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. 2009 Apr;117(4):597-604.
doi: 10.1289/ehp.0800086. Epub 2008 Dec 16.

The relationship of housing and population health: a 30-year retrospective analysis

David E Jacobs  1 , Jonathan Wilson, Sherry L Dixon, Janet Smith, Anne Evens
Affiliations

The relationship of housing and population health: a 30-year retrospective analysis

David E Jacobs et al. Environ Health Perspect. 2009 Apr.

Abstract

Objective: We analyzed the relationship between health status and housing quality over time.

Methods: We combined data from two nationally representative longitudinal surveys of the U.S. population and its housing, the National Health and Nutrition Examination Survey and the American Housing Survey, respectively. We identified housing and health trends from approximately 1970 to 2000, after excluding those trends for which data were missing or where we found no plausible association or change in trend.

Results: Changes in housing include construction type, proportion of rental versus home ownership, age, density, size, moisture, pests, broken windows, ventilation and air conditioning, and water leaks. Changes in health measures include asthma, respiratory illness, obesity and diabetes, and lead poisoning, among others. The results suggest ecologic trends in childhood lead poisoning follow housing age, water leaks, and ventilation; asthma follows ventilation, windows, and age; overweight trends follow ventilation; blood pressure trends follow community measures; and health disparities have not changed greatly.

Conclusions: Housing trends are consistent with certain health trends over time. Future national longitudinal surveys should include health, housing, and community metrics within a single integrated design, instead of separate surveys, in order to develop reliable indicators of how housing changes affect population health and how to best target resources. Little progress has been made in reducing the health and housing disparities of disadvantaged groups, with the notable exception of childhood lead poisoning caused by exposure to lead-based paint hazards. Use of these and other data sets to create reliable integrated indicators of health and housing quality are needed.

Keywords: American Housing Survey (AHS); National Health and Nutrition Examination Survey (NHANES); asthma; health disparities; healthy housing; housing; lead poisoning.

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Figures

Figure 1
Figure 1
Changes in children’s blood lead (μg/dL), housing age, leaks, and central air conditioning over time. Abbreviation: GM, geometric mean.
Figure 2
Figure 2
Changes in asthma, central air conditioning, and forced air furnaces over time.
Figure 3
Figure 3
Changes in asthma, bars on windows, broken windows, and year built over time.
Figure 4
Figure 4
Changes in BMI (kg/m2) and central air conditioning over time.
Figure 5
Figure 5
Changes in high blood pressure, street noise, and bad smells in neighborhoods over time.
Figure 6
Figure 6
Excellent or very good general health status by race/ethnicity.
See this image and copyright information in PMC

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