Housing
Though often overlooked as an important determinant of health, housing quality has important impacts on health of adults and children alike. Housing quality has been shown to be associated with a wide range of health effects. These include:
Infectious disease: Poor housing quality may include a contaminated water supply, poor waste disposal, and insect and rodent infestation, all of which have been shown to contribute to the spread of infectious disease. Crowding of tenants in housing units also facilitates the transfer of disease between people. Tuberculosis and respiratory infections are not uncommon in overcrowded living environments, such as housing for the homeless.
Injuries:The link between housing quality and risk of injuries is well established. Substandard housing has been associated with increased risk of injuries, such as falls and burns. The common attributes of poor housing include “exposed heating sources, unprotected upper-story windows and low sill heights, slippery surfaces, breakable window glass in sites with a high likelihood of contact, and poorly designed stairs with inadequate lighting” (Krieger and Higgins, 2002; p. 759).
Chronic illness: Indoor air quality and exposure to dampness are contributors to asthma and other allergic reactions, particularly among children. It is hypothesized that damp environments are hospitable to mites, roaches, viruses, and molds, which affect respiratory disease. Indoor air pollution is affected by inorganic sources, for example carpeting, floor covering, and heating. Paints used in homes may be contaminated with lead, contributing to neurodevelopment problems in children.
The built environment or neighborhood around the residential environment also affects health through opportunities for physical activity and access to nutritious foods. Neighborhoods also affect exposure to crime and injuries. Furthermore, housing and neighborhood conditions and affect mental health.
External Links
- Eastern Neighborhoods Community Planning (San Francisco Health Department)
- U.S. Department of Housing and Urban Development
- Healthy People in Healthy Communities (Healthy People 2010 Objectives)
- Dataplace. Warehouse of community-level housing and demographic data, maps and summaries. Supported by Fannie Mae. Site is free, but to make full use of the site’s resources, users need to register.
- CDC Healthy Places: Health Effects of Gentrification
- CDC Healthy Places: Healthy Homes
Measurement
Most local municipalities have basic codes and guidelines requiring affordable housing to be safe and sanitary. Housing projects that are subsidized by federal funding must comply with federal housing quality standards in addition to minimum local housing codes.
Downstream Health Effects
Housing conditions affect environmental exposures to chemical and biological agents that can cause disease. These conditions also affect exposure to noise and the level of social interaction between neighbors, both of which have important impacts on mental and physical health.
Policies and Other Determinants
Quality housing is a key determinant in maximizing health outcomes. Policies that promote optimal housing conditions, in concert with safe neighborhoods, parks and public spaces are ideal ways to minimize injury and disease associated with exposure to harmful living environments.
- Distribution and availability of affordable housing- Mixing of housing in different price ranges can increase accountability by ensuring equitable living spaces for people of different economic levels and ethnic backgrounds.
- Public safety can decrease risk of injury, bodily harm and help to quell negative perceptions and fears of living in an unsafe environment.
- Mixed use development, which allows residential, retail and commercial uses in close proximity to one another, sometimes in the same building, can potentially increase property value; fosters social capital, and increases the likelihood that safety standards are adhered.
References
- Bashir SA. Home is where the harm is: inadequate housing as a public health crisis. Am J Public Health. 2002;92(5):733-8.
- Breysse P, Galke W, Lanphear B, Morley R, Bergofsky L. The Relationship between Housing and Health: Children at Risk. Environ Health Perspect. 2004;112(15): 1583–1588.
- Krieger J, Higgins DL. Housing and health: time again for public health action. Am J Public Health. 2002;92(5):758-68.
- Frumkin H. Healthy places: Exploring the evidence. Am J Public Health, 2003;93(9):1451-1456.
- Srinivasan S, O'Fallon LR, Dearry A. Creating healthy communities, healthy homes, healthy people: Initiating a research agenda on the built environment and public health. Am J Public Health, 2003;93(9):1446-1450.