Acklin Matthias, Graham Jay P, Benjamin-Chung Jade
Department of Health Sciences and Technology, Swiss Federal Institute of Technology Zurich (ETH Zurich).
Division of Environmental Health Sciences, University of California, Berkeley School of Public Health.
PLOS Glob Public Health. 2025 Apr 21;5(4):e0003805. doi: 10.1371/journal.pgph.0003805. eCollection 2025.
Housing conditions are intrinsically linked to human health, with inadequate housing potentially increasing exposure to environmentally mediated pathogens. Beyond efforts to improve water and sanitation and reduce household air pollution, housing improvements remain relatively under-explored as health interventions. This study explored facilitators of and barriers to funding, implementing, and scaling up of housing improvements as health interventions to reduce environmentally mediated infectious diseases. Sixteen key informants (KIs) with direct experience conducting housing interventions with a goal to reduce environmentally mediated infectious diseases in low- and middle-income countries were interviewed using a semi-structured interview format. KIs had diverse backgrounds, including academics researching housing interventions, housing policy advisors, and practitioners implementing housing interventions. A thematic analysis approach was used to identify key themes in interview transcripts, highlighting patterns, commonalities, and variations in participants' responses. KIs emphasized that housing interventions can deliver across a broad set of health outcomes, including physical and mental health, as well as environmental, social, and economic dimensions. Funding and financial mechanisms to address housing interventions were highlighted as key barriers, alongside the need to provide more rigorous evidence and cost-benefit analyses for housing interventions. KIs indicated that funding limitations were likely driven by a deficiency in awareness regarding the significance of housing among decision-makers, and suggested that efforts are needed to foster more intersectoral collaboration. The interviews also revealed a need for more context-specific housing policies and a need to contextualize interventions to their specific setting in order to foster community involvement and successful implementation and scale-up. Housing interventions play a pivotal role in mitigating many environmentally mediated diseases. By integrating these interventions with existing programs, such as water and sanitation or efforts to reduce household air pollution, there is the potential to create a more comprehensive approach to healthy housing in the face of climate change.
住房条件与人类健康有着内在联系，住房条件不佳可能会增加接触环境传播病原体的风险。除了改善水和卫生设施以及减少家庭空气污染的努力之外，作为健康干预措施，住房改善方面的探索相对较少。本研究探讨了将住房改善作为减少环境传播传染病的健康干预措施在资金筹集、实施和扩大规模方面的促进因素和障碍。采用半结构化访谈形式，对16名在低收入和中等收入国家直接参与以减少环境传播传染病为目标的住房干预工作的关键信息提供者（KIs）进行了访谈。KIs背景多样，包括研究住房干预措施的学者、住房政策顾问以及实施住房干预措施的从业者。采用主题分析方法来确定访谈记录中的关键主题，突出参与者回答中的模式、共性和差异。KIs强调住房干预措施可以带来广泛的健康成果，包括身心健康以及环境、社会和经济层面。解决住房干预措施的资金和财务机制被突出视为关键障碍，同时还需要为住房干预措施提供更严谨的证据和成本效益分析。KIs指出，资金限制可能是由于决策者对住房重要性的认识不足所致，并建议需要努力促进更多部门间的合作。访谈还揭示了需要更多针对具体情况的住房政策，以及需要将干预措施与其特定背景相结合，以促进社区参与以及成功实施和扩大规模。住房干预措施在减轻许多环境传播疾病方面发挥着关键作用。通过将这些干预措施与现有项目，如水和卫生设施项目或减少家庭空气污染的努力相结合，面对气候变化有可能创建一种更全面的健康住房方法。
