcher Ellen Tohn broke down what’s happening in the world today and she said there’s progress. In just the last few weeks, she’s been at events for climate, energy, and children’s health. All of these events have featured increased communications about solutions for health and buildings.
“In terms of health outcomes, clinical care with doctors or drug prescriptions only make up about 20 percent, while the physical environment– what we do in air and water and housing conditions– counts for 10 percent of what makes us healthy,” she told attendees of the IAQ & Energy 2018 Conference held earlier this month in Portland, Me. “So we’re affecting half of that and that’s quite significant. Doctors are starting to talk about health ‘upstream,’ or the ways we’re living that make us unhealthy and how do we fix that.”
Tohn, who is the founder and principal at Tohn Environmental Strategies in Wayland, Mass., says that for the amount of money the United States spends on healthcare we don’t have very good outcomes. Because of this she’s beginning to see in a variety of sectors that experts are realizing the places we live is a big driver for people’s health. And this is really starting to come to fruition in building standards.
Green Building Standards
The taglines “Buildings Are for People” and “Doing Right By Planet and People” are now no accident. Green building programs are starting to track health benefits of occupants. Workplace studies are now calculating sick days as a means of gauging health.
“All these years we’ve been toiling in the woods talking about indoor air quality,” Tohn said to attendees of the Maine IAQ Council’s annual event. “We’re ready. Now people want to understand our area of expertise. This is your moment.”
Other programs such as EPA’s Indoor Air Plus label and the WELL certification are health driven and growing. EPA’s label is for new construction and they’re currently working on a program for existing homes. WELL, which has only been around in the last five years, already has more than 800 projects worldwide.
According to Tohn, funder Fannie Mae is also getting involved in this health market in the last year with their program called Fitwel. The lender uses “Healthy Housing Rewards” to entice multifamily builders to get cheaper money to build under the Fitwel standard. The U.S. government is using the program as well. There are some IAQ elements in the program. This is a “cost-effective, high-impact” building certification which includes a building rating system on how to design and operate healthier buildings. The U.S. Department of Health and Human Services (HHS) holds the trademark on the Fitwel brand and the science behind it all is controlled through the U.S. Centers for Disease Control and Prevention (CDC) and the General Services Administration (GSA) is using the certification as a tool to assess performance of government-owned buildings.
“More people are focusing on health in relation to building better buildings,” Tohn said. “Now’s the time to figure out where the opportunities are for our industries to get involved in this. I’ve thought a lot about the energy efficiency world and the health benefits of energy efficiency. But the real opportunity may be in that we have a real workforce and a system that funds energy efficiency in this country. What can we be doing to improve the health in buildings using the energy efficiency infrastructure we already have.”
Three Tiers
With the audience divided pretty equally among energy efficiency and IAQ professionals, Tohn talked about the three tiers she saw as a way to get more involved in healthier buildings.
- We have to do the work in a way that doesn’t make people sick. Do no harm. The good thing, she said, is that for the most part the work we do is making people healthy if we do it right.
- Let’s do our energy efficiency work not all by ourselves anymore. Tohn said that’s it’s time to connect with other partners, especially in the health community, way more intentionally.
- We can use this workforce and the jobs we’re doing to not just do energy efficiency but add some other home repairs that will provide health improvements. Tohn said that we need to follow the advice of “stocking the housing pharmacy. The medical community can’t write this type of prescription.”
Tohn added that the research on energy and health already shows there’s benefits, but mostly in the low-income sector. Families that get heating fuel assistance, for example, have children who are healthier because they’re warmer and don’t get sick all the time. Other studies are showing a drop in energy use reduces fuel bills, but also reduced asthma and allergy symptoms as well. Although the data on asthma is currently mixed, the number of people going to the hospital for asthma has gone down in particular. Most people are rating their health better a year after energy improvements to their home.
Work Connections
Finally, Tohn encouraged attendees to make connections with other partners in the field. Her work with One Touch Programs, for example, encourages professionals to connect with health partners, housing partners, and energy partners, like weatherization programs. This way professionals can make themselves part of team programs who already have great access to homes while trying to make them healthier.
“You shouldn’t have to go into home by yourself,” she said. “Go in as part of a team. You’re the one who fixes things. Especially in the low income sector, this is a good prescription to use.”
Tohn also told attendees that whether they liked it or not they were part of the public health workforce, not just energy or IAQ.
“I hope you like it, because we need you,” she said. “The Building Performance Institute (BPI) has a new Healthy Home Evaluator credential which is helping all of us get more qualified to help consumers.”
Her parting advice to attendees was to get in the advocacy game in terms of energy to ensure that state coffers remained filled with these types of efficiency funding. Professionals also need to meet the state and local health partners to explain their work and training. In addition, getting involved with hospitals and public health agencies is important. Make sure you use best practices in the industry.
“IAQ professionals can be brought in on a higher level,” she said. “Don’t worry. There’s plenty of work for both sides.”
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