Housing improvements for health and associated socio-economic outcomes

Thomson, Hilary; Thomas, Siân; Sellström, Eva; Petticrew, Mark

doi:10.1002/14651858.cd008657.pub2

Cited by 205 publications

(215 citation statements)

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“…The causal pathways between poor housing and poor health can therefore be determined only by intervention studies. In a systematic review of the literature, Thomson et al 48 identified 39 housing intervention studies that reported quantitative or qualitative data on health and associated socioeconomic outcomes. Of these, 19 evaluated affordable warmth and energy efficiency improvements relevant to modern-day housing conditions (i.e.…”

Section: Health Impacts Of Energy Efficiency Improvementsmentioning

confidence: 99%

The health impacts of energy performance investments in low-income areas: a mixed-methods approach

et al. 2018

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BackgroundCold homes and fuel poverty contribute to health inequalities in ways that could be addressed through energy efficiency interventions.ObjectivesTo determine the health and psychosocial impacts of energy performance investments in low-income areas, particularly hospital admissions for cardiorespiratory conditions, prevalence of respiratory symptoms and mental health status, hydrothermal conditions and household energy use, psychosocial outcomes, cost consequences to the health system and the cost utility of these investments.DesignA mixed-methods study comprising data linkage (25,908 individuals living in 4968 intervention homes), a field study with a controlled pre-/post-test design (intervention,n = 418; control,n = 418), a controlled multilevel interrupted time series analysis of internal hydrothermal conditions (intervention,n = 48; control,n = 40) and a health economic assessment.SettingLow-income areas across Wales.ParticipantsResidents who received energy efficiency measures through the intervention programme and matched control groups.Main outcome measuresPrimary outcomes – emergency hospital admissions for cardiorespiratory conditions, self-reported respiratory symptoms, mental health status, indoor air temperature and indoor relative humidity. Secondary outcomes – emergency hospital admissions for chronic obstructive pulmonary disease-related cardiorespiratory conditions, excess winter admissions, health-related quality of life, subjective well-being, self-reported fuel poverty, financial stress and difficulties, food security, social interaction, thermal satisfaction and self-reported housing conditions.MethodsAnonymously linked individual health records for emergency hospital admissions were analysed using mixed multilevel linear models. A quasi-experimental controlled field study used a multilevel repeated measures approach. Controlled multilevel interrupted time series analyses were conducted to estimate changes in internal hydrothermal conditions following the intervention. The economic evaluation comprised cost–consequence and cost–utility analyses.Data sourcesThe Patient Episode Database for Wales 2005–14, intervention records from 28 local authorities and housing associations, and scheme managers who delivered the programme.ResultsThe study found no evidence of changes in physical health. However, there were improvements in subjective well-being and a number of psychosocial outcomes. The household monitoring study found that the intervention raised indoor temperature and helped reduce energy use. No evidence was found of substantial increases in indoor humidity levels. The health economic assessment found no explicit cost reductions to the health service as a result of non-significant changes in emergency admissions for cardiorespiratory conditions.LimitationsThis was a non-randomised intervention study with household monitoring and field studies that relied on self-response. Data linkage focused on emergency admissions only.ConclusionAlthough there was no evidence that energy performance investments provide physical health benefits or reduce health service usage, there was evidence that they improve social and economic conditions that are conducive to better health and improved subjective well-being. The intervention has been successful in reducing energy use and improving the living conditions of households in low-income areas. The lack of association of emergency hospital admissions with energy performance investments means that we were unable to evidence cost saving to health-service providers.Future workOur research suggests the importance of incorporating evaluations with follow-up into intervention research from the start.FundingThe National Institute for Health Research Public Health Research programme.

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Section: Health Impacts Of Energy Efficiency Improvementsmentioning

confidence: 99%

The health impacts of energy performance investments in low-income areas: a mixed-methods approach

et al. 2018

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“…The present review is designed to provide this information and complement previous reviews focusing on specific interventions such as infrastructural interventions or housing improvement in slums and their impact on health (Thomson et al 2013, Turley et al 2013.…”

Section: Introductionmentioning

confidence: 99%

Interventions to tackle malnutrition and its risk factors in children living in slums: a scoping review

Goudet

Griffiths

Bogin

et al. 2016

Annals of Human Biology

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(200 words)Context: Children living in slums are at high risk of being malnourished. There are no published reviews on existing interventions promoting better nutrition for children living in slums and the risks factors for children's malnutrition.Improved understanding of the risks factors for malnutrition in slums communities and the impact of interventions on children's health can provide guidance to practitioners and decision-makers. The present review is designed to provide this information. Methods:The search included 30 electronic bibliographic databases, and relevant eligible studies published up to December 2013. Results:The search located 1,512 citations. Full text relevance screening was conducted on 226 studies and on abstracts for 16 studies. The final 58 unique studies included 22 on interventions and 38 on risk. All of the interventions were nutrition-specific with nutritional intervention being the most dominant type. Seventy three percent of the interventions were assessed effective. Conclusion:The findings stressed the gaps in knowledge in terms of quality assessment and programmatic recommendations to identify children who are the most at risk of malnutrition to appropriately target interventions. Finally, the review helped to inform a systematic review (Cochrane Systematic review protocol 2015) that will examine the impact of interventions on outcome measures.3 | P a g e

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“…Le fait d'offrir une aide au logement à des personnes infectées par le VIH qui étaient sans domicile fixe ou qui n'avaient pas de logement adéquat a permis d'améliorer leur état de santé (17). En fait, un logement adéquat est associé à un meilleur état de santé chez les patients atteints de différentes affections (18).…”

Section: Science De La Mise En Oeuvreunclassified

Promouvoir l’équité en santé en vue d’améliorer la santé : le moment d’agir est venu

Jackson¹,

Huston²

2016

RMTC

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Housing improvements for health and associated socio-economic outcomes

Cited by 205 publications

References 118 publications

The health impacts of energy performance investments in low-income areas: a mixed-methods approach

The health impacts of energy performance investments in low-income areas: a mixed-methods approach

Interventions to tackle malnutrition and its risk factors in children living in slums: a scoping review

Promouvoir l’équité en santé en vue d’améliorer la santé : le moment d’agir est venu

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