Emergency hospital admissions associated with a non-randomised housing intervention meeting national housing quality standards: a longitudinal data linkage study (original) (raw)
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Public Health Research, 2018
BackgroundPoor-quality housing adversely affects residents’ health but there is a paucity of high-quality evidence to support this.ObjectiveThis research investigated the health impact of bringing housing to a national quality standard.DesignA natural experiment of improvements to housing quality analysed using repeated measures of health-care utilisation and economic outcomes at an individual person level.SettingCarmarthenshire, UK.ParticipantsA total of 32,009 residents registered for a minimum of 60 days at 8558 social homes that received housing improvements between January 2005 and March 2015.InterventionsMultiple internal and external housing improvements, including wall and loft insulation, windows and doors, heating system upgrades, new kitchens and bathrooms, garden path safety improvements and electrical system upgrades (adding power sockets, and extractor fans in kitchens and bathrooms).Main outcome measuresEmergency hospital admissions for cardiorespiratory conditions an...
Journal of Epidemiology & Community Health, 2007
To assess the short term health effects of improving housing. Design: Randomised to waiting list. Setting: 119 council owned houses in south Devon, UK. Participants: About 480 residents of these houses. Intervention: Upgrading houses (including central heating, ventilation, rewiring, insulation, and re-roofing) in two phases a year apart. Main outcome measures: All residents completed an annual health questionnaire: SF36 and GHQ12 (adults). Residents reporting respiratory illness or arthritis were interviewed using condition-specific questionnaires, the former also completing peak flow and symptom diaries (children) or spirometry (adults). Data on health service use and time lost from school were collected. Results: Interventions improved energy efficiency. For those living in intervention houses, non-asthma-related chest problems (Mann-Whitney test, p = 0.005) and the combined asthma symptom score for adults (Mann-Whitney test, z = 2.7, p = 0.007) diminished significantly compared with control houses. No difference between intervention and control houses was seen for SF36 or GHQ12. Conclusions: Rigorous study designs for the evaluation of complex public health and community based interventions are possible. Quantitatively measured health benefits are small, but as health benefits were measured over a short time scale, there may have been insufficient time for measurable improvements in general and disease-specific health to become apparent.
BMC public health, 2016
Despite the importance of adequate, un-crowded housing as a prerequisite for good health, few large cohort studies have explored the health effects of housing conditions. The Social Housing Outcomes Worth (SHOW) Study was established to assess the relationship between housing conditions and health, particularly between household crowding and infectious diseases. This paper reports on the methods and feasibility of using a large administrative housing database for epidemiological research and the characteristics of the social housing population. This prospective open cohort study was established in 2003 in collaboration with Housing New Zealand Corporation which provides housing for approximately 5 % of the population. The Study measures health outcomes using linked anonymised hospitalisation and mortality records provided by the New Zealand Ministry of Health. It was possible to match the majority (96 %) of applicant and tenant household members with their National Health Index (NHI...
International Journal of Public Health
Objectives We sought to determine the impact of warmthrelated housing improvements on the health, well-being, and quality of life of families living in social housing. Methods An historical cohort study design was used. Households were recruited by Gentoo, a social housing contractor in North East England. Recruited households were asked to complete a quality of life, well-being, and health service use questionnaire before receiving housing improvements (new energy-efficient boiler and doubleglazing) and again 12 months afterwards. Results Data were collected from 228 households. The average intervention cost was £3725. At 12-month postintervention, a 16% reduction (-£94.79) in household 6-month health service use was found. Statistically significant positive improvements were observed in main tenant and household health status (p \ 0.001; p = 0.009, respectively), main tenant satisfaction with financial situation (p = 0.020), number of rooms left unheated per household (p \ 0.001), frequency of household outpatient appointments (p = 0.001), and accident/emergency department attendance (p \ 0.012). Conclusions Warmth-related housing improvements may be a cost-effective means of improving the health of social housing tenants and reducing health service expenditure, particularly in older populations.
Health and housing conditions in public sector housing estates
Public Health, 1984
This article reports some of the findings of a study of health and housing conditions in a sample of households from eight different types of council housing areas in Gateshead. Controlling for age, there were found to be marked and consistent differences in self-reported health between individuals from different areas. For all age groups up to 65 years old, those living in "bad" housing areas reported poorer health, more long-standing illness, more recent illness and more symptoms of respiratory disease and depression. The clearest associations between poor health and bad housing emerged for the generally fittest age-groups (the under 25 years). For the people over 65 years the position was reversed, with those in "good" housing areas reporting poorer health, with the exception of recent illness. This is argued to be the result of local authority lettings policy, which gives priority to re-housing the less-fit elderly. Those in "bad" housing areas were also more likely to report housing defects which affected their health and to feel that their health could be improved by a change in their housing. The study found that "bad" council housing areas did not necessarily conform to the stereotype of non-traditional construction, or high-rise flats. Some consisted of traditionally built houses, while there was a sizeable representation among the "good" housing of system-built high-rise flats.. The "bad" housing areas were marked off more by their location, their poor environment and the low quality of their construction.
Housing improvements for health and associated socio-economic outcomes
The Cochrane database of systematic reviews, 2013
The well established links between poor housing and poor health indicate that housing improvement may be an important mechanism through which public investment can lead to health improvement. Intervention studies which have assessed the health impacts of housing improvements are an important data resource to test assumptions about the potential for health improvement. Evaluations may not detect long term health impacts due to limited follow-up periods. Impacts on socio-economic determinants of health may be a valuable proxy indication of the potential for longer term health impacts. To assess the health and social impacts on residents following improvements to the physical fabric of housing. Twenty seven academic and grey literature bibliographic databases were searched for housing intervention studies from 1887 to July 2012 (ASSIA; Avery Index; CAB Abstracts; The Campbell Library; CINAHL; The Cochrane Library; COPAC; DH-DATA: Health Admin; EMBASE; Geobase; Global Health; IBSS; ICON...
Health & Place, 1998
In the UK housing tenure (whether the dwelling is owner occupied or rented) has consistently been found to be associated with longevity and with a number of measures of health. It has been argued that it is a good measure of material circumstances, and it is often incorporated into area based measures of social or material deprivation. However there is little published research on whether housing tenure predicts mortality and morbidity simply because it is an indicator of material well being, or whether, in addition, dierent categories of housing tenure expose people to dierent levels of health hazards in the dwelling itself or in the immediate environment. In this paper we examine, using data on adults aged 40 and 60 from socially contrasting neighbourhoods in Glasgow, Scotland, whether housing tenure is associated with housing stressors (e.g. overcrowding, dampness, hazards, diculty with heating the home) and with assessment of the local environment (e.g. amenities, problems, crime, neighbourliness, area reputation and satisfaction), and whether this might help to explain tenure dierences in long-standing illness, limiting long-standing illness, anxiety and depression. Controlling for income, age and sex, housing stressors independently predicted limiting long-standing illness; assessment of the area and housing type independently contributed to anxiety; and housing stressors, housing type and assessment of the area independently contributed to depression. This suggests that housing tenure may expose people to dierent levels of health hazards, and has implications for urban housing policies. #
Health effects of housing improvement: systematic review of intervention studies
BMJ, 2001
Objective To review the evidence on the effects of interventions to improve housing on health. Design Systematic review of experimental and non-experimental housing intervention studies that measured quantitative health outcomes. Data sources Studies dating from 1887, in any language or format, identified from clinical, social science, and grey literature databases, personal collections, expert consultation, and reference lists. Main outcome measures Socioeconomic change and health, illness, and social measures. Results 18 completed primary intervention studies were identified. 11 studies were prospective, of which six had control groups. Three of the seven retrospective studies used a control group. The interventions included rehousing, refurbishment, and energy efficiency measures. Many studies showed health gains after the intervention, but the small study populations and lack of controlling for confounders limit the generalisability of these findings. Conclusions The lack of evidence linking housing and health may be attributable to pragmatic difficulties with housing studies as well as the political climate in the United Kingdom. A holistic approach is needed that recognises the multifactorial and complex nature of poor housing and deprivation. Large scale studies that investigate the wider social context of housing interventions are required.