Indoor Environmental Determinants of Health

Indoor environmental determinants of health, or IEDOH, are a subset of the social determinants of health, or SDOH. IEDOH are modifiable indoor environmental factors which can influence an individual’s exposure to environmental contaminants and their health. Managing IEDOH can promote healthier indoor air quality and minimize the risk of developing or exacerbating certain chronic diseases, including asthma. When determining public health solutions within the context of SDOH, it is important to take IEDOH into account as a key contributor to disease outcomes. For example, providing in-home interventions are an important component of comprehensive asthma care in part because they are the primary component of asthma care that address IEDOH.  

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What are the Social Determinants of Health and the Indoor Environmental Determinants of Health? 

According to the U.S. Department of Health and Human Services (HHS), SDOH are the social conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. SDOH can contribute to health disparities, including asthma disparities. 

SDOH can be grouped into five broad categories:  

  1. Social and community context.  
  2. Economic stability. 
  3. Education access and quality.  
  4. Healthcare access and quality.  
  5. Neighborhood and built environment. 

IEDOH are especially important components of SDOH’s 5th category, neighborhood and built environment factors. They are influenced by housing quality, the presence of environmental contaminants indoors and certain building characteristics. Along with the SDOH that contribute to inequities in healthcare access and quality, IEDOH are key drivers of community health outcomes for asthma and asthma disparities. IEDOH include the presence of and exposure to an array of contaminants in homes and other buildings, including the following:  

  • Air pollutants, such as particulate matter, especially due to the lack of adequate ventilation and filtration. 
  • Allergens, such as dust mites and pests, including rodents and cockroaches.  
  • Mold and moisture. 
  • Chemicals and irritants, such as secondhand smoke and aerosols. 

In-home environmental interventions for asthma typically address the IEDOH that are common asthma triggers.  

The Role of Indoor Environmental Determinants of Health in Expanding the Impact of In-Home Interventions 

IEDOH overlap many important sectors, including public health, housing, energy, and weatherization. To broaden the impact of existing community asthma programs, partnerships with and across these sectors, which are aligned in terms of IEDOH, could result in in-home environmental interventions with broader public health impact. For example, intervention programs focused on delivering supplies and providing education services tailored to children’s asthma triggers could be expanded, through partnerships grounded in a shared understanding of the impact of IEDOH, to provide structural improvements (e.g., repairing or replacing an HVAC system to provide increased ventilation and filtration) to a home that may improve its overall indoor air quality and the health of occupants. 

As organizations and communities expand the scope of in-home environmental interventions to incorporate structural services to address IEDOH, not only the child with asthma will benefit, but the entire family. When this happens, there is a potential to see greater improvement in health outcomes at the population level, especially within communities with the greatest proportions of hard-to-control and undiagnosed asthma. 

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Last updated on November 12, 2024