Basement Wetness, Indoor Environmental Hazards, and Health in Climate-Vulnerable Urban Communities: a Community-Engaged Study

Changing precipitation patterns can intensify chronic basement wetness, amplifying health impacts in neighborhoods already affected by disinvestment and inequitable infrastructure decisions. The Health and High Water project examined links between basement wetness, microbial and radon exposures, indoor air quality, and residents’ health and risk perceptions in two predominantly Black communities in Pittsburgh, PA: flatter, poorly draining Homewood and the steeper, better-drained Hill District. The study was conducted as an academic-community partnership using a community-engaged research design, with resident data collectors from the study neighborhoods conducting household surveys and environmental sampling. Surveys and environmental sampling were conducted in 125 households with basements across both neighborhoods between March 2024 and February 2025. Household surveys captured measures of experiences with basement wetness, risk perceptions, mitigation behaviors, housing conditions, and psychological distress. Environmental sampling included 30 d of continuous indoor air quality monitoring and dust collection for microbial analysis. Over three-quarters of households reported experiencing basement wetness, yet few reported taking meaningful mitigation actions (the most common, foundation waterproofing, was reported by 28% of respondents). In the flatter Homewood neighborhood, wetness was more frequent, more severe, and more impactful. Homes in Homewood also showed higher concentrations of mold, bacteria, and nontuberculous mycobacteria than those in the Hill District. Nearly one-quarter of all sampled homes exceeded the U.S. Environmental Protection Agency radon action level of 4 pCi L ^−1 . Residents reporting neighborhood flooding or major home environment problems were more likely to meet criteria for psychological distress, while direct experiences of basement wetness were not significantly associated with distress. Findings reveal accumulating environmental health risks in these communities, with widespread basement wetness, microbial and radon exposures, and limited mitigation action occurring alongside few accessible remediation resources. Policy responses should expand and enhance healthy homes repair programs, subsidize basement wetness and radon mitigation, and better integrate housing, health, and stormwater planning.