Department of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Chile.
Department of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Chile; Institute of Geography, Pontificia Universidad Católica de Chile, Chile.
Soc Sci Med. 2024 Aug;355:117090. doi: 10.1016/j.socscimed.2024.117090. Epub 2024 Jul 5.
Housing is a pressing problem worldwide and a key determinant of health and wellbeing. The right to adequate housing, as a pillar of the right to an adequate standard of living, means more than a roof to live under. Adequate means the dwelling must fulfill material functions and psychosocial functions, thus contributing to dwellers health and wellbeing. Social housing policies aim to fulfill the right to housing, but frequently fail in fulfilling the right to it being adequate. This study capitalizes on the implementation of a national urban regeneration program in two social housing villas in central Chile (one in Santiago, in the central valley, the other in Viña del Mar, a coastal city) to run a natural experiment assessing the impact of dwelling renovation on several dimensions of perceived habitability and housing satisfaction among the -mostly female-household homemakers. We use 5 waves of survey data collected with a step-wedge design to estimate the association between a time-varying exposure status (the intervention) and 7 binary outcomes for habitability and 5 for housing dissatisfaction, including overall housing satisfaction. We use Poisson regression models with robust variance and a random intercept at the respondent level. At baseline, reports of poor habitability and dissatisfaction across all features were markedly high, the highest levels of dissatisfaction being with acoustic insulation and dwelling size in both villas, and with indoor temperature in Santiago. The intervention resulted in statistically significant and markedly large improvements in reported habitability and dissatisfaction relative to those housing components targeted by the intervention, as well as with overall dwelling satisfaction in both study cases. Implications are, first, that the policy response to quantitative housing deficits must not overlook housing quality; second, that housing renovation appears as a promising intervention for qualitative housing crises; third, that while improvements in habitability and satisfaction are specific to the interventions in place, overall housing satisfaction can improve in more limited, tailored, dwelling renovation interventions. Social housing renovation in Latin America appears as a promising intervention to improve quality of life among the urban poor dwellers and reduce inequalities in health related to housing conditions.
住房是一个全球性的紧迫问题,也是健康和幸福感的关键决定因素。作为适足生活水准权的支柱之一,适足住房权不仅仅意味着有一个栖身之所。适足意味着住房必须满足物质功能和社会心理功能,从而促进居民的健康和幸福感。社会住房政策旨在实现住房权,但常常未能实现住房适足权。本研究利用智利中部两个社会住房别墅(一个位于圣地亚哥,在中央山谷,另一个位于瓦尔帕莱索,一个沿海城市)实施国家城市更新计划,开展了一项自然实验,评估住房翻新对居住者感知可居住性和住房满意度的几个方面的影响。我们使用了 5 轮使用阶跃式设计收集的调查数据,以估计时间变化的暴露状况(干预)与 7 个可居住性二分结果和 5 个住房不满结果之间的关联,包括总体住房满意度。我们使用泊松回归模型,具有稳健方差和受访者层面的随机截距。在基线时,所有特征的可居住性和不满报告都明显很高,两个别墅中对隔音和居住面积以及圣地亚哥的室内温度的不满程度最高。干预导致报告的可居住性和不满程度相对于干预目标的住房组件有统计学上显著和明显的改善,并且在两个研究案例中都提高了整体居住满意度。这意味着,首先,政策应对定量住房短缺问题时,不能忽视住房质量;其次,住房翻新似乎是解决住房质量危机的一种很有前途的干预措施;第三,尽管可居住性和满意度的改善是针对具体干预措施的,但在更有限的、有针对性的住房翻新干预措施中,整体住房满意度也可以提高。拉丁美洲的社会住房翻新似乎是改善城市贫困居民生活质量和减少与住房条件相关的健康不平等的一种很有前途的干预措施。