Jacobs David E, Ahonen Emily, Dixon Sherry L, Dorevitch Samuel, Breysse Jill, Smith Janet, Evens Anne, Dobrez Doborah, Isaacson Marjie, Murphy Colin, Conroy Lorraine, Levavi Peter
University of Illinois at Chicago (Drs Jacobs, Ahonen, Dorevitch, Smith, Evens, Dobrez, and Conroy and Mr Murphy); National Center for Healthy Housing, Columbia, Maryland (Drs Jacobs and Dixon and Ms Breysse); Center for Neighborhood Technology Energy, Chicago, Illinois (Drs Evens and Isaacson); and Brinshore Michaels Development, Northbrook, Illinois (Mr Levavi).
J Public Health Manag Pract. 2015 Jul-Aug;21(4):345-54. doi: 10.1097/PHH.0000000000000047.
Green building systems have proliferated but health outcomes and associated costs and benefits remain poorly understood.
To compare health before and after families moved into new green healthy housing with a control group in traditionally repaired housing.
Mixed methods study in 3 Chicago housing developments.
Public housing and low-income subsidized households (n = 325 apartments with 803 individuals).
Self-reported health status, visual assessment of housing condition, indoor air sampling, and Medicaid expenditure and diagnostic data. Medicaid expenditures and International Classification of Diseases, Ninth Revision codes were modeled using a generalized linear model with γ distribution and log-link.
Housing conditions and self-reported physical and mental health improved significantly in the green healthy housing study group compared with both the control group and the dilapidated public housing from which the residents moved, as did hay fever, headaches, sinusitis, angina, and respiratory allergy. Asthma severity measured by self-reported lost school/work days, disturbed sleep, and symptoms improved significantly, as did sadness, nervousness, restlessness, and child behavior. Medicaid data in this exploratory study were inconclusive and inconsistent with self-reported health outcomes and visual assessment data on housing quality but hold promise for future investigation. Possible sources of bias in the Medicaid data include older age in the study group, changes in Medicaid eligibility over time, controlling for Medicaid costs in an urban area, and the increased stress associated with moving, even if the move is into better housing.
The mixed method approach employed here describes the complex relationships among self-reported health, housing conditions, environmental measures, and clinical data. Housing conditions and self-reported physical and mental health improved in green healthy housing. Health care cost savings in Medicaid due to improved housing could not be quantified here but hold promise for future investigations with larger cohorts over a longer follow-up period.
绿色建筑系统已广泛应用，但健康结果以及相关成本和效益仍未得到充分了解。
比较家庭搬入新建绿色健康住房前后的健康状况与传统修缮住房对照组的情况。
在芝加哥3个住房开发项目中进行的混合方法研究。
公共住房和低收入补贴家庭（325套公寓，803人）。
自我报告的健康状况、住房状况的视觉评估、室内空气采样、医疗补助支出及诊断数据。使用具有γ分布和对数链接的广义线性模型对医疗补助支出和国际疾病分类第九版编码进行建模。
与对照组以及居民迁出的破旧公共住房相比，绿色健康住房研究组的住房条件以及自我报告的身心健康状况均有显著改善，花粉症、头痛、鼻窦炎、心绞痛和呼吸道过敏情况也是如此。通过自我报告的缺课/工作日、睡眠障碍和症状衡量的哮喘严重程度显著改善，悲伤、紧张、烦躁和儿童行为问题也有所改善。这项探索性研究中的医疗补助数据尚无定论，且与自我报告的健康结果和住房质量视觉评估数据不一致，但对未来研究具有参考价值。医疗补助数据中可能的偏差来源包括研究组年龄较大、医疗补助资格随时间变化、控制城市地区的医疗补助成本以及搬家带来的压力增加，即使是搬到更好的住房。
此处采用的混合方法描述了自我报告的健康、住房条件、环境指标和临床数据之间的复杂关系。绿色健康住房中住房条件和自我报告的身心健康状况有所改善。因住房改善而节省的医疗补助费用在此处无法量化，但有望在未来对更大队列进行更长随访期的研究中实现。
