>> From WXXI News.

This is Connections.

I'm Evan Dawson.

There's our music and there's our show.

Our connection.

This hour made in Cayuga County with a woman named Amber.

Amber is a mom whose kids range in age from teenagers to infant.

She said with her busy life and with children with different needs, she can't be everywhere at once in her home.

So when it comes to checking to make sure things are safe, she was open to some help through the Healthy Neighborhood Program.

Amber's teenagers received a visit from local firefighters who gave them a lesson in how to put out cooking fires.

They also checked the smoke detectors in the home, and they replaced several expired batteries that inspectors had missed.

Program experts also helped Amber with child proofing and gave her solutions for how to help one of her children better manage his allergies.

She told the Cayuga County Health Department that she recommended the program to some of her neighbors.

After all, that Healthy Neighborhoods is a statewide program in Monroe County.

It serves hundreds of people every year, assisting families with home related health concerns, things like check and smoke and carbon monoxide detectors, addressing pest control or lead exposure, helping to reduce asthma hospitalizations.

Experts say the program provides low cost resources and education, and they've got documentation that it has saved lives, but the program could be in jeopardy.

The New York State Assembly restored funding for the program, but the the Senate did not.

Advocates are left wondering what will happen in the final state budget.

So if you haven't heard of this program, our guest this hour will help you understand what it's about and why these kinds of interventions can really help quality of life and can help life in general be protected in communities.

We're going to welcome our guests now.

Dr.

Katrina Korfmacher is with us, professor of environmental medicine and public health sciences at the University of Rochester.

Welcome back to the program.

Welcome to Elizabeth McDade, director of Rochester Energy Efficiency and Weatherization.

That's renew, which is coming up on quite a milestone for their own projects.

>> Yes.

Very exciting.

>> Nice to see you back here and welcome on the line to Amanda Reddy, executive director of the National Center for Healthy Housing.

Amanda, welcome.

Thanks for being with us.

Do we have.

Thanks for having me, Amanda.

Hey, Amanda.

Ready?

In a moment, we're going to hear from the the public health director for Monroe County.

That's Dr.

Maria Elena Velez Dbrown.

But before we do that Dr.

Korfmacher reached out recently about this issue just to put us put it on our radar.

And I have to say, Katrina, you know, we've been looking at a lot of budgetary stuff.

We talked about, about public union pension funding, which is a lot of money.

Last hour, we talked about a lot of things.

There are a lot of money.

This is a statewide program.

18 counties are participating.

It's 1.45 billion with an M it's 162,000 in Monroe County.

It's one of the smaller budget items that's been controversial that I've probably ever covered on this show.

I'm not saying that's not that's nothing or that that those things don't add up.

It's just smaller than I expected.

So what stands out to you about this story?

Why did you want to make sure people knew what was going on here?

>> Well, I agree that it's a really tough budget year and the state's having to make some really difficult decisions.

and this is one that I think really shows where our priorities are, you know, in a time of crisis and budget crunches, the decisions that we make show what our priorities are.

And this one is about prevention, upstream prevention, and really helping to avoid health problems before they happen.

>> Okay.

And, you know, really Amanda Reddy is going to have kind of the research with the, a wider lens on this, on what it means to, to create healthy housing.

I know Elizabeth McDade has a lot to say about that.

I mean, Elizabeth's been a force of nature in this community for many years on exactly this issue.

But let's hear first from Monroe County.

And we had a chance to talk to the public health director.

That's Dr.

Mary Velez Dbrown.

Dr.

Murray joined us this morning, just for a few minutes, and we're going to listen to this conversation.

I had to kind of get the perspective on what Monroe County says is actually happening for families that have had a chance to access this program and why they think this really, really matters.

Let's listen.

>> Thank you so much for having me.

>> Through the Healthy Neighborhood Program Monroe County.

I know you there's data.

There's there's a history here.

Hundreds of families have been helped.

Why has the county prioritized this particular program?

>> Well, because it's meeting an important need and it's really, really effective.

So for those who might not know, the Healthy Neighborhoods program is a free program to residents who live in specific zip codes.

So those would be 146061460814611 on the west side, and then 14605 and 14621 on the east side.

Now this program targets those zip codes.

They're designated to us by New York State.

And we have staff community health workers who can go in and address really critical home safety and public health risks in these underserved communities.

So they provide one education, but then actual practical safety resources like fire extinguishers and carbon monoxide or smoke detectors, cleaning supplies.

So this program directly reduces preventable household hazards, and it helps avoid costly emergency department visits and hospitalizations.

It's helped prevent fires, and it's been a huge boon.

And as a really good return on investment for the small amount of investment compared to the entire New York state budget.

>> I know you had mentioned, and if you if you don't mind me asking that, you've got some testimonials that kind of speak to the impact here.

Would you mind sharing some.

>> Sure, sure.

We've got lots of really good stories.

So this program is an in-home visitation program.

And so during an initial Healthy Neighborhood Program community health worker identified that a home did not have a functioning carbon monoxide detector.

And so they installed one at no cost to the resident.

And then several months later, during a follow up visit, the homeowner shared that that newly installed carbon monoxide detector had alarmed, and it prompted her to call 911.

So she responded and they actually discovered a gas leak in the home's furnace.

So that homeowner stated that the carbon monoxide detector provided through the Healthy Neighborhood Program directly saved her life.

We have very similar stories.

For example, a 75 year old, very low income resident experienced a fire in her bedroom when her eight year old grandson accidentally started one.

And so, thanks to the smoke alarm installed from the Healthy Neighborhood Program, she and her son were alerted immediately and her son was able to use the fire extinguisher, also provided by the program, to put out the fire before it spread to the rest of the house.

And so that resident credits the smoke alarm and the fire extinguisher from the Healthy Neighborhoods program with saving both her home and her grandson, he only ended up with minor burns instead of what could have been a loss of life and total loss of the property.

>> I mean, those stories, anybody who's ever had a carbon monoxide detector go off, as has happened in my home about five years ago, it was pretty harrowing in the middle of the night.

When it does, I thought a fire in the fireplace was out.

It wasn't.

It's a hard thing to find out at 3 a.m., and it's scary to think about what happens if you don't have that in the home to protect you.

So let me just take this.

Take one more question before we let you go though, about this, because I understand people, people know the value.

They hear those testimonials.

They are powerful at the state level.

You know, whether it's the governor's office or the legislature, they get a lot of requests and people want them to to fund a lot of different things.

And if someone at the state level were to say, look, this sounds important, it's 162 K you're going to have to fund it on your own.

I mean, I don't think we can do that anymore.

What's at risk here if it's not included in state level?

and what would you say to, to state leaders about that?

>> Oh I would say that because the proposed executive budget removed the core appropriation annually across the state, it comes out to actually $1.45 million, but that is really the backbone of the program.

And that also helps us leverage additional local and federal funds.

So really not funding this program would effectively dismantle the entire program.

Now, we have had some good news in that funding for this bill was included in the Assembly's, the New York State Assembly's budget bill, but not in the Senate.

So we are really, really hopeful that the program will be funded as part of budget negotiations.

as that process continues.

But the what we would lose is a program that is extremely effective and really critical specifically for newcomers for refugee and immigrant families, many of whom face language barriers or limited familiarity with the U.S.

housing safety standards.

having someone literally go into your home and do a real time assessment of household conditions is a way of identifying risks that clinicians like myself just can't do in a clinical setting.

You learn so much more about a patient's life when you go into their home.

And this program also helps refer folks to other grant programs or other opportunities to take advantage of maybe remediation or repair grants through the city of Rochester.

So there is a lot of potential improvement in homes that we would forgo, and we would see increased rates of hospitalizations for asthma attacks.

I mean, some of these zip codes have asthma rates of both emergency department visits and hospitalizations that are three times the Monroe County or the New York state rate of hospitalizations for a very preventable illness.

And so there would be a loss of quality of life.

We would certainly lose funding and access to increased matching funds.

And this program is incredibly cost effective.

If we just look at data from the National Center for Healthy Housing they looked at just based on asthma related outcomes and avoiding healthcare utilization, the program generates a positive return on investment ranging from anywhere from 2 to $3.50 for every $1 that's invested in the program.

I don't know a lot of other initiatives that have decades of research that can back up those claims.

>> That is the Monroe County Commissioner of Public Health, Dr.

Maria Elena Velez Dbrown.

Our thanks to Dr.

Velez Dbrown, who couldn't be alive with us this hour, but popped in this morning because really wanted to share some of that data and some of those stories there.

And Elizabeth McDade, director of Renew Rochester ENergy Efficiency and Weatherization, you know, those stories that Dr.

Velez shared, she's got more you've seen stories like that over the years, and I know they can be powerful, but they're probably not surprising for you to hear that.

>> Well, no, it is surprising, right?

Like when you actually talk to somebody who benefited directly from this.

So years ago when I was working with the Coalition to Prevent Lead Poisoning, I happened to answer the phone one day and it was a woman trying desperately to find the name of the person who had helped her a couple of weeks ago.

And she was calling sort of everything she could think of.

And it turned out she had had a visit from one of the community health workers at the Healthy Neighborhoods Program who had installed smoke detectors in her home.

And then two weeks later, there was a fire in the house.

And this woman and her five children escaped from a fire in the house because of the program.

And so she was desperately trying to find the name of that person to thank them.

And so I still remember very vividly.

I hope you can hear from my voice the impact of hearing from this individual who was whose life was saved by simply making sure that the smoke detectors were working.

It was it was amazing.

>> Coming up here, we're going to talk to Elizabeth a little bit more about one of the aspects of what this program focuses on, which is the primary source of exposure for most children with elevated blood levels.

Is the home still?

And we're going to talk about that.

But I want to ask Katrina and I want to ask Amanda Reddy about a couple of aspects of this.

So Katrina, just looking and listening to Dr.

Brown talk about the zip codes that are really hit hard by things like asthma, hospitalization, exposure.

This is probably not going to be the connection show of the year that gets the highest number of downloads and shares.

It's not as sexy.

It's easy to forget about or just put stuff under the radar.

When we're talking about the poorest zip codes, the the least invested neighborhoods.

But these are often the places that, for example, University of Rochester clinicians are providing the most preventive service and care to families.

Disproportionately.

They are in the most divested or least invested or the poorest neighborhoods.

And even though it's not always the headline grabber, to me, this feels like a moment where you stop and say, how do you kind of rebalance society a little bit and make sure people who need the help the most are getting it?

And I wonder if there's anything that you wanted to share on that sort of on that note.

>> Yeah.

I mean, it's not surprising to me that people haven't heard of this program before.

And while it's tragic that it's that the states considering eliminating it, it's also an opportunity to talk about what a unique resource it is.

you know, as Dr.

Velez Dbrown said, there are not a lot of resources when a health care provider sees a patient in their in their office and knows that their home is contributing to their health problems either now or down the road, and this is the one place that that clinician can refer their patients.

It's super cost effective.

It's targeted at these high risk neighborhoods and new Americans who most need the assistance.

As you mentioned, it really is focused on helping families keep their own homes healthy, arming them with the tools and resources and referrals.

So again, as Dr.

Murray said, that, that leveraging the resources that exist in our community and targeting them at those neighborhoods is particularly important.

So it, you know, the data that Amanda Reddy can share shows that this is a program that should be expanded across our city, across our state, if not nationally, has been looked to as a national model.

>> Well, let's bring in Amanda Reddy again, executive director of the National Center for Healthy Housing.

Amanda, tell people what the National Center for Health and Healthy Housing does.

First of all, sure.

>> The National Center for Healthy Housing is a national nonprofit that is really built on the premise that better housing can be a powerful platform for better health.

So it is our privilege, through a combination of research and advocacy and capacity building, to come alongside really proven programs like this.

Communities like Monroe County to help communities and system put in place the things that work to improve housing quality and make sure that housing is a place that helps to support people's health and well-being and not undermine it.

>> So this healthy Neighborhoods program, again, we've been talking about the fact that counties have to opt in.

18 counties have done that.

It is a very small budget expenditure in New York State.

It's not nothing, but it's 1.45 million in a budget that is, you know, orders of magnitude larger than that.

what's the first thing that pops out to you when you see headlines like, you know, legislature might decide it doesn't make the cut this year?

>> Well, it was devastating to receive that news.

The National Center for Healthy Housing has had the privilege of being an evaluator of this program.

So we've seen really firsthand how unique and important it is, not just for New York State, but, as Katrina said, for a model, as a model for the rest of the country and some of the things that make it stand out for us at the national level are the durability of this program.

This program has been around since 1985.

This is a 40 year old program, and we could talk a lot about what that means to have that trust, that anchor within a community.

the scale of it that we are talking about thousands of homes per year across the state.

And in both, you know, some of the most densely populated areas of the state, but also in some of our most rural areas of the state.

So that geographic diversity is really important here also.

And as many have said here, we've got the receipts, right, that we know that this program is successful and not just improving housing conditions, but addressing those risks before they show up in emergency rooms and returning that positive return on investment to the state.

So that this is really an opportunity not just to make an investment, but to really receive a savings as well.

>> I'm really glad you brought up the rural component, Amanda, because when we first of all, everything feels just sort of bifurcated along political lines with the assumption of cities, blue, rural areas, red, different priorities, different people, different different wants and needs.

But there's poverty.

There's very deep poverty in rural America.

There's very deep poverty in urban centers in this country.

And when we talk about issues that affect, for example, the city of Rochester or housing issues in Rochester, I'm really I just appreciate the point that that it's not exclusive to one zip code or one city, or even one sort geographic location, because we're way too divided right now.

And this is an issue in a lot of different places.

So what is the challenge in more rural areas generally across this country or even across this state?

Is it harder to serve those areas given maybe lack of educational centers or professional services nearby?

Is it a bigger challenge in rural areas?

>> It certainly can be in the cost analysis.

In one of the papers that we published evaluating this program, the most rural county that we included in that analysis actually had the highest cost, which surprised a lot of people.

A lot of people assumed it would be you know, one of the more densely populated areas closer to New York City.

and that is exactly for the reason that you mentioned that because there isn't the infrastructure that exists, the workforce infrastructure often that the people conducting the visits have to travel farther distances to be able to get between homes that their costs can be, you know, slightly higher and that there are specific needs.

I think it's also worth mentioning here though that that's another reason why this program is so important.

I know there have been conversations about, you know, how does this interface with other lead poisoning prevention or asthma or falls prevention efforts in the state?

And those things are also important, but they have to be understood as an ecosystem.

that these things are all work together.

They're not duplicative.

and rural communities are a great example of that of, of places that might be left out of the conversation if we undermine an investment in healthy neighborhoods by thinking we've got it covered by some of these other initiatives.

>> And Amanda, similar to what I was asking Dr.

Velez, Dbrown just because when people look at this budget item, you go, if this thing is so effective and I have no reason to challenge the data and the anecdotes, then why doesn't just why don't the individual counties fund it?

I mean, can they come up with another 162 K?

Should it just be up to counties individually?

Why have sort of an overarching either a network or an umbrella that does this?

Why does that matter?

Amanda.

>> I think it matters for a lot of reasons.

I mean, first of all, those counties are feeling the squeeze also, right?

so asking them to come up with additional funding is, you know, can, can feel like an impossible task.

162,000 might, might as well be 162 million.

given some of the challenges that everyone is facing right now, there's also a lot to be gained, I think by having the, the sort of centralized framework and backbone that the state program provides in terms of, you know, the standardized data that we are able to collect to be able to track and monitor this progress, make sure that the program is having the intended impact to be able to provide backbone of training and information about emerging best practices to help enable peer sharing, sharing between communities so that they can benefit from each other and learn about what works.

we really would be undermining that investment if we decided that we wanted to take back this investment, I think we'd see the program disappear in many places.

just because it wouldn't be possible.

And then we'd also lose that ability to really maximize some of the, the potential impact.

>> Well, I want to turn back to Elizabeth McDade because for people who don't know you in this community and a lot of people know you now, they've known you for a long time for the work that you've done.

I still see lead.

I mean, let me just take a step back and ask you.

It's 2026.

How are we doing on lead?

>> We're doing, we're making progress.

You know, we still have older homes in this community.

We have a terrific City of Rochester led ordinance, which is amazing, which is a proactive inspection process.

But that's only the city.

It's not it's not the housing outside of the city.

and New York State, especially any, any, any communities that developed along the Erie Canal or in tandem with the Erie Canal are going to have older homes and there's going to be lead paint in those homes.

So we're making progress.

>> Okay.

I mean, are we as far along as you had hoped?

You know, maybe a decade or two prior?

>> That's a tough question.

I think.

I think as you, are longer in this area of work, you realize how hard it is, right?

And so the kind of the, the goals that we had set earlier, we just learned that they're just harder to achieve.

But, but the progress that has been made.

Right.

And again Amanda did a great job sort of talking about this whole idea of the ecosystem of all of these programs that interconnect and interrelate.

And they're not, they're not duplicative, right?

They really do address different things.

The issue that, that the Healthy Neighborhood Program really focuses on is like smoke detectors, right?

Fire, all of that type of stuff.

Lead is secondary to that.

It's part of it, but it's secondary to that because we have such a great lead program that's through the county because we have the, the proactive inspection process.

it's, it's, it's a, it's really looking at the cohesive, a holistic approach.

Right.

And, and I'll just share that, you know, as the director of renew, which is an initiative at the Rochester Area Community Foundation, we're coming up on our 1,000th project in the next couple of months.

And so we do a lot of we work with community partners to do home rehab, repair, et cetera., and then we survey our clients and everybody talks about the better physical and mental health outcomes as a result of living in a healthier, safer space.

Very few people actually talk about like the fact that they've saved some money on their utility bills.

They talk about the better, like feeling a burden lifted because they feel safer in their homes.

>> So that's the kind of thing.

Tell me some stories here.

What's kind of thing that renew does?

>> renew will fix your broken sewer line.

We work with community partners to to go in and address home health repairs, health and safety issues in low to moderate income homeowners throughout Monroe County.

We've actually been in every single town in Monroe County.

So past own or neighborworks or action for better community could go into your home, evaluate, say yes, you meet our qualifications, you're going to get a new furnace, a new hot water heater.

But it turns out the electrical panel can't accommodate the new upgraded appliance or the sewer lines broken.

And so normally those agencies would have to walk away from that because their funding is very prescriptive.

But by working with renew, we actually make grants to our community partners who allow them to then expand the work scope and pay the contractor to do the additional work that allows them to do the work that they're funding can do.

So by braiding our resources, where, as I said, we're coming up on our thousandth project and we've got almost $16 million worth of rated resources in this community.

>> Where does your funding come from?

>> it comes from SSL charitable Foundation.

It comes from the Rochester Community Foundation.

We had some funding through Monroe County, Arpa.

we always accept donations.

Well.

>> But part of the reason I ask is we're looking at the Healthy Neighborhoods program and the state funding that is, is either going to be there or not for that.

These are, in the grand scheme of things, not the biggest budget expenses, but the impact on lives is pretty amazing.

When you talk about people talking about their mental health or just feeling different in their homes.

>> Well, and then the average grant that renew makes is $5,000 5000.

Yeah.

So, you know, but that's whole that's but we're trying to expand.

And again, building upon this idea of really looking at a holistic approach, right?

One of the things we're working on right now is a pilot to really think about, like, how do we proactively address issues that are in the home rather than just looking at what's broken?

How do we fix it?

How do we sort of look at, you know, does there need to be aging in place, interventions made, et cetera, and all built upon this idea of really thinking about social determinants of health, understanding the impacts that have that, that are made in, in all of the generations and everybody who's visiting these homes to feel safer and healthier in these spaces.

>> And this is where it's like, I'm not trying to use a buzzword.

I think this is a great example when we talk about what equity means, when we talk about structural disadvantages.

So if the homes in the poorer zip codes, wherever you live, again, rural America, suburban America, in cities, if the homes in the poorer areas are more likely to have issues with lead paint, are more likely to have faulty everything, faulty wiring, smoke detectors, carbon monoxide.

And, you know, you're just trying to get by pay, try to pay rent, whatever the case may be.

That's I I'm not an advocate for any program here.

I'm just looking journalistically, it seems like that's where healthy neighborhoods or renew sort of balances things a little bit more here because we have these disproportionate numbers of people who are hospitalized, kids who get sick, really sick.

And why here?

Do you see this as as an equity issue?

What do you think?

>> Are.

>> I'm not.

>> What do you think?

Katrina?

>> Well, it's very clear that people spend a lot of time in their homes, and people who have lower incomes tend to have homes with a higher with more hazards than them.

So absolutely anything you can do to improve housing is going to have disproportionate effects on people who have fewer resources.

and you asked about why it matters at the county level, why they wouldn't sustain it.

the same.

>> Sure.

>> Yeah.

The savings in terms of health now reduced asthma trips and falls, carbon monoxide poisoning.

Those are largely health avoided costs for people who are on Medicaid.

And the county is not going to reap those investments immediately.

We as a society do.

Never mind if you're thinking about many of these environmental exposures where the outcomes in terms of neurodegeneration, cancer, things that you aren't going to see for decades, don't fall into that bottom line, the fact that you can see that this program pays for itself in the short term means it's that's probably just the tip of the iceberg that it's having disproportionate impacts over generations.

>> Amanda Reddy do you see this as an equity issue?

>> Absolutely.

And I want to build on what Katrina was just saying as well.

that the number that you've heard cited a few times that we see a return on investment of between, you know, 2 to $3.50.

that is based on a cost analysis that is looking at just asthma, health care utilization.

So just a return related to asthma outcomes to the health care sector that is not monetizing the benefits that we know are very likely for all of the other types of outcomes that Katrina mentioned or to other parts of society, right?

That when we know that people's homes are taken care of that they are not being unnecessarily exposed to these preventable conditions that people are able to go to work, children are able to go to school and to thrive and show up ready to learn.

so that the, the benefits that we have, the proof we have, you know, very rigorous documentation of it are really, as Katrina said, just the tip of the iceberg.

so it definitely is an equity issue, but this program is providing a real return to the entire state of New York.

>> Well, yeah.

>> I just, you know, I also want to underscore that we're not just talking about like areas where you think.

>> Yeah.

>> You would find, right?

Like we're talking there are people in need in every single corner of our community.

every zip code.

And to assume that somehow it's only going to be in, in a couple of zip codes, it's focused on a couple of zip codes because the highest need.

But these types of programs, I mean, this should be throughout New York State.

>> And that's an interesting point because until Dr.

Korfmacher reached out to me, I didn't know anything about this.

And I know, I know she, she just kind of like your mouth is agape over this is your life, right?

I mean, I, I, I did not know anything about this, and I was a little surprised to see that there are eight, 18 counties participating now.

so Amanda Reddy, why aren't there more counties participating?

>> That's a great question.

I'd love to hear.

the New York State government answer that question.

This is absolutely a program.

it has been expanded.

It should continue to be expanded.

And I think it's again, worth noting that this program has been the foundation and been leveraged to help be a springboard for many of the other investments that New York state has made and is starting to make an additional lead poisoning prevention and asthma and fall prevention efforts.

And that's why, again, it's just so perplexing to understand why this would be the moment where we'd think about undermining this investment.

You know, when you're building a house and you start with the foundation and then you finally finish and you're putting that roof on, that's not the time to rip out the foundation.

and that's basically what this would equate to.

>> Well, when we come back from our only break of the hour here I see a note from my colleague Racquel Stephen at WXXI who reported this week on Rochester being ranked the fifth most challenging place to live for people with allergies as well.

and you know, that's according to the Asthma and Allergy Foundation of America's 2026 Allergy Capital Report, Rochester was ranked 85th on that list last year, and, you know, programs like this have been effective in helping people with things like asthma allergies.

So we'll talk a little bit about that.

I want to talk a little bit more about what Renu and related programs are doing, and we're talking to in studio Katrina Korfmacher, who is professor of environmental medicine and public health sciences at the University of Rochester, alongside Elizabeth McDade director of Renew Rochester ENergy Efficiency and Weatherization.

Amanda Reddy is on the line with U.S., Executive director of the National Center for Healthy Housing.

We'll come right back on Connections.

I'm Evan Dawson on the next Connections.

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And a new show at Blackfriars Theater explores some of these themes.

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We'll reveal the list on Thursday.

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>> Well, if you're like me, there's times of year where your allergies are worse than others, and sometimes you're wondering, why are they so bad recently?

there's a lot of different reasons for that, but sometimes the home can be a factor in.

During a brief break, we were just talking about that doctor Korfmacher can can you relay a little bit of what we were saying about when your allergy or asthma is exacerbated, where we should be looking for answers on that?

>> Yeah.

There are some estimates that that show that about a third of, of asthma exacerbations can be attributed to triggers in the home that could be dust mites, rodents, mold and also you mentioned Elizabeth was mentioning about healthier homes and, Amanda was talking about people being able to go to work, go to school.

A significant proportion of kids who miss school, it's because of allergy and asthma exacerbations.

So, you know, you do the math by keeping kids homes healthy and safe.

They can breathe easier, not end up in the hospital and go to school so their parents can go to work.

>> And Amanda.

>> You solved all the problems.

>> Indeed.

Amanda, you want to add to that?

>> Yeah, absolutely.

and again, we have many, many just not only stories here, but we have published results on the impacts for both children and adults with asthma that not only are we improving their housing conditions, but that this shows statistically significant improvements in their ability to manage and control their asthma, to be able to show up to school and work and to really just live their lives.

and as Katrina mentioned, there are a number of important allergen and asthma triggers in the home environment that this program addresses.

and you know, that asthma and allergies report you mentioned focuses a lot on outdoor allergies, right?

Pollen exposure.

but we also have to think about the, the cumulative load that many of our residents may be experiencing so that when pollen is high outside and, you know, they may have be having to manage an allergic response to that, let's make sure that their home environment isn't adding to that load, right?

So that they're not also having to deal with allergic responses to cockroaches or mold or other irritants that might be in the indoor air.

>> So let me get a little bit of feedback from listeners.

Charles watching on YouTube says funding this program is a no brainer, and that is what worries me.

Programs like this are the easiest to cut to pay the payback for every dollar spent should make it a lock.

Amanda, that last point is an interesting one because you heard Dr.

Velez Dbrown talk about the return on investment here for a program that costs in Monroe County, $162,000 this year statewide, less than $1.5 million.

Are you confident that that those sort of return on every dollar spent that can be hard to measure?

Are you pretty confident that this is one of those good examples of return on investment?

Amanda.

>> I am extremely confident.

As I mentioned before, that analysis is really looking at a narrow slice of the benefits that this program delivers, really focused on just the asthma outcomes and health care utilization, not focused on all of the other benefits that we've been hearing about today.

So if anything, that return is likely to be a significant undercount of the benefits that New York State and New Yorkers are receiving in response to this program.

And I think it's worth mentioning, you know, with all of the stories and the data that we have and, and it's just worth reminding ourselves of the scale of what we're talking about this analysis that has been referred to a couple of times with the peer reviewed publications.

We looked at like a 4 to 5 year period that we were talking about 29,000 homes and 82,000 New Yorkers that were impacted by this program with this very modest investment.

And I think, you know, I appreciate the listeners comment about these programs being sometimes the easiest to cut.

And I think that a part of that reason and a part of the reason that you had never heard of this program is that prevention can be hard to measure because when it works, the crisis never happens, right?

We heard the commissioner and Elizabeth and others telling stories about, you know, we gave out that smoke detector and then two weeks later, there was a fire.

Well, sometimes we get that phone call that tells us that happened, but more often than not, those things are just happening in the background.

And so the you know, the, the truth about this, a program like this is that when it works, it's often invisible.

and so I think that as Katrina mentioned, this threat, which hopefully is, is passing is giving us an opportunity to really communicate a lot more about what the data, what the stories of 40 years of this work in New York state has really meant.

>> let me grab a phone call from Jessica in Rochester who wants to jump in.

Hi, Jessica.

Go ahead.

>> Hi, Evan.

Thank you.

I work with both Katrina and Elizabeth at URMC.

I'm an allergist immunologist, and I see patients with asthma all the time.

And it really is reassuring to have the Healthy Neighborhood Program when a patient comes in, either a child or an adult and tells me about exposures in their home, whether it's something related to moisture or pests or even not having enough smoke detectors, knowing that there are multimodal places where I can go to to get extra help for my the patients I'm taking care of is really beneficial.

And as Amanda said, it really does make a difference if someone has asthma, that's an underlying immunologic disease and they have exposures within their home.

thinking about their participation in school, which has a down downstream effects on their parents going to work, it really is important that we listen, we look at our, our patients in a really holistic way.

And so having the community fund and have this program is important for someone who sees patients with asthma and allergic problems all the time.

And I do see the benefit of that, of having this extra resource.

>> Jessica, thank you for the phone call.

Katrina, do you want to share anything there or anything to add to Jessica's points there?

>> Yeah.

Well, as I said, I think that having the resource for people like Dr.

Stern to refer to is super important.

for, for those patients who have extreme asthma issues, but also for people who don't that there are so many ways that our home affects our health that you just don't know the number of homes that I've been into where people know that it's not clean unless it smells like bleach or a really strong smelling fragrance.

And I always think of the case of the mom who thought she was doing such a good job engaging her kids in their asthma care by saying, you go and clean the bathroom and giving them bleach or a very you know, highly fragranced cleaner and it would trigger their asthma and make it worse.

And she just didn't know.

>> And so well intended.

>> Of course, because that's how we were taught to clean.

And one of the things that I think is so special about this program is it's sharing information with people to help them help themselves keep a healthier home.

>> Elizabeth, anything to add there?

>> I just am going to underscore all of this.

I just think the value.

So one of the things that, you know, Renee was working during the pandemic and, you know, everybody was being told to stay at home.

And I was like, man, oh man, that's coming from privilege, right?

That's assuming that your home is not making you.

I mean, you know, going out was going to make you sick, but that's assuming your home is not making you sick.

And by working and seeing and talking to some of the clients that Renee has worked with, but also being a partner with the Rock home study, you know, really just understanding that there's all kinds of things that people can learn to make their spaces a healthier space, right?

It's not that somebody's doing something wrong, right?

Or they're doing it the wrong way, but it's just there's lots of ways to learn how to make it a safe, a healthier, safer space.

And this program is such a rock for that.

>> Yeah.

Thank you very much, Jessica, for that phone call.

we're going to get back in just a second to the rock home study, but let me just grab a couple more emails.

Molly wrote in to say, and Molly was responding to Amanda's point about the, the sort of the curse of prevention.

Molly says it's the polio vaccine story all over again.

So I think Amanda, what Molly's referring to is so I didn't grow up in the polio era, but we've interviewed people who have, we've interviewed people who've been really direly affected and they're sort of amazed that so many people these days are, you know, well, I mean, do we really need the vaccine or are we sure the vaccine did that much?

Or what could it have been something else?

Or, and the further you get down the line from a crisis that has been either solved or prevented, the more people doubt that it was that bad or that the emphasis needs to continue.

And so it's kind of the curse of success there.

And anybody who works in the field of prevention has dealt with this.

So I think that's Molly.

Anyway, that's my interpretation or email that it's the polio vaccine all over again.

How do you like that analogy?

Amanda.

>> I think that's spot on.

And you know, I think it also you are hitting on another theme here, which is the longevity of this program, I think can sometimes, you know, people can say, well, if we've had it for 40 years, isn't our work done?

But all of the stories that we've heard today are proof that it's not done.

And actually the longevity is part of its success, right?

It's the reason that the clinician that we just heard who called in knows that she can, that this is a resource she can refer to, right?

This isn't a program that parachutes in for 2 or 3 years and then leaves.

It's there, it's enduring.

And because of that trust that they've built with community, that's another benefit.

I don't think that we talk about enough.

Evan, you mentioned earlier in the program how divided everything seems, how distrustful people are of each other and of government.

and this program is really an opportunity to help repair some of that trust.

I'll just share one story briefly when I remember maybe a decade ago getting an annual, a quarterly report from one of the grantees, and it included a photo of a door that they had gone to knock on, and the sign had a whole list of things that they did not want people coming to the door for, you know, no solicitors.

We don't want to buy anything.

It was a whole list of things.

And at the bottom it said, we'll only accept visits from the Niagara County Healthy Neighborhood Program.

Right.

This family knew that this program existed and was waiting to welcome them in.

And we've seen many, many stories like that, where then this program becomes the entry point and people feel safe.

Then accessing the nutrition program or other services.

Again, just really serving as that foundation for our communities.

>> Why do you think this program is different?

Why does it break down barriers?

Amanda.

>> Well, I mean, first and foremost, I think is that durability, right?

That it's again, it's not coming in and out of the community, that it's been there as a trusted partner, that they hire people often, you know, who are from the community who are providing these services.

that we have, you know, decades of experience and knowing what works, it is really focused on these practical actions as Katrina and Elizabeth and the commissioner have said about really equipping families and residents with things that they can do that really make a difference in people's lives, people can see it.

I can measure it right in the analysis that I do, but people can feel it.

Elizabeth said that so eloquently before about the way that it makes people feel.

and it really is special and unique.

And I hope that New Yorkers listening today feel really proud of this model that you have and that you fight so fiercely to keep it.

>> In studio here.

Elizabeth, has anything changed for you in terms of establishing trust, people, getting people to let you into their homes?

have you experienced any issues with that?

>> not in general.

I mean, because the programs that I work with are really, really about trying to figure out how do we help you, right?

How do we make sure that you're living in a space that works for you and your family and is impactful and doesn't have a huge impact on your on your own personal finances, et cetera.?

It's just really about sharing information.

And it's doing so in a way that is not shameful.

Like, it's not like we're, you know, shaking a finger at anybody like that.

We're not, you know, it's not going in and trying to convince somebody to do something that they don't want to do.

It's really just trying to provide information, resources.

Etcetera.

and, and we have such a great variety of, of, of agencies and organizations in this community that are all focused on that, that, that connect and overlap.

I mean, the Rochester Health Partnership is a great example of that, how people come together to try to figure out how do we help people, right?

I mean, that's, that's what you grew out of.

It grew out of the Rochester Health Partnership and the coalition Prevent Lead Poisoning organizations that have been in this community for decades, along with the healthy homes, with the Healthy Neighborhoods program, working with the city of Rochester, working with the county health department.

I mean, everybody's been having these conversations.

And how do you make all this stuff work for a very long time?

And we work closely together to interweave and interconnect.

>> Will you want to add there, Katrina?

>> Well, I was just laughing when when you said, you know, how does this program build trust?

And if you had the opportunity to meet the workers who do this work, you wouldn't have to ask that question.

They're civil servants who are super committed.

They are often from the communities they serve, and they do this difficult, humble work all day, every day, and they clearly earn the trust of people, whether they're working in a rural community or an urban community.

You see that from the fact that so many of the families they serve have been referred by their friends or neighbors.

So they do target neighborhoods.

But it's often, you know, I told my friend, I told my neighbor, and they want this, this help as well.

It's done in a very respectful educational, open way of what that family needs and helping them find the resources in the community.

And I find that such a powerful model as a researcher, the only way I was, you know, frustrated that despite Amanda's evidence and the work that she's done to promote this as a national model, that it didn't take off.

So the only tool I have is to study it.

So, so you know, geeky as it may be, we got a study to look at how a program like this could add into home remediation efforts and whether that could magnify the effect of when we're making public investments in housing, you know, giving people housing grants, take care of the house.

But do we help that family understand how to keep it healthy?

And we don't.

So we started this rock home study that you mentioned before with funding from HUD and from NIH to ask that question.

If we add this kind of healthy neighborhoods intervention into work on homes, can we magnify the effect and the impact of that public investment?

And the data is still coming out, but it's looking like that's a really strong intervention.

We're going to have even more evidence that this is an effective approach.

>> So is it kind of strange or surprising for you as a researcher?

Your work entails trying to understand our world better, and there's going to be times where a hypothesis doesn't lead, where you might expect, and there's times where you go, wow, this is working so much better.

Well, in your world, from what Amanda is telling you and all the data, the stories that you're all sharing, this is kind of a no brainer.

Is it weird to see something that is this successful set aside saying, you know, maybe we won't do this anymore.

It's hard enough to get programs funded and off the ground.

This has years now, decades now.

Is it strange to be in this position to see this conversation happening?

>> Well, it's frustrating for sure, because, you know, you'd like to think that if you're it is difficult to show in the environmental health field when our work is making a difference, because it is the avoided disease, right?

It's the the thing that doesn't happen decades from now.

And when we have such strong evidence for something like this having magnified effects and not not being able to push that forward, yeah, it's, it's pretty frustrating.

But I think that that by helping people know about it and look at ways that we can expand it we're going to make progress.

>> All right, two more emails here.

staying with the theme of the great work that Katrina is doing, educating people about something they didn't know about, here's Rick says, Evan, I've been able to listen to both your hours of the program today.

Each of them provided me new information and insights about the issues addressed.

I'm especially grateful for the information from your guests during the second hour, as I did not know about the program nor its tremendous benefits to our community.

Thanks to your guests for that.

So look what you've done, Katrina, and gray wants to know, what am I doing at home that is making me sicker or less likely to be healthy?

What should I stop doing on behalf of my family?

Should I stop burning wood?

Is there something else I should be doing?

Well, that's a whole other conversation.

Gray.

but.

>> We have a list.

We could have.

We could have a whole 'nother show.

>> Is there.

Is there a common mistake that we make at home that makes us sicker?

I mean, Katrina.

>> There's not a common mistake.

>> Oh, my top one is going to be bleach.

>> Oh, bleach.

>> It's just so.

>> Ironic.

Go ahead.

Gray.

>> You know I love bleach because so many of us were taught by our families, by our, our cultures that you need bleach to kill germs to be healthy.

And that's not true.

And as the story I mentioned earlier says, it can often make you, more sick.

and simply learning about other things that you can do.

Why that's not necessary.

You can.

yeah, a lot of people make the bleach mistake and that's an easy one to solve.

>> Okay.

And I'll just.

>> Say plug ins and handrails.

>> Plug ins and handrails.

>> Get rid of the plug ins, get some handrails.

>> Fragrances often have phthalates and other endocrine disrupting chemicals in them.

So they are marketed to us as things that make the air fresher and cleaner.

But actually, they're adding things to the air that can harm our health.

And so by simply unplugging the plugin, you're doing something to protect your family's.

>> Health and you're saving energy.

>> And money, plug ins and handrails, handrails.

What's the story on the handrails?

>> Trips and falls?

You know, you want to make sure there's handrails on stairs and that you're not.

>> Oh, not that, not that handrails are the problem, that we need more handrails.

>> You need more handrails.

We got to get rid of plugins.

>> Okay, so plugins bad handrails.

Good.

Yes.

Okay.

On the theme, I mean, I don't know if you want to add anything to this one.

Amanda, before we go, anything you want to say about this one?

Amanda.

>> Yeah, I just want to amplify what Katrina was.

She gave some great examples of how sometimes people are trying to solve one problem, and then they wind up inadvertently creating another, you know, add on the example of dealing with pests like cockroaches or mice or other pests.

Sometimes people are trying to deal with that, which is a real health issue, and introduce a lot of pesticides or toxic chemicals.

And so I think the underlying takeaway here is there are a lot of resources out here.

You've met some people now today who can help connect you to them, to help you figure out what the risks are in your home, and what are the best ways that you can address those things safely for you and your family?

>> Amanda Reddy where can people learn more about the National Center for Healthy Housing?

>> You can find us at NCH dot are online and on all of the socials, so we hope to see you there.

please do reach out.

We'd love to connect you to some of this information.

>> Amanda, thank you for your expertise this hour.

Thanks for being with us.

>> Thanks so much.

>> And for our guests in studio.

Let me just close with this.

Ellie writes to say for folks who don't live in the zip codes or counties, this program covers the Western New York chapter of the American Red cross offers free fire safety visits, potentially can offer up to four free smoke alarms, and many local fire departments can come and help with the installation if requested.

For folks who aren't able to reach their ceilings for various reasons.

So helpful for sure.

and it's good to know what is out there to help you.

For the moment, the Healthy Neighborhood Program is one of those things.

And we're going to find out if New York State continues to prioritize it.

Now, you know the story in studio Katrina Korfmacher.

Dr.

Korfmacher is a professor of environmental medicine and public health sciences at the University of Rochester.

Thank you for being here.

>> Thanks so much for having us.

>> Elizabeth McDade Director of Renew.

Come back, talk, renew sometime.

>> We'd love to.

And I just want to remind everybody to contact your local representatives to show your support for this program.

>> Thank you for being here as always and from all of us at Connections.

Thanks for watching.

Thanks for listening wherever you're finding us.

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