Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, Northern Territory, Australia.
BMC Public Health. 2010 Mar 20;10:147. doi: 10.1186/1471-2458-10-147.
There is limited epidemiological research that provides insight into the complex web of causative and moderating factors that links housing conditions to a variety of poor health outcomes. This study explores the relationship between housing conditions (with a primary focus on the functional state of infrastructure) and common childhood illness in remote Australian Aboriginal communities for the purpose of informing development of housing interventions to improve child health.
Hierarchical multi-level analysis of association between carer report of common childhood illnesses and functional and hygienic state of housing infrastructure, socio-economic, psychosocial and health related behaviours using baseline survey data from a housing intervention study.
Multivariate analysis showed a strong independent association between report of respiratory infection and overall functional condition of the house (Odds Ratio (OR) 3.00; 95%CI 1.36-6.63), but no significant association between report of other illnesses and the overall functional condition or the functional condition of infrastructure required for specific healthy living practices. Associations between report of child illness and secondary explanatory variables which showed an OR of 2 or more included: for skin infection--evidence of poor temperature control in the house (OR 3.25; 95%CI 1.06-9.94), evidence of pests and vermin in the house (OR 2.88; 95%CI 1.25-6.60); for respiratory infection--breastfeeding in infancy (OR 0.27; 95%CI 0.14-0.49); for diarrhoea/vomiting--hygienic state of food preparation and storage areas (OR 2.10; 95%CI 1.10-4.00); for ear infection--child care attendance (OR 2.25; 95%CI 1.26-3.99).
These findings add to other evidence that building programs need to be supported by a range of other social and behavioural interventions for potential health gains to be more fully realised.
目前有关住房条件与各种健康不良结果之间因果关系和调节因素的复杂关系的流行病学研究有限。本研究旨在为改善儿童健康的住房干预措施的制定提供信息，探讨了澳大利亚偏远地区土著社区住房条件（主要侧重于基础设施的功能状态）与常见儿童疾病之间的关系。
利用住房干预研究的基线调查数据，采用分层多水平分析方法，研究了看护人报告的常见儿童疾病与住房基础设施的功能和卫生状况、社会经济、心理社会和健康相关行为之间的关联。
多变量分析显示，呼吸道感染报告与房屋整体功能状况之间存在很强的独立关联（优势比（OR）为 3.00；95%置信区间（CI）为 1.36-6.63），但报告的其他疾病与房屋整体功能状况或特定健康生活实践所需的基础设施功能状况之间没有显著关联。与儿童疾病报告相关的次要解释变量的关联显示，OR 值为 2 或更高的变量包括：皮肤感染-房屋内温度控制不佳的证据（OR 3.25；95%CI 1.06-9.94）、房屋内有虫害的证据（OR 2.88；95%CI 1.25-6.60）；呼吸道感染-婴儿期母乳喂养（OR 0.27；95%CI 0.14-0.49）；腹泻/呕吐-食物准备和储存区域的卫生状况（OR 2.10；95%CI 1.10-4.00）；耳部感染-儿童保育出勤率（OR 2.25；95%CI 1.26-3.99）。
这些发现增加了其他证据，即建筑计划需要得到一系列其他社会和行为干预措施的支持，以更充分地实现潜在的健康收益。
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