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'Healthy Homes' links home data to health of children

As Section Chief of Medical Toxicology within the Division of Clinical Pharmacology, Toxicology and Therapeutic Innovations at Children's Mercy, Jennifer Lowry, MD, goes beyond treating the patient. She advocates to treat their homes.

She also is the Director of Mid-America Pediatric Environmental Health Specialty Unit, Medical Director of the Center for Environmental Health (CEH) and of the Individualized Pediatric Therapeutics Program, as well as an Associate Professor of Pediatrics at the University of Missouri-Kansas City School of Medicine.

"You can see a kid in front of you for 10 minutes in your clinic, and they've dressed up, have taken a bath and look nice because parents want their kids to look nice for the doctor," Dr. Lowry said, "but you have no idea that they've got rats and cockroaches in their homes, unless you ask about the situation or see it for yourself."

Healthy Homes

That's where Healthy Homes comes in. The program is a partnership between Children's Mercy staff, health-care providers and families to help identify and reduce environmental exposures that may cause or worsen respiratory health problems within the home. Dr. Lowry works primarily with the clinical care of the patient, but also provides medical direction for the Healthy Homes program.

Before this program was established, home assessments only focused on asthma or lead. Children may have asthma, but other things like chipping or peeling paint, rotting wood or mold also can impact health in addition to asthma. Triggers for asthma may include pet dander, cockroaches, poor ventilation, mold, smoking, etc. In the past, if a case worker only addressed the lead problem; for example, they may not have felt obligated to assess the rest of the house for possible triggers. With the Healthy Homes approach, Dr. Lowry and the CEH staff have found there are actually more triggers for both lead and asthma.

"Lead and asthma are just two parts of the larger problem, which is the whole home," Dr. Lowry said.

With the Healthy Homes approach, CEH staff members have been trained to look at the comprehensive health of the home, rather than just one aspect of it. This is more beneficial for the family.

"One of the homes our program assessed had a large hole in the middle of the house," Dr. Lowry said, "but the family was very proud of the fact that they owned the home. By using the Healthy Homes approach and doing home assessments, you actually get a better picture of the social determinants of health."

Comprehensive information

Healthy Homes staff members bring together their expertise with physicians and the Health Department to provide comprehensive information, moving the patient's health forward. Dr. Lowry and the CEH staff are currently following the progress of over 80 children within the Healthy Homes program.

"My work is to decide if a family qualifies for a Healthy Homes assessment and if it's appropriate to approach the family," Dr. Lowry said. "I have to make sure we're utilizing research and decide which families to educate and which homes to visit."

Education is a huge part of Dr. Lowry's role at the Children's Mercy Center for Environmental Health. She's currently working on a grant with the Environmental Protection Agency so that she can present at medical schools and educate health care professionals. Oftentimes, Dr. Lowry said, health-care professionals know a lot about lead and asthma, but not about other impacts that the home can have on health.

Collaboration provides unique program

Though Healthy Homes programs have been in place all over the country, Dr. Lowry said the Children's Mercy program is gaining more attention because of the vision and expertise of Kevin Kennedy, MPH, CIEC, Managing Director of the Center for Environmental Health. The collaboration between Dr. Lowry and Kennedy has provided a unique program for a children's hospital, as Children's Mercy is on the forefront for linking home data to the health of the child.

"We're ensuring our patients have safe homes," Dr. Lowry said, "so kids with chronic diseases can return to healthy homes."

In 2012, Dr. Lowry was awarded the Lead Star Award for her partnership with Kansas Healthy Homes and Lead Hazard Prevention Program. She and staff of the Center for Environmental Health presented their data at the 2014 National Healthy Homes Conference.