Seattle, Washington: Prioritizing Health in Public Housing Redevelopment

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Seattle, Washington: Prioritizing Health in Public Housing Redevelopment

Begun in 2012, the Seattle Housing Authority’s (SHA’s) ongoing redevelopment of Yesler Terrace is a model for healthy housing. The original 561-unit public housing complex dating from the early 1940s is transforming into a mixed-income community that will include up to 5,000 affordable and market-rate residential units when completed. As part of the transformation, SHA instituted the Yesler Breathe Easy program, a suite of home features and supportive services to promote respiratory health that was successfully piloted in the award-winning High Point redevelopment project. In 2016, the Yesler Breathe Easy program won the HUD Secretary’s Award for Healthy Homes in the category of Cross Program Coordination among Health, Environment, and Housing in recognition of SHA’s partnership with other city agencies and nonprofit organizations to implement the program. Although redevelopment of the complex will not be complete until approximately 2030, resident testimonials are early indications that the Breathe Easy program is improving the well-being of Yesler Terrace residents.

Yesler Terrace Redevelopment

The redevelopment of Yesler Terrace by SHA and private developers will both replace the original, very low-income housing units and add low-income and market-rate housing (table 1). In addition to providing 561 units affordable to households earning 30 percent of the area median income (AMI), SHA’s redevelopment projects will include 300 units affordable to those earning up to 60 percent of AMI. Private developers are currently constructing or designing 1,570 units in mixed-income projects, and another 1,400 to 2,000 units constructed by private developers are anticipated in future phases. Of these privately constructed units, 26 percent must be affordable to households earning up to 80 percent of AMI.

SHA’s concept for the redevelopment is to create a sustainable, mixed-income neighborhood near the major employment centers of downtown Seattle and First Hill. To take full advantage of the accessible site, SHA envisions increasing its density roughly sevenfold, replacing the site’s original two-story structures primarily with low- and mid-rise apartment buildings. The expected density of 120 to 140 units per acre would make Yesler Terrace the densest neighborhood in Seattle.

Breathe Easy at Yesler Terrace

The Breathe Easy program was created as part of the High Point redevelopment after a community leader raised the issue of poor indoor air quality in the existing units and challenged SHA to make improved air quality a central goal of the redevelopment. SHA then developed practices for its 861 apartments at Yesler Terrace based on the lessons learned at High Point. These practices — which have been implemented in the 312 units that SHA has constructed so far — include features that improve indoor air quality. In addition, households living in SHA units with a member suffering from a respiratory illness are eligible for educational programs that encourage healthy behavior. SHA partnered with local medical provider Neighborcare Health, the American Lung Association, and the King County Local Hazardous Waste Management Program for the development and implementation of Breathe Easy at Yesler Terrace.

Each apartment includes an energy recovery ventilator (ERV) with a filter, which captures 99 percent of air particulates and reduces indoor humidity while also achieving 70 to 80 percent energy recovery. The apartments also feature cabinet construction, trim, and millwork with low or no volatile organic compounds. Most units are not carpeted, and Breathe Easy program participants with respiratory illnesses receive priority occupancy for those apartments. SHA also enforces a strict nonsmoking policy in all of its buildings and outdoor common areas.

As of 2017, 30 households participate in the Breathe Easy educational programs. Four community health workers, residents of Yesler Terrace who received 40 hours of training with the American Lung Association and the King County Local Hazardous Waste Management Program, make an initial home visit to households shortly after they move in as well as followup visits when appropriate. During these visits, the workers assess the home environment according to the criteria of the American Lung Association’s Master Home Environmentalist program and educate residents on how to better manage their respiratory health. The health workers encourage residents to take steps to reduce the presence of asthma triggers, such as vacuuming their homes frequently, using baking soda instead of harsh cleaning chemicals, and taking their shoes off at the door. They also deliver household supplies such as Green Cleaning Kits, mattress and pillowcase covers, and vacuum cleaners with high-efficiency particulate air filters. In addition, the health workers administer an annual health needs assessment survey to all SHA residents to track outcomes such as resident health, healthcare access, and general well-being.

To further support the health of all Yesler Terrace residents, Neighborcare Health operates a community clinic in a nearby elementary school and hosts community events at Yesler Terrace such as weekly group walks and monthly health chats. SHA also designed a system of pathways and parks on the Yesler Terrace site to encourage physical activity. The Green Street Loop, a half-mile walkway featuring fitness stations and seating areas, encircles the site, and the Yesler Hillclimb provides a wheelchair-accessible route up a steep slope, along with other features, to connect Yesler Terrace to neighboring communities.

The Breathe Easy apartment features increase the per-unit construction cost by less than 2 percent; a filtered ERV system costs approximately $3,000 per unit, and the flooring in noncarpeted units costs an additional $4,000. However, SHA expects Breathe Easy features to lower healthcare costs for residents with respiratory illnesses. The annual operating cost of Breathe Easy programming is $15,000, which includes the cost of training and wages for the community health workers as well as supplies distributed to residents.

Financing Redevelopment

The total cost of SHA’s portion of the Yesler Terrace redevelopment is anticipated to be approximately $466 million (for housing, infrastructure, and amenities construction and support services) (table 2). SHA expects to fund its future phases of redevelopment with the same major sources it used to construct the 312 units it has built so far. The major sources of financing have been low-income housing tax credits and debt issued by private banks. Additional funding includes implementation grants through HUD’s Choice Neighborhoods initiative and grants from the city of Seattle. Project-based rental assistance for the very low-income units also helped SHA create the financing package. Funding from these sources left a gap of approximately $146 million, which SHA filled by subdividing lots from the 30-acre site and selling them to private developers to build mixed-income projects.

Effects of the Yesler Terrace Redevelopment

SHA has commissioned a study of the redevelopment’s effects on resident health and well-being. Funded by the Robert Wood Johnson Foundation, the study, which will be completed in 2018, draws on several quantitative and qualitative data sources, including the health needs assessment study, Medicaid claims, and resident focus group discussions. Although the study is ongoing, SHA is expecting the Yesler Breathe Easy program to have positive effects similar to those demonstrated with the High Point redevelopment. At High Point, residents with asthmatic children residing in Breathe Easy homes reported a 63 percent increase in symptom-free days and a 66 percent reduction in the need for urgent medical care after move-in. SHA is also confident of the effects of the Master Home Environmentalist program; a 1997 study by the University of Washington found that 86 percent of participating households made at least one positive behavioral change to reduce indoor home pollutants.

Apart from the Breathe Easy program, many other elements of the redevelopment have already benefited Yesler Terrace residents. SHA has partnered with several organizations to lead education, employment, and community-building initiatives at Yesler Terrace. For example, in 2016, 100 low-income children at Yesler Terrace participated in summer academic enrichment programs, and an onsite job placement specialist successfully assisted 41 Yesler Terrace residents in securing a job. In addition, a survey found a significant increase in the number of residents who regularly engaged with their neighbors and who reported being happy to live in the neighborhood. These results demonstrate SHA’s early success in building a supportive community for old and new residents alike.