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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (30 June 2017) | Viewed by 78584

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Prof. Dr. Philippa Howden-Chapman

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Guest Editor

He Kainga Oranga/Housing and Health Research Programme, Department of Public Health, University of Otago, Wellington, New Zealand
Interests: housing and health; reducing inequalities; carbon mitigation policies; evidence-based policy

Special Issue Information

Dear Colleagues,

In the developed world, we spend most of our time indoors, inside our homes, and this is particularly so for the very young and old, whose health is more vulnerable. The quality of our houses, and particularly the indoor environment, is a critical exposure for occupants’ health and well-being. It is essential we can demonstrate the causal relationships between different aspects of housing and health through robust research. For example, retrofitting existing houses for energy efficiency as part of the green economy has co-benefits for health and well-being, as well as carbon mitigation.

As populations become more mobile and there is an increase in migration and refugees, designing an adequate supply of flexible housing and apartment spaces, so that several generations can live together securely without being crowded, and changing needs over the life course can be met, requires innovative designs and governance strategies. Severe housing deprivation increases close-contact infectious diseases, as well as stress and mental health problems.

While housing is the only major asset most households have, in many developed countries home ownership rates are declining, and renting from private landlords is becoming more common. As social and council housing is declining in many countries and people are paying a greater proportion of their disposable incomes for housing costs, there is an urgent need to work out ways of effectively regulating the quality in the private rental market and trying new housing (including tenure) arrangements.

In developing countries, informal settlements and slums have spread around most urban areas. Here, the lack of formal infrastructure makes households very vulnerable to extreme climate events. Yet these households’ needs for clean water, sanitation and reliable renewable energy supplies are urgent and growing.

In this Special Issue we are looking for a range of innovative research and evidence-based policy ideas that demonstrate just how important housing research and policy is for health and well-being.

Prof. Dr. Philippa Howden-Chapman
Guest Editor

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Keywords

housing interventions to improve health and environmental outcomes
co-benefits of retrofitting housing
evidence-based policies to improve health

Published Papers (13 papers)

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Research

300 KiB

Open AccessArticle

Setting Housing Standards to Improve Global Health

by Philippa Howden-Chapman, Nathalie Roebbel and Elinor Chisholm

Int. J. Environ. Res. Public Health 2017, 14(12), 1542; https://doi.org/10.3390/ijerph14121542 - 09 Dec 2017

Cited by 29 | Viewed by 6184

Abstract

Developing World Health Organization international guidelines is a highly formal process. Yet the resulting guidelines, which Member States are encouraged, but not required to adopt, are a powerful way of developing rigorous policy and fostering implementation. Using the example of the housing and health guidelines, which are currently being finalised, this paper outlines the process for developing WHO guidelines. This includes: forming a Guidelines Review Group that represents all regions of the world, and ensures gender balance and technical expertise; identifying key health outcomes of interest; commissioning systematic reviews of the evidence; assessing the evidence; and formulating recommendations. The strength of each recommendation is assessed based on the quality of the evidence, along with consideration of issues such as equity, acceptability, and feasibility of the implementation of the recommendation. The proposed housing guidelines will address: cold and hot indoor temperatures, home injuries, household crowding, accessibility and access to active travel infrastructure. Full article

(This article belongs to the Special Issue Housing and Health)

641 KiB

Open AccessArticle

Measuring the Effect of Housing Quality Interventions: The Case of the New Zealand “Rental Warrant of Fitness”

by Lucy Telfar-Barnard, Julie Bennett, Philippa Howden-Chapman, David E. Jacobs, David Ormandy, Matthew Cutler-Welsh, Nicholas Preval, Michael G. Baker and Michael Keall

Int. J. Environ. Res. Public Health 2017, 14(11), 1352; https://doi.org/10.3390/ijerph14111352 - 07 Nov 2017

Cited by 20 | Viewed by 7371

Abstract

In New Zealand, as in many other countries, housing in the private-rental sector is in worse condition than in the owner-occupier housing sector. New Zealand residential buildings have no inspection regime after original construction signoff. Laws and regulations mandating standards for existing residential housing are outdated and spread over a range of instruments. Policies to improve standards in existing housing have been notoriously difficult to implement. In this methods paper, we describe the development and implementation of a rental Warrant of Fitness (WoF) intended to address these problems. Dwellings must pass each of 29 criteria for habitability, insulation, heating, ventilation, safety, amenities, and basic structural soundness to reach the WoF minimum standard. The WoF’s development was based on two decades of research on the impact of housing quality on health and wellbeing, and strongly influenced by the UK Housing Health and Safety Rating System and US federal government housing standards. Criteria were field-tested across a range of dwelling types and sizes, cities, and climate zones. The implementation stage of our WoF research consists of a non-random controlled quasi-experimental study in which we work with two city-level local government councils to implement the rental WoF, recruiting adjoining council areas as controls, and measuring changes in health, economic, and social outcomes. Full article

(This article belongs to the Special Issue Housing and Health)

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496 KiB

Open AccessArticle

Living Arrangements and Health-Related Quality of Life in Chinese Adolescents Who Migrate from Rural to Urban Schools: Mediating Effect of Social Support

by Haiyan Wu, Shan Wu, Haibo Wu, Qiming Xia and Ningxiu Li

Int. J. Environ. Res. Public Health 2017, 14(10), 1249; https://doi.org/10.3390/ijerph14101249 - 19 Oct 2017

Cited by 14 | Viewed by 3703

Abstract

Changes in living arrangements (from living with, or not living with family) may affect the health-related quality of life (HRQoL). This study aimed to investigate the impact of living arrangement on HRQoL among adolescents migrating from rural to urban schools, and whether social support, in addition to living with a family, had an impact. A cross-sectional survey of 459 school adolescents was carried out in two public schools in Guyuan County, Ningxia Hui Autonomous Region, China in 2015. The survey contained the following questionnaires: a self-designed questionnaire, the 12-item Short Form Health Survey (SF-12), and the Social Support Rating Scale (SSRS). Of the 459 adolescents sampled (aged 15.41 ± 1.07 years with range of 13 to 18), 61.7% were living with family, and 38.3% were not living with family. Those students not living with families had lower Mental Component Scale (MCS) scores as well as less social support overall. Those students, who were not living with families, also reported more chronic health problems and more alcohol consumption compared to those students living with families. Social support was a statistically significant mediating factor on the effect of living arrangements on MCS. Our findings demonstrated that those students, who were not living with families, tended to have more health-related quality of life issues, but social support partially mediated the relationship between living arrangements and health. Full article

(This article belongs to the Special Issue Housing and Health)

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265 KiB

Open AccessArticle

Housing and Health of Kiribati Migrants Living in New Zealand

by Mary Anne Teariki

Int. J. Environ. Res. Public Health 2017, 14(10), 1237; https://doi.org/10.3390/ijerph14101237 - 17 Oct 2017

Cited by 9 | Viewed by 4439

Abstract

Settlement is a complex process of adjustment for migrants and refugees. Drawing on recent research on the settlement experiences of Kiribati migrants and their families living in New Zealand, this article examines the role of housing as an influencer of the settlement and health of Kiribati migrants. Using qualitative methodology, in-depth interviews were conducted with fourteen Kiribati migrants (eight women and six men) representing 91 family members about the key issues and events that shaped their settlement in New Zealand. The stories told by participants affirm the association between housing and health. The study serves as an important reminder that children bear a great cost from living in poorly insulated and damp housing, and adults bear the mental costs, including social isolation resulting from inadequate rental housing. Detailed information about how this migrant group entered the private rental housing market, by taking over the rental leases of other Kiribati migrants vacating their rental properties, indicated some of the unintended consequences related to a lack of incentives for landlords to make improvements. With the most vulnerable families most at risk from inadequate housing, this research concludes that there is a need for minimum housing standards to protect tenants. Full article

(This article belongs to the Special Issue Housing and Health)

1228 KiB

Open AccessArticle

Housing as a Determinant of Tongan Children’s Health: Innovative Methodology Using Wearable Cameras

by Andrew Robinson, Sarah Hulme-Moir, Viliami Puloka, Moira Smith, James Stanley and Louise Signal

Int. J. Environ. Res. Public Health 2017, 14(10), 1170; https://doi.org/10.3390/ijerph14101170 - 04 Oct 2017

Cited by 4 | Viewed by 4234

Abstract

Housing is a significant determinant of health, particularly in developing countries such as Tonga. Currently, very little is known about the quality of the housing in Tonga, as is the case with many developing countries, nor about the interaction between children and the home environment. This study aimed to identify the nature and extent of health risk factors and behaviours in Tongan houses from a child’s perspective. An innovative methodology was used, Kids’Cam Tonga. Seventy-two Class 6 children (10 to 13-year-olds) were randomly selected from 12 randomly selected schools in Tongatapu, the main island. Each participating child wore a wearable camera on lanyards around their neck. The device automatically took wide-angled, 136° images of the child’s perspective every seven seconds. The children were instructed to wear the camera all day from Friday morning to Sunday evening, inclusive. The analysis showed that the majority of Tongan children in the study live in houses that have structural deficiencies and hazards, including water damage (42%), mould (36%), and electrical (89%) and burn risk factors (28%). The findings suggest that improvements to the housing stock may reduce the associated health burden and increase buildings’ resilience to natural hazards. A collaborative approach between communities, community leaders, government and non-governmental organisations (NGOs) is urgently needed. This research methodology may be of value to other developing countries. Full article

(This article belongs to the Special Issue Housing and Health)

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927 KiB

Open AccessFeature PaperArticle

Neighborhood Context, Homeownership and Home Value: An Ecological Analysis of Implications for Health

by Roshanak Mehdipanah, Amy J. Schulz, Barbara A. Israel, Graciela Mentz, Alexa Eisenberg, Carmen Stokes and Zachary Rowe

Int. J. Environ. Res. Public Health 2017, 14(10), 1098; https://doi.org/10.3390/ijerph14101098 - 22 Sep 2017

Cited by 12 | Viewed by 5546

Abstract

While homeownership has been linked to positive health outcomes there is limited evidence regarding the conditions under which it may be health protective. We present a conceptual model linking homeownership to health, highlighting key potential pathways. Using the Detroit Metropolitan Area as a case study, and data from the American Community Survey (2009–2013; 5-years estimates) and Michigan Department of Community Health, we tested the following questions: (1) Is neighborhood percentage non-Hispanic Black (NHB) associated with homeownership? (2) Is neighborhood percentage NHB associated with health? (3) Is the association between percentage NHB and health mediated by homeownership? (4) Does neighborhood housing value modify associations between percentage NHB and health, or between homeownership and health? Percentage NHB was associated with homeownership and health outcomes; Associations between percentage NHB and mortality, but not disability, were partially mediated by neighborhood homeownership. Neighborhood housing value modified associations between neighborhood homeownership and both disability and mortality, but not between percentage NHB and health outcomes. Findings are consistent with the thesis that health-promoting effects of homeownership may be contingent upon house values. These results add to a limited body of evidence suggesting that variations in homeownership may contribute to persistent racial and socioeconomic health inequities. Full article

(This article belongs to the Special Issue Housing and Health)

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351 KiB

Open AccessFeature PaperArticle

Exploring the Relationship between Housing and Health for Refugees and Asylum Seekers in South Australia: A Qualitative Study

by Anna Ziersch, Moira Walsh, Clemence Due and Emily Duivesteyn

Int. J. Environ. Res. Public Health 2017, 14(9), 1036; https://doi.org/10.3390/ijerph14091036 - 08 Sep 2017

Cited by 52 | Viewed by 12812

Abstract

Housing is an important social determinant of health; however, little is known about the impact of housing experiences on health and wellbeing for people from refugee and asylum-seeking backgrounds. In this paper, we outline a qualitative component of a study in South Australia examining these links. Specifically, interviews were conducted with 50 refugees and asylum seekers who were purposively sampled according to gender, continent and visa status, from a broader survey. Interviews were analysed thematically. The results indicated that housing was of central importance to health and wellbeing and impacted on health through a range of pathways including affordability, the suitability of housing in relation to physical aspects such as condition and layout, and social aspects such as safety and belonging and issues around security of tenure. Asylum seekers in particular reported that living in housing in poor condition negatively affected their health. Our research reinforces the importance of housing for both the physical and mental health for asylum seekers and refugees living in resettlement countries. Improving housing quality, affordability and tenure security all have the potential to lead to more positive health outcomes. Full article

(This article belongs to the Special Issue Housing and Health)

298 KiB

Open AccessArticle

How Economic Analysis Can Contribute to Understanding the Links between Housing and Health

by Ralph Chapman, Nicholas Preval and Philippa Howden-Chapman

Int. J. Environ. Res. Public Health 2017, 14(9), 996; https://doi.org/10.3390/ijerph14090996 - 31 Aug 2017

Cited by 4 | Viewed by 4883

Abstract

An economic analysis of housing’s linkages to health can assist policy makers and researchers to make better decisions about which housing interventions and policies are the most cost-beneficial. The challenge is to include cobenefits. The adoption in 2015 of the UN Sustainable Development Goals underscores the importance of understanding how policies interact, and the merit of comprehensively evaluating cobenefits. We explain our approach to the empirical assessment of such cobenefits in the housing and health context, and consider lessons from empirical economic appraisals of the impact of housing on health outcomes. Critical assumptions relating to cobenefits are explicitly examined. A key finding is that when wider policy outcome measures are included, such as mental health impacts and carbon emission reductions, it is important that effects of assumptions on outcomes are considered. Another is that differing values underlie appraisal, for example, the weight given to future generations through the discount rate. Cost-benefit analyses (CBAs) can better facilitate meaningful debate when they are based on explicit assumptions about values. In short, the insights drawn from an economic framework for housing-and-health studies are valuable, but nonetheless contingent. Given that housing interventions typically have both health and other cobenefits, and incorporate social value judgements, it is important to take a broad view but be explicit about how such interventions are assessed. Full article

(This article belongs to the Special Issue Housing and Health)

338 KiB

Open AccessArticle

Peri-Urbanism in Globalizing India: A Study of Pollution, Health and Community Awareness

by Linda Waldman, Ramila Bisht, Rajashree Saharia, Abhinav Kapoor, Bushra Rizvi, Yasir Hamid, Meghana Arora, Ima Chopra, Kumud T. Sawansi, Ritu Priya and Fiona Marshall

Int. J. Environ. Res. Public Health 2017, 14(9), 980; https://doi.org/10.3390/ijerph14090980 - 30 Aug 2017

Cited by 12 | Viewed by 5033

Abstract

This paper examines the intersection between environmental pollution and people’s acknowledgements of, and responses to, health issues in Karhera, a former agricultural village situated between the rapidly expanding cities of New Delhi (India’s capital) and Ghaziabad (an industrial district in Uttar Pradesh). A relational place-based view is integrated with an interpretive approach, highlighting the significance of place, people’s emic experiences, and the creation of meaning through social interactions. Research included surveying 1788 households, in-depth interviews, participatory mapping exercises, and a review of media articles on environment, pollution, and health. Karhera experiences both domestic pollution, through the use of domestic waste water, or gandapani, for vegetable irrigation, and industrial pollution through factories’ emissions into both the air and water. The paper shows that there is no uniform articulation of any environment/health threats associated with gandapani. Some people take preventative actions to avoid exposure while others do not acknowledge health implications. By contrast, industrial pollution is widely noted and frequently commented upon, but little collective action addresses this. The paper explores how the characteristics of Karhera, its heterogeneous population, diverse forms of environmental pollution, and broader governance processes, limit the potential for citizen action against pollution. Full article

(This article belongs to the Special Issue Housing and Health)

657 KiB

Open AccessArticle

Improved Housing Accessibility for Older People in Sweden and Germany: Short Term Costs and Long-Term Gains

by Björn Slaug, Carlos Chiatti, Frank Oswald, Roman Kaspar and Steven M. Schmidt

Int. J. Environ. Res. Public Health 2017, 14(9), 964; https://doi.org/10.3390/ijerph14090964 - 26 Aug 2017

Cited by 12 | Viewed by 5868

Abstract

The physical housing environment is important to facilitate activities of daily living (ADL) for older people. A hindering environment may lead to ADL dependence and thus increase the need for home services, which is individually restricting and a growing societal burden. This study presents simulations of policy changes with regard to housing accessibility that estimates the potential impact specifically on instrumental activities of daily living (I-ADL), usage of home services, and related costs. The models integrate empirical data to test the hypothesis that a policy providing funding to remove the five most severe environmental barriers in the homes of older people who are at risk of developing dependence in I-ADL, can maintain independence and reduce the need for home services. In addition to official statistics from state agencies in Sweden and Germany, we utilized published results from the ENABLE-AGE and other scientific studies to generate the simulations. The simulations predicted that new policies that remove potentially hindering housing features would improve I-ADL performance among older people and reduce the need for home services. Our findings suggest that a policy change can contribute to positive effects with regard to I-ADL independence among older people and to a reduction of societal burden. Full article

(This article belongs to the Special Issue Housing and Health)

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268 KiB

Open AccessFeature PaperCommunication

Constancy and Change: Key Issues in Housing and Health Research, 1987–2017

by Roderick J. Lawrence

Int. J. Environ. Res. Public Health 2017, 14(7), 763; https://doi.org/10.3390/ijerph14070763 - 12 Jul 2017

Cited by 19 | Viewed by 3720

Abstract

The low impact of scientific research on the relations between housing and health during the last 30 years can be attributed to a number of reasons. First, statistical analyses have meant to improve understanding of the relations between what are interpreted and measured as causal factors. However, any single statistical approach fails to account for the dynamic non-linear relations between multiple factors and therefore cannot analyze systemic complexity. Second, there has been too little accumulation and validation of knowledge from scientific research owing to the dominance of cross-sectional studies, and the lack of coordinated research agendas using these approaches in order to confirm empirical findings. Hence, there is little evidence indicating that public policies in both the housing and the public health sectors in specific localities have benefited from the accumulated evidence of empirical research. Third, the findings from empirical studies have been published in academic journals and monographs but rarely disseminated to actors and institutions in the public and private sectors. Hence housing and health research and policy formulation have not been consolidated during the last three decades. The author of this communication argues for a radical shift from conventional disciplinary and multi-disciplinary contributions to transdisciplinary research programmes and projects that formulate and apply innovative approaches founded on conceptual frameworks that apply systems thinking for the integration of knowledge and know-how of researchers, policy makers, and professional practitioners in precise localities. Full article

(This article belongs to the Special Issue Housing and Health)

460 KiB

Open AccessArticle

Lower Physical Performance in Colder Seasons and Colder Houses: Evidence from a Field Study on Older People Living in the Community

by Yukie Hayashi, Steven M. Schmidt, Agneta Malmgren Fänge, Tanji Hoshi and Toshiharu Ikaga

Int. J. Environ. Res. Public Health 2017, 14(6), 651; https://doi.org/10.3390/ijerph14060651 - 17 Jun 2017

Cited by 18 | Viewed by 4667

Abstract

The aim of this paper was to explore the effect of seasonal temperature differences and cold indoor environment in winter on the physical performance of older people living in the community based on a field study. We recruited 162 home-dwelling older people from a rehabilitation facility in the Osaka prefecture, Japan; physical performance data were available from 98/162 (60.5%). At the same time, for some participants, a questionnaire survey and a measurement of the indoor temperature of individual houses were conducted. The analysis showed that there were seasonal trends in the physical performance of older people and that physical performance was worse in the winter compared with the autumn. Furthermore, people living in colder houses had worse physical performance. The findings indicate that keeping the house warm in the winter can help to maintain physical performance. Full article

(This article belongs to the Special Issue Housing and Health)

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Open AccessArticle

Is Housing a Health Insult?

by Emma Baker, Andrew Beer, Laurence Lester, David Pevalin, Christine Whitehead and Rebecca Bentley

Int. J. Environ. Res. Public Health 2017, 14(6), 567; https://doi.org/10.3390/ijerph14060567 - 26 May 2017

Cited by 47 | Viewed by 9314

Abstract

In seeking to understand the relationship between housing and health, research attention is often focussed on separate components of people’s whole housing ‘bundles’. We propose in this paper that such conceptual and methodological abstraction of elements of the housing and health relationship limits our ability to understand the scale of the accumulated effect of housing on health and thereby contributes to the under-recognition of adequate housing as a social policy tool and powerful health intervention. In this paper, we propose and describe an index to capture the means by which housing bundles influence health. We conceptualise the index as reflecting accumulated housing ‘insults to health’—an Index of Housing Insults (IHI). We apply the index to a sample of 1000 low-income households in Australia. The analysis shows a graded association between housing insults and health on all outcome measures. Further, after controlling for possible confounders, the IHI is shown to provide additional predictive power to the explanation of levels of mental health, general health and clinical depression beyond more traditional proxy measures. Overall, this paper reinforces the need to look not just at separate housing components but to embrace a broader understanding of the relationship between housing and health. Full article

(This article belongs to the Special Issue Housing and Health)

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