Lack of housing maintenance may lead to poor housing conditions inside the home (e.g., damaged appliances, exposed nails, or peeling paint) as well as poor housing conditions outside the home (e.g., damage to stairs and windows).7 These conditions may harm health by increasing exposure to hazards such as carbon monoxide,11 allergens,2 and lead in paint,12, 13 pipes, and faucets.14 Carbon monoxide has been shown to cause heart damage, neurological impairment, and death.14 Likewise, even low levels of lead exposure can have serious effects on children’s health and behavior.12
Inadequate plumbing and lack of air conditioning in homes may also impact health.14, 15 Corroded plumbing infrastructure (e.g., in Flint, Michigan) increases residents’ exposure to lead16 and their risk of lead poisoning.17 Living in a home without air conditioning may increase the risk of vector-borne diseases, like dengue fever, if people leave unscreened windows open for ventilation.15, 18
Low-income families may be more likely to live in poor-quality housing that can damage health.4, 6, 18 These homes may be underinsulated, lack air conditioning, and cost more to heat, leaving homes either too hot or too cold, which has been linked to poorer health outcomes.2, 4, 19 For example, spending time in a cold home may raise blood pressure or even lead to a heart attack.20, 21 In addition, residents of overcrowded homes may be at risk for poor mental health, food insecurity, and infectious diseases.2, 12, 22, 23 Additionally, the homes of low-income families are more likely to have water leaks;5 these leaks are associated with mold growth,5 which has been shown to affect respiratory health24 and increase the likelihood of asthma, coughing, and wheezing.25
Children twelve and older adults with physical limitations may be especially susceptible to negative health outcomes when living in poor quality housing.1, 4 Inadequately vented appliances in the home may result in increased exposure to carbon monoxide in utero, which may affect fetal development or even result in fetal death.11, 12 Children’s behaviors, such as hand-to-mouth activity, may increase their exposure to home pollutants.12, 26 Older adults may experience serious injury from falls in the home, especially in homes with stairs, narrow doorways, or other obstacles.1, 4, 27
Interventions to improve housing quality, such as restrictions on lead paint and renovations of older homes, have been shown to decrease certain health risks (e.g., through decreased rates of lead poisoning).12 Further research is needed to develop other effective interventions to improve housing quality. This additional evidence will facilitate public health efforts to address quality of housing as a social determinant of health.
Disclaimer: This summary of the literature on quality of housing as a social determinant of health is a narrowly defined review that may not address all dimensions of the issue.i, ii Please keep in mind that the summary is likely to evolve as new evidence emerges or as additional research is conducted.
Endnotes
i Terminology used in the summary is consistent with the respective references. As a result, there may be variability in the use of terms, for example, black versus African American.
ii The term minority, when used in a summary, refers to racial/ethnic minority, unless otherwise specified.
References: Click Page 1 Click Page 2
https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health/interventions-resources/quality-of-housing
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