| The Relationship of Housing and Population Health:
A 30-Year Retrospective Analysis David E. Jacobs,1,2 Jonathan Wilson,1 Sherry L. Dixon,1 Janet Smith,2 and Anne Evens2 1National Center for Healthy Housing, Columbia, Maryland, USA; 2University of Illinois at Chicago, Chicago, Illinois, USA Abstract
Objective: We analyzed the relationship between health status and housing quality over time. Methods: We combined data from two nationally representative longitudinal surveys of the U.S. population and its housing, the National Health and Nutrition Examination Survey and the American Housing Survey, respectively. We identified housing and health trends from approximately 1970 to 2000, after excluding those trends for which data were missing or where we found no plausible association or change in trend. Results: Changes in housing include construction type, proportion of rental versus home ownership, age, density, size, moisture, pests, broken windows, ventilation and air conditioning, and water leaks. Changes in health measures include asthma, respiratory illness, obesity and diabetes, and lead poisoning, among others. The results suggest ecologic trends in childhood lead poisoning follow housing age, water leaks, and ventilation ; asthma follows ventilation, windows, and age ; overweight trends follow ventilation ; blood pressure trends follow community measures ; and health disparities have not changed greatly. Conclusions: Housing trends are consistent with certain health trends over time. Future national longitudinal surveys should include health, housing, and community metrics within a single integrated design, instead of separate surveys, in order to develop reliable indicators of how housing changes affect population health and how to best target resources. Little progress has been made in reducing the health and housing disparities of disadvantaged groups, with the notable exception of childhood lead poisoning caused by exposure to lead-based paint hazards. Use of these and other data sets to create reliable integrated indicators of health and housing quality are needed. Key words: American Housing Survey (AHS) , asthma, health disparities, healthy housing, housing, lead poisoning, National Health and Nutrition Examination Survey (NHANES) . Environ Health Perspect 117:597–604 (2009) . doi:10.1289/ehp.0800086 available via http://dx.doi.org/ [Online 16 December 2008]
Address correspondence to D.E. Jacobs, National Center for Healthy Housing, 10320 Little Patuxent Parkway, Suite 500, Columbia, MD 21044 USA. Telephone: (202) 607-0938. Fax: (443) 539-4150. E-mail: djacobs@nchh.org The U.S. Department of Housing and Urban Development funded this project under MDLHH0154-06. D.E.J. is employed by the National Center for Healthy Housing, where he is the director of research, and the University of Illinois at Chicago, where he is an unpaid adjunct associate professor. The other authors declare they have no competing financial interests. Received 11 August 2008 ; accepted 16 December 2008.
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