Health effects of housing improvement: systematic review of intervention studies

Objective To review the evidence on the effects of interventions to improve housing on health. Design Systematic review of experimental and non-experimental housing inter vention studies that measured quantitative health outcomes. Data sources Studies dating from 1887, in any language or format, identifie d from clinical, social science, and grey literature databases, personal co llections, expert consultation, and reference lists. Main outcome measures Socioeconomic change and health, illness, and social measures. Results 18 completed primary intervention studies were identified. 11 studi es were prospective, of which six had control groups. Three of the seven re trospective studies used a control group. The interventions included rehous ing, refurbishment, and energy efficiency measures. Many studies showed hea lth gains after the intervention, but the small study populations and lack of controlling for confounders limit the generalisability of these findings . Conclusions The lack of evidence linking housing and health may be attribut able to pragmatic difficulties with housing studies as well as the politica l climate in the United Kingdom. A holistic approach is needed that recogni ses the multifactorial and complex nature of poor housing and deprivation. Large scale studies that investigate the wider social context of housing in terventions are required.