Sustainable Housing as a Social Determinant of Health and Wellbeing
Abstract
1. Introduction
2. What Is Sustainable Housing?
3. Sustainable Housing and Health Equity in Theoretical Context
Where Housing and Health Theories Intersect
4. Empirical Evidence Linking Sustainable Housing to Health Outcomes
4.1. Methodology for Literature Identification
4.2. Sustainable Housing and Health Outcomes
4.3. Sustainable Housing Interventions
4.4. Geographic and Contextual Variations in Evidence
5. Integrating Sustainable Housing into Public Health Policy
6. Equity-Centered Approaches to Sustainable Housing
7. Digital Technologies in Sustainable Housing
8. Climate Resilience and Health-Protective Housing Design
9. Future Directions for Research and Advocacy
10. Conclusions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
AI | Artificial Intelligence |
ASHRAE | American Society of Heating, Refrigerating and Air-Conditioning Engineers |
Bla g1 | Blattella germanica allergen 1 (cockroach allergen) |
CFU/m3 | Colony Forming Units per cubic meter (measure of fungal/bacterial contamination) |
CO2 | Carbon Dioxide |
GAD-7 | Generalized Anxiety Disorder-7 |
HDB | Housing and Development Board |
HSHI | Healthy-Sustainable Housing Index |
HVAC | Heating, Ventilation, and Air Conditioning |
IAQ | Indoor Air Quality |
K-10 | Kessler Psychological Distress Scale |
LEED | Leadership in Energy and Environmental Design |
Mus m1 | Mus musculus allergen 1 (mouse allergen) |
OR | Odds Ratio |
PHQ-9 | Patient Health Questionnaire-9 |
pCi/L | Picocuries per liter (measure of radon concentration) |
ppm | Parts per million |
RH | Relative Humidity |
SBS | Sick Building Syndrome |
SDH | Social Determinant of Health |
VOC | Volatile Organic Compounds |
WHO | World Health Organization |
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Sustainable Design Feature | Function/Mechanism | Potential Health Outcomes |
---|---|---|
Energy-efficient housing (e.g., insulation, passive solar design) | Reduces energy demand through better thermal regulation and passive heating/cooling | Reduced respiratory illness, improved thermal comfort, lowered household energy stress |
Use of non-toxic, low-VOC (volatile organic compound) building materials | Replaces harmful chemicals in construction with safer alternatives | Decreased exposure to allergens and carcinogens, improved indoor air quality |
Green space integration (e.g., gardens, communal parks) | Incorporates vegetation and nature into residential design | Lowered stress levels, improved mental wellbeing, increased physical activity |
Active transport infrastructure (e.g., bike paths, walkability) | Encourages walking and cycling through design and connectivity | Reduced obesity risk, cardiovascular benefits, enhanced social cohesion |
Affordable, inclusive housing design | Provides equitable access to housing, considering income, disability, and aging | Reduced housing insecurity and associated mental distress, improved social determinants of health |
Natural lighting and ventilation | Enhances indoor environmental quality through architectural design | Improved circadian rhythm and mental health, reduced dependence on artificial lighting |
Reference | Sustainable Housing Feature or Intervention | Health Outcome | Population/Setting | Study Findings |
---|---|---|---|---|
Breysse et al., 2011 [32] |
| General health, asthma, respiratory conditions, injuries | Population: Low-income families (49 adults, 30 children; 57% immigrant, median income of $29K) Setting: Renovated 60-unit affordable housing complex, Minnesota Study design: Pre-post intervention (baseline recall, 1-year follow-up) |
|
D’Alessandro et al., 2020 [38] |
| Mental health (stress, anxiety and depression); COVID-19 transmission; chronic diseases due to sedentary lifestyles during lockdown | Population: Italian residents (16.8 million living in overcrowded housing; 28.8% of population) Setting: Urban apartments across Italy (average size 88 m2 in Milan, 20.7% of units < 80 m2 for families of 4+) Study design: Cross-sectional analysis of national housing census data and policy review |
|
Garland et al., 2013 [34] |
| Asthma symptoms, urgent healthcare use | Population: Low-income tenants (adults/children with asthma) Setting: Melrose Commons V (LEED-certified affordable housing), South Bronx, New York Study design: Longitudinal (18-month follow-up) |
|
Jacobs et al., 2014 [33] |
| General health, asthma, mental health, injuries, allergen exposure | Population: Low-income, primarily African American residents (57 adults, 64 children) Setting: Renovated housing in Washington, DC Study design: Pre-post intervention (baseline and 1-year) |
|
Norhidayah et al., 2013 [35] |
| Sick Building Syndrome (SBS) symptoms (ophthalmic, respiratory, psychological, dermal) | Population: Office workers (44 in PPAP, 5 in PKBF, 9 in PMA; mean age, 35–39 years) Setting: Three public buildings in Malaysia (PPAP, PKBF, PMA; aged 53–100 years) Study design: Cross-sectional comparative study |
|
Prochorskaite et al., 2016 [39] |
| Mental health symptoms, physical health, social wellbeing, and general quality of life | Population: 235 housing stakeholders (123 housing users, 48 housing associations, 34 local authorities, 30 private developers) Setting: West Midlands and Northwest England, UK Study design: Cross-sectional study |
|
Zúñiga-Bello et al., 2019 [36] |
| Respiratory symptoms and conditions | Population: School children aged 7–12 years Setting: Semi-urban community (Alpuyeca, Mexico) Study design: Cross-sectional pilot study (60 households) |
|
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Rana, K. Sustainable Housing as a Social Determinant of Health and Wellbeing. Sustainability 2025, 17, 7519. https://doi.org/10.3390/su17167519
Rana K. Sustainable Housing as a Social Determinant of Health and Wellbeing. Sustainability. 2025; 17(16):7519. https://doi.org/10.3390/su17167519
Chicago/Turabian StyleRana, Kritika. 2025. "Sustainable Housing as a Social Determinant of Health and Wellbeing" Sustainability 17, no. 16: 7519. https://doi.org/10.3390/su17167519
APA StyleRana, K. (2025). Sustainable Housing as a Social Determinant of Health and Wellbeing. Sustainability, 17(16), 7519. https://doi.org/10.3390/su17167519