Abstract
Objectives
Houses designed for one climate and cultural group may not be appropriate for other places and people. Our aim is to find cost-effective ways to improve the characteristics of older homes, ill-fitted for New Zealand’s climate, in order to improve the occupants’ health.
Method
We have carried out two community randomised trials, in partnership with local communities, which have focused on retrofitted insulation and more effective heating and have two other studies under way, one which focuses on electricity vouchers and the other on housing hazard remediation.
Results
The Housing, Insulation and Health Study showed that insulating 1,350 houses, built before insulation was required, improved the occupants’ health and well being as well as household energy efficiency. In the Housing, Heating and Health Study we investigated the impact of installing more effective heating in insulated houses for 409 households, where there was a child with doctor-diagnosed asthma. Again, the study showed significant results in the intervention group; indoor temperatures increased and levels of NO2 were halved. Children reported less poor health, lower levels of asthma symptoms and sleep disturbances by wheeze and dry cough. Children also had fewer days off school.
Conclusion
Improving the energy efficiency of older housing leads to health improvements and energy efficiency improvements. Multidisciplinary studies of housing interventions can create compelling evidence to support policies for sustainable housing developments which improve health.
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References
Asher I, Byrnes C (2006) Trying to catch our breath: the burden of preventable breathing disease in children and young people. The Asthma and Respiratory Foundation of New Zealand, Wellington
Asher MI, Montefort S, Bjorksten B, Lai CK, Strachan DP, Weiland SK, Williams H, The Isaac Phase Three Study Group (2006) Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC phases one and three repeat multicountry cross-sectional surveys. Lancet 368:733–743
Chapman R, Howden-Chapman P, O’Dea D, Viggers H, Kennedy M (2007) Retrofitting houses with insulation: cost-benefit analysis of a randomised community trial. J Epidemiol Commun H 63:271–277
Chauhan AJ, Inskip HM, Linaker CH et al (2003) Personal exposure to nitrogen dioxide (NO2) and the severity of virus-induced asthma in children. Lancet 361:1939–1944
Davie GS, Baker MG, Hales S, Carlin JB (2007) Trends, determinants of excess winter mortality in New Zealand: 1980 to 2000. BMC Pub Health 7:263
Free S, Howden-Chapman P, Pierse N, Viggers H, Housing Heating and Health Study Research Team Study Team (2009) Does more effective home heating reduce school absences for children with asthma? J Epidemiol Commun H. doi:10.1136/jech.2008.086520
Gillespie-Bennett J, Pierse N, Wickens K, Crane J, Howden-Chapman P, Housing Heating and Health Team (2011) The respiratory health effects of nitrogen dioxide exposure. Eur Respir J 38. doi:10.1183/09031936.00115409
Graham H (2007) Unequal Lives: health and socioeconomic inequalities. Open University Press: Maidenhead, Berkshire
Healy JD (2004) Housing, fuel poverty and health: a pan-European analysis. Ashgate, Aldershot
Herandez D, Bird S (2010) Energy burden and the need for integrated low-income housing and energy policy. Poverty Pub Policy 2:5–25
Housing New Zealand Corporation (2006) New Zealand Housing Strategy HNZC: Wellington
Howden-Chapman P, Signal L, Crane J (1999) Housing and health in older people; ageing in place. Soc Policy J NZ 13:14–30
Howden-Chapman P, Crane J, Matheson A, Viggers H, Cunningham M, Blakely T, O’Dea D, Cunningham C, Woodward A, Saville-Smith K, Baker M, Waipara N (2005) Retrofitting houses with insulation to reduce health inequalities: aims and methods of a clustered, randomised trial in community settings. Soc Sci Med 61:2600–2610
Howden-Chapman P, Matheson A, Viggers H, Crane J, Cunningham M, Blakely T, O’Dea D, Cunningham C, Woodward A, Saville-Smith K, Baker M, Waipara N (2007) Retrofitting houses with insulation to reduce health inequalities: results of a clustered, randomised trial in a community setting. Br Med J 334:460–464
Howden-Chapman P, Pierse N, Nicholls S, Gillespie-Bennett J, Viggers H, Cunningham M, Phipps R, Boulic M, Fjällström P, Free S, Chapman R, Lloyd B, Wickens K, Shields D, Baker M, Cunningham C, Woodward A, Bullen C, Crane J (2008) Effects of improved home heating on asthma in community dwelling children: randomised community study. Br Med J 337:852–855
Howden-Chapman P, Viggers H, Chapman R, O’Des D, Free S, O’Sullivan K (2009) Warm homes: drivers of the demand for heating in the residential sector in New Zealand. Energ Policy 37:3387–3399
Israel B, Schulz A, Parker E, Becker AB (1998) Review of community-based participatory research: assessing partnership approaches to improving public health. Annu Rev Pub H 19:173–202
Keall M, Baker M, Howden-Chapman P, Cunningham C (2008) Association between the number of home injury hazards and home injury. Accid Analy Prev 40:887–893
Keall MD, Guria J, Howden-Chapman P, Baker MG (2011) Estimation of the social costs of home injury: a comparison with estimates for road injury accident. Anal Prev 43:998–1002
Krieger J, Takaro TK, Allen C, Song L, Weaver M, Chai S, Dickey P (2002) The Seattle-King County Healthy Homes Project: implementation of a comprehensive approach to improving indoor environmental quality for low-income children with asthma. Environ Health Persp 110:311–322
Laforest L, Yin D, Kocevar VS et al (2004) Association between asthma control in children and loss of workdays by caregivers. Ann Allerg, Asthma Im 93:265–271
Lawrence RJ (1993) An ecological blueprint for healthy housing. In: Burridge R, Ormandy D (eds) Unhealthy Housing. Chapman & Hall, London, pp 338–359
Lawrence RJ (1995) Housing quality: an agenda for research. Urban Stud 35:1655–1664
Lawrence RJ (2005) Housing and health: a way forward. Built Environ 31:315–325
Lloyd B (2006) Fuel poverty in New Zealand. Soc Policy J NZ:142–155
Matheson A, Howden-Chapman P, Dew K (2005) Engaging communities to reduce inequalities in health: why partnership? Soc Policy J NZ 26:1–16
Ministry of Economic Development (2007) Powering our future: New Zealand energy strategy. Ministry of Economic Development, Wellington
Preval N, Chapman R, Pierse N, Howden-Chapman P (2010) Housing Heating Health Study Research Team evaluating energy, health and carbon co-benefits from improved domestic space heating: a randomised community trial. Energ Policy 38:3965–3972
Rada J, Ratima M, Howden-Chapman P (1999) Evidence-based purchasing of health promotion: methodology for reviewing evidence. Health Promot Int 14:177–187
Schipper L et al (2001) Indicators of energy use and efficiency in New Zealand in International Perspective: comparison of trends through 1995. IEA, Paris
Signal L, Martin J, Reid P, Carroll C, Howden-Chapman P, Keefe Ormsby V, Richards R, Robson B, Wall T (2007) Tackling health inequalities: moving theory to action. Int J Equity Health 6. doi:10.1186/1475-9276-1186-1112
Sommerville M, Basham M, Foy C, Ballinger G, Gay T, Shute P, AGobotTHHG Barton (2002) From local concern to randomized trial: the Watcombe Housing Project. Health Expect 5:127–135
Statistics New Zealand (2007) Housing quality statistics: physical amenities: fuel types used to heat dwelling (total responses), for private occupied dwellings, 2001. http://wdmzpub01.stats.govt.nz/wds/TableViewer/tableView.aspx?ReportId=123. Accessed 1 August 2007
Strachan DP (2000) The role of environmental factors in asthma. Br Med Bulletin 56:865–882
Taras H, Potts-Datema W (2005) Childhood asthma and student performance at school. J Sch Health 75:296–312
Thomson H, Petticrew M, Morrison D (2001) Health effects of housing improvement: systematic review of intervention studies. Br Med J 323:187–190
Thomson H, Thomas S, Sellstrom E, Petticrew M (2009) The health impacts of housing improvement: a systematic review of intervention studies (1887–2007). Am J Public Health 99:S681–S692
Walker J, Mitchell R, Platt SD, Petticrew MP, Hopton J (2006) Does usage of domestic heating influence internal environmental conditions and health? Eur J Public Health 16:463–469
Wilkinson P, Smith KR, Beevers S, Tonne C, Oreszczyn T (2007) Energy and health 4: energy, energy efficiency, and the built environment. Lancet doi:10.1016/S0140-6736(07)61255-0
World Health Organization (1987) Health impact of low indoor temperatures: Report on a WHO meeting, Copenhagen, 11–14 November, 1985. WHO, Copenhagen
World Health Organization (2011) Health and the Green Economy: health co-benefits of climate change mitigation—Housing sector. WHO: Geneva
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This paper belongs to the special issue “Housing for health promotion”.
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Howden-Chapman, P., Crane, J., Chapman, R. et al. Improving health and energy efficiency through community-based housing interventions. Int J Public Health 56, 583–588 (2011). https://doi.org/10.1007/s00038-011-0287-z
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DOI: https://doi.org/10.1007/s00038-011-0287-z