Environmental hazards and likelihood of mitigation in renter-occupied housing units in Clark County, Nevada

ABSTRACT

Limited research exists on the effectiveness of the NV state statutes on ensuring habitability and access to essential services, and the characteristics of environmental hazards found in Clark County, NV renter-occupied units (ROUs). We examined data from the Clark County Landlord and Tenant Hotline Study to determine which ROUs are most at-risk for hazards and what factors are associated with remediation, examining age of unit, hazard type, and tenant-initiated intervention data. Results suggest that the mean age of ROUs with essential service complaints is higher than ROUs with complaints categorized as mold or other hazards. Furthermore, a tenant’s probability of getting hazards remediated was not significantly increased if they pursued different levels of intervention (e.g., landlord letter, site inspection, legal advice). The data suggests that tenants were less likely to get their hazard remediated by landlords if they had multiple complaints, lived in an older home, or had a non-essential complaint. The results of this study can be used to enhance our ability to identify higher risk ROUs given factors related to their age, environmental hazards, and level of intervention sought by tenants in order to better understand the likelihood of remediation in Clark County, NV.

KEYWORDS:

• Renter-occupied units
• environmental health
• habitability law
• healthy homes
• social determinants of health

Introduction

Over one-third of American households rent their housing (Desilver, 2021). As renters, they rely on and compensate their landlords to maintain their housing in a state that is safe and that does not compromise their health. There is an abundance of research-linking elements in the home with the health of its occupants, suggesting that housing conditions are a critical health determinant (Coyle et al., 2016; Gielen et al., 2012; Jacobs, 2011; Krieger & Higgins, 2002; Weitzman et al., 2013; Wu et al., 2007). However, there is limited research on the characteristics of environmental hazards found in these renter-occupied units (ROUs) and the processes by which landlords and tenants resolve grievances related to those hazards across the U.S. Clark County, located in Southern Nevada, is the 11th most populous county in the United States (U.S.) (Clark County NV, 2021a), with an estimated population of over 2 million people (U.S. Census Bureau, 2017). Of the over 880,000 housing units in Clark County, nearly half are renter-occupied units (ROUs) (U.S. Census Bureau, 2017). And Nevada is extremely diverse – with about 38.8% of its population identifying as non-Hispanic White (U.S. Census Bureau, 2017). Given its size, disproportionate share of ROUs, and demographics, Clark County presents a notable location to try to understand environmental hazards in ROUs and how landlords and tenants address them and draw lessons applicable in other localities.

Laws can set and can enforce minimum housing standards that are important for health, including requiring ROUs to be habitable. In the U.S., the federalist system splits power between the federal government and state governments. Many U.S. housing laws are set at the state level, including most laws about habitability. However, this does not mean that state housing laws lack similarity. The Uniform Law Commission, which creates model laws for states to consider adopting, drafted, and recommended that states adopt the Uniform Residential Landlord and Tenant Act of 1972 (URLTA) and the Revised Uniform Landlord and Tenant Act (RURLTA) of 2015 ROUs (Uniform Law Commission [ULC], 2015; Willis et al., 2017). For example, URLTA sets out a habitability requirement that landlords must comply with health-related building and housing codes; keep ROUs habitable; maintain ROU common areas, plumbing, electrical, sanitary, HVAC, and other systems; arrange for trash removal; and provide running water (ULC, 2015). At least 22 states have adopted warranty of habitability statutes that are based on this URLTA provision. Many other states were influenced by URLTA’s habitability concepts when adopting their warranty of habitability in state statutes (Noble-Allgire, 2012).

Habitability, however, does not mean healthy housing; RURLTA goes beyond habitability to promote healthy housing principles. It outlines the responsibilities of landlords and tenants to maintain a home in a habitable condition, referencing every element outlined in the Centers for Disease Control and Prevention (CDC) and U.S. Department of Housing and Urban Development’s (HUD) Healthy Housing Reference Manual (2006). Specifically, these elements address: (1) disease vectors and pests, (2) indoor air pollutants and toxic materials, (3) housing structures, (4) environmental barriers, (5) water supply and quality, (6) plumbing, (7) waste management, (8) electricity, and (9) heating, ventilation, and air conditioning (HVAC). Although each of these categories are individually important, it is equally important to examine them as a collective, interdependent system. The common solution to prevent hazards is to be proactive and continually assess, remediate, and maintain all housing hazards identified by the CDC and HUD (Centers for Disease Control and Prevention [CDC] & U.S. Department of Housing and Urban Development [HUD], 2006).

Nevertheless, habitability standards are important because they set a floor for housing safety. In Nevada, laws ensuring habitability of ROUs are outlined in Chapter 118A of the Nevada Revised Statutes (N.R.S.) (Landlord and Tenant: Dwellings, 2021). Chapter 118A of the N.R.S. has adopted elements of the URLTA and, to a lesser extent, of RURLTA (ULC, 2015; Landlord and Tenant: Dwellings, 2021; Willis et al., 2017). Nevada landlords and tenants are generally bound by lease agreements (Landlord and Tenant: Dwellings, 2021). Nevada law also requires landlords to maintain residential properties in compliance with state habitability laws as stated in N.R.S. §118A.290. Importantly, if done in good faith, landlords and tenants may agree to make tenants responsible for specified repairs and maintenance (Landlord and Tenant: Dwellings, 2021). Maintaining residential properties includes meeting specific, statutory habitability requirements, some of which are given extra emphasis and deemed “essential services” by the N.R.S. and are subject to different standards and processes (Landlord and Tenant: Dwellings, 2021).

As default, under N.R.S. § 118A.380, a Nevada landlord has 48 h, excluding weekends and holidays, to remedy or reasonably attempt to remedy a known habitability problem that impacts an “essential service” or, with some exceptions, the tenant may take steps to alleviate the problem. Essential services include a working HVAC system; utilities, such as running water, hot water, gas, and electricity; and functioning door locks (Landlord and Tenant: Dwellings, 2021). In addition, the N.R.S. requires that a rental property be in a habitable condition as outlined in N.R.S. §118A.290. This includes weather protection; functioning plumbing, water, heating facilities, air conditioning, ventilation, and electricity; garbage receptacles and removal arrangements; clean and sanitary conditions at the start of the tenancy; and basic, fundamental structures like walls, floors, and ceilings in good repair. A rental property is not habitable if it fails to comply with certain health and housing code requirements regarding health, safety, and fitness for habitation or if it has a deficiency enumerated in N.R.S. § 118A.290.

However, the N.R.S. outlines a complex process for tenants to redress habitability concerns. Usually, tenants can seek remedies only if they first notify the landlord of the violation in writing and request remediation and then the deficiencies are not addressed within 48 hours for essential services and within 14 days for non-essential habitability concerns, as outlined in N.R.S. §§ 118A.350–.380.

Tenants can seek remedies only if the violation was not related to their intentional or negligent actions per N.R.S. § 118A.355 & § 118A.380. To seek remedies for non-essential habitability violations, tenants must provide landlords sufficient property access under N.R.S. § 118A.355. To seek remedies for essential services violations, N.R.S. § 118A.380 states tenants must be current in rental payments. If remediation or at least a reasonable attempt is not achieved in the prescribed time, in addition to seeking damages or other remedies, tenants may pursue the following, depending on whether the violation involves non-essential habitability or an essential service and the projected repair costs: self-help to repair non-essential habitability problems that do not exceed the value of one month’s rent or to repair essential services problems (per N.R.S. § 118A.360 & § 118A.380); terminate the lease for non-essential habitability deficiencies (per N.R.S. § 118A.355); procure alternative housing for essential service violations (per N.R.S. § 118A.380); or withhold rent in a court-maintained escrow account (per N.R.S. § 118A.355 & § 118A.380).

Given this complexity, tenants may be unable to enforce and assert their habitability rights and even hesitate to identify and report housing problems. Explanations for this include lack of knowledge and inability to access the needed legal help. They also include difficulty and volatility in finding available housing (Flage, 2018; Tighe et al., 2017), fear of eviction, termination of lease, or other forms of retaliation by landlords. Retaliation may be especially concerning given the power imbalances between landlords and tenants, with the most vulnerable tenants being especially reluctant to challenge their landlords (Chisholm et al., 2020).

In addition to habitability laws, housing code enforcement also has been used to address inadequate housing conditions. Code enforcement agencies could be especially helpful in driving safe housing but research shows that building inspectors are often unable to ensure resolution of all violations or can lack jurisdiction for interior housing concerns (Horner, 2019; Stacy et al., 2019). Bartram (2019a, 2019b) has also found that when code enforcement is able to pursue violations, the end result can further inequality in housing through higher rental prices or retaliatory landlord actions, and that there is variability in how violations are addressed based on property owner/landlord economic standings. Some localities, including Clark County, NV, also focus their code enforcement to violations of building code related to exterior, structural, or beautification issues (Clark County, NV, 2021b; Stacy et al., 2019). This means that many housing inadequacies in Clark County, NV are not under the jurisdiction of code enforcement and must be pursued according to the Chapter 118 of the N.R.S (Clark County, NV, 2021c). Furthermore, in an area like Southern Nevada, with various municipalities and affiliated housing codes and code enforcement agencies, the state habitability requirements set a uniform floor for the habitability conditions of ROUs that apply throughout the Las Vegas, NV metropolitan area and the state.

Despite the existence of URLTA and RURLTA and manystates, including Nevada, adopting their provisions, there is little research on whether state habitability laws are adequate to produce ROUs that are habitable and contain essential services. Understanding the common environmental hazards in ROUs and how they may deviate from habitability requirements as well as compliance with and use of legal processes created to ensure habitability and access to essential services in those ROUs would help determine whether the status quo is sufficient. It would also benefit public health because research has linked the conditions of housing to the health of occupants. Many environmental hazards in the home can lead to various injuries, morbidities, and mortality (CDC & HUD, 2006; Coyle et al., 2016).

The purpose of this study is to explore gaps in knowledge surrounding identification of higher risk ROUs given factors related to their age, environmental hazards, and level of intervention sought by tenants in order to better understand the likelihood of remediation. The more efficient we are at identifying these ROUs, the earlier interventions can be applied, which is important to population health and those most vulnerable, as they are the most likely to live in homes that contain environmental hazards. The goals of this study were to (1) examine if the age of the ROU was associated with environmental hazards; (2) understand if the likelihood of remediation differed for tenants who pursued different levels of intervention (i.e., receiving a site inspection from the Southern Nevada Health District (SNHD) – the regional health department for Clark County) vs. seeking legal advice from an attorney and legal recourse); and (3) identify factors associated with the likelihood of remediation.

Methods

We utilized data from the Clark County Landlord and Tenant Hotline Study (CCLTHS) to evaluate and address the goals of this project based on thesis research conducted by Bertran (2018). The CCLTHS is a University of Nevada, Las Vegas (UNLV) and SNHD collaboration that collects information regarding the conditions of ROUs in Clark County and assists landlords and tenants with grievances regarding hazards found in ROUs (Marshall et al., 2018). A component of the hotline obtains consent from those willing to participate and then (1) obtains additional information regarding household demographics, (2) collects details of the complaint(s), (3) schedules a site inspection performed by the SNHD, and (4) conducts a follow-up survey about the outcomes of the complaint and related habitability issues.

Participants

The CCLTHS database contained 3,326 logged hotline calls between March 2014 and September 2016. A final dataset of verbally consented cases that met the following inclusion criteria were used for this study: (1) the caller was a tenant or landlord of a private ROU in Clark County, NV, and (2) the caller had a qualified complaint defined in N.R.S. Chapter 118A as an ROU habitability or essential service issue. Calls regarding owner-occupied homes or units, public housing, public accommodations, properties outside Clark County, NV, or complaints that were not considered essential service or habitability issues as defined in N.R.S. Chapter 118A were excluded. A final dataset of 520 consented cases that answered the CCLTHS follow-up survey were included in this analysis.

Measures

Participants were asked to self-report household demographics, including age, gender, race and ethnicity, and categories of reported hazard(s) (mold, general maintenance, bedbugs, cockroaches, other insects, heating ventilation and air conditioning [HVAC] outages, odors, water outages, electric or gas outages, rodents, domestic animals, pigeons, hoarders, environmental tobacco smoke [ETS], and other hazards). These hazards primarily involved issues pertaining to essential services and habitability. For analysis purposes, categories were condensed because some of the hazard categories contained small sample sizes. The condensed categories were: (1) Pests/animals: bedbugs, cockroaches, other insects, rodents, domestic animals, and pigeons; (2) Essential services: HVAC outage, water outage, electric/gas outage; (3) Mold; (4) General maintenance; (5) Other: odor, hoarding, ETS, and other. Participants also self-reported the actions they took as a result: (1) sent a letter to their landlord, (2) received a site inspection from SNHD, (3) sought legal advice (defined as consulting with an attorney about these issues), and (4) filed a related claim in court. Participants also reported whether the hazards were ultimately remediated. ROU age was reported by participants and verified using the Clark County Assessor’s website.

Analysis

An analysis of variance (ANOVA) was utilized to determine if the average age of ROUs differed as a function of the type of environmental hazard reported. Post hoc comparisons were performed using Bonferroni’s method to protect for Type I error. A chi-square test of homogeneity was conducted to determine if there was a statistically significant difference in the proportions of hazards remediated by tenants who pursued different interventions. A binary logistic regression model was used to examine if there was a statistically significant relationship between the remediation of a reported hazard and the age of an ROU, the number of complaints made by a tenant, or complaint category. All distributional and modeling assumptions were met for the included analyses. All analyses were performed using SPSS software (v. 24; IBM, Armonk, NJ) with a defined significance level of p ≤ 0.05.

IRB and data management

The Institutional Review Board (IRB) of the University of Nevada, Las Vegas granted an exempt status for this study [protocol #1291742–1]. Data, document, and record use ensured the identities of study participants could not be revealed.

Results

Descriptive statistics

A full description of summary statistics of demographics collected and tenant complaints can be seen in Table 1. There were 521 cases in the CCLTHS follow-up study, with a majority of callers self-reporting as female (n = 355, 68.1%), Non-Hispanic/Latino (n = 406, 77.9%), White (n = 295, 56.6%), and living in the City of Las Vegas (n = 430, 82.5%). Of the 520 consented cases in the final data set, 736 complaints were made and the number of complaints made by each tenant ranged from one to five, with the majority of tenants, 355 (68.3%), registering only one complaint. The top three primary complaint types per case were mold (n = 205, 39.4%), pests/animals (n = 131, 25.1%), and general maintenance issues (n = 91, 17.5%). The majority of cases had complaints that fell under the non-essential service category (n = 415, 79.7%).

Table 1. Descriptive summary statistics of Complainants from a sample of tenants or landlords of a Private rental occupied unit in Clark County, NV.

Measure	Category	Frequency	%
Gender	Male	164	31.5
	Female	355	68.1
	Other/Missing	2	0.4
Ethnicity	Hispanic/Latino	106	20.3
	Non-Hispanic/Latino	406	77.9
	Other/Missing	9	1.7
Race	Am. Ind./AK Native	4	0.8
	Asian	7	1.3
	Black/African Am.	129	24.8
	White	295	56.6
	Other/Missing	86	16.5
City	Henderson	50	9.6
	Las Vegas	430	82.5
	North Las Vegas	37	7.1
	Other	4	0.8
Complaint Year	2014	172	33.0
	2015	166	31.9
	2016	182	34.9
Number of Complaints	1	355	68.1
	2	125	24.0
	3	30	5.8
	4	9	1.7
	5	1	0.2
Primary Complaint Type	Pest/Animals	131	25.1
	Essential Services	72	13.8
	Mold	205	39.4
	General Maintenance	91	17.5
	Other	21	4.0
Total Complaint Type^1	Pest/Animals	191	26.0
	Essential Services	123	16.7
	Mold	205	27.9
	General Maintenance	171	23.2
	Other	46	6.3
Service Type	Essential Service	67	12.9
	Non-Essential Service	415	79.7
	Both^2	39	7.4

¹Tenants could report multiple complaints, among the 521 respondents, 736 total complaints were made. ²Tenant reported multiple complaints that fell under both service types. *Am. Ind.=American Indian.

When asked if their grievance was resolved, 23 (34.8%) tenants with essential services complaints reported no resolution, 279 (67.9%) tenants with non-essential complaints reported no resolution, and 30 (78.9%) tenants with both essential and non-essential complaints reported no resolution. Collectively, 332 (63.8%) tenants reported no resolution. Forty-two (8.1%) tenants reported that they filed a claim in court. The age of ROUs was normally distributed, with a mean of 29.8 years (n = 451), 95% CI [28.5, 31.1].

Age of ROU and environmental hazards

Of the 736 total complaint types, see Table 1, the most reported hazard was mold (n = 205), followed by pests/animals (n = 191) and general maintenance (n = 171). The mean age of ROUs was highest for essential services complaints (35.27 years), followed by general maintenance complaints (31.99 years). See Figure 1 for the number of complaints and mean ROU age in years by hazard category. An analysis of variance (ANOVA) indicated that the mean age of ROUs was significantly different among hazard categories, F(4, 445) = 5.11, p < 0.05. A Bonferroni analysis revealed statistically significant mean differences between essential services ($\bar{x}$ = 35.27, SD = 16.59) and mold ($\bar{x}$ = 27.64, SD = 12.77; p < 0.05) and essential services and other hazards ($\bar{x}$ = 23.25, SD = 11.62; p < 0.05), with the mean age of ROUs being higher for essential services complaints.

Figure 1. Number of complaints (bars) and mean rental occupied unit (ROU) age in years (line) by hazard category from a sample of tenants or landlords of a Private ROU in Clark County, NV.

Environmental hazards remediated by different interventions

Of the 520 consented cases, only 71 tenants completed some level of intervention. The data indicate that 16.7% (n = 2) of the 12 tenants who only sent a letter to their landlord were able to get their hazard remediated, compared to 35% (n = 14) of the 40 tenants who sent a letter and received a site inspection by the SNHD, and 36.8% (n = 7) of the 19 tenants who sent a letter, received an SNHD site inspection, and sought legal advice. A chi-square test of homogeneity suggested that there was no statistically significant difference in the proportions of hazards remediated by tenants who pursued different levels of intervention, X² = 1.65, p = 0.439.

Factors Associated with likelihood of remediation

A binary logistic regression was performed to determine if (1) the age of an ROU, (2) the number of complaints made by the tenant, or (3) whether a complaint was categorized as essential or non-essential were associated with the likelihood of remediation. A Hosmer and Lemeshow goodness-of-fit test indicated that the model was a good fit to the data, X²(8) = 2.69, p = 0.952.

Age of the ROU and complaint categorization predicted the likelihood of remediation (p = 0.003). For each increase in the age of the ROU by 1 year, the likelihood of remediation decreased by 2.5% (95% CI: 0.1%, 4.0%). For tenants with one complaint, the odds of remediation were 1.75 times (p = 0.030; 95% CI: 1.06, 2.89) that of tenants with multiple complaints. For complaints categorized as essential, the odds of remediation were 4.15 times (p = 0.013; 95% CI: 1.36, 12.67) that of complaints categorized as non-essential.

Discussion

This study examined data from the Clark County Landlord and Tenant Hotline to better understand environmental hazards found in ROUs and determine factors associated with remediation. We found that mold was the most reported environmental hazard and that the older ROUs were more likely to have complaints regarding essential services. We also found that the tenant-initiated level of intervention – that is, whether a tenant sent a letter to the landlord, SNHD performed an ROU inspection, the tenant sought legal advice, or filed a claim in court – was not associated with the likelihood of remediation. However, ROU age and whether or not the complaint was essential were associated with the likelihood of remediation. These findings present valuable information on what ROUs look like and how ROU deficiencies are addressed under the current system of habitability laws.

The presence of mold was the most common complaint. This is a concern because mold in the home has been linked to numerous health conditions including upper respiratory tract symptoms, cough, wheezing, diagnosed asthma, asthma development (Fisk et al., 2006), rhinitis (Jaakkola et al., 2013), and depression (Shenassa et al., 2007). Since nearly 35% of study participants reported mold, efforts targeting prevention and/or early mitigation of mold hazards in ROUs in Clark County may be warranted. Further, compared to the other groups, mold was more likely to be associated with newer homes. This coincides with research that suggests that the introduction of gypsum drywall into the structural elements of homes increased the chances of mold growth compared to plaster and lathe (Vesper et al., 2016). This is due to the binders and additives that are found in the gypsum drywall, which fosters an ideal environment for fungal growth (Vesper et al., 2016). It would therefore not be surprising if mold was a major concern in other U.S. jurisdictions outside of Clark County, especially those with newer construction or otherwise similar housing stock.

Essential services complaints were most common in ROUs with the highest mean age. Essential services complaints pose the most immediate risk to the health and well-being of tenants, and those who live in older homes appear most vulnerable. ROU age may be a useful metric to help target certain properties for inspections and evaluations, in Clark County and in other communities in and out of the U.S., to determine if they are meeting habitability and essential service requirements prior to any failures or imminent risks to health and safety. Additionally, this information may be useful for policy makers across communities, as well as landlords, in anticipating needs and securing adequate funding to identify and mitigate such hazards. For example, it may lead to targeted establishment and use of rehabilitation, weatherization, and home improvement to assist qualified landlords and tenants with the cost of repairs to their homes.

Although statistically significant, the mean age difference between essential services and hazards categorized as “other” provided little insight because the “other” category aggregated four types of hazards with small sample sizes compared to the other categories.

Most strikingly, 63.8% of tenants reported that their grievances were not resolved. This indicates that, overall, tenants have trouble addressing inadequacies in their ROUs. The staggering proportion of tenants whose concerns were unaddressed is unsurprising given the many explanations for why tenants struggle with enforcing their rights – lack of knowledge, resources, and legal assistance; fear of retaliation; and power imbalances between tenants and landlords (Chisholm et al., 2020). These explanations and the alarmingly high rate of unresolved complaints found in this study underscore questions about the adequacy of existing legal mechanisms, processes, and systems to address habitability concerns in Nevada. Because both Nevada and almost all other U.S. states either incorporate URLTA’s habitability concepts into their statutes or are at least influenced by them, existing legal mechanisms, processes, and systems may be insufficient to resolve habitability concerns in other states too.

The data did not suggest a statistically significant difference in the proportions of hazards remediated by tenants who pursued different levels of intervention. However, the proportion of tenants whose hazards were remediated did increase with each additional intervention. The proportion of tenants who were able to get their hazards remediated was more than two times higher in those who sought more than one level of intervention. The sample size for each intervention group was relatively small and could explain the statistical insignificance. Each level of intervention, a site inspection or legal advice, places the tenant with an expert in either the environmental hazard or legal profession. This could have led to tenants making more informed decisions about how to address hazards or providing them with access to professionals who could help navigate this field. At the same time, this highlights the burden on tenants to seek multiple ways to redress the grievance in the current system.

The data suggest that to be in the best position to get a hazard remediated, a tenant should reside in a newer ROU and have one complaint categorized as an essential service. This is of concern because the mean age of ROUs in each hazard category ranged from 23.25 to 35.27 years, and older ROUs will inherently experience more housing-related hazards than newer ones. Our findings also highlight the potential for health and housing inequities, as those most likely to live in older homes in Clark County, NV, may be the most vulnerable, such as lower-income individuals and families and older adults. In Clark County and in other communities, resource limitations may make it difficult for renters to cover or make advance payments for any remediation costs themselves or to have the financial means to remove themselves from homes without having their credits or eviction histories negatively impacted. A previous analysis of a subset of Clark County Landlord Hotline Study data did not find an association between the income of callers and resolution of their complaints (Marquez et al., 2022). However, it has been documented that socioeconomic status or income level influences the condition of housing accessible to occupants, and, to an extent, the resources available to a landlord for maintenance of properties (Bartram, 2019a; Evans & Kantrowitz, 2002). This may provide a potential explanation for the greater hazard remediation among tenants living in newer ROUs with fewer essential complaints in that these occupants may have benefited from higher socioeconomic status and therefore were able to afford ROUs owned or managed by higher resourced landlords.

It should be no surprise that the odds of remediation of essential service complaints were 4.15 times that of non-essential complaints. Essential services, as defined, are also some of the most basic features of healthy housing and may garner greater concern by both landlords and tenants. The absence of essential services, such as a working HVAC system during the summer in Clark County, can lead to immediate negative health outcomes. By default, the N.R.S. gives the landlord 48 h to remedy essential service hazards (Landlord and Tenant: Dwellings, 2021). The nature of the complaint and the short time allotted by the N.R.S. to remedy it could give the tenant more leverage when seeking remediation from their landlord.

The number of non-essential habitability complaints that were not remediated is of concern. Non-essential habitability complaints, such as general maintenance issues, might not pose the degree of immediate risks compared to essential services, but often are associated with subsequent essential services hazards. Additionally, individuals who are vulnerable, such as those with asthma, are more likely to experience negative outcomes from issues such as pests (Leas et al., 2018), which may not be “essential” under the N.R.S. but pose important health hazards. Greater attention to these issues could reduce the incidence and severity of future hazards and associated health consequences.

Finally, the odds of remediation were significantly higher if the tenant had a single complaint. This could indicate some element of uniqueness in relation to ROUs with one hazard. For example, those landlords may be more responsive to tenant requests or to general maintenance required to keep ROUs in good condition and habitable. Conversely, landlords of ROUs with multiple hazards may have different management practices and be less responsive to requests and overall upkeep. Additionally, tenants that live in ROUs with multiple hazards may be different in some capacity than those living in ROUs with one hazard, as disparities in substandard housing and landlord-tenant power imbalances exist. Additionally, the decrease in odds of remediation associated with multiple complaints could indicate the financial burden placed on landlords to remedy several complaints simultaneously. Landlords also may be less likely to address non-essential complaints because the requirements to do so differ from those applicable to essential services. Further investigation into this phenomenon is warranted.

To be sure, there are a number of reasons why tenants may not seek remedies for housing and habitability violations. Racial discrimination in the housing market is well documented and may lead to disparities in remediation. In one meta-analysis of 25 different studies, Flage (2018) concluded that discrimination in the rental house market is apparent, with “minority applicants hav[ing] 47% lower odds than majority applicants of receiving a positive response or being invited to provide further information from a private landlord or a real-estate agent” (Flage, 2018, p. 261). Studies also confirm that racial discrimination is apparent in the mortgage market as well, with Black and Hispanics being rejected at higher rates and having higher mortgage costs compared to their white counterparts (Quillian et al., 2020). Additionally, persons of color are less likely to be shown or made aware of available housing units (Quillian et al., 2020; Turner et al., 2013). In a similar manner, socioeconomic discrimination has a role in the landlord-tenant power dynamic, with lower income renters also being relegated to certain areas geographically and having fewer housing options (Flage, 2018; Tighe et al., 2017). Not only is housing discrimination a social justice issue that is associated with numerous negative health outcomes (Cross et al., 2023), inequitable access to housing limits economic opportunities, and finding habitable housing is much more difficult and volatile for those with low income and persons of color. While our study did not examine socioeconomic or racial discrimination, the extant literature on the topic is sufficient to presume that it has a role in the landlord–tenant relationship, and thus, decisions to seek remediation for habitability violations.

Limitations

This study was not without limitations. The data were self-reported. The complaints made to the hotline were not independently verified, unless the tenant qualified and opted for a SNHD site inspection; only 40 out of 520 cases received site inspections. Only 53 cases provided the hotline with a copy of the letter sent to their landlord. This study also had a relatively small sample size, which may not be representative of the Clark County renter community. Clark County tenants might have not been aware of the existence of the hotline, as little outreach was conducted and the only link to it can be found on the SNHD website, or otherwise chose not to contact the hotline. Additionally, those that sought hotline assistance may have already requested remediation from their landlord but were unhappy with the outcomes or felt that remediation was not taking place in what they perceived to be an acceptable amount of time. Also, those who lack the financial means and/or social capital might have been reluctant to call the hotline. This includes those who fear landlord retaliation, discrimination and/or volatility in available homes, and those with citizenship and/or language barriers. The extent of tenant participation may have been limited due to the participant being evicted or moving before a resolution. Collectively, study participant characteristics may have resulted in selection bias.

Recommendations to improve habitability in ROUs in Clark County NV

Nevada’s landlord and tenant habitability statutes contain elements of URLTA and, to a lesser extent, RURLTA model legislation and is considered among the stronger pieces of legislation in the nation (ULC, 2015; Landlord and Tenant: Dwellings, 2021; Willis et al., 2017). Despite this, 63% of participants reported not having hazards remediated. This indicates that the statutes as written, coupled with how they are implemented and enforced, do not seem to address most problems from the tenants’ perspectives. Since so many other states base their habitability laws on URLTA, similar concerns may also emerge in other U.S. states. At the same time, those who live in ROUs are more likely to be lower income, and thus, are more vulnerable to negative housing conditions (U.S. Department of Housing and Urban Development [HUD], 2005). There is a need to bridge the disconnect between those in most need of assistance with healthy housing conditions and the legislation created to protect them. Policy changes to simplify implementation, expanding and improving aid tools such as the Landlord and Tenant Hotline, expanding access to legal assistance, and providing landlords with additional resources targeted to remediate habitability concerns could help bridge this disconnect. While these policy discussions focus on Clark County and Nevada, they are useful for other states with similar legal mechanisms, processes, and systems around habitability also to consider.

Policy changes

Given the significant disparity between the likelihood of remediation of an essential service and non-essential service, reducing the number of allowable days to remediate or make reasonable progress toward remediation of a non-essential service could (1) increase the landlord’s perceived urgency to remediate the hazard, (2) improve tenant satisfaction and/or (3) reduce the likelihood of the tenant defaulting on rent or moving out. In addition, given the prevalence of mold as a complaint and its connection to health, explicitly clarifying in the N.R.S. that the statewide definition of habitability includes the absence of mold may further support the idea that there should be no visible mold in a habitable residence and that landlords and tenants need to be informed about this. California, for example, has adopted this approach and included “visible mold growth” as one of the features that could deem a building “substandard” (California Health & Safety Code, 1961). This may benefit both Nevada and other states that incorporate URLTA elements into their habitability laws.

Further, regulatory changes that require an inspection before any new tenant moves in could ensure a baseline of quality housing. Options may include having both parties inspect the ROU together to identify and address habitability and essential services issues, or to have a professional inspection by a private company, the SNHD, or local code enforcement agencies. Although the upfront cost of this option would be higher, an inspection performed by a professional could yield findings that would otherwise have been missed, saving the landlord time and money in the long term and potentially avoiding negative health consequences through early identification and remediation. Additionally, policy changes to require periodic inspections of all ROUs beyond a certain age to obtain and/or maintain licensure could also be considered; this could be especially effective given the apparent link between older ROUs and essential service complaints. This too may be a valuable option in other jurisdictions that can build on existing approaches in other localities.

In fact, policy changes similar to the ones proposed above have been implemented in other U.S. cities. Kansas City, MO was successful in passing a Healthy Homes Initiative to address home health hazards through a complaint driven rental property inspection policy program (Rhoads et al., 2021). Other cities including Boston, MA and Seattle, WA have versions of proactive rental inspections where rental properties are registered and inspected every 5–10 years (City of Boston, 2022; City of Seattle, 2023). These programs do not void the need for landlord and tenant habitability laws but are additional means for verifying that rental properties meet a set housing standard.

Finally, SNHD does not have jurisdictional enforcement over the state of ROUs. Its powers are limited to performing site inspections and providing the tenant with a report of its findings. Although a site inspection report can be useful to catalyze remediation or in a civil action, it may be insufficient to obtain landlord compliance. Granting SNHD the ability to cite landlords could help increase the likelihood of remediation, reduce the time and money spent on litigation, and stave off negative health consequences associated with certain hazards. With the requisite authority, public health agencies like SNHD can be important partners to ensure safe and healthy housing.

Hotline improvements

The goal of the Landlord and Tenant Hotline was to help bridge the gap between tenants in need and the laws created to protect them by acting as a conduit to educational and legal resources. However, improvements to the Hotline may aid in achieving this goal. First, data are currently self-reported. Instilling a mechanism to verify the validity and accuracy of the tenant’s claims and steps taken to get the hazard remediated could produce a more accurate picture of ROU hazards in Clark County, support resolutions, and ultimately increase ROU habitability. The verification process may include site visits by local code enforcement agencies or SNHD. Alternatively, the tenant could provide photographic evidence of the hazard to the hotline. Second, expanding the hotline partnerships to include legal professionals and organizations, such as legal aid attorneys, could increase ease and reduce barriers to tenants seeking legal advice and assistance. Third, increasing awareness of and accessibility to the hotline through enhanced outreach could expand the reach of the hotline. Currently, information about the hotline can only be found on the SNHD’s website and is only available in English. This limits participants to those who are actively seeking information about ROU hazards, habitability issues, and/or landlord/tenant issues, those with access to the internet, and those who speak English. Finally, the creation of a smartphone application could help streamline the process by providing N.R.S. information, enabling photo uploads, the ability to schedule a site inspection with SNHD, and may reach tenants who are reluctant to talk to a hotline operator. The application could also benefit hotline operators by reducing their call volume. These lessons can be useful to improve the Landlord and Tenant Hotline in Clark County; and they can also be helpful to consider for other jurisdictions operating or creating similar hotlines.

Landlords

Owning and maintaining a rental property requires a substantial financial commitment. However, one should not assume that the landlord has the financial means to upkeep an older property, knowledge of the potential environmental hazards in their properties, or knowledge of Nevada’s landlord and tenant laws. Proactively reaching out to landlords who own ROUs most at risk for habitability and essential service issues could help to reduce environmental hazards in homes and circumvent the associated negative health outcomes. Educational outreach ensuring landlords are aware of services or financial assistance programs, such as weatherization assistance programs, could help reduce the financial burden associated with making an ROU fit for habitation. Finally, licensure to operate an ROU could be contingent on the completion of mandatory courses provided by SNHD or code enforcement aimed to educate landlords of the landlord-tenant statutes, the importance of healthy housing, how to identify and prevent environmental hazards in the home, and available assistance programs. Licensure could also be contingent on proving financial solvency and ability to fund ROU upkeep and repair. Tulsa, OK, for example, has a “Gold Star Landlord” program that incorporates these concepts to support landlords, provides healthy homes education, works to increase availability of affordable housing, and seeks higher compliance with housing codes and laws (Tulsa, 2023).

Conclusion

Our study findings suggest that essential service complaints are more common in older ROUs, and that the probability of hazard remediation was not associated with different levels of intervention (e.g., landlord letter, site inspection, legal advice). Further, the likelihood of remediation was greater for tenants having only one complaint, those having essential service complaints, and those living in a younger ROU. The current study contributes to the understanding of common environmental hazards in ROUs and the relationship between ROU age and hazards. It also enhances our knowledge on the likelihood of remediation for various types of interventions. Public health and housing professionals can use this information to identify ROUs at risk for hazards more quickly in order to promote health and equity for ROU tenants and ultimately to improve population health. Adopting and implementing the above recommendations in Clark County, Nevada, and other jurisdictions operating in similar habitability landscapes could enhance the services available to tenants in handling habitability issues, strengthen the ability to mitigate negative health outcomes, and enhance overall public health.

Author contribution

Conceptualization – JB, CC, MG, SG, MM; Data collection – MM, SG; Data analysis and interpretation – JB, CLC; Writing original draft – JB; Writing review and editing: all authors Supervision: CC, SG

Availability of data and material

Data can be available upon written request to the corresponding author.

Consent to participate

Consent participation in the Clark County Landlord and Tenant Hotline Study was approved by UNLV IRB (protocol #1312–4664, approved 02/07/14).

Consent for publication

The authors would like to acknowledge that this work stems from a study that was conducted and published as an MPH thesis. We do have the right to republish the data. All authors have approved of the final version of the manuscript being submitted and it is not under consideration for publication elsewhere.

Ethics approval

Data analysis in this study was approved for IRB exemption by UNLV.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The research leading to the data analyzed in this paper received funding from the U.S. Department of Housing and Urban Development’s Office of Lead Hazard Control and Healthy Homes [grant number: NVHHU0020-13].

Notes on contributors

Shawn L. Gerstenberger

Shawn L. Gerstenberger is Dean of the School of Public Health at the University of Nevada, Las Vegas. Shawn’s research interests focus on childhood lead poisoning prevention and the impact of the built environment on human health. He is the founder of the Nevada Healthy Homes Partnership.

Jorge L. Bertran

Jorge L. Bertran is Researcher of Environmental and Occupational Health at the University of Nevada, Las Vegas, School of Public Health. Jorge’s research interests include environmental home health, lead poisoning prevention, and consumer safety.

Melissa J. Marshall

Melissa J. Marshall is Lecturer of Environmental and Occupational Health at the University of Nevada, Las Vegas, School of Public Health. Melissa’s research interests are in environmental home health, lead poisoning prevention, and occupational health and safety training.

Courtney Coughenour

Courtney Coughenour is Associate Professor of Environmental and Occupational Health at the University of Nevada, Las Vegas, School of Public Health. Courtney’s research interests are in the area of Health & Place, specifically the association between the built environment and health behaviors, health outcomes, and health disparities. This includes the exploration of the causes and consequences of food and housing insecurity, opportunities for physical activity, pedestrian safety and injury prevention, and bias that may impact health outcomes and health equity related to community design.

Maxim Gakh

Maxim Gakh is Associate Professor of Environmental and Occupational Health at the University of Nevada, Las Vegas, School of Public Health and the Associate Director of the UNLV Health Law Program. His research interests center on the intersection of law, policy, and public health and investigates how legal mechanisms and policies can improve or hinder the health of communities. This includes exploring the government’s legal authority to promote public health, laws relevant to public health emergencies, and laws and policies outside the health sector that impact health.

Chad L. Cross

Chad L. Cross is Professor-in-Residence of Biostatics and Epidemiology at the University of Nevada, Las Vegas, School of Public Health. Chad’s research interests include investigations in population health with a special emphasis on quantitative methodology and use of large databases; applications of statistics and epidemiological principles to problems in the health, environmental, ecological, and psychological sciences; and applied research and field work in arthropod-borne and parasitic diseases.