Dimensions of the Social Environment: Housing

Overview

Associations between housing and health have been studied from several perspectives. Most concretely, physical characteristics of housing have been linked to adverse outcomes. For example, the presence of dampness and mold leads to increased risk of respiratory and other illnesses (Platt et al. 1989; Packer and Stewart–Brown and Fowle 1994). Dilapidated and abandoned housing in the local area increases the risk of accidental injury among residents (Gielen et al. 1995), is associated with increased emotional stress (Ellaway and Macintyre 2000), and may provide situational opportunities for high–risk behaviors (Cohen et al. 2000). Population density and overcrowding have also been associated with increased chances of contracting infections and sustaining injury (Agran et al. 1996; Acevedo–Garcia 2000).

Home ownership has been associated with reduced morbidity and mortality risk (Filakti and Fox 1995; O’Campo et al. 1997). In most cases this housing variable is regarded as a marker for general material well–being. It has been suggested, however, that long–term exposure to specific health promoting or damaging characteristics of housing itself is likely to account for some of the observed health effects (Macintyre et al. 1998; Ellaway and Macintyre 1998).

There is also some evidence that poor housing conditions during childhood can adversely affect health in later life. For example, Barker and colleagues (1990) found an association between domestic crowding during childhood and later stomach cancer mortality rates, suggesting that overcrowding may promote the transmission of causative organisms among children that exert negative health effects later in life. Similarly, Dedman et al. (2001) noted aspects of poorer childhood housing conditions were associated with increased mortality risk from common diseases in adulthood.

Our consultants suggested that we include these characteristics of housing in our framework, as well as other aspects of residential patterns within communities. Homelessness, for example, has known associations with differentially poorer health (Barrow et al. 1999; Hwang 2001). Segregation by race has been associated with adverse health outcomes among blacks (Williams and Collins 2001; Jackson et al. 2000), as well as among whites in some cases (Collins and Williams 1999). Similarly, concentration of poverty has been found to be associated with elevated mortality risk (Waitzman and Smith 1998a).

We also include two other components within the housing dimension. Regulations such as zoning and industrial/residential segregation can affect which residential areas are exposed to industrial pollution and other health threats such as increased traffic. Financial issues specific to housing, such as housing costs, the availability and characteristics of low–income housing, mortgage lending practices, and community reinvestment initiatives are also considered.

This table describes the components and indicators of the housing dimension.  Four housing components are identified:

1. Housing Stock
2. Residential Patterns
3. Regulation
4. Financial Issues

Within each component, several indicators are identified, and for each indicator at least one data set is listed.

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Date last reviewed: 05/12/2006
Content source: Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion