Health inequalities and inadequate housing: the case of exceptions to hygienic requirements for dwellings in Italy

Effects of the residential built environment on remote work productivity and satisfaction during COVID-19 lockdowns: An analysis of workers' perceptions

COVID-19 pandemic has forced people to stay home and switch to the remote working mode, which - reportedly - affect job satisfaction and productivity. The present study investigates the relationship between the residential environment and worker's job satisfaction and productivity in the remote working mode during the COVID-19 pandemic. A hypothetical structural equation model (SEM) of the influencing factors is constructed based on a literature review and experts' opinions. A survey-based respondents' opinions (n = 2276) were then used to test and analyze the model. The model results reveal that a residential built environment has an indirect effect on both remote work satisfaction and productivity. However, among all the factors, comfortable space (separate space and ergonomic furniture) is found to be the most important. This study presents the importance of adopting a residential built environment to respond to a crisis like a pandemic in achieving the desired comfort level of remote work. Although this study provides a holistic approach, it also proposes a base for the future country-specific analysis by providing some possible countries' differences.

Assessment method for new sustainability indicators providing pandemic resilience for residential buildings

The method presented in this paper aims to support the sustainability assessment methods of residential buildings under pandemic conditions. The main purpose of the study is to review existing criteria of the well-known assessment tools and then to suggest a set of assessment measures for the emerging pandemic-resilient indicators. Current sustainability assessment methodologies mostly focus on the conventional sustainability pillars (Environmental, Social, Economic), whereas the proposed emerging sustainability assessment indicators include changes in sustainability requirements brought by the current pandemic. Firstly, a set of indicators with possible measures was identified; then, we reviewed several existing green building certification systems to identify their gaps and developed a foundation for each indicator. Finally, several round table discussions involving various stakeholders (e.g., engineers, designers, health care experts, academics) were conducted to consolidate the identified measures. The findings of the present study indicate that certain pandemic-resilient indicators are not fully addressed by existing assessment tools, pointing out the importance of the development of new measures to make them more suitable to use under pandemic conditions. Thus, the present study contributes to the building assessment methods by proposing a set of emerging assessment indicators with measures, which can be used by various professionals that would contribute to more sustainable buildings in upcoming pandemics.•A 5-point scale was used to assess the indicators, and various stakeholders in a previous study identified their weights.•The methodology introduces new pandemic-related indicators into the conventional sustainability concept.•The assessment measures are rapid and economically efficient to apply for any residential building.

Which qualities should built environment possess to ensure satisfaction of higher-education students with remote education during pandemics?

The COVID-19 pandemic has suddenly switched most education processes from face-to-face to remote mode, obliging millions of students to utilize their residences as study spaces. However, the characteristics of their residential built environments differ in terms of regional, social, cultural, and technological aspects. These differences should impact the students' performance and satisfaction which needs to be measured and studied. The present study aims to identify the effect of the residential built environment on students' satisfaction and academic performance during the COVID-19 pandemic. It was conducted in two countries, Kazakhstan (KZ) and Norway (NO), using a comprehensive online survey to gather data. An empirical assessment based on the structural equation model was employed to identify links between health, safety, and comfort of students' facilities and academic performance and satisfaction. We conclude that the built environment affects both satisfaction for remote education and their learning performance. Significant differences in readiness for remote education have been observed between urban and non-urban living areas: (1) The role of health-and-safety convenience seems to increase with the urbanization level of the respondents' living spaces; (2) in contrast, for non-urban residents, the provision of comfort facilities is dominant. In the meantime, an analysis "by regions" revealed that health-and-safety-related facilities in residences are more critical for remote education in Central Asia (KZ). In contrast, the comfort features of residences being more important for the students studying remotely in Northern Europe (NO). These results provide an understanding that would assist in improving remote education and preparing pandemic-ready living areas.

Housing and Health: Here We Go Again

Housing is one of the major determinants of human health and the current COVID-19 pandemic has highlighted its relevance. The authors summarize the main issues, including dimensional standards, indoor air quality, safety, accessibility, neighborhoods, and area characteristics. The authors propose an operating scheme in order to implement actions to improve residential wellbeing on a local, national, and international level.

Indoor Environmental Quality in Dwellings and Lifestyle Behaviors during the COVID-19 Pandemic: Russian Perspective

The novel coronavirus (COVID-19) outbreak is a public health emergency of international concern, and as a response, public health authorities started enforcing preventive measures like self-isolation and social distancing. The enforcement of isolation has consequences that may affect the lifestyle-related behavior of the general population. Quarantine encompasses a range of strategies that can be used to detain, isolate, or conditionally release individuals or populations infected or exposed to contagious diseases and should be tailored to circumstances. Interestingly, medical students may represent an example of how the COVID-19 pandemic can form new habits and change lifestyle behaviors. We conducted a web-based survey to assess changes in lifestyle-related behavior of self-isolated medical students during the COVID-19 pandemic. Then we analyzed the sanitary-hygienic regulations of the Russian Federation to determine the requirements for healthy buildings. Results showed that during the pandemic, the enforcement of isolation affects medical students’ lifestyle-related behavior and accompanies an increase in non-communicable diseases (NCDs). Indoor environmental quality (IEQ) and healthy buildings are cutting-edge factors in preventing COVID-19 and NCDs. The Russian sanitary-hygienic regulations support improving this factor with suitable requirements for ventilation, sewage, waste management, and disinfection. Herein, assessing isolation is possible through the hygienic self-isolation index.

Housing Spaces in Nine European Countries: A Comparison of Dimensional Requirements

Modern housing units must meet new needs and requirements; housing dimensions and functional characteristics are relevant issues, mainly considering population ageing and disability. The housing standards of nine European countries were compared to analyze their ability to satisfy new population need, in terms of size. The regulations were downloaded from the websites of the official channels of each country. A wide variability in room size was observed (e.g., single room: from 9 m² in Italy to 7 m² in France, to the absence of any limit in England and Wales, Germany-Hesse, and Denmark). Italian and French legislations define housing dimension considering the room destination and the number of people. The Swedish regulation provides performance requirements and functional indications but does not specify the minimum dimensions of habitable rooms. The rooms’ minimum heights vary between 2.70 m in Italy and Portugal and 2.60 m in the Netherlands, but no limits are established in England and Wales. A diverse approach among European countries regulations is observed: from a market-oriented logic one (e.g., England and Wales) in which room minimum dimensions are not defined to a prescriptive one (Italy) and one that is functionality-oriented (the Netherlands). However, considering the health, social, environmental, and economic trends, many of these standards should be revised.

Reliability of T-WSI to Evaluate Neighborhoods Walkability and Its Changes over Time

More walkable neighborhoods are linked to increased physical activity. The Walking Suitability Index of the territory (T-WSI) is an easy method to evaluate walkability on the basis of direct observation. T-WSI provides 12 indicators divided into 4 categories (practicability, safety, urbanity, pleasantness); the weighted analysis of these indicators gives an overall score of the actual usability of the neighborhood. The aim of the study is to evaluate the ability of T-WSI’ indicators to measure, in a reliable way, any street’s walkability variations occurred over time. The investigation was performed in 2018 in nine urban neighborhoods of Rieti city. Cronbach’s α is used to evaluate internal consistency of T-WSI; Intraclass Correlation Coefficient (ICC) is used to evaluate the reproducibility of measurements (or ratings) made by different investigators. Cronbach’s α is 0.89 (± 0.02); ICC is also good (ICC = 0.89; 95% CI: 0.84–0.92). The results of the 2018 investigation are also compared with those collected in 2016 in the same districts. The results show that T-WSI is a reliable and easy to use tool, useful to measure the effectiveness of the interventions already realized at local level, but it could also contribute to making decisions to develop regeneration projects.

How is COVID-19 Experience Transforming Sustainability Requirements of Residential Buildings? A Review

The COVID-19 pandemic is bringing about changes, and alongside these, we can alter the way we design our living spaces. The need for a healthy and comfortable living space is essential to mental and physical well-being. The present study covers the most up-to-date documents, including peer-reviewed papers, blog posts, news, journal articles, and expert opinions, to critically review lessons learned from the COVID-19 pandemic and evaluates the expected changes in sustainability requirements of residential buildings. Health and safety, environment, and comfort are the three main aspects of residential buildings that have been tested during quarantines and are also expected to experience major transformations toward sustainability. Residential houses should provide certain health and safety protective measures to their occupants, such as the application of new touchless technologies, having proper sanitation to diminish the probability of getting infected, and developing greener and more intimate spaces that can help recover and improve mental states. Our findings address the need to reconsider sustainability requirements for residential buildings, which will provide adequate health and safety and comfort with no significant harm to the environment.

COVID-19 Lockdown: Housing Built Environment's Effects on Mental Health

Since the World Health Organization (WHO) declared the coronavirus infectious disease 2019 (COVID-19) outbreak a pandemic on 11 March, severe lockdown measures have been adopted by the Italian Government. For over two months of stay-at-home orders, houses became the only place where people slept, ate, worked, practiced sports, and socialized. As consolidated evidence exists on housing as a determinant of health, it is of great interest to explore the impact that COVID-19 response-related lockdown measures have had on mental health and well-being. We conducted a large web-based survey on 8177 students from a university institute in Milan, Northern Italy, one of the regions most heavily hit by the pandemic in Europe. As emerged from our analysis, poor housing is associated with increased risk of depressive symptoms during lockdown. In particular, living in apartments <60 m² with poor views and scarce indoor quality is associated with, respectively, 1.31 (95% CI: 1046–1637), 1.368 (95% CI: 1166–1605), and 2.253 (95% CI: 1918–2647) times the risk of moderate–severe and severe depressive symptoms. Subjects reporting worsened working performance from home were over four times more likely to also report depression (OR = 4.28, 95% CI: 3713–4924). Housing design strategies should focus on larger and more livable living spaces facing green areas. We argue that a strengthened multi-interdisciplinary approach, involving urban planning, public mental health, environmental health, epidemiology, and sociology, is needed to investigate the effects of the built environment on mental health, so as to inform welfare and housing policies centered on population well-being.

COVID-19 and Living space challenge. Well-being and Public Health recommendations for a healthy, safe, and sustainable housing

BACKGROUND AND AIM OF THE WORK

The ongoing pandemic of COVID-19 is a strong reminder that the lockdown period has changed the way that people and communities live, work, and interact, and it's necessary to make resilient the built environment, both outdoor and mainly the indoor spaces: housing, workplaces, public buildings, and entertainment facilities. How can we re-design the concept of Well-being and Public Health in relation to the living places of the future?

METHODS

According to the previous statements and scenario, this paper aims to integrate the building hygiene and well-being, focusing the possible responses, both existing and for the new buildings, taking home a strong message from this "period" of physical distancing.

RESULTS

The Well-being and Public Health recommendations for a healthy, safe, and sustainable housing are framed into the following key points: 1. Visible and accessible green elements and spaces; 2. Flexibility, adaptability, sharing, and crowding of living spaces, and compliant functions located into the buildings; 3. Re-appropriation of the basic principles and archetypes of sustainable architecture, thermal comfort and Indoor Air Quality (IAQ); 4. Water consumption and Wastewater Management; 5. Urban Solid Waste Management; 6. Housing automation and electromagnetic fields; 7. Indoor building and finishing materials.

CONCLUSIONS

The Well-being and Public Health recommendations for a healthy, safe and sustainable housing may provide a useful basis for Designers, Policy Makers (fostering tax incentives for building renewal), Public Health experts and Local Health Agencies, in promoting actions and policies aimed to transform living places in healthier and Salutogenic spaces.

The homes in the COVID-19 era. How their use and values are changing

The long lockdown, the frequent adoption of smart working, the online lessons for both school and university pupils, and the domestic isolation of many people in order to stop the spread of the SARS-CoV-2, have changed the way millions of people lived their home spaces in the last few months. This also led to a backlash on real estate values, enhancing some characteristics and penalizing others.

COVID-19 and Cities: from Urban Health strategies to the pandemic challenge. A Decalogue of Public Health opportunities

BACKGROUND AND AIM OF THE WORK

The ongoing pandemic of COVID-19, which nowadays has exceeded 2.5 million notified infections in the world and about 200,000 deaths, is a strong reminder that urbanization has changed the way that people and communities live, work, and interact, and it's necessary to make resilient the systems and local capacities to prevent the spread of infectious diseases. How we can re-design the concept of Public Health in relation to the built environment and the contemporary cities?

METHODS

According to the previous statements and scenario, aim of this paper is to integrate the Urban Health strategic objectives, focusing the possible responses, both immediate and medium-long term, to the current environmental, social, and economic aspects of the "period" of physical distancing.  Results. Immediate Actions are 01. program the flexibility of city schedules; 02. plan a smart and sustainable mobility network; 03. define a neighborhood services' plan; 04. develop a digitization of the urban context, promoting the smart communities; 05. re-think the accessibility to the places of culture and tourism.  Medium-long term Actions are 06. design the indoor flexibility of domestic living spaces; 07. re-think building typologies, fostering the presence of semi-private or collective spaces; 08. renovate the basic care services' network; 09. integrate the existing environmental emergency plans, with those related to the health emergencies; 10. improve stakeholders' awareness of the factors affecting Public Health in the cities.

CONCLUSIONS

The Decalogue of Public Health opportunities may provide a useful basis for Designers (Architects and Urban Planners), Policy Makers, Public Health experts and Local Health Agencies, in promoting actions and policies aimed to transform our cities in healthier and Salutogenic living environments. (www.actabiomedica.it).

Housing Demand in Urban Areas and Sanitary Requirements of Dwellings in Italy

The phenomenon of urbanisation is becoming increasingly prevalent on a global level, and the health issues regarding the urban environment are of primary importance in public health. Accordingly, the present manuscript describes an analysis of the housing conditions of Italian urban areas, referring to the city of Sassari (Sardinia), Italy, focused on the dwelling structural and sanitary conditions issued by the Italian regulations. Data relating to the housing conditions of the population were acquired by the Local Hygiene and Public Health Service (SISP), in a period between 2012 and 2016. Qualitative variables were summarised with absolute and relative (percentages) frequencies, whereas quantitative variables with means and standard deviations depending on their parametric distribution. Statistical comparisons for qualitative and quantitative variables were performed with the χ ² test or Student's t-test, respectively. A p value less than 0.05 was considered statistically significant. Finally, the dwellings and the collected variables were georeferenced on a city map. During the 2012-2016 observation period, 363 certification requests were received from 193 (53.2%) foreign-born citizens and 170 (46.8%) Italians at the SISP offices. The main reasons relate to the request for a residency permit (46.6%) and to obtain a subsidy from the local government (32.8%). Overall, 15.4% of dwellings were found to be improper, while 35.3% and 22.0% were found to be unhygienic and uninhabitable, respectively. The foreigners' homes were found to be suitable in 82.7% of cases; the housing of Italian citizens, on the contrary, was found to be suitable in 28% of the observations. The present study offers a cross section of the housing conditions of Italian urban areas, referring to the city of Sassari. To the authors' best knowledge, this observation is the first one carried out in Sardinia and one of the first observations in Italy. It has emerged that "hygienically unsuitable" homes are those that, in most cases, are located in the city centre. Moreover, the Italian population is hit by a significant housing problem, due to overcrowding, uninhabitability, and unhygienic conditions. Overall, our findings suggest that it is necessary to develop a multidisciplinary approach to guarantee public health, with safe dwellings homes and the surrounding urban context alongside the development of social relations. Nevertheless, there is still little evidence available today on the population housing conditions, especially regarding the private indoor environment, and further research is needed to bridge this knowledge gap.

Spatiotemporal Analysis of Influenza Morbidity and Its Association with Climatic and Housing Conditions in Ecuador

The external environment directly influences human health. However, what happens inside? This work deals with the effect that the interior thermal variables have on the propagation of respiratory diseases and focused on the relation of the temperature and relative humidity inside social housing in the 1040 parishes of Ecuador and the transmission of influenza. On the one hand, historical weather-related variables were used to simulate and estimate the interior conditions, and thresholds on temperature and humidity were determined. On the other hand, the health-related variable was determined by analyzing the statistics corresponding to the influenza and viral pneumonia in 2009 since that year was critical for these diseases; the data were divided by month for each parish. Finally, the correlation of these variables determines the relative importance of the interior conditions on the respiratory health of its inhabitants. The preliminary results indicate that the places with the lowest temperatures and relative humidity could favor the virus transmission. Also, the analysis indicated that respiratory diseases increase in August and October. In this way, it is clear that social housing projects in Ecuador require a study which guarantees not only energy efficiency and sustainability related issues but also the well-being of their inhabitants.

Healthy Design and Urban Planning Strategies, Actions, and Policy to Achieve Salutogenic Cities

Starting from a previous experience carried out by the working group "Building and Environmental Hygiene" of the Italian Society of Hygiene and Preventive Medicine (SItI), the aim of the present work is to define new strategic goals for achieving a "Healthy and Salutogenic City", which will be useful to designers, local governments and public bodies, policy makers, and all professionals working at local health agencies. Ten key points have been formulated: 1. climate change and management of adverse weather events; 2. land consumption, sprawl, and shrinking cities; 3. tactical urbanism and urban resilience; 4. urban comfort, safety, and security perception; 5. strengths and weaknesses of urban green areas and infrastructures; 6. urban solid waste management; 7. housing emergencies in relation to socio-economic and environmental changes; 8. energy aspects and environmental planning at an urban scale; 9. socio-assistance and welfare network at an urban scale: importance of a rational and widespread system; and 10. new forms of living, conscious of coparticipation models and aware of sharing quality objectives. Design strategies, actions, and policies, identified to improve public health and wellbeing, underline that the connection between morphological and functional features of urban context and public health is crucial for contemporary cities and modern societies.