Green & Healthy Homes Initiative

Full charitable recipient support; 2022–24 standalone expense series. Latest consolidated 2025 accounts disclosed separately. Conditional c includes allocated delivery/administration costs, f includes the ordinary-support portfolio share; partner repair costs must be added or explicitly attributed, not treated as free.

USA-50-states-DC-v 1 residents. Operations are predominantly domestic; g=.99 is a judgment for this narrow direct-service probe, not an observed health-weighted share. Global climate spillovers excluded.

Q_USA=(G*b*f/c)*[s*e*(d1+d2/1.03)*u/365-h]*g + G*theta_other; G=10000 computational normalization only. d1=.81*365/14; d2=.59*365/14. theta_other is net USA QALYs per unrestricted dollar from non-overlapping remaining pathways. Cost per 10=10G/Q_USA when positive.

G

10000 USD normalization (judgment). Arithmetic disclosure, not suggested gift size.

C2024

17630687 USD recipient annual expense (observed). Part IX total; all recipient functions retained. [ghhi-tax24]

c

8000 USD per completed asthma intervention (judgment). Illustrative full delivery/allocated support cost; not derived by dividing mixed services or old trial costs. [ghhi-tax24] [kattan-cost]

b

0.5 fraction (judgment). Additional spending after funding substitution/reserves; unresolved. [ghhi-tax24] [ghhi-audit25]

f

0.2 fraction (judgment). Share of ordinary marginal support reaching completed asthma work; unresolved. [ghhi-tax24] [ghhi-audit25]

s

0.7 fraction (judgment). Health gain not supplied by household/public/insurance alternatives. [ghhi-tax24] [ghhi-audit25]

e

0.75 fraction (judgment). Transport differences from the trial's delivered intervention and population only; randomized symptom differences already include trial-level nonadherence, which must not be discounted again. [morgan-asthma]

u

0.1 utility difference on symptom day (judgment). Generic utility loss per symptomatic day; not measured by the trial. [morgan-asthma]

h

0.0005 QALYs harm per completed intervention (judgment). Incremental temporary disruption, unsafe repair and downside relative to actual alternative care; not observed incidence. Shared burden cancels under identical repairs. [ghhi-tax24] [ghhi-audit25]

g

0.99 fraction (judgment). Domestic health share for the narrow probe, not location-count ratio. [ghhi-tax24] [ghhi-audit25]

d1

21.117857142857144 symptom days avoided first year (observed). Annualization of randomized 0.81/14-day difference; assumes measured intervals represent the year. [morgan-asthma]

d2

15.382142857142856 symptom days avoided second year (observed). Annualization of randomized 0.59/14-day difference; discounted 3% in model. [morgan-asthma]

theta_other

0 net USA QALYs per unrestricted USD (judgment). We adopt the cautious asthma model: $8,000 per completed intervention, 20% portfolio allocation and 50% funding response. The cost allows a broader contemporary housing bundle than the older trial; allocation is a judgment informed by a mixed portfolio, not a reported asthma spending share. Lead, falls and policy effects remain unpriced, not worthless.

Best estimate — explicit judgment: Cost: $10K; USA QALYs: 0.000579837833737864; all-population QALYs: 0.0005856947815533981. {"c":8000,"b":0.5,"f":0.2,"s":0.7,"e":0.75,"u":0.1,"h":0.0005,"g":0.99,"d1":21.117857142857144,"d2":15.382142857142856}; asthma symptom pathway only; other portfolio net health set to zero for this conditional probe, not an expected value. We adopt the cautious asthma model: $8,000 per completed intervention, 20% portfolio allocation and 50% funding response. The cost allows a broader contemporary housing bundle than the older trial; allocation is a judgment informed by a mixed portfolio, not a reported asthma spending share. Lead, falls and policy effects remain unpriced, not worthless.

Conditional asthma symptom pathway: Cost: $10K; USA QALYs: 0.000579837833737864; all-population QALYs: 0.0005856947815533981. {"c":8000,"b":0.5,"f":0.2,"s":0.7,"e":0.75,"u":0.1,"h":0.0005,"g":0.99,"d1":21.117857142857144,"d2":15.382142857142856}; asthma symptom pathway only; other portfolio net health set to zero for this conditional probe, not an expected value.

Favorable asthma assumptions, not a bound: Cost: $10K; USA QALYs: 0.02816202607489598; all-population QALYs: 0.028446490984743417. {"c":3000,"b":0.8,"f":0.6,"s":0.9,"e":1,"u":0.2,"h":0,"g":0.99,"d1":21.117857142857144,"d2":15.382142857142856}; asthma symptom pathway only; other portfolio net health set to zero for this conditional probe, not an expected value.

Poor implementation and adverse net health: Cost: $10K; USA QALYs: -0.0000018638449202496532; all-population QALYs: -0.0000018826716366158114. {"c":20000,"b":0.1,"f":0.05,"s":0.2,"e":0.25,"u":0.05,"h":0.001,"g":0.99,"d1":21.117857142857144,"d2":15.382142857142856}; asthma symptom pathway only; other portfolio net health set to zero for this conditional probe, not an expected value.

No additional work: Cost: $10K; USA QALYs: 0; all-population QALYs: 0. {"c":8000,"b":0,"f":0.2,"s":0.7,"e":0.75,"u":0.1,"h":0.0005,"g":0.99,"d1":21.117857142857144,"d2":15.382142857142856}; asthma symptom pathway only; other portfolio net health set to zero for this conditional probe, not an expected value.

Equivalent benefit available otherwise; retain harm: Cost: $10K; USA QALYs: -0.000061875; all-population QALYs: -0.0000625. {"c":8000,"b":0.5,"f":0.2,"s":0,"e":0.75,"u":0.1,"h":0.0005,"g":0.99,"d1":21.117857142857144,"d2":15.382142857142856}; asthma symptom pathway only; other portfolio net health set to zero for this conditional probe, not an expected value. Equivalent symptom benefit comes from a different, less-disruptive alternative; this extra repair adds burden. Identical replacement repairs instead have incremental h=0.

Counterfactual: b measures additional service spending rather than reserves or replacement funding; s is the fraction of asthma benefit absent without GHHI after landlord, public, insurer and other-provider alternatives. Both are currently judgmental rather than observed. h is incremental disruption or harm relative to the actual alternative. A different, less-disruptive option can deliver equivalent benefit while the extra repair adds harm; identical replacement repairs cancel shared burdens.

Attribution: f isolates completed asthma remediation from lead, energy, grants, education and policy. e discounts trial transport, adherence and delivery differences. Do not credit public grant face value, partner-financed activity or coalition outcomes in full.

We adopt the cautious asthma model: $8,000 per completed intervention, 20% portfolio allocation and 50% funding response. The cost allows a broader contemporary housing bundle than the older trial; allocation is a judgment informed by a mixed portfolio, not a reported asthma spending share. Lead, falls and policy effects remain unpriced, not worthless. Zero and adverse outcomes remain possible; the quantified pathway is not a complete portfolio valuation.

Sensitivity

• Conditional net asthma gain is 0.0046856 QALY per completed intervention. At b=.5, f=.2, c=$8,000 and g=.99, reaching $1 m per 10 requires 0.8081 QALY per intervention; $100 k requires 8.0808. These are ~172 and ~1,725 times the symptom-only probe.
• Holding narrow probe fixed, theta_other must add 0.0000099420 USA QALY/USD to reach $1 m per 10, or 0.0000999420 for $100 k per 10. This is an explicit missing portfolio yield, not a claim it exists.
• At the $17.63 m annual recipient cost scale, the $1 m threshold needs about 176.31 net USA QALYs per year and the $100 k threshold about 1,763.07, before any marginal scaling assumption.
• Public-funding leverage could improve the donor ratio but requires evidence of additional appropriations or completed repairs, donor causal share and added public resource costs; crowd-out can instead reduce b toward zero.
• Do not add avoided hospital bills to QALYs, convert IQ into health without a defensible mapping, or count fall-rate reduction as equivalent mortality reduction.

Unresolved inputs

• Current recipient-only financial reconciliation excluding subsidiary and 501(c)(4) spending.
• Next-dollar allocation to each program; committed grant coverage; unrestricted gap and contractor/referral bottlenecks.
• Completed unique asthma households with all payer costs, severity, sustained repairs and credible comparison care.
• Lead exposure reductions by age and baseline level, causal health rather than earnings/IQ bridge, duration and double counting.
• Serious injury outcome data and attributable implementation in the 461-member payer pilot; results beyond a before-after ROI forecast.
• Environmental subaward and policy portfolio implementation probabilities, causal health exposure changes, geographic health shares and marginal GHHI attribution.