MRT Innovations in Social Determinants of Health Initiative

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NYC Department of Health and Mental Hygiene

Q1 Please provide your contact information below.

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Q2 Please describe your company or organizations overall goals and mission.

NYC DOHMH's Healthy Homes Program overall goals and mission include reducing and preventing environmental exposures to allergens in the homes of children with persistent asthma.

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Q4 Innovation Executive Summary. Please describe the innovation, and how it addresses the social determinants of health. Please identify how the innovation addresses the 6 innovation criteria (i.e. ROI, scalability, feasibility, evidence–based support for innovation, relevance to the Medicaid population and speed to market).

NYC DOHMH´s Healthy Homes Program (NYC DOHMH HHP) proposes integrating the delivery of integrated pest management (IPM) in the homes of high–risk patients with persistent asthma and pests (cockroaches and/or mice) in order to prevent exposure to pest– related asthma allergens. IPM is a prevention–based pest management method that provides long–lasting pest control, improves building conditions, and is less harmful to residents than traditional pest control methods.

Children spend 90% of their time indoors. Given that the presence of allergens in the home is tied inexorably to poor housing conditions, low–income families of children with asthma are disproportionately impacted and are frequently unable to afford the types of services necessary to decrease or eliminate these allergens. Thirty six percent of inner–city children with asthma have cockroach sensitivity, the exposure to which can worsen asthma symptoms and lead to significantly increased hospitalizations and unscheduled medical visits compared to children who are not exposed. Therefore, addressing pest allergens in the home is a key component to improving health outcomes among inner–city and low–income children with asthma and reducing health care utilization rates.

While studies have assessed the economic value of home–based environmental interventions that include IPM, there have been no papers that have only looked at the ROI of IPM on its own. However, when IPM is included as part of a multi–faceted home–based approach, studies reviewed by the CDC indicate an ROI ranging from $5.30 to $14.00 for every dollar invested. Cost effectiveness, as measured by costs per symptom–free day gained, ranged from $12.00 to $57.00. Based on this evidence, the economic benefits have the potential to match or exceed the cost of the intervention. The average unit–level IPM treatment currently costs about $700, depending on how intensive the treatment provided is.

IPM is a cost–effective, evidence–based, feasible and scalable strategy that is already on the market and can be provided by a licensed pest management professional who has IPM certification or training.

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