Skip to main content

Advertisement

SpringerLink
Log in

Housing Determinants of Health in Urban China: A Structural Equation Modeling Analysis

  • Published:
Social Indicators Research Aims and scope Submit manuscript

Abstract

Housing and health are two important interrelated indicators to measure the quality of life of an individual, the pathways through which housing affects health have continuously attracted worldwide attention from both scholars and policymakers, yet the empirical evidence from China is inexplicably scant. Distinguishing the dual attributes of housing as dwelling space and wealth carrier, in a unified analytical framework, the cross effects of residence-based housing (housing space, quality, and facility) and asset-based housing (housing tenure, affordability, and wealth) on the physical and mental health at the objective level as well as the self-assessed health at the subject level are jointly examined. The structural equation modeling analysis based on the data from China Family Panel Studies identifies the housing determinants that influence health and reveals concrete pathways. Results indicate that residence-based housing plays a dominated role in determining the impact of housing on health than the asset-based housing. More specifically, good residence-based housing condition improves both the physical and mental health, and is associated with well self-assessed health through the transmission mechanism; while the asset-based housing does not show a significant effect on both physical and mental health. Our findings point to the priority of improving dwelling quality to promoting asset building in the housing policy agenda towards health intervention.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  • Acock, A. (2013). Discovering structural equation modeling using Stata. College Station: StataCorp LP.

    Google Scholar 

  • Alex, M., Gordon, D., Heslop, P., & Pantazis, C. (2000). Housing deprivation and health: A longitudinal analysis. Housing Studies, 15(3), 411–428.

    Article  Google Scholar 

  • Altman, C. E., Van, H. J., & Hillemeier, M. (2016). What does self-rated health mean? Changes and variations in the association of obesity with objective and subjective components of self-rated health. Journal of Health and Social Behavior, 57(1), 39–58.

    Article  Google Scholar 

  • Angel, S., & Bittschi, B. (2017). Housing and health. ZEW Discussion Papers, 58(8), 216–222.

    Google Scholar 

  • Baker, E., Beer, A., Lester, L., Pevalin, D., Whitehead, C., & Bentley, R. (2017). Is housing a health insult? International Journal of Environmental Research & Public Health, 14(6), 567.

    Article  Google Scholar 

  • Baker, E., Bentley, R., & Mason, K. (2013a). The mental health effects of housing tenure: Causal or compositional? Urban Studies, 50(2), 426–442.

    Article  Google Scholar 

  • Baker, E., Mason, K., Bentley, R., & Mallett, S. (2014). Exploring the bi-directional relationship between health and housing in Australia. Urban Policy & Research, 32(1), 71–84.

    Article  Google Scholar 

  • Baker, M., McDonald, A., Zhang, J., et al. (2013b). Infectious diseases attributable to household crowding in New Zealand: A systematic review and burden of disease estimate. Wellington: He Kainga Oranga/Housing and Health Research.

    Google Scholar 

  • Baker, M. G., Barnard, L. T., Kvalsvig, A., Verrall, A., Zhang, J., Keall, M., et al. (2012). Increasing incidence of serious infectious diseases and inequalities in New Zealand: A national epidemiological study. Lancet, 379(9821), 1112–1119.

    Article  Google Scholar 

  • Bentler, P. M. (1990). Comparative fit indices in structural models. Psychological Bulletin, 107, 238–246.

    Article  Google Scholar 

  • Bentler, P. M., & Bonett, D. G. (1980). Significance tests and goodness of fit in the analysis of covariance structures. Psychological Bulletin, 88(3), 588–606.

    Article  Google Scholar 

  • Bentley, R., Baker, E., Mason, K., Subramanian, S. V., & Kavanagh, A. M. (2011). Association between housing affordability and mental health: A longitudinal analysis of a nationally representative household survey in Australia. American Journal of Epidemiology, 174(7), 753–760.

    Article  Google Scholar 

  • Bentley, R. J., Pevalin, D., Baker, E., Mason, K., Reeves, A., & Beer, A. (2016). Housing affordability, tenure and mental health in Australia and the United Kingdom: A comparative panel analysis. Housing Studies, 31(2), 208–222.

    Article  Google Scholar 

  • Bloze, G., & Skak, M. (2012). Housing tenure and psychological distress. International Journal of Housing Policy, 12(4), 471–488.

    Article  Google Scholar 

  • Bonnefoy, X. (2007). Inadequate housing and health: An overview. International Journal of Environment and Pollution, 30(3/4), 411–429.

    Article  Google Scholar 

  • Braubach, M. (2011). Key challenges of housing and health from WHO perspective. International Journal of Public Health, 56(6), 579–580.

    Article  Google Scholar 

  • Braubach, M., Jacobs, D. E., Ormandy, D., Braubach, M., Jacobs, D. E., & Ormandy, D. (2011). Environmental burden of disease associated with inadequate housing: A method guide to the quantification of health effects of selected housing risks in the WHO European region. Ultrasound in Obstetrics and Gynecology, 24(3), 323.

    Google Scholar 

  • Browne, M. W. (1984). Asymptotically distribution-free methods for the analysis of covariance structures. British Journal of Mathematical and Statistical Psychology, 37(1), 62–83.

    Article  Google Scholar 

  • Cairney, J., & Boyle, M. (2004). Home ownership, mortgages and psychological distress. Housing Studies, 19(2), 161–174.

    Article  Google Scholar 

  • Cervero, R., & Murakami, J. (2010). Effects of built environments on vehicle miles traveled: Evidence from 370 US urbanized areas. Environment and Planning A, 42(2), 400–418.

    Article  Google Scholar 

  • Chadwick, E. (1842). Report on the sanitary conditions of the laboring population of Great Britain. London: HMSO.

    Google Scholar 

  • Chen, G. (2016). The heterogeneity of housing-tenure choice in urban China: A case study based in Guangzhou. Urban Studies, 53(5), 957-977.

    Article  Google Scholar 

  • Curl, A., Kearns, A., Mason, P., Egan, M., Tannahill, C., & Ellaway, A. (2015). Physical and mental health outcomes following housing improvements: Evidence from the GoWell study. Journal of Epidemiology and Community Health, 69(1), 12–19.

    Article  Google Scholar 

  • Cutler, D. M., Lleras-Muney, A., & Vogl, T. (2011). Socioeconomic status and health: Dimensions and mechanisms. NBER Working Papers.

  • Distefano, C. (2002). The impact of categorization with confirmatory factor analysis. Structural Equation Modeling: A Multidisciplinary Journal, 9(3), 327–346.

    Article  Google Scholar 

  • Dunn, J. R. (2000). Housing and health inequalities: Review and prospects for research. Housing Studies, 15(3), 341–366.

    Article  Google Scholar 

  • Elsinga, M. (2009). Exploring ‘housing asset-based welfare’. Can the UK be held up as an example for Europe? Housing Studies, 24(5), 669–692.

    Article  Google Scholar 

  • Evans, G. W. (2001). Environmental stress and health. In A. Baum, T. A. Revenson, & J. E. Singer (Eds.), Handbook of health psychology (pp. 365–385). Mahwah, NJ: Lawrence Erlbaum.

    Google Scholar 

  • Evans, G. W., Wells, N. M., Chan, H. Y., & Saltzman, H. (2000). Housing quality and mental health. Journal of Consulting and Clinical Psychology, 68, 526–530.

    Article  Google Scholar 

  • Evans, G. W., Wells, N. M., & Moch, A. (2003). Housing and mental health: A review of the evidence and a methodological and conceptual critique. Journal of Social Issues, 59(3), 475–500.

    Article  Google Scholar 

  • Freeman, H. (2008). Housing and mental health. In H. Freeman & S. Stansfeld (Eds.), The impact of the environment on psychiatric disorder (pp. 210–241). London: Routledge.

    Google Scholar 

  • Gan, L., Yin, Z., Jia, N., et al. (2014). Data you need to know about China: Research report of China household finance survey 2012. Heidelberg: Springer.

    Book  Google Scholar 

  • Gibson, M., Petticrew, M., Bambra, C., Sowden, A. J., Wright, K. E., & Whitehead, M. (2011). Housing and health inequalities: A synthesis of systematic reviews of interventions aimed at different pathways linking housing and health. Health & Place, 17(1), 175–184.

    Article  Google Scholar 

  • Gu, L., Xie, J., Long, J., Chen, Q., Chen, Q., Pan, R., et al. (2013). Epidemiology of major depressive disorder in mainland China: A systematic review. PLoS ONE, 8(6), e65356.

    Article  Google Scholar 

  • Hong, J. Y., & Jin, Y. J. (2015). Influence of urban contexts on soundscape perceptions: A structural equation modeling approach. Landscape & Urban Planning, 141, 78–87.

    Article  Google Scholar 

  • Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1–55.

    Article  Google Scholar 

  • Institute of Social Science Survey (ISSS), Peking University. (2015). China Family Panel Studies (CFPS). http://dx.doi.org/10.18170/DVN/45LCSO, Peking University Open Research Data Platform, V17.

  • Jaine, R., Baker, M., & Venugopal, K. (2011). Acute rheumatic fever associated with household crowding in a developed country. Pediatric Infectious Disease Journal, 30(4), 315–319.

    Article  Google Scholar 

  • Kendig, H., Browning, C., & Teshuva, K. (1998). Health actions and social class among older Australians. Australian and New Zealand Journal of Public Health, 22(7), 808–813.

    Article  Google Scholar 

  • Kline, R. B. (2015). Principles and practice of structural equation modelling (3rd ed.). New York: Guilford.

    Google Scholar 

  • Lawrence, R. J. (2004). Housing, health and well-being: Moving forward. Reviews on Environmental Health, 19(3–4), 161–176.

    Google Scholar 

  • Lawrence, R. J. (2010). Housing and health promotion: Moving forward. International Journal of Public Health, 55(3), 145–146.

    Article  Google Scholar 

  • Lawrence, R. J. (2017). Constancy and change: Key issues in housing and health research, 1987–2017. International Journal of Environmental Research & Public Health, 14(7), 763.

    Article  Google Scholar 

  • Liu, H., Yang, F., & Xu, Y. (2013a). Housing distribution in urban China basing on China’s 2010 census. Journal of Tsinghua University (Philosophy and Social Sciences), 28(6), 138–147. (In Chinese).

    Google Scholar 

  • Liu, Z., Wang, Y., & Tao, R. (2013b). Social capital and migrant housing experiences in urban China: A structural equation modeling analysis. Housing Studies, 28(8), 1155–1174.

    Article  Google Scholar 

  • Lubell, J., Morley, R., Ashe, M., & Merola, L. (2011). Housing and health: New opportunities for dialogue and action. Washington, DC: National Center for Healthy Housing.

    Google Scholar 

  • Macintyre, S., Ellaway, A., Hiscock, R., Kearns, A., Der, G., & Mckay, L. (2003). What features of the home and the area might help to explain observed relationships between housing tenure and health? Evidence from the west of Scotland. Health & Place, 9(3), 207–218.

    Article  Google Scholar 

  • Maqbool, N., Viveiros, J., & Ault, M. (2015). The impacts of affordable housing on health: A research summary. Washington, DC: Center for Housing Policy, National Housing Conference.

    Google Scholar 

  • Marídell’Olmo, M., Novoa, A. M., Camprubí, L., Peralta, A., Vásquezvera, H., Bosch, J., et al. (2017). Housing policies and health inequalities. International Journal of Health Services, 47(2), 207–232.

    Article  Google Scholar 

  • Matthews, K. A., Kiefe, C. I., Lewis, C. E., Liu, K., Sidney, S., & Yunis, C. (2002). Socioeconomic trajectories and incident hypertension in a biracial cohort of young adults. Hypertension, 39(3), 772.

    Article  Google Scholar 

  • Meltzer, R., & Schwartz, A. (2016). Housing affordability and health: Evidence from New York City. Housing Policy Debate, 26(1), 80–104.

    Article  Google Scholar 

  • Misa, I. (2016). Reconsidering the housing asset-based welfare approach: Reflection from East Asian experiences. Social Policy & Society, 15(2), 177–188.

    Article  Google Scholar 

  • National Bureau of Statistics (NBS) (2018). Statistical Bulletin of People’s Republic of China on National Economic and Social Development in 2017.

  • Northridge, M. E., Sclar, E. D., & Biswas, P. (2003). Sorting out the connections between the built environment and health: A conceptual framework for navigating pathways and planning healthy cities. Journal of Urban Health, 80(4), 556–568.

    Article  Google Scholar 

  • Novoa, A. M., Bosch, J., Díaz, F., Malmusi, D., Darnell, M., & Trilla, C. (2014). Impact of the crisis on the relationship between housing and health. Policies for good practice to reduce inequalities in health related to housing conditions. Gaceta Sanitaria, 1, 44–50.

    Article  Google Scholar 

  • O’Mahony, L. F., & Overton, L. (2015). Asset-based welfare, equity release and the meaning of the owned home. Housing Studies, 30(3), 392–412.

    Article  Google Scholar 

  • Pearl, J. (2000). Causality: Models, reasoning and inference. Cambridge: Cambridge University Press.

    Google Scholar 

  • Phillips, M. R., Zhang, J., Shi, Q., Song, Z., Ding, Z., Pang, S., et al. (2009). Prevalence, treatment, and associated disability of mental disorders in four provinces in China during 2001-05: An epidemiological survey. Lancet, 373(9680), 2041–2053.

    Article  Google Scholar 

  • Pollack, C. E., Griffin, B. A., & Lynch, J. (2010). Housing affordability and health among homeowners and renters. American Journal of Preventive Medicine, 39(6), 515–521.

    Article  Google Scholar 

  • Prus, S. G. (2011). Comparing social determinants of self-rated health across the United States and Canada. Social Science and Medicine, 73(1), 50–59.

    Article  Google Scholar 

  • Ranson, R. (1991). Healthy Housing: A Practical Guide. E&FN Spon on behalf of the WHO Regional Office for Europe, Chapman & Hall, London.

  • Rosenstreich, D. L., Eggleston, P., Kattan, M., Baker, D., Slavin, R. G., Gergen, P., et al. (1997). The role of cockroach allergy and exposure to cockroach allergen in causing morbidity among inner-city children with asthma. New England Journal of Medicine, 336(19), 1356–1363.

    Article  Google Scholar 

  • Ross, C. E., & Bird, C. E. (1994). Sex stratification and health lifestyle: Consequences for men’s and women’s perceived health. Journal of Health and Social Behavior, 35(2), 161–178.

    Article  Google Scholar 

  • Sandel, M., & Wright, R. J. (2007). When home is where the stress is: Expanding the dimensions of housing that influence asthma morbidity. Child: Care, Health and Development, 33(1), 111–112.

    Google Scholar 

  • Shaw, M. (2004). Housing and public health. Annual Review of Public Health, 25, 397–418.

    Article  Google Scholar 

  • Shortt, N. K., & Hammett, D. (2013). Housing and health in an informal settlement upgrade in Cape Town, South Africa. Journal of Housing and the Built Environment, 28(4), 615–627.

    Article  Google Scholar 

  • Smith, S. J., Easterlow, D., & Munro, M. (2004). Housing for health: Does the market work? Environment and Planning A, 36(4), 579–600.

    Article  Google Scholar 

  • Steiger, J. H. (1990). Structure model evaluation and modification: An interval estimation approach. Multivariate Behavioral Research, 25, 173–180.

    Article  Google Scholar 

  • Tan, S., Wang, S., & Cheng, C. (2016). Change of housing inequality in urban China and its decomposition: 1989–2011. Social Indicators Research, 22(4), 1–17.

    Google Scholar 

  • Thomson, H., Thomas, S., Sellstrom, E., & Petticrew, M. (2013). Housing improvements for health and associated socio-economic outcomes. Cochrane Database of Systematic Reviews, 2(2), CD008657.

    Google Scholar 

  • Vaid, U., & Evans, G. W. (2016). Housing quality and health: An evaluation of slum rehabilitation in India. Environment & Behavior, 49(7), 771–790.

    Article  Google Scholar 

  • Wang, Y. (1995). Public sector housing in urban china 1949–1988: The case of Xian. Housing Studies, 10(1), 57–82.

    Article  Google Scholar 

  • Wang, D., & Chai, Y. (2009). The jobs–housing relationship and commuting in Beijing, China: The legacy of Danwei. Journal of Transport Geography, 17(1), 30–38.

    Article  Google Scholar 

  • Wilkinson, R. (1996). Unhealthy societies: The afflictions of inequality. London: Routledge.

    Google Scholar 

  • Windle, G. S., Burholt, V., & Edwards, R. T. (2006). Housing related difficulties, housing tenure and variations in health status: Evidence from older people in Wales. Health and Place, 12(3), 267–278.

    Article  Google Scholar 

  • World Health Organization (WHO). (2010). Developing guidance for health protection in the built environment—mitigation and adaptation responses. International Workshop on Housing, Health and Climate Change.

  • World Health Organization (WHO). (2018). World Health Statistics 2018: Monitoring health for the SDGs, sustainable development goals. Licence: CC BY-NC-SA 3.0 IGO.

  • Xi, B., Liang, Y., He, T., Reilly, K. H., Hu, Y., Wang, Q., et al. (2012). Secular trends in the prevalence of general and abdominal obesity among Chinese adults, 1993-2009. Obesity Reviews, 13(3), 287–296.

    Article  Google Scholar 

  • Yang, G., & Liu, S. (2015). Analysis on the average life expectancy in population of China based on Bayesian random-effect model. Statistical Research, 32(12), 95–100. (In Chinese).

    Google Scholar 

  • Yang, J., Siri, J. G., Remais, J. V., Cheng, Q., Zhang, H., Chan, K. K. Y., et al. (2018). The Tsinghua– Lancet Commission on Healthy Cities in China: Unlocking the power of cities for a healthy China. Lancet, 391(10135), 2140–2184.

    Article  Google Scholar 

  • Yang, Z., & Wang, S. (2011). The impact of privatization of public housing on housing affordability in Beijing: An assessment using household survey data. Local Economy, 26(5), 384–400.

    Article  Google Scholar 

Download references

Acknowledgements

This work was financially supported by the National Natural Science Foundation of China (Grant No. 71804051) and the Chinese Postdoctoral Funds (Grant No. 2017M620307). The data are from China Family Panel Studies (CFPS), funded by 985 Program of Peking University and carried out by the Institution of Social Science Survey of Peking University.

Author information

Authors and Affiliations

  1. College of Public Administration, Huazhong University of Science and Technology, Wuhan, 430074, China

    Siliang Wang & Shukui Tan

  2. Department of Public Administration, Law School, Hunan University, Changsha, 410082, China

    Conghui Cheng

Authors
  1. Siliang Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Conghui Cheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shukui Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shukui Tan.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, S., Cheng, C. & Tan, S. Housing Determinants of Health in Urban China: A Structural Equation Modeling Analysis. Soc Indic Res 143, 1245–1270 (2019). https://doi.org/10.1007/s11205-018-2022-0

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11205-018-2022-0

Keywords

Search

Navigation