When the City of Boston passed its Rental Inspection Ordinance in December 2012, Mayor Thomas M. Menino issued a statement saying, “Landlords must be held responsible when it comes to providing safe and healthy housing for their tenants.” He was referring to the unhealthy living environments that fall on many city tenants when landlords neglect to request city housing inspections. This negligence leads to a higher prevalence of health hazards such as asthma and lead poisoning. Liz Connolly and Katherine Tanefis, of Boston’s non-profit, Health Resources in Action (HRIA), have been instrumental in promoting this protective rental policy. It is not an easy mission.

Health hazards in the home are not distributed evenly across the city. This has been a concern voiced by many environmental justice (EJ) advocates. Tanefis and Connolly spend a majority of their time working with communities in Dorchester and Roxbury, two of Boston’s neighborhoods with the highest concentration of low-income and minority residents. This is where they also see the highest rates of environmental health disparities. In Boston, minority and low-income children suffer from asthma rates up to five times higher than white children. Children are particularly vulnerable because of their smaller body mass and higher proportional rates of exposure to environmental hazards and toxins. Eighty percent of all asthma cases are diagnosed by age 5.

Connolly and Tanefis believe in the importance of addressing environmental and health equity in both the home and school environment. Not only because this is where children spend the majority of their time, but for some neighborhoods, it is also where indoor air can be full of asthma triggers. They do this as part of a three-person team running the Boston Healthy Homes and Schools Colaborative (BHHSC). BHHSC is a program within HRIA’s Environmental Health Department that is looking to close the gaps in health equity by focusing on the occurrence of asthma and lead poisoning in the home and at school.

Luckily, the new city rental policy Mayor Menino announced has managed to remove many social and political obstacles that stood in the way of many minority and low-income residents living in unhealthy homes. Tanefis gives the example of a family living in a triple-decker rental unit in Dorchester before the ordinance was created. “If they have problems with pests—like roaches and mice—or general unsafe living conditions, it is up to them to call the city inspection services. A lot of people don’t feel comfortable doing that, because that’s where they live, and they don’t want to risk eviction or retaliation from the landlord, and/or, they just don’t trust the city. There are a lot of issues there.”

The new policy mandates that the city inspects all rental units every five years, rather than leaving it up to residents to try and find the resources. This would apply to 140,000 units in Boston; roughly 53 percent of all city rentals. Prior to this policy ninety-eight percent of all city inspections were prompted by a complaint and, often, sick renters. Not only does the ordinance place the responsibility on the landlord, but when inspections begin this fall, the city will also focus first on “problem properties.” The city identifies problem properties by looking at poor inspection records, and a history of complaints by tenants. In practice, this will hopefully address the disparities in which tenants have historically been able to get their homes inspected.  “Environmental justice is the precursor to public health,” Connolly says with conviction in her voice, “If we can successfully address EJ, then we can work towards fixing a lot of things.”

Tanefis explains how this ordinance is especially important for Boston—a city in which 80 percent of its houses and buildings were built before the 1980s. Older buildings are more prone to structural problems that facilitate pest invasions, and are vulnerable to dust and mold, especially in low-income neighborhoods where properties are not receiving much-needed inspections. Additionally, both women emphasized the misconceptions and paradoxes that surround common perceptions of a “healthy environment.” While parents may use household cleaning products to get rid of cockroaches and early childhood educators may use bleach to disinfect spaces used for childcare, they are unknowingly using chemicals and toxins that trigger asthma.

While the rental ordinance has been a victory for BHHSC, Tanefis and Connolly’s work is far from being over.  Together they are working with a multitude of community organization, city agencies and residents to begin developing more innovative solutions to address home and school health disparities from all angles. Sitting next to each other, both women list off numerous partnerships as they speak. The Boston Public Health Commission, Family Childcare Workgroup, Department of Early Education and Care, Head Start, and the City Department of Neighborhood Development, are just a handful. The collective engagement of these groups has lead to considerable change over the past few years. Because of initiatives started by BHHSC, Boston also has 26,000 housing units that are designated “smoke-free,” Tanefis and Connolly lead trainings and outreach programs with early educators and community members about identifying and avoiding health risks, and many public schools are now following preventative policies to combat pests.

Although the BHHSC’s many programs are steps in the right direction, both Connolly and Tanefis worry about the ever-present battle for financial support. Connolly says, “We know what the problem is, and we have all these ideas about how to solve it, and yet in order to connect the two there is a huge third piece of ‘How are we going to get the money to do this?’” HRIA, as with many non-profits, has to deal with foundations’ ever-changing funding priorities, and the pitfalls of short-term contributions. All their programs are funded by grants that are set to last only one or two years. Not only does this mean that a large portion of the job is spent trying to secure funding, but it has also lead to a lack of continuity and follow-up with some of their crucial programs. Tanefis, who has now been working at HRIA for seven years, continues, “It’s hard to be really strategic about where we want to go long-term, when a portion of our time is always figuring out the goals of a short-term grant.”

However, going forward, Connolly and Tanefis remain optimistic. The promotion of healthy housing through education and city policy is gaining traction, as more non-traditional, stakeholders such as contractors, landlords, and residents are beginning to get involved in the decision-making process. Meanwhile organizations that have historically pushed back against much of the work BHHSC has done are starting to turn around, which points towards the crucial progress that both women are hoping for. “Health is a 24/7 part of your life, and therefore we need to start thinking about health in every moment, and in where we spend the most of our time,” Connolly ends, “More than anything, we need to start asking “How do we balance wellness and health for everyone?”