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.


Title and Organization




ZIP/Postal Code

Email Address

Phone Number

Andriana Azarias

Senior Advisor, NYC DOHMH, Healthy Homes Program

125 Worth Street

New York




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.

Q3 Please indicate which category your organization falls under.

Other (please describe below: 150 character maximum):
Local health department

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.

Q5 Was your innovation implemented? If so, please explain when, the number of people impacted, and the results.

Yes (please specify when and the estimated number of people impacted):

The Healthy Homes Program (HHP) currently provides IPM as a contracted service to OneCity Health patients with asthma and pests in the home. From February 2017 through April 2018, HHP has received 549 referrals from OneCity Health partners, conducted 422 home pest assessments, and completed 327 IPM treatments. The overall health and economic impacts of this service will be assessed after the conclusion of DSRIP Year 5.

Q6 Please identify the SDH Domain that your innovation addresses. (Select all that apply.)

Neighborhood and Environment

Q7 I give the Department of Health the right to share the information submitted in this application publicly (for example: on the DOH website). I understand that there is no monetary reward/reimbursement for my submission or for attending the summit should my innovation be selected.

I consent to have my innovation shared