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Housing is one of the key modifiable determinants of health. Inadequate housing can have far-reaching consequences for health outcomes.
A healthy home is a core foundation for positive health and wellbeing.
A healthy home can be defined as one that is:
- of good quality and habitable
- well insulated, ventilated and fitted with good, reliable heating
- not overcrowded
- pest and contaminant free
- safe (potential hazards are minimised and/or isolated and/or eliminated)
- clean and maintained [see note 1].
Unhealthy homes are often cold, damp and mouldy due to inadequate insulation, heating and ventilation.
People who live in unhealthy homes have increased risk of contracting a range of serious and avoidable illnesses such as meningitis, rheumatic fever and pneumonia.
Unhealthy homes also heighten the risk of physical injury and can lead to depression and other forms of mental illness.
These health risks are often exacerbated by the fact that people who live in unhealthy homes are more likely to have to make trade-offs between housing costs and decent food, heating, health services and other necessities of life.
Those who are affected, including children, are often hospitalised and treated but they return home to the same conditions that caused the illness. The most vulnerable people, particularly children and older people, are among those who experience the worst effects of inadequate housing.
Unhealthy homes and health
Poor quality housing is a significant driver of hospitalisation among children [see note 2].
Poor quality housing, particularly cold and damp houses, is linked to the following diseases:
- asthma
- respiratory infections
- rheumatic fever
- cardiovascular disease
- respiratory illnesses and infections, including asthma, bronchiolitis, pneumonia, bronchiectasis, tuberculosis [see note 3].
Doctors report that illnesses related to poor quality housing are increasing in number and severity, with serious long-term consequences and disability. The rate bronchiectasis hospitalisation rate in children aged under 15 years has tripled in 15 years [see note 4]. Bronchiectasis is an irreversible, life-threatening lung disease usually only seen in adults or in developing countries
Childhood hospitalisation rates for bronchiolitis have increased by nearly half between 2000 and 2017, from 3,984 to 6,320 (2065 per 100,000 children). [see note 5].
Over 325 per 100,000 children were hospitalised in 2017 for asthma [see note 6].
Sub-standard, high-cost housing at least doubles the risk of admittance to hospital for pneumonia, and is the most important risk factor for rheumatic fever and meningococcal disease [see note 7].
Māori and Pacific children are at significantly greater risk of hospitalisation and death from preventable housing related disease. Rates of hospitalisation for Māori aged under 15 with bronchiectasis were 4 times higher than for non-Māori, Pacific, Asian (MPA) peoples.
Overall, Pacific peoples were 6.2 times more likely to be hospitalised with bronchiectasis than non-MPA and Māori were 3.8 times more likely to be hospitalised [see note 8].
Poverty is one of the most significant determinants of poor health outcomes, and poor housing is a key component of poverty. Auckland’s low-income suburbs have the worst rates of preventable, poverty-related childhood diseases in Auckland.
There is no simple means of ensuring all Aucklanders have access to healthy homes. Solutions will involve increasing supply, and building to high standards, increasing the social housing stock, as well as improving the built quality of existing dwellings (particularly rental properties).
Notes
[1] Includes excerpts from National Center for Healthy Housing.
[2] Howden-Chapman, P., Baker, M. and Bierre, S. (2013). The houses children live in. Policy Quarterly Vol 9:2 – May 2013 – Page 35.
[3] Environmental Health Indicators New Zealand. Poor quality housing and health .
[5] Ibid
[6] Ibid.
[7] Child Poverty Action Group. A New Zealand where children can flourish (PDF 876KB).