Jacobs David E, Wilson Jonathan, Dixon Sherry L, Smith Janet, Evens Anne
National Center for Healthy Housing, Columbia, Maryland 21044, USA.
Environ Health Perspect. 2009 Apr;117(4):597-604. doi: 10.1289/ehp.0800086. Epub 2008 Dec 16.
We analyzed the relationship between health status and housing quality over time.
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.
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.
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.
我们分析了健康状况与住房质量随时间的关系。
我们分别合并了来自两项具有全国代表性的关于美国人口及其住房的纵向调查数据，即国家健康与营养检查调查和美国住房调查。在排除数据缺失或我们未发现合理关联或趋势变化的那些趋势后，我们确定了大约1970年至2000年期间的住房和健康趋势。
住房方面的变化包括建筑类型、租赁与自有住房的比例、房龄、密度、面积、湿度、虫害、窗户破损、通风与空调以及漏水情况。健康指标方面的变化包括哮喘、呼吸道疾病、肥胖症和糖尿病以及铅中毒等。结果表明，儿童铅中毒的生态趋势与住房年龄、漏水和通风情况相关；哮喘与通风、窗户和房龄相关；超重趋势与通风相关；血压趋势与社区指标相关；且健康差距变化不大。
随着时间推移，住房趋势与某些健康趋势一致。未来的全国纵向调查应在单一综合设计中纳入健康、住房和社区指标，而非单独进行调查，以便制定可靠指标，说明住房变化如何影响人口健康以及如何最佳地分配资源。在减少弱势群体的健康和住房差距方面进展甚微，但因接触含铅油漆危害导致儿童铅中毒的情况是个明显例外。需要利用这些及其他数据集来创建可靠的健康和住房质量综合指标。
