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Your Environment. Your Health.

Healthy homes: in-home environmental asthma intervention in a diverse urban community

Environmental Health Economic Analysis Annotated Bibliography


Research article Cost-benefit analysis (CBA)
Turcotte DA, Alker H, Chaves E, Gore R, and Woskie S
Am J Public Health
This cost-benefit analysis demonstrated that implementing an in-home environmental asthma intervention for the Lowell, Massachusetts community resulted in a significant health improvement from baseline to follow-up. The cost of the interventions (not including personnel) was $36,240, whereas the estimated savings due to reductions in asthma-related hospitalizations, emergency department visits, and doctor visits over a 4-week assessment period was $71,162, resulting in an estimated annual savings of about $821,304. The authors concluded that low-cost, multicomponent interventions decrease all measures of asthma severity and health care utilization in this diverse population of urban children.
Children with asthma (< 15 years)

Health Outcomes

  • Respiratory outcomes (asthma attacks, wheeze, rhinitis, eczema, cough, phlegm)

Environmental Agents

List of Environmental Agents:

  • Air pollutants (tobacco smoke)
  • environmental asthma triggers, such as pests (roaches and mice), mold, dust mites, furry pets, outdoor allergens

Source of Environmental Agents:

  • Allergens from pests (roaches and mice), combustion sources, moisture, dust, pets

Economic Evaluation / Methods and Source


  • Cost-benefit analysis (CBA)

Cost Measured:

  • Cost of the in-home intervention

Potential Cost Measures: (Not available)

Benefits Measures:

  • Savings resulting from reductions in hospitalizations, emergency department visits, and doctor visits

Potential Benefits: (Not available)


  • Lowell, Massachusetts

Models Used: (Not available)

Methods Used:

  • The authors evaluated health care cost savings resulting from individualized interventions focused on reducing indoor allergen levels and asthma triggers. The authors — 1) used a questionnaire tool to conduct a pre-intervention health assessment; 2) used a questionnaire and collected floor dust samples to conduct pre-intervention environmental assessment; 3) implemented customized home and education intervention; 4) followed-up 11 to 12 months post-intervention to evaluate impact of the intervention on the child’s health; 5) determined reduction in urgent care costs resulting from intervention; 6) analyzed change in medication use pre- and post-intervention using a test of proportion.

Sources Used:

  • Data on costs of asthma-related hospitalizations, emergency department visits, and doctor visits from Massachusetts Department of Public Health; Massachusetts Emergency Department Discharge Database (2012)

Economic Evaluation / Methods and Source


  • Turcotte DA, Alker H, Chaves E, Gore R, and Woskie S. 2014. Healthy homes: in-home environmental asthma intervention in a diverse urban community. Am J Public Health.
  • Pubmed
  • DOI

NIEHS Funding: (Not available)

Other Funding:

  • US Department of Housing and Urban Development, Office of Healthy Homes and Lead Hazard Control (grant MALHH0171-8)
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