NHMRC Centre of Research Excellence in Healthy Housing, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia.
NHMRC Centre of Research Excellence in Healthy Housing, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia.
Lancet Planet Health. 2023 Jun;7(6):e490-e500. doi: 10.1016/S2542-5196(23)00089-X.
Understanding the role of how people are housed in reducing the long-term health and housing effects of climate-related disasters is crucial given our changing climate. We examine long-term health and housing trajectories and health effects of climate-related disasters in relation to housing vulnerabilities over a decade.
We conducted a matched case-control study using longitudinal population-based data from the Household, Income and Labour Dynamics in Australia survey. We included data from people whose homes had been damaged by climate-related disasters (eg, flood, bushfire, or cyclone) between 2009 and 2019 and matched control cohorts with similar sociodemographic profiles who had not been exposed to disaster-related home damage during this period. We included data from de-identified individuals with at least 1 year of data before disaster and 3 years after disaster. One-to-one nearest neighbour matching was performed on the basis of demographic, socioeconomic, housing, health, neighbourhood, location, and climate characteristics 1 year before disaster. Conditional fixed-effects models for matched case-control groups were used to assess health trajectories, using eight quality-of-life domains on mental, emotional, social, and physical wellbeing, and housing trajectories, using three housing aspects of cost (ie, housing affordability and fuel poverty), security (ie, residential stability and tenure security), and condition (ie, housing quality and suitability).
Exposure to home damage from climate-related disasters had significant negative effects on people's health and wellbeing at disaster year (difference between exposure and control groups in mental health score was -2·03, 95% CI -3·28 to -0·78; in social functioning score was -3·95, -5·57 to -2·33; and in emotional wellbeing score was -4·62, -7·06 to -2·18), with some effects lasting for 1-2 years after disaster. These effects were more severe for people who had housing affordability stress or were living in poor quality housing before the disaster. People in the exposure group had a slight increase in housing and fuel payment arrears following disasters. Homeowners had increased housing affordability stress (1 year after disaster: 0·29, 95% CI 0·02 to 0·57; 2 years after disaster: 0·25, 0·01 to 0·50), renters had a higher prevalence of acute residential instability (disaster year: 0·27, 0·08 to 0·47), and people who were exposed to disaster-related home damage had a higher prevalence of forced moves than did the control group (disaster year: 0·29, 0·14 to 0·45).
Findings support the need for recovery planning and resilience building to consider housing affordability, tenure security, and housing condition. Interventions might require divergent strategies for populations in different precarious housing circumstances, and policies should target long-term housing support services for highly vulnerable groups.
The National Health and Medical Research Council Centre of Research Excellence in Healthy Housing, University of Melbourne Affordable Housing Hallmark Research Initiative Seed Funding, Australian Research Council's Centre of Excellence for Children and Families over the Life Course, and Lord Mayor's Charitable Foundation.
随着气候变化，了解人们的住房安置方式如何减少与气候相关灾害对长期健康和住房的影响至关重要。我们研究了与住房脆弱性相关的与气候相关灾害的长期健康和住房轨迹以及健康影响超过十年。
我们使用来自澳大利亚家庭、收入和劳动力动态调查的纵向基于人群的数据进行了匹配病例对照研究。我们纳入了在 2009 年至 2019 年间家中遭受与气候相关灾害（如洪水、丛林大火或旋风）破坏的人群的数据，并将具有相似社会人口学特征且在此期间未遭受与灾害相关的房屋损坏的对照组数据进行了匹配。我们纳入了至少在灾难前一年和灾难后三年有一年以上数据的个人的数据。在灾难前一年，根据人口统计学、社会经济、住房、健康、社区、位置和气候特征，进行一对一最近邻匹配。使用八项关于心理健康、情绪、社会和身体幸福感的生活质量领域，以及住房成本（即住房负担能力和燃料贫困）、安全性（即住宅稳定性和保有权保障）和住房状况（即住房质量和适宜性）的三个住房方面，对匹配的病例对照组使用条件固定效应模型评估健康轨迹。
暴露于与气候相关的灾害导致房屋损坏对人们的健康和幸福感产生了重大负面影响，表现在灾难年心理健康评分下降 2.03（暴露组与对照组之间的差异，95%CI-3.28 至-0.78；社会功能评分下降 3.95，-5.57 至-2.33；情绪健康评分下降 4.62，-7.06 至-2.18），一些影响持续了灾难发生后 1-2 年。对于那些在灾难前住房负担能力紧张或居住在住房质量较差的房屋的人来说，这些影响更为严重。受灾后，暴露组的住房和燃料支付拖欠略有增加。房屋所有者的住房负担能力压力增加（1 年后：0.29，95%CI0.02 至 0.57；2 年后：0.25，0.01 至 0.50），租户的急性住宅不稳定现象更为普遍（灾难年：0.27，0.08 至 0.47），受灾相关房屋损坏的暴露组比对照组更有可能被迫搬迁（灾难年：0.29，0.14 至 0.45）。
研究结果支持灾后恢复规划和弹性建设需要考虑住房负担能力、保有权保障和住房状况。干预措施可能需要针对不同住房不稳定情况的人群制定不同的策略，政策应针对高度脆弱群体提供长期住房支持服务。
澳大利亚墨尔本大学宜居住房中心卓越研究中心、澳大利亚研究委员会儿童和家庭终生卓越研究中心、澳大利亚市长慈善基金会资助的健康住房重点研究计划。
