The Watcombe Housing Study: the short term effect of improving housing conditions on the health of residents

Abstract

Objective: 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 (MannWhitney 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.

External Wall Insulation (EWI): Engaging Social Tenants in Energy Efficiency Retrofitting in the North East of England

“…Most also reported improvements to their health and wellbeing, which was linked to increased warmth in their homes. Again, this reinforces previous findings on positive health effects arising from energy saving measures [15,16]. In homes that were previously considered hard to heat and where some occupants reported that they felt they were never warm enough, tenants considered this improvement in thermal comfort to be more significant than money saving; improvement in thermal comfort was in fact identified as the best thing about EWI, indicating that concerns about quality of life and day-to-day comfort can take precedence over financial savings, even for low-income households.…”

“…There may be variation in how occupiers respond to feedback: for instance, an increase in internal temperatures due to improved energy efficiency may be seen as an opportunity to reduce heating demand, or simply to enjoy the resulting increase in comfort, described as the 'temperature take back factor' [14]. Housing improvements involving measures to improve thermal comfort can have a positive health impact on residents [15]. A recent study from Japan emphasized the importance of wider economic impacts of energy saving measures such as insulation, referred to as 'non-energy benefits'; these include health improvements and associated reductions in medical expenses and sickness leave from work [16].…”

The effects of home heating on asthma: evidence from New Zealand

“…International retrospective empirical studies suggest that the lack of home heating is associated with higher asthma rates (Borooah, 2007;Thomson et al, 2009) and a limited number of randomized controlled trials seem to support this hypothesis (Barton et al, 2007). However, the evidence to date is inconclusive and many of the studies available do not control adequately for the endogeneity of home heating.…”

“…The Watcombe housing study conducted in the UK (Barton et al, 2007) investigated self-reported asthma rates in households with improved heating and insulation and found a statistically significant but negligible effect on asthma prevalence. Two prominent randomized controlled studies in NZ looked at the effects of housing improvement on respiratory conditions in general (Howden-Chapman et al, 2007) and asthma specifically (HowdenChapman et al, 2008) and found beneficial causal effects.…”

Not Just “A Roof over Your Head”: The Meaning of Healthy Housing for People Living with HIV

“…For populations with a history of housing instability, housing stability has been associated with reduced hospitalization and emergency room visits (Hanrahan et al 2001;Sadowski et al 2009), as well as improvements in mental health and substance use issues (Clark and Rich 2003;Tsemberis, Gulcur, and Nakae 2004). Improvements in poor housing conditions have also been associated with enhancing physical, mental and social wellbeing (Barton et al 2007;Braubach, Heinen, and Dame 2008;Dunn 2000;Howden-Chapman et al 2008;Shortt and Rugkåsa 2007;Thomson et al 2009). …”