by Jeff Sykes

New mapping technology, and a dedicated research center at UNCG, is giving community health and housing advocates in Greensboro the ability to focus their efforts on specific needs like never before.

Community groups like the Greensboro Housing Coalition, Cone Health System, and others, possess mountains of data showing a connection between substandard housing, environmental conditions and poor health, but it’s often difficult to translate the data for policy makers and grant proposals.

A new research center formed this year in the Office of Research and Economic Development at UNC- Greensboro, however, is using an interdisciplinary team of social scientists and geographic information systems to harness the power of that information.

The Center for Housing and Community Studies, formed under the leadership of Stephen Sills, a sociology professor with a long track record of housing research, is aggregating data from a variety of sources into geospatial maps with the potential to do much more than just paint a picture.

One point along the intersection of mapping technology and community need is nicely illustrated by the Greensboro Housing Coalition’s current work to understand and combat the prevalence of asthma cases in substandard housing. The federal Affordable Care Act contains provisions that push hospitals to get out into the community and find upstream solutions to major health concerns, said Brett Byerly, executive director of the Greensboro Housing Coalition.

Cone Health has been on the leading edge of accountability care, Byerly said. As part of an effort to understand what health factors the community is facing, Cone Health provided researchers at UNCG with patient data on asthma cases, which Sills and others have plugged into geospatial software to produce maps that help staff at GHC target their work on two projects focused on improving environmental factors contributing to asthma treatment costs.

As part of the larger Advancing Safe and Healthy Homes Initiative, in which GHC worked with residents in 120 homes in Greensboro to improve living conditions, staff had access to 40 asthma patients who previously sought treatment at Cone Health. Funded by a grant from the Kresge Foundation, the Asthma Demonstration Project let housing advocates connect with those patients, surveying their homes while looking for asthma triggers caused by housing or behavioral conditions.

That work concluded in May, but a new project launched last fall has the potential to make an even greater impact. GHC won a competitive operating agreement in September 2014 with the U.S. Environmental Protection Agency. Known as an Environmental Justice Collaborative Problem-Solving Agreement, the grant will fund work that seeks “to reduce housing-related asthma hospitalizations in lowincome, minority neighborhoods in Greensboro.”

The two-year, $120,000 grant, requires GHC staff to work with the community to help them identify issues that contribute to asthma hospitalizations and to remediate substandard housing conditions in patient homes. The work is focused on four Greensboro zip codes, but again the challenge at the outset is where to target effort?

Cone Health stepped up its contribution to the project by providing Sills and his team at the Center for Housing and Community Studies with a trove of data on asthma hospitalizations in those four zip codes. April Richard, GHC’s Healthy Homes team manager, said the center’s maps gave her a context within which to begin the work.

“They created a map that we call the ‘hot spot’ map,” Richard said. “It allows us to see the areas in those zip codes that have the highest number of asthma related hospitalizations. You want to go to the areas that are having the issues. Those maps allow us to really see if this area in this zip code is really having an issue with asthma control.”

The asthma work is targeting Greensboro zip codes 27401, 27405, 27406, and 27407, Richard said. Going into those large geographical areas blind would be like throwing a dart at a map. The work Sills and others have done to aggregate patient data and visualize it on searchable GIS tools is critical to giving the Healthy Homes team a powerful starting point.

“Data is data. It gives you one picture,” Richard said. “You need context to put with that data. Talking to the community, asking them what’s going on?

When you go out and ask them about some of their community concerns, asthma is probably not going to be what they will say.”

She noted that many would cite crime, housing affordability and quality, and lack of financial assistance as their primary challenges.

“They don’t know the statistics about how often someone is going to the hospital for asthma and heart disease and things of that nature,” Richard said. “That’s what gives you the context. Working with the community puts that data in context. Sills is using the maps to also give us some context about what is really going on. If you can see asthma lining up with structural issues then you can really start drawing some preliminary conclusions.”

Dr. Sills has strong ties to Greensboro. His greatgrandparents owned farmland in what became the Glenwood neighborhood. His grandfather built a home in Glenwood as the neighborhood took off as GIs returned from the Second World War.

“I have some deep connections to the immediate vicinity. As I walk around UNCG and the neighborhood I say ‘you know, that’s where my great aunt used to live, now it’s a parking lot. That’s where my grandmother was, now it’s part of the entrance to the Coliseum,” Sills said.

He left Greensboro in 1992 to go to the West Coast, and to travel, but returned in 2006 after receiving his PhD in sociology from Arizona State and having worked in Detroit at Wayne State University. Former GHC Director Beth McGee-Huger approached Sills in 2007 looking for help with data analysis related to the Healthy Homes grant funded by the Z. Smith Reynolds Foundation.

“We started there. We were looking at mobile home parks that were gouging Latino residents using leverage against them,” Sills said, citing the work done to combat unfair practices and unhealthy living conditions for immigrants who lacked a voice. Sills’ work had focused on feminist labor rights in Southeast Asia and then globalization research once he returned to Greensboro. His interest in challenges facing Greensboro’s immigrant community led him to begin work in housing. Sills moved on to a series of fair housing projects, many of which have been featured in academic journals and the local press. His efforts helped secure a major HUD grant to study discrimination in rental housing. According to UNCG, Sills has secured more than $200,000 in research grants and awards.

Working with Faith Action, GHC and the City of Greensboro, Sills participated in five fair housing studies between 2007 and 2013. His work gave him a deep understanding of the social and structural impediments to fair housing in Greensboro. While participating in the city’s 10-year human relations analysis in 2010, he helped build the methodology for field research in fair housing.

“All of this background in housing research kind of pulled me away from doing global work,” Sills said. “I saw more immediate need here in housing that I could actually directly influence, work on, and I felt could make a bigger difference here locally with some issues that are very global. As our city diversifies, it’s a global issue.”

Last summer Sills began to think on a deeper level about local housing issues. He’d been working with his father, Mark Sills, who has decades of experience in civil rights. The two ran a consulting firm that did a wide range of work, including working with a homeless shelter in Biloxi, Mississippi trying to rebuild after Hurricane Katrina, and with a homeless and drug rehabilitation program in Detroit, where Stephen used to work at Wayne State University from 2004-06.

“We had projects all over the place, but I needed something that was going to allow me to bring together the talents of different faculty members, graduate students, undergraduates, to really tap the resources of UNCG and focus on housing here,” Sills said.

Reflecting back on his work at the Center for Urban Studies at Wayne State, Sills decided there was a need for a similar model in Greensboro. Our state has poverty institutes and some housing research being done from the real estate, financial and legal aspects, but most of the work takes place in Raleigh and Chapel Hill. Sills wanted to unify teams of geographers, public affairs graduates, public health advocates, and the talented faculty at UNCG’s Center for Community Engaged Design.

He also wanted to build a research center that could eventually reach beyond Greensboro.

“What was missing was good data collection, good data analysis, and creative, innovative thinking about how to solve housing issues. And not just at the local level,” Sills said. “There are gaps. The rural areas are really kind of abandoned. There is nobody looking at the region as a system. It’s a transportation and economic system that also includes housing as an aspect of that. We think in terms of people moving back and forth on I-85/40 but we don’t think in terms of housing. It’s all along that corridor as well.”

He put together a proposal last fall and approached administrators with a plan for the Center for Housing and Community Studies. He felt the community needed to make use of the disparate data being collected in various ways. His vision was for a research center that could bring together the skills and knowledge in the field and amplify those efforts. Sills received a positive reaction from UNCG administrators, but was cautioned to wait while the UNC Board of Governors conducted a critical review of established centers across the state. Once that process was finished in early 2015, Sills received the green light and modest funding to provide summer pay for one faculty member and two graduate assistants.

Sills hopes to make the center self-sufficient within two years.

He jumped into the community asthma projects as a way to test the center’s ability to make use of the data being collected. “You ask a research question and then go after the data and methodology for collecting, analyzing, and interpreting data,” Sills said.

“If the data is something about space, then you can add to it a geospatial analysis.”

Having collected numerous data sets on housing, Sills was plugging the information into GIS software. Once he decided to overlay the vacant and substandard housing maps with the asthma data from Cone Health, new insights were born.

Sills can overlay known asthma cases with other data sets such as industrial pollution sites, maps of air pollution, known vacant and abandoned homes, and endless data from federal census and other government sources. This allows community groups like Greensboro Housing Coalition, and others, to look at asthma or cancer rates linked to environmental and structural factors, neurological conditions linked to lead, death by falls, and infant mortality rates.

In the case of asthma and housing, the correlation was clear. The geospatial analysis looks at the vacant house and the asthma case data and visualizes the proximity.

“Is the distance to a vacant house a predictor of an asthma case?” Sills said. “Well, I have to do the geospatial analysis to give me the data to then be able to do the statistical analysis to make that correlation. We employ the GIS to inform the statistics that then give us the answers about predictors. We’re able then to make some quality decisions.”

For example, Sills and his team are looking at the statistical role vacant housing might play in predicting asthma cases. They are examining if unemployment or living in public housing has a bigger impact than vacant housing. They are trying to determine what role proximity to environmental hazards such as landfills and superfund sites might play.

As GHC and student volunteers from UNCG conduct housing assessments, Sills and his team will plug the information in to add internal factors such as dust, mold and roach infestation.

“That data will go on the house end,” Sills said.

“We will know if in certain houses, does that play a bigger part? We know that indoor air quality is a huge element, but does the community play as big a part? Does having five vacant houses on your block that are moldy because the roofs are leaking and dust is being stirred up when people are bulldozing, and lead contamination is being released if it’s an older home, is that having a bigger effect? We will be able to look at neighborhood, social, and economic conditions.”

Sills plans continuous neighborhood surveys in partnerships with Community Housing Solutions and the Greensboro Housing Coalition. Student volunteers will conduct parcel level surveys of specific neighborhoods, beginning with the Woodmere Park area of northeast Greensboro this fall. The Center for Housing and Community Studies is working out access to powerful technology that integrates Google maps with licensed software from a Detroit-based firm, Loveland Technologies.

The software allows parcel data to be collected from a variety of sources, including city code enforcement, citizen complaints, and street surveys.

The city might know where the boarded up vacant homes are, Sills said, but they don’t know where every vacant and abandoned home is in Greensboro.

“Our data will be continuously updated while the city’s data is updated, but there have to be a certain number of neighborhood complaints before they come in and board up the house,” Sills said.

Another immediate project is to develop a universal housing assessment form than can be used by various agencies in the field. Sills hopes that CHCS can become a hub for neighborhood indicators, a resource for the community where the information they need can be stored and accessed to help inform good decision making.

An agency may have a data set of 500 homes collected over a decade, but not really know what to do with it.

“We do. We’re going to analyze it,” Sills said. “We’re going to add that to our maps. It might be crumbs off the table but we will put it together with something else to make something useful out of it.” !