WHO Housing, Health & Accessibility

Multi coloured graphic depicting the key elements in the guidelines "How housing can improve health and well-being".There are five key areas for healthy housing and accessibility is one of them. The WHO latest guidelines on housing and health takes into consideration ageing populations and people with functional impairments. It recommends an “adequate proportion of housing stock should be accessible.

In the remarks section it argues that living in an accessible home improves both independence and health outcomes. Although the guidelines argue for a proportion of housing stock it has put the issue on the agenda. It shows it is as important as all other factors. However, the notion of proportion can lead some agencies to think that means specialised and segregated housing. It is worth noting that the lead author of this section is an Australian, Professor Peter Phibbs.

The other key areas are crowding, indoor cold, indoor heat, and home safety. For more detail there is an additional document showing method and results of the systematic review that underpinned this section of the Guidelines – Web Annex F. and includes interventions such as home modifications and assistive technology. 

Relationship between housing and health

A yellow brick house with yellow steps to the front door set back under a red brick archway.By undertaking a systematic review of the literature, Janet Ige and colleagues in UK found there is a strong association between housing and health. However, it is not clear that there is a causal link and their article argues that more research needs to be done. The team found more than 7,000 studies on the topic, with 39 matching their criteria for analysis. Findings showed that housing refurbishment and modifications, provision of adequate heating, improvements to ventilation and water supply were associated with improved respiratory outcomes, quality of life and mental health. The title of the article is, The relationship between buildings and health: a systematic review, and this can be downloaded from the Journal of Public Health, or you can download the PDF directly. 

Abstract: Background – The built environment exerts one of the strongest directly measurable effects on physical and mental health, yet the evidence base underpinning the design of healthy urban planning is not fully developed.  

Method: This study provides a systematic review of quantitative studies assessing the impact of buildings on health. In total, 7127 studies were identified from a structured search of eight databases combined with manual searching for grey literature. Only quantitative studies conducted between January 2000 and November 2016 were eligible for inclusion. Studies were assessed using the quality assessment tool for quantitative studies.

Results: In total, 39 studies were included in this review. Findings showed consistently that housing refurbishment and modifications, provision of adequate heating, improvements to ventilation and water supply were associated with improved respiratory outcomes, quality of life and mental health. Prioritization of housing for vulnerable groups led to improved wellbeing. However, the quality of the underpinning evidence and lack of methodological rigour in most of the studies makes it difficult to draw causal links.

Conclusion: This review identified evidence to demonstrate the strong association between certain features of housing and wellbeing such as adequate heating and ventilation. Our findings highlight the need for strengthening of the evidence base in order for meaningful conclusions to be drawn.