A lot has been written about how social housing conditions such as neighbourhood crime and community cohesion can affect the well-being of children and families. However, less is known about how ongoing environmental housing conditions affect children’s health.
There is no widely accepted definition of what constitutes sub-standard, inadequate or non-decent housing. Policy from the Department for Work and Pensions (DWP) has, however, defined acceptable conditions as “homes that are warm and weatherproof with reasonably modern facilities”.
Reports from housing charity Shelter have found that more than one million children in England are living in “damp, cold, infested” housing. Moreover, more than one million houses in England are considered “unfit to live in”. A survey based on the 2001 census has also found that more than half a million families in the UK live in officially overcrowded housing.
These statistics have major implications. A person’s physical environment affects their health and well-being. This is especially the case for young children, who can spend 90% of their time in the home. Other groups of children are also vulnerable to environmental conditions within the home, especially children with asthma or related conditions, and small, immature or pre-term infants.
Dampness, moisture and mould
Dampness includes the presence of water damage, damp stains, visible mould and condensation. Some studies and reviews from the UK and elsewhere have reported an association between dampness, moisture and mould and the prevalence of respiratory symptoms among children of all ages. For example, one review found that children in homes with damp and/or mould are two and a half times more likely to have coughs or wheezes than children in “dry” homes. Another UK study found that visible mould was significantly associated with an increased risk of wheezing illness among children aged 9-11 years. A wider European study of older children also found prevalence of asthma and chronic cough was higher in damp homes. The association between moisture and cough or respiratory problems is particularly significant with regard to nocturnal symptoms and more significant still for children who have a predisposition to allergies.
A Finnish study found a significant association between eczema in preschool children and visible moisture and mould in the home, and a relationship between these environmental conditions and nausea in older children. All age groups in this study were found to visit primary care more frequently than their counterparts in dryer houses.
Other household factors
US research has found that indoor allergens, especially dust mites, can exacerbate or cause asthma. Also, overcrowding has been found by one study to be associated with infection in the lower respiratory tract in pre-term infants but not term infants.
Overcrowding has also been found by other studies to have an impact on the psychological health of very young children. A US study that used an objective measure of housing quality, which included heating, wall and ceiling surfaces, but not dampness specifically, and the condition of structures such as stairs, found that there was an association between adverse housing conditions and the poor psychological health of children aged 8-11 years.
As well as depression and anxiety, these children demonstrated less ability to persist with tasks. The study hypothetically explained these children’s feelings of helplessness as a response to “chronic exposure to aversive housing conditions that one can do little to change”.
A UK study examined the effectiveness of installing central heating into homes in which the bedrooms of children aged 9-11 years were found to be unheated and in most cases damp. The study found that respiratory problems among children with asthma, both cough and more severe symptoms, were significantly alleviated by the installation of central heating. The amount of school-time lost by these children was improved. But an earlier similar study investigating the effect of an improved heating system in countering the adverse effect of damp on the health on children found that the intervention prevented further deterioration in their health, but did not improve it.
One US study assessed the value of targeting blood lead levels (BLLs) testing at very young (9-24 months) children in older and less expensive housing, and successfully identified higher BLLs among this group, which could then be addressed by safer housing policies. Another US review found that children exposed to lead dust as a result of living in substandard housing could be given modest protection by professional visiting dust control teams, but it is unlikely that this service would be available to all relevant people in high-risk housing. Rehousing may also have a positive impact on residents’ mental health, but the association has not been proven unequivocally. Finally, trials of interventions to manage dust-mite levels to reduce their effect on childhood asthmatics have found that only actions such as frequent, intense cleaning and carpet removal can have any effect.
Research Abstracts: Environmental housing factors
● SCIE research briefing 19: What is the impact of environmental housing conditions on the health and well-being of children?
● The Centre for Housing Policy at the University of York (CHP) was established in 1990 with the support of the Joseph Rowntree Foundation. It was designed to become a leader in policy relevant research and is one of the leading centres of housing and social policy research in the UK.
● Faculty of Public Health, Royal College of Physicians: this faculty has network groups on both child public health and housing and homelessness.
● NCH provides services to support vulnerable and excluded children and young people
● Shelter provides advice and support on housing issues.
● WHO. Children’s Environmental Health – This website also includes a section on housing and its impact on children’s healthThis article appeared in the 22 November issue under the headline “The impact of environmental housing conditions on the health and well-being of children”