Dear Colleagues,

In the developed world, we spend most of our time indoors, inside our homes, and this is particularly so for the very young and old, whose health is more vulnerable. The quality of our houses, and particularly the indoor environment, is a critical exposure for occupants’ health and well-being. It is essential we can demonstrate the causal relationships between different aspects of housing and health through robust research.  For example, retrofitting existing houses for energy efficiency as part of the green economy has co-benefits for health and well-being, as well as carbon mitigation.

As populations become more mobile and there is an increase in migration and refugees, designing an adequate supply of flexible housing and apartment spaces, so that several generations can live together securely without being crowded, and changing needs over the life course can be met, requires innovative designs and governance strategies. Severe housing deprivation increases close-contact infectious diseases, as well as stress and mental health problems.

While housing is the only major asset most households have, in many developed countries home ownership rates are declining, and renting from private landlords is becoming more common. As social and council housing is declining in many countries and people are paying a greater proportion of their disposable incomes for housing costs, there is an urgent need to work out ways of effectively regulating the quality in the private rental market and trying new housing (including tenure) arrangements.

In developing countries, informal settlements and slums have spread around most urban areas. Here, the lack of formal infrastructure makes households very vulnerable to extreme climate events. Yet these households’ needs for clean water, sanitation and reliable renewable energy supplies are urgent and growing.

In this Special Issue we are looking for a range of innovative research and evidence-based policy ideas that demonstrate just how important housing research and policy is for health and well-being.

Prof. Dr. Philippa Howden-Chapman
Guest Editor

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• housing interventions to improve health and environmental outcomes
• co-benefits of retrofitting housing
• evidence-based policies to improve health

Article Type: Article
Title: Lower Physical Performance in Colder Season and Colder Houses: Evidence from a Field Study on Older People Living in the Community
Authors: Yukie Hayashi ^1,*, Steven M. Schmidt ², Agneta Malmgren Fänge ², Tanji Hoshi³, and Toshiharu Ikaga ¹
Affiliations: ¹. School of Science for Open and Environmental Systems, Graduate School of Science and Technology, Keio University, Hiyoshi 3 14 1, Kohoku, Yokohama, Japan ; ikaga@sd.keio.ac.jp (T.I.)
². Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, Lund 221 00, Sweden; schmidt@med.lu.se (S.S.); agneta.malmgren_fange@med.lu.se (A.M.F)
³. Department of Urban Science, Tokyo Metropolitan University, Minamiosawa 1 1, Hachioji, Tokyo, Japan; star@onyx.dti.ne.jp (T.H.)
*. Correspondence: yukie1222@z2.keio.jp; Tel.: +81-45-566-1770
Abstract: The aim of the paper was to explore the effect of seasonal temperature differences and cold indoor environment of housing in winter on physical performance of older people living in the community based on a field study. We recruited 162 home-dwelling older people using a rehabilitation facility in Osaka prefecture, Japan and collected data on physical performance. At the same time, a questionnaire survey and a measurement of indoor temperature of individual houses were conducted for some participants. The analysis showed that there were seasonal trends in physical performance of older people and physical performance was worse in winter compared to intermediate seasons such as autumn. Furthermore, people living in colder houses had worse physical performance. The findings indicate that keeping the house warm in winter can help to maintain physical performance.
Keywords: indoor thermal environment; field study; frail; physical strength examination

Type of Paper: Article
Title: How economic analysis can contribute to understanding the links between housing and health
Authors: Ralph Chapman ^1,* and Philippa Howden-Chapman ²
Affiliation: ¹ School of Geography, Environment and Earth Sciences, Victoria University of Wellington, Wellington 6012, New Zealand; Email: Ralph.Chapman@vuw.ac.nz; ² He Kainga Oranga/Housing and Health Research Programme, Department of Public Health, University of Otago, Wellington, New Zealand
Abstract: An economic analysis of housing’s linkages to health assists researchers and policy makers to make decisions about which interventions and policies are the most cost-beneficial. In this paper we highlight the importance of cobenefits, as well as adverse side-effects, including some that are difficult to assess, and key uncertainties. We consider a range of empirical studies of how, using an economic framework, researchers have evaluated ways in which housing conditions can affect health outcomes, and critique this literature. We embed this analysis within an examination of insights which economics can offer, and consider ways in which the insights of an economic framework for housing-health studies may be both valuable and limited, before assessing the pros and cons of cost-benefit analysis as a specific analytical tool. We explore how a broader, rounded view of housing policy interventions – particularly (but not solely) interventions with health benefits – may be desirable for policy-oriented evaluation.

Type of Paper: Article
Title: Exploring the relationship between housing and health for refugees and asylum seekers in South Australia: a qualitative study
Authors: Anna Ziersch *, Clemence Due Moira Walsh and Emily Duivesteyn
Affiliation: ¹ Australian Research Council Future Fellow, Southgate Institute for Health, Society and Equity, Flinders University, GPO Box 2100, Adelaide SA 5001, Australia; Email: anna.ziersch@flinders.edu.au Abstract: Housing in an important social determinant of health, however little is known about how the housing experiences of refugees and asylum seekers impact their health and wellbeing. As such, there is little evidence-based policy concerning housing provision for refugees and asylum seekers in resettlement countries such as Australia. In this paper, we outline a qualitative component of a study of the housing experiences of asylum seekers and refugees in South Australia, and the links between housing and health and wellbeing. Specifically, interviews were conducted with 46 refugees and asylum seekers who were purposively sampled from a survey to gain a range of people from diverse countries of origin, lengths of time in Australia, and on varying visa types. Interviews were then analysed thematically. The results indicated that both refugees and asylum seekers felt that housing was a central aspect of their health and wellbeing, and that housing impacted health through a range of pathways. In particular, these were: difficulties findings and obtaining suitable housing, housing being in poor condition, housing being in a layout which wasn’t suitable, feelings of safety and belonging related to housing, and economic aspects of housing. In addition, our results suggest important differences in experiences of housing for different groups of people, most notably that asylum seekers were most likely to discuss living in housing in poor condition. Overall, our research provides further evidence concerning the importance of housing to both physical and mental health for asylum seekers and refugees living in resettlement countries. Improving housing quality, affordability and increasing diversity in the type of housing available to asylum seeker and refugee families all have the potential to lead to more positive health outcomes. We recommend that housing should be considered an important policy issue when planning resettlement strategies for this group of people.

Type of Paper: Article
Title: Is Owning a Home Good or Bad for Your Health? The Systemic Level Effects of Housing Ownership on the Health of Detroit Residents
Authors: Roshanak Mehdipanah ^1,*, Amy J. Schulz¹, Barbara A. Israel¹, Carmen Stokes², Alexa Eisenberg¹, Zachary Rowe³
Affiliation: ¹ University of Michigan, School of Public Health, Ann Arbor, MI, USA; Email: rmehdipa@umich.edu; ² University of Detroit Mercy, McAuley School of Nursing, Detroit, MI, USA; ³ Friends of Parkside, Detroit, MI, USA

Abstract: There continue to be racial and ethnic inequities associated with home ownership in the United States.  These inequities have worsened by the economic recession and the mortgage crisis beginning in 2008, which had particularly adverse effects in Detroit, Michigan. As a result, some, especially low-income households, have experienced economic strain, reduced home values, and in some cases, foreclosure. Existing literature connects housing ownership to positive health outcomes due to the stability and wealth accumulation it provides. However, there is limited evidence on the systemic level effects of the historical and political context on the home ownership experience and resulting health outcomes, favorable and unfavorable, on Detroit homeowners. Based on prior studies and a review of the literature, the purpose of this article is to adapt and explicate an existing conceptual model to highlight the relationship between some of these systemic factors on housing ownership in Detroit and their proposed effects on health. We will empirically test a subset of pathways specified in the conceptual model, specifically examining the extent to which associations between neighborhood racial composition and health outcomes are mediated by indicators of home ownership and home value. This paper will contribute to the limited evidence needed to develop scientifically informed intervention and policy recommendations that translate this research into actions to reduce health inequities.

Keywords: housing systems, housing ownership, Detroit, health equity, foreclosure