Poortinga Wouter, Jones Nikki, Lannon Simon, Jenkins Huw
Welsh School of Architecture, Cardiff University, Bute Building, King Edward VII Avenue, Cardiff, Wales, CF10 3NB, UK.
School of Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff, Wales, CF10 3AT, UK.
BMC Public Health. 2017 Dec 2;17(1):927. doi: 10.1186/s12889-017-4928-x.
While existing research indicates that housing improvements are associated with health improvements, less is known about the wider social and health benefits of meeting national housing standards, as well as those of their specific constituent measures. This study evaluates the impacts of a managed housing upgrade programme through a repeated cross-sectional survey design.
A five-wave repeated cross-sectional survey was conducted over a seven-year period from 2009 to 2016 (n = 2075; n = 2219; n = 2015; n = 1991; and n = 1709, respectively). The study followed a managed upgrade programme designed to meet a national social housing standard over an extended period. The data were analysed from a multilevel perspective to take account of the time-dependent nature of the observations and differences in socio-demographic composition.
The installation of the majority of individual housing measures (new windows and doors; boilers; kitchens; bathrooms; electrics; loft insulation; and cavity/external wall insulation) were associated with improvements in several social (housing suitability, satisfaction, and quality; thermal comfort and household finances) and health (mental, respiratory and general health) outcomes; and analyses showed relationships between the number of measures installed and the total amount invested on the one hand and the social and health outcomes on the other. There were however a few exceptions. Most notably, the installation of cavity wall insulation was associated with poorer health outcomes, and did not lead to better social outcomes. Also, no association was found between the number of measures installed and respiratory health.
The study suggests that substantial housing investments through a managed upgrade programme may result in better social and health outcomes, and that the size of the improvements are proportionate to the number of measures installed and amount invested. However, there may be risks associated with specific measures; and more attention is needed for mechanical ventilation when upgrading energy efficiency of houses through fabric work. In addition to providing new evidence regarding the wider social and health outcomes, the study provides an analytical approach to evaluate upgrade programmes that are delivered over multiple years.
虽然现有研究表明住房条件改善与健康状况改善相关，但对于达到国家住房标准及其具体构成措施所带来的更广泛社会和健康益处，人们了解较少。本研究通过重复横断面调查设计评估了一项有管理的住房升级计划的影响。
在2009年至2016年的七年期间进行了五次重复横断面调查（分别为n = 2075；n = 2219；n = 2015；n = 1991；以及n = 1709）。该研究遵循一项旨在长期达到国家社会住房标准的有管理的升级计划。从多层次角度对数据进行分析，以考虑观察结果的时间依赖性以及社会人口构成差异。
大多数单项住房措施（新门窗、锅炉、厨房、浴室、电气设施、阁楼隔热材料以及空心墙/外墙隔热材料）的安装与若干社会（住房适用性、满意度和质量；热舒适度和家庭财务状况）和健康（心理、呼吸和总体健康）结果的改善相关；分析表明，一方面安装的措施数量和投资总额与另一方面的社会和健康结果之间存在关联。然而，也有一些例外情况。最显著的是，安装空心墙隔热材料与较差的健康结果相关，且未带来更好的社会结果。此外，未发现安装的措施数量与呼吸健康之间存在关联。
该研究表明，通过有管理的升级计划进行大量住房投资可能会带来更好的社会和健康结果，且改善程度与安装的措施数量和投资金额成比例。然而，特定措施可能存在风险；在通过建筑工程提高房屋能源效率时，机械通风需要更多关注。除了提供关于更广泛社会和健康结果的新证据外，该研究还提供了一种评估多年实施的升级计划的分析方法。
