Skip to main content
man working construction

Children's National

Good Health Starts at Home:

Virtual Visits Help Doctors Diagnose Home Repairs to Combat Asthma

Asthma is the most common chronic pediatric condition in the U.S., affecting an estimated 6 million children under the age of 18. In Washington, D.C., pediatric asthma rates are highest in Wards 7 and 8, an area southeast of the Anacostia River where the District’s greatest share of older, poorly maintained housing is also concentrated. That’s no coincidence, according to doctors at Children’s National Hospital, who say that substandard housing conditions can act as environmental triggers for asthma.

With support from Fannie Mae’s Innovation Challenge, Children’s National Hospital is bringing together housing and medical experts to identify and fix the issues inside the home that are contributing to elevated asthma rates in kids. This work is improving the health of families while also improving the quality of affordable housing in rapidly changing neighborhoods.

In many homes across D.C.’s Wards 7 and 8, wet basements, leaks, and failing roofs cause mildew and mold; a lack of air-conditioning creates excessive heat; and pest and rodent droppings contaminate the air.

 
 
 

Dr. Candice Dawes, a pediatrician with Children’s National Hospital, says all these indoor environmental exposures trigger asthma.

When we see carpet that has mold, or poor ventilation, then I understand why this child is having a cough, why this child is having wheezing, why this child has been in the emergency room.” Dr. Candice Dawes, Pediatrician, Children’s National Hospital
 
 

With its Fannie Mae Innovation Challenge contract award, Children’s National is working with several partners, including Yachad, a housing remediation not-for-profit, to conduct virtual visits through its Healthy Housing Virtual Home Visiting Program to identify and repair potential indoor environmental hazards in homes across D.C.

 
 

Leveraging a telehealth platform on a smartphone, virtual home visits allow medical and housing experts to see the home, identify issues, and work with families to address them. “We can identify a number of needs in that virtual visit that just starts everything moving,” says Dr. Eduardo Fox, Assistant Medical Director of the Impact D.C. Asthma Clinic at Children’s National Hospital.

 

Yachad provides remediations ranging from new furnace filters and dehumidifiers to extensive roof repairs. The remediations improve the quality of housing and reduce the risk of future displacement of long-term residents.

These are the next communities that are set to be gentrified. If we don’t stabilize the families that live here, there will be great pressure for them to sell and move, and where are they going?” Audrey Lyon, Executive Director, Yachad

Dionne White rushed her six-year-old daughter, Dior, to the emergency room in January 2021, terrified that her kindergartner wasn’t breathing. Dior was hospitalized, receiving round-the-clock steroids and asthma medicine. Her older brother Christian also has asthma, and throughout the pandemic, he has experienced frequent nosebleeds. On a virtual visit, Yachad’s housing experts noted extensive mold in the house. The culprit: water intrusion on multiple levels of the home, caused by a basement flood in 2014 and a failing roof.

I started seeing the water damage from the roof, where it was a small leak at first. Then over the years, it started turning into multiple leaks.” Dionne White, Washington, D.C., resident

Dionne’s mother purchased the home in Ward 8 more than 30 years ago. A Lead Officer for D.C.’s Department of General Services with 27 years of service under her belt, the grandmother of four worked two side jobs to afford the house. But with her family unable to keep up with repairs, she and her daughter are balancing a desire to remain in the community with the knowledge that the home’s condition is contributing to the children’s illnesses.

Yachad provided the White family with two treatments for roaches and mice, advised them to remove all the carpeting in the house, and repaired the roof and a leaking sky light. Extensive interior work is also scheduled. Both children are being treated with daily doses of prescribed asthma medication, and with regular telehealth check-ins with Dr. Fox, there have been no further flare-ups.

For decades, redlining, restrictive covenants, and urban renewal programs pushed low-income, primarily Black residents around the country into neighborhoods like those in Wards 7 and 8 — racially segregated with lower quality housing stock. Today, those aging, poorly maintained homes — not to mention the polluting facilities in that part of the city — are making residents sick.

It should be no surprise that children living in Wards 7 and 8 are 10 times as likely to visit the emergency room for an asthma attack as children living in the upper Northwest quadrant of the city.” Dr. Janet Phoenix, George Washington University public health professor and Yachad Board Member

Despite disparities in income and health, some neighborhoods in Wards 7 and 8 are anticipating big changes. For example, work on the 11th Street Bridge Park and Anacostia Waterfront are underway, and private capital has been injected into affordable housing developments like St. Elizabeths East. Families like the Whites, with deep roots in the community, want to stay and be part of the changes.

 
 
 
I’ve been here since I was a child. This is my community. I want to stay here — I want to stay in my home.” Dionne White
We’re excited to support this initiative. By coordinating medical and housing services, this program is expediating care and improving the quality of housing. They are truly reimagining housing as a prescription for a healthy life.” Maria Evans, Vice President of Community Impact, Fannie Mae

View the Fact Sheet View Children’s Research