Dr KK Aggarwal & JK Jain
The WHO defines health as “not just the absence of disease, but a state of complete physical, mental and social well-being”. This means that the conditions, in which we live, learn, work and grow old, “the social contexts of health and disease” also influence our health and well-being. These social factors are called the social determinants of health.
Social gradient has been identified as one of the 10 social determinants of health, which also include stress, early life, social exclusion, work, unemployment, social support, addiction, food and transport.
Social gradient is measured by variables such as income, education, occupation or housing.
The quality of housing is becoming increasingly important to public health. To reiterate the significance of housing in health and well-being, on Tuesday, WHO released new guidelines on housing and health.
Healthy housing is not just the physical structure, which protects from extremes of temperature, injury hazards, animals/pests and provides adequate sanitation and illumination, it also means a feeling of home, which provides security, privacy and a sense of belonging.
Health housing is also determined by local community, which enables social interactions that support health and well-being. The immediate surroundings and the environment such as green space, access to services, transport options also influence health housing.
The new guidelines take into account the major health risks associated with poor housing conditions in four areas:
- Inadequate living space (crowding):
- Low and high indoor temperatures
- Injury hazards in the home
- Accessibility of housing for people with functional impairments.
The key recommendations are as follows:
- Crowding: Strategies should be developed and implemented to prevent and reduce household crowding.
- Indoor cold and insulation: Indoor housing temperatures should be high enough to protect residents from the harmful health effects of cold. For countries with temperate or colder climates, 18oC has been proposed as a safe and well-balanced indoor temperature to protect the health of general populations during cold seasons. In climate zones with a cold season, efficient and safe thermal insulation should be installed in new housing and retrofitted in existing housing.
- Indoor heat: In populations exposed to high ambient temperatures, strategies to protect populations from excess indoor heat should be developed and implemented.
- Home safety and injuries: Housing should be equipped with safety devices (such as smoke and carbon monoxide alarms, stair gates and window guards) and measures should be taken to reduce hazards that lead to unintentional injuries.
- Accessibility: Based on the current and projected national prevalence of populations with functional impairments and taking into account trends of ageing, an adequate proportion of the housing stock should be accessible to people with functional impairments.
According to the WHO, “Improved housing conditions can save lives, prevent disease, increase quality of life, reduce poverty, and help mitigate climate change and contribute to the achievement of a number of Sustainable Development Goals, in particular those addressing Health (SDG 3) and Sustainable Cities (SDG 11).”
Housing is therefore a major entry point for intersectoral public health programmes and primary prevention.
(Source: WHO Housing and health guidelines, 2018)
Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Immediate Past National President IMA