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Manzo LKC, Grove H. Inadequate Social Housing and Health: The Case of Oliver Bond House, The Liberties, Dublin. OPEN RESEARCH EUROPE 2024; 3:211. [PMID: 38384817 PMCID: PMC10879759 DOI: 10.12688/openreseurope.16767.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/26/2024] [Indexed: 02/23/2024]
Abstract
Background Inadequate housing is an important social justice issue that adversely affects health. Methods Drawing on an extended ethnography case study, this paper presents the results of a resident-led survey to highlight the health consequences of inadequate social housing, as residents wait for a 'fair regeneration' of their social housing 'flats' estate within a gentrifying inner-city Dublin neighbourhood. Results Four key concerns were identified by residents as part of this analysis: (1) substandard housing conditions which are physically harmful to health; (2) the emotional toll of an unsafe social environment; (3) lack of child friendly and community green spaces; and (4) constrained mobility due to inaccessible housing design. Conclusions The results highlight the urgent need to place greater priority on the maintenance of the existing social housing stock and demonstrate the need for public housing policies that recognize the quality and quantity of adequate housing provision, where care is at the heart of housing policies. The paper also presents a novel 'City of Care' framework, following the need to develop an ethics of care within cities where public health, community wellbeing, solidarity, residents' empowerment, and social justice principles are at the forefront. Given that housing is an essential contributor to good health, it is now time for a joint public housing and public health agenda to create healthier homes by confronting the everyday impact of inadequate housing to tackle social inequalities more broadly.
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Affiliation(s)
- Lidia Katia C. Manzo
- Languages, Literatures, Cultures and Mediations, University of Milan, Milan, Lombardy, Italy
- Department of Geography and Maynooth University Social Sciences Institute, Maynooth University, Maynooth, Ireland
| | - Hannah Grove
- Global Centre on Healthcare & Urbanisation, Kellogg College, University of Oxford, Oxford, UK
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2
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Duclos D, Sharma E, Banke-Thomas A, Castaner MM. Unsafe and unstable housing for refugees and asylum seekers is a threat to intergenerational health. BMJ 2024; 384:q561. [PMID: 38448085 DOI: 10.1136/bmj.q561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Affiliation(s)
- Diane Duclos
- London School of Hygiene and Tropical Medicine, UK
| | | | | | - Maria Marti Castaner
- Research Center for Migration, Ethnicity, and Health, University of Copenhagen, Denmark
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3
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Murphy M, Grundy EMD. Housing tenure and disability in the UK: trends and projections 2004-2030. Front Public Health 2024; 11:1248909. [PMID: 38239788 PMCID: PMC10795505 DOI: 10.3389/fpubh.2023.1248909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/08/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction Housing is a major influence on health. Housing tenure is associated with housing conditions, affordability, and security and is an important dimension of housing. In the UK there have been profound changes in both housing conditions and the distribution of households by tenure over the past century, that is during the lifetimes of the current population. Methods We firstly reviewed and summarise changes in housing conditions, housing policy and tenure distribution as they provide a context to possible explanations for health variations by housing tenure, including health related selection into different tenure types. We then use 2015-2021 data from a large nationally representative UK survey to analyse associations between housing tenure and self-reported disability among those aged 40-69 controlling for other socio-demographic factors also associated with health. We additionally examine changes in the association between housing tenure and self-reported disability in the population aged 25 and over in the first two decades of the 21st century and project trends forward to 2030. Results Results show that associations between housing tenure and disability by tenure were stronger than for any other indicator of socio-economic position considered with owner-occupiers having the best, and social renters the worst, health. Differences were particularly marked in reported mental health conditions and in economic activity, with 28% of social renters being economically inactive due to health problems, compared with 4% of owner-occupiers. Rates of disability have increased over time, and become increasingly polarised by tenure. By 2020 the age standardised disability rate among tenants of social housing was over twice as high as that for owner occupiers, with projections indicating further increases in both levels, and differentials in, disability by 2030. Discussion These results have substantial implications for housing providers, local authorities and for public health.
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Affiliation(s)
- Michael Murphy
- Department of Social Policy, London School of Economics and Political Science, London, United Kingdom
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Emily M. D. Grundy
- Institute for Economic and Social Research, University of Essex, Essex, United Kingdom
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4
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Uprety S, Sherchan SP, Narayanan P, Dangol B, Maggos M, Celmer A, Shisler J, Amarasiri M, Sano D, Nguyen TH. Microbial assessment of water, sanitation, and hygiene (WaSH) in temporary and permanent settlements two years after Nepal 2015 earthquake. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 877:162867. [PMID: 36931512 DOI: 10.1016/j.scitotenv.2023.162867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 03/10/2023] [Accepted: 03/10/2023] [Indexed: 05/06/2023]
Abstract
Disaster-induced displacement often causes people to live in temporary settlements that have limited infrastructure and access to water, sanitation, and hygiene (WaSH). Reducing the risk of diarrheal diseases in such situations requires knowing how housing influences the presence of pathogens in water and the interaction between human settlements and exposure to pathogens. A cross-sectional study was conducted in May 2017 in two communities hard-hit by the Nepal 2015 earthquake: one recovered with newly reconstructed houses, and one recovered with residents still living in sheet metal temporary shelters constructed after the earthquake. We collected 60 water (30 drinking water and 30 cleaning water), 30 hand rinse, and 90 environmental swab samples (30 toilet handles, 30 utensils, and 30 water vessels) from selected households in each location and quantified 22 bacterial pathogens using microfluidic quantitative polymerase chain reaction (mfqPCR). A total of 59 samples were randomly selected for amplicon-based sequencing of the 16S rRNA, and it identified bacterial community profiles between these two settlements and their association with target genes of pathogenic bacteria. Target genes like uidA of Escherichia coli and the mip gene of Legionella pnuemophila showed significantly high frequency in specific sample types in temporary settlements than in permanent settlements. A significantly high concentration was observed in temporary settlements for Enterococcus spp. and S. typhimurium, specifically in swab samples. There was a sharp distinction of microbial community profiles between water and hand rinse samples with environmental swab samples, with a large abundance of potentially pathogenic bacteria in swab samples in both settlements. This observation highlighted that fomite could be an important transmission route for pathogens in rural settings and designing key interventions to target different stages of transmission pathways is essential. Overall findings from this study suggest that the recovered settlement with higher quality housing may be less impacted by fecal contamination than recovering settlements and that interventions should be designed to disrupt multiple transmission pathways to reduce pathogen exposure.
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Affiliation(s)
- Sital Uprety
- Department of Civil and Environmental Engineering, University of Illinois at Urbana Champaign, Urbana, IL, USA; Department of Sanitation, Water and Solid Waste for Development (Sandec), Swiss Federal Institute of Aquatic Science and Technology (Eawag), Dübendorf, Zurich, Switzerland; Department of Civil and Environmental Engineering, Tohoku University, Sendai, Japan.
| | - Samendra P Sherchan
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, New Orleans, LA, USA; Department of Biology, Morgan State University, Baltimore, MD, USA
| | - Preeti Narayanan
- Department of Chemistry, University of Illinois at Urbana Champaign, Urbana, IL, USA
| | - Bipin Dangol
- Environment and Public Health Organization (ENPHO), Kathmandu, Nepal
| | - Marika Maggos
- Department of Microbiology, University of Illinois at Urbana Champaign, Urbana, IL, USA
| | - Alex Celmer
- Department of Microbiology, University of Illinois at Urbana Champaign, Urbana, IL, USA
| | - Joanna Shisler
- Department of Microbiology, University of Illinois at Urbana Champaign, Urbana, IL, USA; Institute of Genomic Biology, University of Illinois at Urbana Champaign, Urbana, IL, USA
| | - Mohan Amarasiri
- Department of Health Science, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
| | - Daisuke Sano
- Department of Civil and Environmental Engineering, Tohoku University, Sendai, Japan
| | - Thanh H Nguyen
- Department of Civil and Environmental Engineering, University of Illinois at Urbana Champaign, Urbana, IL, USA; Institute of Genomic Biology, University of Illinois at Urbana Champaign, Urbana, IL, USA
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Howden-Chapman P, Crane J, Keall M, Pierse N, Baker MG, Cunningham C, Amore K, Aspinall C, Bennett J, Bierre S, Boulic M, Chapman R, Chisholm E, Davies C, Fougere G, Fraser B, Fyfe C, Grant L, Grimes A, Halley C, Logan-Riley A, Nathan K, Olin C, Ombler J, O’Sullivan K, Pehi T, Penny G, Phipps R, Plagman M, Randal E, Riggs L, Robson B, Ruru J, Shaw C, Schrader B, Teariki MA, Telfar Barnard L, Tiatia R, Toy-Cronin B, Tupara H, Viggers H, Wall T, Wilkie M, Woodward A, Zhang W. He Kāinga Oranga: reflections on 25 years of measuring the improved health, wellbeing and sustainability of healthier housing. J R Soc N Z 2023. [DOI: 10.1080/03036758.2023.2170427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- Philippa Howden-Chapman
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Julian Crane
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Michael Keall
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Nevil Pierse
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Michael G. Baker
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Chris Cunningham
- Research Centre for Hauora & Health, Massey University, Wellington, New Zealand
| | - Kate Amore
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Clare Aspinall
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Julie Bennett
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Sarah Bierre
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Mikael Boulic
- School of the Built Environment, Massey University, Auckland, New Zealand
| | - Ralph Chapman
- School of Geography, Environment and Earth Sciences, Te Herenga Waka, Victoria University of Wellington, New Zealand
| | - Elinor Chisholm
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Cheryl Davies
- Tu Kotahi Māori Asthma Trust, Wainuiomata, Lower Hutt, New Zealand
| | - Geoff Fougere
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Brodie Fraser
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Caro Fyfe
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Libby Grant
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Arthur Grimes
- Motu Economic and Public Policy Research, Wellington, New Zealand
| | - Caroline Halley
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Amber Logan-Riley
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Kim Nathan
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Crystal Olin
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Jenny Ombler
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Kimberley O’Sullivan
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Tiria Pehi
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Guy Penny
- EMPlan Services Ltd, Wellington, New Zealand
| | - Robyn Phipps
- Faculty of Architecture and Design Innovation, Te Herenga Waka, Victoria University of Wellington, Wellington, New Zealand
| | - Manfred Plagman
- Building Research Association of New Zealand, Porirua, New Zealand
| | - Edward Randal
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Lynn Riggs
- Motu Economic and Public Policy Research, Wellington, New Zealand
| | - Bridget Robson
- Eru Pomare Māori Health Research Centre, University of Otago, Wellington, New Zealand
| | - Jacinta Ruru
- Faculty of Law, University of Otago, Dunedin, New Zealand
| | - Caroline Shaw
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Ben Schrader
- Stout Research Centre, Te Herenga Waka, Victoria University of Wellington, Wellington, New Zealand
| | - Mary Anne Teariki
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Lucy Telfar Barnard
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Ramona Tiatia
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | | | - Hope Tupara
- Research Centre for Hauora & Health, Massey University, Wellington, New Zealand
| | - Helen Viggers
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | | | - Marg Wilkie
- Research Centre for Hauora & Health, Massey University, Wellington, New Zealand
| | - Alistair Woodward
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Wei Zhang
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
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Johnes C, Sharpe RA, Menneer T, Taylor T, Nestel P. Using Sensor Data to Identify Factors Affecting Internal Air Quality within 279 Lower Income Households in Cornwall, South West of England. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1075. [PMID: 36673833 PMCID: PMC9858683 DOI: 10.3390/ijerph20021075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/18/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: Poor air quality affects health and causes premature death and disease. Outdoor air quality has received significant attention, but there has been less focus on indoor air quality and what drives levels of diverse pollutants in the home, such as particulate matter, and the impact this has on health; (2) Methods: This study conducts analysis of cross-sectional data from the Smartline project. Analyses of data from 279 social housing properties with indoor sensor data were used to assess multiple factors that could impact levels of particulate matter. T-Tests and Anova tests were used to explore associations between elevated PM2.5 and building, household and smoking and vaping characteristics. Binary logistic regression was used to test the association between elevated particulate matter and self-reported health; (3) Results: Of the multiple potential drivers of the particulate matter investigated, smoking and vaping were significantly associated with mean PM2.5. Following multivariate analysis, only smoking remained significantly associated with higher mean concentrations. Properties in which <15 cigarettes/day were smoked were predicted to have PM2.5 concentrations 9.06 µg/m3 higher (95% CI 6.4, 12.82, p ≤ 0.001) than those in which residents were non-smokers and 11.82 µg/m3 higher (95% CI 7.67, 18.19, p ≤ 0.001) where >15 cigarettes were smoked; (4) Conclusions: A total of 25% of social housing properties in this study experienced levels of indoor PM greater than WHO guideline levels for ambient air pollution. Although there are many factors that impact air quality, in this study the main driver was smoking. This highlights the importance of targeting smoking in indoor environments in future smoking cessation and control policy and practice and of understanding how pollutants interact in the home environment. There is also a need for further research into the impact on indoor air quality of vaping, particularly due to the rise in use and uncertainty of its long-term impact.
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Affiliation(s)
- Christopher Johnes
- Faculty of Medicine, University of Southampton, University Road, Southampton SO17 1BJ, UK
| | - Richard A. Sharpe
- Wellbeing and Public Health Service, Cornwall Council, Truro TR1 3AY, UK
- European Centre for Environment and Human Health, College of Medicine and Health, University of Exeter, Truro TR1 3HD, UK
| | - Tamaryn Menneer
- European Centre for Environment and Human Health, College of Medicine and Health, University of Exeter, Truro TR1 3HD, UK
- Environment and Sustainability Institute, Penryn Campus, University of Exeter, Penryn TR10 9FE, UK
| | - Timothy Taylor
- European Centre for Environment and Human Health, College of Medicine and Health, University of Exeter, Truro TR1 3HD, UK
| | - Penelope Nestel
- Faculty of Medicine, University of Southampton, University Road, Southampton SO17 1BJ, UK
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Crawford G, Connor E, McCausland K, Reeves K, Blackford K. Public Health Interventions to Address Housing and Mental Health amongst Migrants from Culturally and Linguistically Diverse Backgrounds Living in High-Income Countries: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16946. [PMID: 36554827 PMCID: PMC9778908 DOI: 10.3390/ijerph192416946] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/09/2022] [Accepted: 12/11/2022] [Indexed: 06/17/2023]
Abstract
Migrants from culturally and linguistically diverse (CaLD) backgrounds experience factors that may increase health inequities related to a range of determinants of health including housing and mental health. However, the intersection between mental health and housing for migrants is poorly understood. A scoping review searched four academic databases for concepts related to cultural and linguistic diversity, housing conditions, and public health interventions to address homelessness. A total of 49 articles were included and seven key themes identified: housing provision; mental health intersections and interventions; complexity and needs beyond housing; substance use; service provider and policy issues; the role of cultural and linguistic diversity; and consumer experience. The intersection of ethnicity with other social determinants of health and housing was highlighted though there were limited interventions tailored for migrants. Studies generally pointed to the positive impacts of Housing First. Other sub-themes emerged: social connection and community; shame, stigma, and discrimination; health and support requirements; and employment, financial assistance, and income. Consumer choice was identified as vital, along with the need for systemic anti-racism work and interventions. To support secure housing for migrants and mitigate mental health impacts, closer attention is required towards migration factors along with broader, tailored services complementing housing provision.
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Affiliation(s)
- Gemma Crawford
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, WA 6845, Australia
- School of Population Health, Curtin University, Perth, WA 6845, Australia
| | - Elizabeth Connor
- School of Population Health, Curtin University, Perth, WA 6845, Australia
| | - Kahlia McCausland
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, WA 6845, Australia
- School of Population Health, Curtin University, Perth, WA 6845, Australia
| | - Karina Reeves
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, WA 6845, Australia
- School of Population Health, Curtin University, Perth, WA 6845, Australia
| | - Krysten Blackford
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, WA 6845, Australia
- School of Population Health, Curtin University, Perth, WA 6845, Australia
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Ucci M, Ortegon-Sanchez A, Mead NE, Godward C, Rahman A, Islam S, Pleace N, Albert A, Christie N. Exploring the Interactions between Housing and Neighbourhood Environments for Enhanced Child Wellbeing: The Lived Experience of Parents Living in Areas of High Child Poverty in England, UK. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12563. [PMID: 36231860 PMCID: PMC9566732 DOI: 10.3390/ijerph191912563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/23/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
Children's health can be affected by the interrelated characteristics of the physical and social environment where they live, including housing quality, neighbourhood characteristics and the local community. Following a systems-based approach, this exploratory project sought to understand how the needs and aspirations associated with the home environment can work in synergy with, or be exacerbated by, other aspects of the local area. The study recruited parents of children aged 2-12 years old from two local authorities in England with high levels of child poverty: Tower Hamlets in East London, and Bradford District in West Yorkshire. Thematic analysis of participant interviews highlighted ten themes and opportunities for improvements. The evidence presented in this research emphasises how environmental quality issues within and outside the home, compounded further by delays in repairs and reduction in service standards, as well as affordability issues, are likely to deeply affect the wellbeing of an entire generation of disadvantaged children whose parents can feel disempowered, neglected and often isolated when attempting to tackle various dimensions of inequalities. Interventions which can improve the quality of housing, and access to space and services, are urgently needed, including initiatives to support and empower families and local communities, especially those prioritising opportunities for action.
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Affiliation(s)
- Marcella Ucci
- UCL Institute for Environmental Design and Engineering, The Bartlett Faculty of the Built Environment, University College London (UCL), London WC1H 0NN, UK
| | - Adriana Ortegon-Sanchez
- Centre for Transport Studies, Department of Civil, Environmental and Geomatic Engineering, University College London (UCL), London WC1E 6BT, UK
| | - Naomi E. Mead
- Bromley by Bow Centre, St. Leonard’s Street, London E3 3BT, UK
| | - Catherine Godward
- Department for Transport, Great Minster House, 33 Horseferry Road, London SW1P 4DR, UK
| | - Aamnah Rahman
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford BD9 6RJ, UK
| | - Shahid Islam
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford BD9 6RJ, UK
| | - Nicholas Pleace
- Centre for Housing Policy, University of York, Heslington, York YO10 5DD, UK
| | - Alexandra Albert
- Thomas Coram Research Unit, University College London (UCL), 27-28 Woburn Square, London WC1H 0AA, UK
| | - Nicola Christie
- Centre for Transport Studies, Department of Civil, Environmental and Geomatic Engineering, University College London (UCL), London WC1E 6BT, UK
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Wilderink L, Bakker I, Schuit AJ, Seidell JC, Pop IA, Renders CM. A Theoretical Perspective on Why Socioeconomic Health Inequalities Are Persistent: Building the Case for an Effective Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8384. [PMID: 35886234 PMCID: PMC9317352 DOI: 10.3390/ijerph19148384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/24/2022] [Accepted: 06/30/2022] [Indexed: 12/10/2022]
Abstract
Despite policy intentions and many interventions aimed at reducing socioeconomic health inequalities in recent decades in the Netherlands and other affluent countries, these inequalities have not been reduced. Based on a narrative literature review, this paper aims to increase insight into why socioeconomic health inequalities are so persistent and build a way forward for improved approaches from a theoretical perspective. Firstly, we present relevant theories focusing on individual determinants of health-related behaviors. Thereafter, we present theories that take into account determinants of the individual level and the environmental level. Lastly, we show the complexity of the system of individual determinants, environmental determinants and behavior change for low socioeconomic position (SEP) groups and describe the next steps in developing and evaluating future effective approaches. These steps include systems thinking, a complex whole-system approach and participation of all stakeholders in system change.
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Affiliation(s)
- Lisa Wilderink
- Department of Health Sciences, Faculty of Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands; (J.C.S.); (C.M.R.)
- Department of Healthy Society, Windesheim University of Applied Sciences, 8017 CA Zwolle, The Netherlands;
| | - Ingrid Bakker
- Department of Healthy Society, Windesheim University of Applied Sciences, 8017 CA Zwolle, The Netherlands;
| | - Albertine J. Schuit
- School of Social and Behavioral Sciences, Tilburg University, 5037 AB Tilburg, The Netherlands; (A.J.S.); (I.A.P.)
| | - Jacob C. Seidell
- Department of Health Sciences, Faculty of Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands; (J.C.S.); (C.M.R.)
| | - Ioana A. Pop
- School of Social and Behavioral Sciences, Tilburg University, 5037 AB Tilburg, The Netherlands; (A.J.S.); (I.A.P.)
| | - Carry M. Renders
- Department of Health Sciences, Faculty of Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands; (J.C.S.); (C.M.R.)
- Department of Healthy Society, Windesheim University of Applied Sciences, 8017 CA Zwolle, The Netherlands;
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Colburn G, Fyall R, McHugh C, Moraras P, Ewing V, Thompson S, Dean T, Argodale S. Hotels as Noncongregate Emergency Shelters: An Analysis of Investments in Hotels as Emergency Shelter in King County, Washington During the COVID-19 Pandemic. HOUSING POLICY DEBATE 2022; 32:853-875. [PMID: 37860162 PMCID: PMC10586465 DOI: 10.1080/10511482.2022.2075027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 01/21/2022] [Accepted: 05/04/2022] [Indexed: 10/21/2023]
Abstract
This study analyzes the COVID-19 homelessness response in King County, Washington, in which people were moved out of high-density emergency shelters into hotel rooms. This intervention was part of a regional effort to de-intensify the shelter system and limit the transmission of the virus to protect vulnerable individuals experiencing homelessness. This study used quantitative and qualitative methods to describe the experiences of and outcomes on individuals who were moved from shelters to noncongregate hotel settings. The study highlights a new approach to shelter delivery that not only responded to the public health imperatives of COVID-19, but also indicated positive health and social outcomes compared to traditional congregate settings. The findings establish an evidence base to help inform future strategic responses to homelessness as well as to contribute to the broader policy conversations on our nation's response to homelessness.
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Affiliation(s)
| | - Rachel Fyall
- University of Washington, Seattle, WA 98104, USA
| | | | - Pear Moraras
- University of Washington, Seattle, WA 98104, USA
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11
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Do the Determinants of Mental Wellbeing Vary by Housing Tenure Status? Secondary Analysis of a 2017 Cross-Sectional Residents Survey in Cornwall, South West England. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073816. [PMID: 35409496 PMCID: PMC8997911 DOI: 10.3390/ijerph19073816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/18/2022] [Accepted: 03/20/2022] [Indexed: 11/27/2022]
Abstract
Housing is a social determinant of health, comprising multiple interrelated attributes; the current study was developed to examine whether differences in mental wellbeing across housing tenure types might relate to individual, living, or neighbourhood circumstances. To achieve this aim, an exploratory cross-sectional analysis was conducted using secondary data from a county-wide resident survey undertaken by Cornwall Council in 2017. The survey included questions about individual, living, or neighbourhood circumstances, as well as mental wellbeing (Short Warwick-Edinburgh Mental Wellbeing Scale). A random sample of 30,152 households in Cornwall were sent the survey, from whom 11,247 valid responses were received (38% response), but only 4085 (13.5%) provided complete data for this study. Stratified stepwise models were estimated to generate hypotheses about inequalities in mental wellbeing related to housing tenure. Health, life satisfaction, and social connectedness were found to be universal determinants of mental wellbeing, whereas issues related to living circumstances (quality of housing, fuel poverty) were only found to be related to wellbeing among residents of privately owned and rented properties. Sense of safety and belonging (neighbourhood circumstances) were also found to be related to wellbeing, which together suggests that whole system place-based home and people/community-centred approaches are needed to reduce inequalities.
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Prevalence, Risk Factors and Impacts Related to Mould-Affected Housing: An Australian Integrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031854. [PMID: 35162876 PMCID: PMC8835129 DOI: 10.3390/ijerph19031854] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 11/25/2022]
Abstract
In response to an Australian governmental inquiry into biotoxin-related illness, the purpose of this integrative review is to bring together the current state of evidence on the prevalence, risk factors and impacts related to mould-affected housing in an Australian context, in order to inform building, housing and health research, practice and policy. The robust integrative review methodology simultaneously sought quantitative and qualitative studies and grey literature from multiple disciplines, identifying only 45 studies directly relating to Australian housing and indoor mould. Twenty-one studies highlight negative health impacts relating to indoor residential mould, with asthma, respiratory, allergy conditions and emerging health concerns for chronic multiple-symptom presentation. The majority of studies reported risk factors for indoor mould including poor housing conditions, poor-quality rental accommodation, socioeconomic circumstance, age-related housing issues and concerns for surface/interstitial condensation and building defects in newer housing. Risks for indoor mould in both older and newer housing raise concerns for the extent of the problem of indoor mould in Australia. Understanding the national prevalence of housing risks and “root cause” associated with indoor mould is not conclusive from the limited existing evidence. Synthesis of this evidence reveals a lack of coverage on: (1) national and geographical representation, (2) climatical coverage, (3) housing typologies, (4) housing defects, (5) maintenance, (6) impact from urbanisation, and (7) occupant’s behaviour. This integrative review was key in identifying emerging housing and health concerns, highlighting gaps in data and implications to be addressed by researchers, practice and policy and acts as a comprehensive holistic review process that can be applied to other countries.
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French MA, Fiona Barker S, Taruc RR, Ansariadi A, Duffy GA, Saifuddaolah M, Zulkifli Agussalim A, Awaluddin F, Zainal Z, Wardani J, Faber PA, Fleming G, Ramsay EE, Henry R, Lin A, O'Toole J, Openshaw J, Sweeney R, Sinharoy SS, Kolotelo P, Jovanovic D, Schang C, Higginson EE, Prescott MF, Burge K, Davis B, Ramirez-Lovering D, Reidpath D, Greening C, Allotey P, Simpson JA, Forbes A, Chown SL, McCarthy D, Johnston D, Wong T, Brown R, Clasen T, Luby S, Leder K. A planetary health model for reducing exposure to faecal contamination in urban informal settlements: Baseline findings from Makassar, Indonesia. ENVIRONMENT INTERNATIONAL 2021; 155:106679. [PMID: 34126296 DOI: 10.1016/j.envint.2021.106679] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/26/2021] [Accepted: 05/26/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The intense interactions between people, animals and environmental systems in urban informal settlements compromise human and environmental health. Inadequate water and sanitation services, compounded by exposure to flooding and climate change risks, expose inhabitants to environmental contamination causing poor health and wellbeing and degrading ecosystems. However, the exact nature and full scope of risks and exposure pathways between human health and the environment in informal settlements are uncertain. Existing models are limited to microbiological linkages related to faecal-oral exposures at the individual level, and do not account for a broader range of human-environmental variables and interactions that affect population health and wellbeing. METHODS We undertook a 12-month health and environmental assessment in 12 flood-prone informal settlements in Makassar, Indonesia. We obtained caregiver-reported health data, anthropometric measurements, stool and blood samples from children < 5 years, and health and wellbeing data for children 5-14 years and adult respondents. We collected environmental data including temperature, mosquito and rat species abundance, and water and sediment samples. Demographic, built environment and household asset data were also collected. We combined our data with existing literature to generate a novel planetary health model of health and environment in informal settlements. RESULTS Across the 12 settlements, 593 households and 2764 participants were enrolled. Two-thirds (64·1%) of all houses (26·3-82·7% per settlement) had formal land tenure documentation. Cough, fever and diarrhoea in the week prior to the survey were reported among an average of 34.3%, 26.9% and 9.7% of children aged < 5 years, respectively; although proportions varied over time, prevalence among these youngest children was consistently higher than among children 5-14 years or adult respondents. Among children < 5 years, 44·3% experienced stunting, 41·1% underweight, 12.4% wasting, and 26.5% were anaemic. There was self- or carer-reported poor mental health among 16.6% of children aged 5-14 years and 13.9% of adult respondents. Rates of potential risky exposures from swimming in waterways, eating uncooked produce, and eating soil or dirt were high, as were exposures to flooding and livestock. Just over one third of households (35.3%) had access to municipal water, and contamination of well water with E. coli and nitrogen species was common. Most (79·5%) houses had an in-house toilet, but no houses were connected to a piped sewer network or safe, properly constructed septic tank. Median monthly settlement outdoor temperatures ranged from 26·2 °C to 29.3 °C, and were on average, 1·1 °C warmer inside houses than outside. Mosquito density varied over time, with Culex quinquefasciatus accounting for 94·7% of species. Framed by a planetary health lens, our model includes four thematic domains: (1) the physical/built environment; (2) the ecological environment; (3) human health; and (4) socio-economic wellbeing, and is structured at individual, household, settlement, and city/beyond spatial scales. CONCLUSIONS Our planetary health model includes key risk factors and faecal-oral exposure pathways but extends beyond conventional microbiological faecal-oral enteropathogen exposure pathways to comprehensively account for a wider range of variables affecting health in urban informal settlements. It includes broader ecological interconnections and planetary health-related variables at the household, settlement and city levels. It proposes a composite framework of markers to assess water and sanitation challenges and flood risks in urban informal settlements for optimal design and monitoring of interventions.
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Affiliation(s)
- Matthew A French
- Monash Sustainable Development Institute, Monash University, Victoria 3800, Australia
| | - S Fiona Barker
- School of Public Health and Preventive Medicine, Monash University, Victoria 3004, Australia
| | - Ruzka R Taruc
- RISE Program, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | | | - Grant A Duffy
- School of Biological Sciences, Monash University, Victoria 3800, Australia
| | | | | | - Fitriyanty Awaluddin
- RISE Program, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Zainal Zainal
- RISE Program, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Jane Wardani
- Monash Sustainable Development Institute, Monash University, Victoria 3800, Australia
| | - Peter A Faber
- School of Biological Sciences, Monash University, Victoria 3800, Australia
| | - Genie Fleming
- School of Biological Sciences, Monash University, Victoria 3800, Australia
| | - Emma E Ramsay
- School of Biological Sciences, Monash University, Victoria 3800, Australia
| | - Rebekah Henry
- Environmental and Public Health Microbiology Laboratory (EPHM Lab), Department of Civil Engineering, Monash University, Victoria 3800, Australia
| | - Audrie Lin
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Joanne O'Toole
- School of Public Health and Preventive Medicine, Monash University, Victoria 3004, Australia
| | - John Openshaw
- Woods Institute and the Freeman Spogli Institute, Stanford University, Stanford, CA 94305, USA
| | - Rohan Sweeney
- Centre for Health Economics, Monash Business School, Monash University, Victoria 3145, Australia
| | - Sheela S Sinharoy
- Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Peter Kolotelo
- Environmental and Public Health Microbiology Laboratory (EPHM Lab), Department of Civil Engineering, Monash University, Victoria 3800, Australia
| | - Dusan Jovanovic
- Environmental and Public Health Microbiology Laboratory (EPHM Lab), Department of Civil Engineering, Monash University, Victoria 3800, Australia
| | - Christelle Schang
- Environmental and Public Health Microbiology Laboratory (EPHM Lab), Department of Civil Engineering, Monash University, Victoria 3800, Australia
| | - Ellen E Higginson
- Cambridge Institute for Therapeutic Immunology and Infectious Disease, University of Cambridge, Cambridge, UK
| | - Michaela F Prescott
- Informal Cities Lab, Monash Art Design & Architecture, Monash University, Victoria 3145, Australia
| | - Kerrie Burge
- Monash Sustainable Development Institute, Monash University, Victoria 3800, Australia
| | - Brett Davis
- Monash Sustainable Development Institute, Monash University, Victoria 3800, Australia
| | - Diego Ramirez-Lovering
- Informal Cities Lab, Monash Art Design & Architecture, Monash University, Victoria 3145, Australia
| | - Daniel Reidpath
- The International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Chris Greening
- Biomedicine Discovery Institute, Department of Microbiology, Monash University, Victoria 3800, Australia
| | - Pascale Allotey
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia; International Institute for Global Health, United Nations University, Kuala Lumpur, Malaysia
| | - Julie A Simpson
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Andrew Forbes
- School of Public Health and Preventive Medicine, Monash University, Victoria 3004, Australia
| | - Steven L Chown
- School of Biological Sciences, Monash University, Victoria 3800, Australia
| | - David McCarthy
- Environmental and Public Health Microbiology Laboratory (EPHM Lab), Department of Civil Engineering, Monash University, Victoria 3800, Australia
| | - David Johnston
- Centre for Health Economics, Monash Business School, Monash University, Victoria 3145, Australia
| | - Tony Wong
- Water Sensitive Cities Institute, Monash University, Victoria 3800, Australia
| | - Rebekah Brown
- Monash Sustainable Development Institute, Monash University, Victoria 3800, Australia
| | - Thomas Clasen
- Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Stephen Luby
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Karin Leder
- School of Public Health and Preventive Medicine, Monash University, Victoria 3004, Australia.
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A Critical Success Factor Framework for Implementing Sustainable Innovative and Affordable Housing: A Systematic Review and Bibliometric Analysis. BUILDINGS 2021. [DOI: 10.3390/buildings11080317] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The actualization of affordable housing remains a challenge. This challenge is exacerbated by the increasing societal demand for the incorporation of sustainability principles into such housing types to improve levels of occupant health and well-being whilst avouching the desired levels of affordability. Innovative technologies and practices have been described as beneficial to the effectuation of sustainable affordable housing. However, knowledge concerning the deployment of innovative technologies and practices in sustainable affordable housing (sustainable, innovative, affordable housing—SIAH) delivery remains nascent. Consequently, there is a lack of a common ontology among stakeholders concerning how to realize SIAH. This study aims to contribute toward the development of this body of knowledge through the establishment of the critical success factors (CSFs) for effective SIAH implementation. To achieve this objective, a systematic review and bibliometric analysis focusing on a juxtaposition of sustainable, innovative and affordable housing concepts was carried out based on the relevant literature. This led to the identification and clustering of CSFs for these housing concepts at individual levels and as a collective (SIAH). The findings of the study consisted of the establishment of four distinct yet interrelated facets through which SIAH can be achieved holistically, namely, housing design, house element, housing production method and housing technology. A total of 127 CSFs were found to be aligned to these facets, subsequently clustered, and conclusively used for the development of a SIAH CSF framework. The most frequently occurring CSFs with predominant interconnections were the utilization of energy-efficient systems/fittings, tenure security, a comfortable and healthy indoor environment, affordable housing price in relation to income and using water-efficient systems/fittings CSFs, and establishing the emergent SIAH CSF framework. The framework in this study is useful in the documentation of SIAH features for construction projects and further studies into SIAH CSFs.
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Schuler MS, Prince DM, Collins RL. Disparities in Social and Economic Determinants of Health by Sexual Identity, Gender, and Age: Results from the 2015-2018 National Survey on Drug Use and Health. LGBT Health 2021; 8:330-339. [PMID: 34101498 DOI: 10.1089/lgbt.2020.0390] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Purpose: We characterize disparities between lesbian, gay, and bisexual (LGB) adults and heterosexual adults across multiple health determinants in a nationally representative sample. Methods: Data on 153,939 adults (including 11,133 LGB adults) were from the 2015-2018 National Survey on Drug Use and Health. Separate Poisson regression models were used to estimate the relative risk (RR) that gay/lesbian and bisexual adults, respectively, experienced each health determinant, relative to heterosexual adults of the same gender and age group (ages 18-25, 26-34, 35-49, and 50-64). Statistically significant RR estimates were interpreted as a disparity. Results: Bisexual females exhibited disparities on all economic/health care access factors (no college degree, household poverty, means-tested assistance, unemployment, and lacking health insurance) across nearly all age groups; lesbian/gay females exhibited disparities in means-tested assistance and health insurance for some age groups. Notably fewer economic disparities were observed among gay and bisexual males. LGB adults (across identity, gender, and age group) were more likely to live alone, to have never been married, and to report low religious service attendance. Bisexual and lesbian/gay females, across age groups, had 1.7-2.2 times the risk of a lifetime arrest for a criminal offense, relative to same-age heterosexual females. Conclusions: Our results highlight that LGB females, particularly bisexual females, experience significant disparities in economic determinants of health, and all LGB subgroups exhibited disparities in some of the examined social determinants of health. The observed disparities, which spanned across age groups, likely contribute to disparities in physical and mental health observed among LGB adults.
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Affiliation(s)
| | - Dana M Prince
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, USA
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Reifsnider E, Packer PW, Argent-DeLorme A, Suarez C. Community development for improved housing, health equity, and education in rural Honduras. Public Health Nurs 2021; 38:680-686. [PMID: 33860566 DOI: 10.1111/phn.12902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 11/28/2022]
Abstract
This paper describes an international, long-term, population health project in rural Honduras among Mayan villagers, focused on collaboration, community building, partnership formation, and improvement of their living situation. Improved housing, health checks, education for their children, and clean water were chosen by the Honduran residents as the projects they thought were most important to improve their health and living conditions. During the short mission trips, the North Americans (NAs) and the villagers worked side-by-side on house building and participated in village life. The Hondurans organized into communities that mutually decided on which families received homes and together worked on each other's homes with the NAs' assistance. Nurse-led health clinics and scholarships for students were provided by the visitors during their time in the villages. Health has improved from better housing and periodic health checks, and most significantly, sustainable community organizing occurred. Public Health Nurses can work towards health equity and population health improvement by basing efforts on what the community partners request and create outcomes through relationships with those who stand to benefit from the improvement.
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Adapting the environmental risk transition theory for urban health inequities: An observational study examining complex environmental riskscapes in seven neighborhoods in Global North cities. Soc Sci Med 2021; 277:113907. [PMID: 33882438 DOI: 10.1016/j.socscimed.2021.113907] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/18/2020] [Accepted: 04/01/2021] [Indexed: 11/21/2022]
Abstract
Theories of epidemiologic transition analyze the shift in causes of mortality due to changes in risk factors over time, and through processes of urbanization and development by comparing risk factors between countries or over time. These theories do not account for health inequities such as those resulting from environmental injustice, in which minority and lower income residents are more likely to be exposed to environmental hazards or have less access to environmental goods. Neighborhoods with histories of environmental injustice are also at risk for gentrification as they undergo environmental improvements and new greening projects. We aimed to understand how environmental injustice, urban renewal and green gentrification could inform the understanding of epidemiologic risk transitions. We examined 7 case neighborhoods in cities in the United States and Western Europe which were representative in terms of city region and type, which 1) had experienced a history of environmental injustice and 2) exhibited evidence of recent processes of urban renewal and/or gentrification. In each city, we conducted semi-structured qualitative interviews (n = 172) with city representatives, activists, non-profits, developers and residents. Respondents reported health implications of traditional (heavy pollutants, poor social conditions), transitional (decontamination, new amenities), new (gentrification, access to amenities), and emerging (displacement, climate-related risks, re-emergence of traditional exposures) exposures. Respondents reported renewed, complexified and overlapping exposures leading to poor mental and physical health and to new patterns of health inequity. Our findings point to the need for theories of environmental and epidemiologic risk transitions to incorporate analysis of trends 1) on a city-scale, acknowledging that segregation and patterns of environmental injustice have created unequal conditions within cities and 2) over a shorter and more recent time period, taking into account worsening patterns of social inequity in cities.
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A Study on the Relationship between Usability of GUIs and Power Consumption of a PC: The Case of PHRs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041385. [PMID: 33546174 PMCID: PMC7913159 DOI: 10.3390/ijerph18041385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/23/2021] [Accepted: 01/28/2021] [Indexed: 12/26/2022]
Abstract
Usability is key to achieve quality in software products. The client applications with a high score in usability might impact on the power consumption when they are run in a PC. For this reason, energy savings turn to be critical in green software systems. In this paper the relationship between the usability evaluations of the GUIs and the power consumption measurements of the main components of a PC were analysed. A set of 5 web-based personal health records (PHRs) were selected as a case study. The usability assessment was performed by an expert, employing the 14 principles of design by Alan Dix as heuristics. They were scored on a Likert scale after performing a collection of common tasks in the PHRs. At the same time, an equipment to measure the energy consumption of hard disk drive, graphics card, processor, monitor and power supply was used. Spearman’s index was studied for the correlations between the usability assessments and the power consumption measurements. As a results, some weak relationships were found. A total of 5 usability heuristics were observed to may influence energy consumption when they were considered in the implementation of the PHRs. These heuristics were the following ones: consistency, task migratability, observability, recoverability and responsiveness. Based on the results, the usability principles of design cannot always be related to lower energy consumption. Future research should focus on the tradeoffs between usability and power consumption of client applications when they are used in a computer.
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Stegeman I, Godfrey A, Romeo-Velilla M, Bell R, Staatsen B, van der Vliet N, Kruize H, Morris G, Taylor T, Strube R, Anthun K, Lillefjell M, Zvěřinová I, Ščasný M, Máca V, Costongs C. Encouraging and Enabling Lifestyles and Behaviours to Simultaneously Promote Environmental Sustainability, Health and Equity: Key Policy Messages from INHERIT. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7166. [PMID: 33007942 PMCID: PMC7579413 DOI: 10.3390/ijerph17197166] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/12/2020] [Accepted: 09/24/2020] [Indexed: 01/12/2023]
Abstract
Human consumption and activity are damaging the global ecosystem and the resources on which we rely for health, well-being and survival. The COVID-19 crisis is yet another manifestation of the urgent need to transition to more sustainable societies, further exposing the weaknesses in health systems and the injustice in our societies. It also underlines that many of the factors leading to environmental degradation, ill health and social and health inequities are interlinked. The current situation provides an unprecedented opportunity to invest in initiatives that address these common factors and encourage people to live more healthily and sustainably. Such initiatives can generate the positive feedback loops needed to change the systems and structures that shape our lives. INHERIT (January 2016-December 2019), an ambitious, multisectoral and transnational research project that involved 18 organisations across Europe, funded by the European Commission, explored such solutions. It identified, defined and analysed promising inter-sectoral policies, practices and approaches to simultaneously promote environmental sustainability, protect and promote health and contribute to health equity (the INHERIT "triple-win") and that can encourage and enable people to live, move and consume more healthfully and sustainably. It also explored the facilitators and barriers to working across sectors and in public private cooperation. The insights were brought together in guidelines setting out how policy makers can help instigate and support local "triple-win" initiatives that influence behaviours as an approach to contributing to the change that is so urgently needed to stem environmental degradation and the interlinked threats to health and wellbeing. This article sets out this guidance, providing timely insights on how to "build back better" in the post pandemic era.
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Affiliation(s)
- Ingrid Stegeman
- EuroHealthNet, Royale Rue 146, 1000 Brussels, Belgium; (A.G.); (M.R.-V.); (C.C.)
| | - Alba Godfrey
- EuroHealthNet, Royale Rue 146, 1000 Brussels, Belgium; (A.G.); (M.R.-V.); (C.C.)
| | - Maria Romeo-Velilla
- EuroHealthNet, Royale Rue 146, 1000 Brussels, Belgium; (A.G.); (M.R.-V.); (C.C.)
| | - Ruth Bell
- Institute of Health Equity, UCL, London WC1E 7HB, UK;
| | - Brigit Staatsen
- Centre for Environmental Health Research, National Institute for Public Health and the Environment (RIVM), 3720 BA Bilthoven, The Netherlands; (B.S.); (H.K.)
| | - Nina van der Vliet
- Centre for Sustainability, Environment and Health, National Institute for Public Health and the Environment (RIVM), 3720 BA Bilthoven, The Netherlands;
| | - Hanneke Kruize
- Centre for Environmental Health Research, National Institute for Public Health and the Environment (RIVM), 3720 BA Bilthoven, The Netherlands; (B.S.); (H.K.)
| | - George Morris
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro TR1 3HD, UK; (G.M.); (T.T.)
| | - Timothy Taylor
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro TR1 3HD, UK; (G.M.); (T.T.)
| | - Rosa Strube
- Collaborating Centre on Sustainable Consumption and Production (CSCP) gGmbH, Hagenauer Strasse 30, 42107 Wuppertal, Germany;
| | - Kirsti Anthun
- Norwegian University of Science and Technology, Tungasletta 2, NO-7491 Trondheim, Norway; (K.A.); (M.L.)
| | - Monica Lillefjell
- Norwegian University of Science and Technology, Tungasletta 2, NO-7491 Trondheim, Norway; (K.A.); (M.L.)
| | - Iva Zvěřinová
- Environment Centre, Charles University, 16200 Praha, Czech Republic; (I.Z.); (M.Š.); (V.M.)
| | - Milan Ščasný
- Environment Centre, Charles University, 16200 Praha, Czech Republic; (I.Z.); (M.Š.); (V.M.)
| | - Vojtěch Máca
- Environment Centre, Charles University, 16200 Praha, Czech Republic; (I.Z.); (M.Š.); (V.M.)
| | - Caroline Costongs
- EuroHealthNet, Royale Rue 146, 1000 Brussels, Belgium; (A.G.); (M.R.-V.); (C.C.)
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20
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Henson RM, Ortigoza A, Martinez-Folgar K, Baeza F, Caiaffa W, Vives Vergara A, Diez Roux AV, Lovasi G. Evaluating the health effects of place-based slum upgrading physical environment interventions: A systematic review (2012-2018). Soc Sci Med 2020; 261:113102. [PMID: 32739786 PMCID: PMC7611465 DOI: 10.1016/j.socscimed.2020.113102] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/28/2020] [Accepted: 05/31/2020] [Indexed: 11/04/2022]
Abstract
Rapid urbanization in low- and middle-income countries (LMIC) is associated with increasing population living in informal settlements. Inadequate infrastructure and disenfranchisement in settlements can create environments hazardous to health. Placed-based physical environment upgrading interventions have potential to improve environmental and economic conditions linked to health outcomes. Summarizing and assessing evidence of the impact of prior interventions is critical to motivating and selecting the most effective upgrading strategies moving forward. Scientific and grey literature were systematically reviewed to identify evaluations of physical environment slum upgrading interventions in LMICs published between 2012 and 2018. Thirteen evaluations that fulfilled inclusion criteria were reviewed. Quality of evaluations was assessed using an adapted Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Findings were then pooled with those published prior to 2012. Narrative analysis was performed. Of thirteen evaluations, eight used a longitudinal study design (“primary evaluations”). All primary evaluations were based in Latin America and included two housing, two transportation, and four comprehensive intervention evaluations. Three supporting evaluations assessed housing interventions in Argentina and South Africa; two assessed a comprehensive intervention in India. Effects by intervention-type included improvements in quality of life and communicable diseases after housing interventions, possible improvements in safety after transportation and comprehensive interventions, and possible non-statistically significant effects on social capital after comprehensive interventions. Effects due to interventions may vary by regional context and intervention scope. Limited strong evidence and the diffuse nature of comprehensive interventions suggests a need for attention to measurement of intervention exposure and analytic approaches to account for confounding and selection bias in evaluation. In addition to health improvements, evaluators should consider unintended health consequences and environmental impact. Understanding and isolating the effects of place-based interventions can inform necessary policy decisions to address inadequate living conditions as rapid urban growth continues across the globe.
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Affiliation(s)
- Rosie Mae Henson
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3600 Market Street, 7th Floor, Philadelphia, PA, USA, 19104.
| | - Ana Ortigoza
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3600 Market Street, 7th Floor, Philadelphia, PA, USA, 19104
| | - Kevin Martinez-Folgar
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3600 Market Street, 7th Floor, Philadelphia, PA, USA, 19104; Instituto de Nutrición de Centroamérica y Panamá (INCAP), Guatemala
| | - Fernando Baeza
- Departamento de Salud Pública, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Waleska Caiaffa
- Observatório de Saúde Urbana de Belo Horizonte, Universidade Federal de Minas Gerais, Brazil
| | - Alejandra Vives Vergara
- Departamento de Salud Pública, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile; Centro de Desarrollo Urbano Sustentable (CEDEUS), Pontificia Universidad Católica de Chile, Chile
| | - Ana V Diez Roux
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3600 Market Street, 7th Floor, Philadelphia, PA, USA, 19104
| | - Gina Lovasi
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3600 Market Street, 7th Floor, Philadelphia, PA, USA, 19104
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Shenassa ED, Williams AD. Concomitant exposure to area-level poverty, ambient air volatile organic compounds, and cardiometabolic dysfunction: a cross-sectional study of U.S. adolescents. Ann Epidemiol 2020; 48:15-22. [PMID: 32778227 DOI: 10.1016/j.annepidem.2020.05.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 05/09/2020] [Accepted: 05/27/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE A key to better understanding the influence of the place of residence on cardiometabolic function is the effect of concomitant exposure to both air pollution and residence in economically marginalized areas. We hypothesized that, among adolescents, the association between air pollution and cardiometabolic function is exacerbated among residents of economically marginalized areas. METHODS In this cross-sectional study, individual-level data on cardiometabolic function collected from a representative sample of U.S. adolescents in the National Health and Nutrition Examination Survey (n = 10,415) were merged with data on area-level poverty (U.S. decennial survey and American Community Survey) and air pollution levels (National-Scale Air Toxics Assessment ) using contemporary census-tract identifiers. We excluded respondents who were pregnant, had hypertension or diabetes or using medication for hypertension or diabetes, or with missing data on outcome variables. RESULTS We observed a significant interaction between area-level poverty and air pollution. Among residents of high-poverty areas, exposure to high levels of air pollution predicted a 30% elevated odds of cardiometabolic dysfunction (OR = 1.30; 95% CI: 1.04, 1.61), whereas in low-poverty areas, exposure to high levels of air pollution was not associated with elevated odds of cardiometabolic dysfunction (OR = 1.04; 95% CI: 0.85, 1.28). CONCLUSIONS Our findings suggest that the cardiometabolic consequences of air pollution are more readily realized among residents of economically marginalized areas. Structural remedies are discussed.
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Affiliation(s)
- Edmond D Shenassa
- Maternal and Child Health Program, Department of Family Science, University of Maryland, College Park; Department of Epidemiology and Biostatistics, University of Maryland, College Park, MD; Department of Epidemiology and Biostatistics, School of Public Health, Brown University, Providence, RI; Department of Epidemiology and Biostatistics, School of Medicine, University of Maryland Baltimore, Baltimore, MD.
| | - Andrew D Williams
- Public Health Program, School of Medicine & Health Sciences, University of North Dakota, Grand Forks
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Van der Linden BWA, Cheval B, Sieber S, Orsholits D, Guessous I, Stringhini S, Gabriel R, Aartsen M, Blane D, Courvoisier D, Burton-Jeangros C, Kliegel M, Cullati S. Life Course Socioeconomic Conditions and Frailty at Older Ages. J Gerontol B Psychol Sci Soc Sci 2020; 75:1348-1357. [PMID: 30753721 PMCID: PMC7265806 DOI: 10.1093/geronb/gbz018] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 02/01/2019] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES This article aimed to assess associations of childhood socioeconomic conditions (CSC) with the risk of frailty in old age and whether adulthood socioeconomic conditions (ASC) influence this association. METHODS Data from 21,185 individuals aged 50 years and older included in the longitudinal Survey of Health, Ageing, and Retirement in Europe were used. Frailty was operationalized as a sum of presenting weakness, shrinking, exhaustion, slowness, or low activity. Confounder-adjusted multilevel logistic regression models were used to analyze associations of CSC and ASC with frailty. RESULTS While disadvantaged CSC was associated with higher odds of (pre-)frailty in women and men (odds ratio [OR] = 1.73, 95% confidence interval [CI] 1.34, 2.24; OR = 1.84, 95% CI 1.27, 2.66, respectively), this association was mediated by ASC. Personal factors and demographics, such as birth cohort, chronic conditions, and difficulties with activities of daily living, increased the odds of being (pre-)frail. DISCUSSION Findings suggest that CSC are associated with frailty at old age. However, when taking into account ASC, this association no longer persists. The results show the importance of improving socioeconomic conditions over the whole life course in order to reduce health inequalities in old age.
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Affiliation(s)
- Bernadette Wilhelmina Antonia Van der Linden
- Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”Arve, Geneva, Switzerland
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Switzerland
| | - Boris Cheval
- Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”Arve, Geneva, Switzerland
| | - Stefan Sieber
- Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”Arve, Geneva, Switzerland
| | - Dan Orsholits
- Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”Arve, Geneva, Switzerland
| | - Idris Guessous
- Unit of Population Epidemiology, Department of Community Medicine, Primary Care and Emergency Medicine, Geneva University Hospitals, Switzerland
- Department of Epidemiology, Emory University, Atlanta, Georgia
- Department of Ambulatory Care and Community Medicine, University of Lausanne, Switzerland
| | - Silvia Stringhini
- Institute of Social and Preventive Medicine, Lausanne University Hospital, Switzerland
| | - Rainer Gabriel
- Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”Arve, Geneva, Switzerland
- ZHAW, Zurich University of Applied Sciences, Switzerland
| | - Marja Aartsen
- NOVA - Norwegian Social Research, Center for Welfare and Labor Research, Oslo, Norway
| | - David Blane
- International Centre for Life Course Studies in Society and Health, Department of Epidemiology and Public Health, University College London, UK
| | - Delphine Courvoisier
- Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”Arve, Geneva, Switzerland
- Unit of Population Epidemiology, Department of Community Medicine, Primary Care and Emergency Medicine, Geneva University Hospitals, Switzerland
| | - Claudine Burton-Jeangros
- Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”Arve, Geneva, Switzerland
| | - Matthias Kliegel
- Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”Arve, Geneva, Switzerland
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Switzerland
| | - Stéphane Cullati
- Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”Arve, Geneva, Switzerland
- Department of General Internal Medicine, Rehabilitation and Geriatrics, University of Geneva, Switzerland
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Van Der Linden BWA, Sieber S, Cheval B, Orsholits D, Guessous I, Gabriel R, Von Arx M, Kelly-Irving M, Aartsen M, Blane D, Boisgontier MP, Courvoisier D, Oris M, Kliegel M, Cullati S. Life-Course Circumstances and Frailty in Old Age Within Different European Welfare Regimes: A Longitudinal Study With SHARE. J Gerontol B Psychol Sci Soc Sci 2020; 75:1326-1335. [PMID: 31665484 PMCID: PMC7265805 DOI: 10.1093/geronb/gbz140] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES This study aimed to assess whether cumulative disadvantage in childhood misfortune and adult-life socioeconomic conditions influence the risk of frailty in old age and whether welfare regimes influence these associations. METHOD Data from 23,358 participants aged 50 years and older included in the longitudinal SHARE survey were used. Frailty was operationalized according to Fried's phenotype as presenting either weakness, shrinking, exhaustion, slowness, or low activity. Confounder-adjusted mixed-effects logistic regression models were used to analyze associations of childhood misfortune and life-course socioeconomic conditions with frailty. RESULTS Childhood misfortune and poor adult-life socioeconomic conditions increased the odds of (pre-)frailty at older age. With aging, differences narrowed between categories of adverse childhood experiences (driven by Scandinavian welfare regime) and adverse childhood health experiences (driven by Eastern European welfare regime), but increased between categories of occupational position (driven by Bismarckian welfare regime). DISCUSSION These findings suggest that childhood misfortune is linked to frailty in old age. Such a disadvantaged start in life does not seem to be compensated by a person's life-course socioeconomic trajectory, though certain types of welfare regimes affected this relationship. Apart from main occupational position, our findings do not support the cumulative dis/advantage theory, but rather show narrowing differences.
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Affiliation(s)
| | - Stefan Sieber
- Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”
| | - Boris Cheval
- Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”
- Department of Readaptation and Geriatrics, University of Geneva, Switzerland
| | - Dan Orsholits
- Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”
| | - Idris Guessous
- Department of Community Medicine, Primary Care and Emergency Medicine, Geneva University Hospitals, Switzerland
- Department of Ambulatory Care and Community Medicine, University of Lausanne, Switzerland
| | - Rainer Gabriel
- Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”
- ZHAW, Zurich University of Applied Sciences, Switzerland
| | - Martina Von Arx
- Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”
| | - Michelle Kelly-Irving
- INSERM, UMR1027, Toulouse, France
- Université Toulouse III Paul-Sabatier, UMR1027, Toulouse, France
| | - Marja Aartsen
- NOVA - Norwegian Social Research, Center for Welfare and Labor Research, Oslo, Norway
| | - David Blane
- International Centre for Life Course Studies in Society and Health, Department of Epidemiology and Public Health, University College London, UK
| | | | | | - Michel Oris
- Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”
- Center for the Interdisciplinary Study of Gerontology and Vulnerability
| | - Matthias Kliegel
- Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”
- Center for the Interdisciplinary Study of Gerontology and Vulnerability
| | - Stéphane Cullati
- Swiss NCCR “LIVES - Overcoming Vulnerability: Life Course Perspectives”
- Department of Readaptation and Geriatrics, University of Geneva, Switzerland
- Institute of Sociological Research, University of Geneva, Switzerland
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Sharpe RA, Machray KE, Fleming LE, Taylor T, Henley W, Chenore T, Hutchcroft I, Taylor J, Heaviside C, Wheeler BW. Household energy efficiency and health: Area-level analysis of hospital admissions in England. ENVIRONMENT INTERNATIONAL 2019; 133:105164. [PMID: 31518939 PMCID: PMC6853278 DOI: 10.1016/j.envint.2019.105164] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 09/04/2019] [Accepted: 09/05/2019] [Indexed: 05/15/2023]
Abstract
INTRODUCTION Fuel poverty affects up to 35% of European homes, which represents a significant burden on society and healthcare systems. Draught proofing homes to prevent heat loss, improved glazing, insulation and heating (energy efficiency measures) can make more homes more affordable to heat. This has prompted significant investment in energy efficiency upgrades for around 40% of UK households to reduce the impact of fuel poverty. Despite some inconsistent evidence, household energy efficiency interventions can improve cardiovascular and respiratory health outcomes. However, the health benefits of these interventions have not been fully explored; this is the focus of this study. METHODS In this cross sectional ecological study, we conducted two sets of analyses at different spatial resolution to explore population data on housing energy efficiency measures and hospital admissions at the area-level (counts grouped over a 3-year period). Housing data were obtained from three data sets covering housing across England (Household Energy Efficiency Database), Energy Performance Certificate (EPC) and, in the South West of England, the Devon Home Analytics Portal. These databases provided data aggregated to Lower Area Super Output Area and postcode level (Home Analytics Portal only). These datasets provided measures of both state (e.g. EPC ratings) and intervention (e.g. number of boiler replacements), aggregated spatially and temporally to enable cross-sectional analyses with health outcome data. Hospital admissions for adult (over 18 years) asthma, chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) were obtained from the Hospital Episode Statistics database for the national (1st April 2011 to 31st March 2014) and Devon, South West of England (1st April 2014 to 31st March 2017) analyses. Descriptive statistics and regression models were used to describe the associations between small area household energy efficiency measures and hospital admissions. Three main analyses were undertaken to investigate the relationships between; 1) household energy efficiency improvements (i.e. improved glazing, insulation and boiler upgrades); 2) higher levels of energy efficiency ratings (measured by Energy Performance Certificate ratings); 3) energy efficiency improvements and ratings (i.e. physical improvements and rating assessed by the Standard Assessment Procedure) and hospital admissions. RESULTS In the national analyses, household energy performance certificate ratings ranged from 37 to 83 (mean 61.98; Standard Deviation 5.24). There were a total of 312,837 emergency admissions for asthma, 587,770 for COPD and 839,416 for CVD. While analyses for individual energy efficiency metrics (i.e. boiler upgrades, draught proofing, glazing, loft and wall insulation) were mixed; a unit increase in mean energy performance rating was associated with increases of around 0.5% in asthma and CVD admissions, and 1% higher COPD admission rates. Admission rates were also influenced by the type of dwelling, tenure status (e.g. home owner versus renting), living in a rural area, and minimum winter temperature. DISCUSSION Despite a range of limitations and some mixed and contrasting findings across the national and local analyses, there was some evidence that areas with more energy efficiency improvements resulted in higher admission rates for respiratory and cardiovascular diseases. This builds on existing evidence highlighting the complex relationships between health and housing. While energy efficiency measures can improve health outcomes (especially when targeting those with chronic respiratory illness), reduced household ventilation rates can impact indoor air quality for example and increase the risk of diseases such as asthma. Alternatively, these findings could be due to the ecological study design, reverse causality, or the non-detection of more vulnerable subpopulations, as well as the targeting of areas with poor housing stock, low income households, and the lack of "whole house approaches" when retrofitting the existing housing stock. CONCLUSION To be sustainable, household energy efficiency policies and resulting interventions must account for whole house approaches (i.e. consideration of the whole house and occupant lifestyles). These must consider more alternative 'greener' and more sustainable measures, which are capable of accounting for variable lifestyles, as well as the need for adequate heating and ventilation. Larger natural experiments and more complex modelling are needed to further investigate the impact of ongoing dramatic changes in the housing stock and health. STUDY IMPLICATIONS This study supports the need for more holistic approaches to delivering healthier indoor environments, which must consider a dynamic and complex system with multiple interactions between a range of interrelated factors. These need to consider the drivers and pressures (e.g. quality of the built environment and resident behaviours) resulting in environmental exposures and adverse health outcomes.
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Affiliation(s)
- R A Sharpe
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, United Kingdom; Public Health, Cornwall Council, 1E, New County Hall, Truro TR1 3AY, United Kingdom
| | - K E Machray
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, United Kingdom
| | - L E Fleming
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, United Kingdom
| | - T Taylor
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, United Kingdom
| | - W Henley
- Health Statistics Research Group, Institute of Health Research, University of Exeter Medical School, St Luke's Campus, Exeter, EX1 2LU, United Kingdom
| | - T Chenore
- NHS NEW Devon Clinical Commissioning Group, County Hall, Exeter EX2 4QD, United Kingdom
| | - I Hutchcroft
- Regen, Bradninch Court, Castle Street, Exeter EX4 3PL and Energiesprong UK Limited, National Energy Centre, Davy Avenue, Knowlhill, Milton Keynes MK5 8NG, United Kingdom
| | - J Taylor
- UCL Institute for Environmental Design and Engineering, UCL, 14 Upper Woburn Plc, London WC1H 0NN, United Kingdom
| | - C Heaviside
- Environmental Change Institute, University of Oxford, South Parks Road, Oxford OX1 3QY, Oxford, United Kingdom
| | - B W Wheeler
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall TR1 3HD, United Kingdom.
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Williams AD, Shenassa ED. Sex-Specific Associations Between Area-Level Poverty and Cardiometabolic Dysfunction Among US Adolescents. Public Health Rep 2019; 135:47-55. [PMID: 31725345 DOI: 10.1177/0033354919884303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Cardiometabolic disease is the leading cause of mortality in the United States. Cardiometabolic function during adolescence predicts future cardiometabolic disease, yet few studies have examined early determinants of cardiometabolic function. Informed by evidence of sex differences in the prevalence and severity of cardiometabolic disorders and evidence of sexual dimorphism in the stress response, we examined sex differences in the association between living in poverty and cardiometabolic function during adolescence, a precursor of later cardiometabolic disorders. METHODS We linked data from 10 415 adolescents aged 12-19 in the National Health and Nutrition Examination Survey (1999-2012) with US Census-tract data on area-level poverty (percentage of the population living in poverty, grouped into quartiles). We parameterized cardiometabolic dysfunction by summing the z scores of 6 cardiometabolic biomarkers, grouped into quintiles. Hierarchical ordinal models estimated associations. RESULTS Compared with residents in low-poverty areas, residents in high-poverty areas had elevated odds of cardiometabolic dysfunction (highest quartile of poverty odds ratio [OR] = 1.27; 95% confidence interval [CI], 1.08-1.50). This association was more pronounced among boys than girls (highest quartile of poverty for boys: OR = 1.36; 95% CI, 1.10-1.70; highest quartile of poverty for girls: OR = 1.17; 95% CI, 0.94-1.47). CONCLUSION Our study supports the existence of sex-specific associations. These results highlight the potential for community-based programs, such as housing assistance, to improve population health.
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Affiliation(s)
- Andrew D Williams
- Department of Family Science, Maternal and Child Health Program, University of Maryland College Park, College Park, MD, USA
| | - Edmond D Shenassa
- Department of Family Science, Maternal and Child Health Program, University of Maryland College Park, College Park, MD, USA.,Department of Epidemiology and Biostatistics, University of Maryland College Park, College Park, MD, USA.,Department of Epidemiology and Biostatistics, School of Public Health, Brown University, Providence, RI, USA.,Department of Epidemiology and Biostatistics, School of Medicine, University of Maryland Baltimore, Baltimore, MD, USA
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Pollard A, Jones T, Sherratt S, Sharpe RA. Use of Simple Telemetry to Reduce the Health Impacts of Fuel Poverty and Living in Cold Homes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16162853. [PMID: 31405064 PMCID: PMC6720612 DOI: 10.3390/ijerph16162853] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 07/31/2019] [Accepted: 08/04/2019] [Indexed: 11/16/2022]
Abstract
INTRODUCTION In Great Britain, roughly half of people with at least one long-standing illness (LSI) live in low-income households. Lower-income households are at risk of fuel poverty and living in a colder house, which can worsen certain health conditions, causing related morbidity and mortality. This pilot study aimed to assess whether raising occupants' awareness of indoor temperatures in the home could initiate improved health and well-being among such vulnerable residents. METHODS Thermometers were placed inside a manufactured bamboo brooch to be worn or placed within homes during the winter of 2016/17. These devices were supplied to households (n = 34) already assisted by Community Energy Plus, which is a private social enterprise in Cornwall, United Kingdom (UK), using initiatives aimed at maintaining "healthy homes". Questionnaires were supplied to households before devices were supplied, and then again at the end of a three-month period, with further questions asked when devices were collected. Temperatures were recorded automatically every half-hour and used to draw inference from questionnaire responses, particularly around health and well-being. RESULTS Questionnaires were completed by 22 households. Throughout the winter, those declaring the poorest health when supplied with devices maintained homes at a higher average temperature. There were also indications that those with raised awareness of interior temperatures sought fewer casual medicines. CONCLUSION Simple telemetry could play a role in the management of chronic health conditions in winter, helping healthcare systems become more sustainable. The need for higher indoor temperatures among people with an LSI highlights the need to consider this approach alongside more sustainable household energy-efficiency improvements. A larger study is needed to explore this further and quantify the cost benefit of this approach.
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Affiliation(s)
- Adam Pollard
- Numeration Systems, Ltd., Health and Well-Being Innovation Centre, Truro TR1 3FF, UK
| | - Tim Jones
- Community Energy Plus, Truro TR1 2SJ, UK
| | - Stephen Sherratt
- Numeration Systems, Ltd., Health and Well-Being Innovation Centre, Truro TR1 3FF, UK
| | - Richard A Sharpe
- Health and Well-being and Public Health, Cornwall Council, Truro TR1 3AY, UK.
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro TR1 3HD, UK.
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Exposure to Indoor Mouldy Odour Increases the Risk of Asthma in Older Adults Living in Social Housing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16142600. [PMID: 31336583 PMCID: PMC6679100 DOI: 10.3390/ijerph16142600] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 07/12/2019] [Accepted: 07/15/2019] [Indexed: 12/19/2022]
Abstract
Background: Indoor dampness is thought to affect around 16% of European homes. It is generally accepted that increased exposure to indoor dampness and mould contamination (e.g., spores and hyphae) increases the risk of developing and/or exacerbating asthma. Around 30% of people in the Western world have an allergic disease (e.g., allergy, wheeze and asthma). The role of indoor mould contamination in the risk of allergic diseases in older adults is yet to be fully explored. This is of interest because older people spend more time indoors, as well as facing health issues due to the ageing process, and may be at greater risk of developing and/or exacerbating asthma as a result of indoor dampness. Methods: Face-to-face questionnaires were carried out with 302 participants residing in social housing properties located in South West England. Self-reported demographic, mould contamination (i.e., presence of mould growth and mouldy odour) and health information was linked with the asset management records (e.g., building type, age and levels of maintenance). Multivariate logistic regression was used to calculate the odd ratios and confidence intervals of developing and/or exacerbating asthma, wheeze and allergy with exposure to reported indoor mould contamination. We adjusted for a range of factors that may affect asthma outcomes, which include age, sex, current smoking, presence of pets, education, and building type and age. To assess the role of mould contamination in older adults, we compared younger adults to those aged over 50 years. Results: Doctor-diagnosed adult asthma was reported by 26% of respondents, 34% had current wheeze while 18% had allergies. Asthma was common among subjects exposed to reported visible mould (32%) and reported mouldy odour (42%). Exposure to visible mould growth and mouldy odour were risk factors for asthma, but not for wheeze or allergy. Exposure to mouldy odour increased the risk of asthma in adults over the age of 50 years (odds ratio (OR) 2.4, 95% confidence interval (CI) 1.10–5.34) and the risk was higher for females than for males (OR 3.5, 95% CI 1.37–9.08). These associations were modified by a range of built environment characteristics. Conclusions: We found that older adults living in social (public) housing properties, specifically women, may be at higher risk of asthma when exposed to mouldy odour, which has a number of implications for policy makers and practitioners working in the health and housing sector. Additional measures should be put in place to protect older people living in social housing against indoor damp and mould contamination.
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Goodman JM, Boone-Heinonen J, Richardson DM, Andrea SB, Messer LC. Analyzing Policies Through a DOHaD Lens: What Can We Learn? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2906. [PMID: 30572594 PMCID: PMC6313805 DOI: 10.3390/ijerph15122906] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 12/14/2018] [Accepted: 12/17/2018] [Indexed: 12/17/2022]
Abstract
Social, health, and environmental policies are critical tools for providing the conditions needed for healthy populations. However, current policy analyses fall short of capturing their full potential impacts across the life course and from generation to generation. We argue that the field of Developmental Origins of Health and Disease (DOHaD), a conceptual and research framework positing that early life experiences significantly affect health trajectories across the lifespan and into future generations, provides an important lens through which to analyze social policies. To illustrate this point, we synthesized evidence related to policies from three domains-family leave, nutrition, and housing-to examine the health implications for multiple generations. We selected these policy domains because they represent increasing distance from a reproductive health focus, each with a growing evidence base to support a potential impact on pregnant women and their offspring. Each of these examples represents an opportunity to extend our understanding of policy impact using a DOHaD lens, taking into account the potential life course and intergenerational effects that have previously been overlooked.
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Affiliation(s)
- Julia M Goodman
- Oregon Health & Science University-Portland State University School of Public Health, Portland, OR 97201, USA.
| | - Janne Boone-Heinonen
- Oregon Health & Science University-Portland State University School of Public Health, Portland, OR 97201, USA.
| | - Dawn M Richardson
- Oregon Health & Science University-Portland State University School of Public Health, Portland, OR 97201, USA.
| | - Sarah B Andrea
- Oregon Health & Science University-Portland State University School of Public Health, Portland, OR 97201, USA.
| | - Lynne C Messer
- Oregon Health & Science University-Portland State University School of Public Health, Portland, OR 97201, USA.
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