Housing is one of the key modifiable determinants of health. Inadequate housing can have far-reaching consequences for health outcomes.
A healthy home is a core foundation for positive health and wellbeing.
A healthy home can be defined as one that is:
- of good quality and inhabitable
- well insulated, ventilated and fitted with good, reliable heating
- not overcrowded
- pest and contaminant free
- safe (potential hazards are minimised and/or isolated and/or eliminated)
- clean and maintained [see note 2] .
Unhealthy homes are often cold, damp and mouldy due to inadequate insulation, heating and ventilation.
People who live in unhealthy homes have increased risk of contracting a range of serious and avoidable illnesses such as meningitis, rheumatic fever and pneumonia.
Unhealthy homes also heighten the risk of physical injury and can lead to depression and other forms of mental illness.
These health risks are often exacerbated by the fact that people who live in unhealthy homes are more likely to have to make trade-offs between housing costs and decent food, heating, health services and other necessities of life.
Those who are affected, including children, are often hospitalised and treated but they return home to the same conditions that caused the illness. The most vulnerable people, particularly children and older people, are among those who experience the worst effects of inadequate housing.
Unhealthy homes and health
Poor quality housing is a significant driver of hospitalisation among children [see note 3].
Poor quality housing, particularly cold and damp houses, is linked to the following diseases:
- respiratory infections
- rheumatic fever
- cardiovascular disease
- respiratory illnesses and infections, including asthma, bronchiolitis, pneumonia, bronchiectasis, tuberculosis [see note 4] .
Doctors report that illnesses related to poor quality housing are increasing in number and severity, with serious long-term consequences and disability. The rate of bronchiectasis in children (an irreversible, life-threatening lung disease usually only seen in adults or in developing countries) has tripled in 15 years [see note 5].
Hospitalisation rates for bronchiolitis have nearly doubled from 2000 to 2015, over 2000 per 100,000 children [see note 6].
Over 400 per 100,000 children were hospitalised in 2015 for asthma [see note 7].
Sub-standard, high-cost housing at least doubles the risk of admittance to hospital for pneumonia, and is the most important risk factor for rheumatic fever and meningococcal disease [see note 8].
Māori and Pacific children are at significantly greater risk of hospitalisation and death from preventable housing related disease. Māori and Pacific children bronchiectasis hospitalisation rates were 14.5 times higher than for non-MPA. Pacific peoples were eight times more likely to be hospitalised than non-MPA, Māori were 4.4 times more likely to be hospitalised [see note 9].
Poverty is one of the most significant determinants of poor health outcomes, and poor housing is a key component of poverty. Auckland’s low-income suburbs have the worst rates of preventable, poverty-related childhood diseases in Auckland.
There is no simple means of ensuring all Aucklanders have access to healthy homes.
Solutions will involve increasing supply, and building to high standards, increasing the social housing stock, as well as improving the built quality of existing dwellings (particularly rental properties).
 Includes excerpts from Michigan Department of Health & Human Services: http://www.michigan.gov/mdhhs/0,5885,7-339-71550_2955_2983-252982--,00.html
 Howden-Chapman, P., Baker, M. and Bierre, S. (2013). The houses children live in. Policy Quarterly Vol 9:2 – May 2013 – Page 35
 Environmental Health Indicators New Zealand. Poor quality housing and health.
 Asthma and Respiratory Foundation. (2016) The impact of respiratory disease in New Zealand: 2016 Update. https://www.asthmafoundation.org.nz/research/the-impact-of-respiratory-disease-in-new-zealand-2016-update
 Asthma and Respiratory Foundation key statistics https://www.asthmafoundation.org.nz/research/key-statistics
 Child Poverty Action Group. A New Zealand where children can flourish. http://www.cpag.org.nz/assets/170512%20CPAG%20Reducing%20the%20health%20risks%20for%20children%20backgrounder_v2.pdf
 The Impact of Respiratory Disease in New Zealand: 2016 Update. Asthma and Respiratory Foundation. https://www.asthmafoundation.org.nz/research/the-impact-of-respiratory-disease-in-new-zealand-2016-update