Housing-Sensitive Health Conditions Can Predict Poor-Quality Housing.

Improving housing quality may improve residents' health, but identifying buildings in poor repair is challenging. We developed a method to improve health-related building inspection targeting. Linking New York City Medicaid claims data to Landlord Watchlist data, we used machine learning to identify housing-sensitive health conditions correlated with a building's presence on the Watchlist. We identified twenty-three specific housing-sensitive health conditions in five broad categories consistent with the existing literature on housing and health. We used these results to generate a housing health index from building-level claims data that can be used to rank buildings by the likelihood that their poor quality is affecting residents' health. We found that buildings in the highest decile of the housing health index (controlling for building size, community district, and subsidization status) scored worse across a variety of housing quality indicators, validating our approach. We discuss how the housing health index could be used by local governments to target building inspections with a focus on improving health.

The impact of the cost-of-living crisis on population health in the UK: rapid evidence review.

BACKGROUND: In the UK, unique and unforeseen factors, including COVID-19, Brexit, and Ukraine-Russia war, have resulted in an unprecedented cost of living crisis, creating a second health emergency. We present, one of the first rapid reviews with the aim of examining the impact of this current crisis, at a population level. We reviewed published literature, as well as grey literature, examining a broad range of physical and mental impacts on health in the short, mid, and long term, identifying those most at risk, impacts on system partners, including emergency services and the third sector, as well as mitigation strategies. METHODS: We conducted a rapid review by searching PubMed, Embase, MEDLINE, and HMIC (2020 to 2023). We searched for grey literature on Google and hand-searched the reports of relevant public health organisations. We included interventional and observational studies that reported outcomes of interventions aimed at mitigating against the impacts of cost of living at a population level. RESULTS: We found that the strongest evidence was for the impact of cold and mouldy homes on respiratory-related infections and respiratory conditions. Those at an increased risk were young children (0-4 years), the elderly (aged 75 and over), as well as those already vulnerable, including those with long-term multimorbidity. Further short-term impacts include an increased risk of physical pain including musculoskeletal and chest pain, and increased risk of enteric infections and malnutrition. In the mid-term, we could see increases in hypertension, transient ischaemic attacks, and myocardial infarctions, and respiratory illnesses. In the long term we could see an increase in mortality and morbidity rates from respiratory and cardiovascular disease, as well as increase rates of suicide and self-harm and infectious disease outcomes. Changes in behaviour are likely particularly around changes in food buying patterns and the ability to heat a home. System partners are also impacted, with voluntary sectors seeing fewer volunteers, an increase in petty crime and theft, alternative heating appliances causing fires, and an increase in burns and burn-related admissions. To mitigate against these impacts, support should be provided, to the most vulnerable, to help increase disposable income, reduce energy bills, and encourage home improvements linked with energy efficiency. Stronger links to bridge voluntary, community, charity and faith groups are needed to help provide additional aid and support. CONCLUSION: Although the CoL crisis affects the entire population, the impacts are exacerbated in those that are most vulnerable, particularly young children, single parents, multigenerational families. More can be done at a community and societal level to support the most vulnerable, and those living with long-term multimorbidity. This review consolidates the current evidence on the impacts of the cost of living crisis and may enable decision makers to target limited resources more effectively.

Vivaria housing conditions expose sex differences in brain oxidation, microglial activation, and immune system states in aged hAPOE4 mice.

Apolipoprotein E ε4 allele (APOE4) is the predominant genetic risk factor for late-onset Alzheimer's disease (AD). APOE4 mouse models have provided advances in the understanding of disease pathogenesis, but unaccounted variables like rodent housing status may hinder translational outcomes. Non-sterile aspects like food and bedding can be major sources of changes in rodent microflora. Alterations in intestinal microbial ecology can cause mucosal barrier impairment and increase pro-inflammatory signals. The present study examined the role of sterile and non-sterile food and housing on redox indicators and the immune status of humanized-APOE4 knock-in mice (hAPOe4). hAPOE4 mice were housed under sterile conditions until 22 months of age, followed by the transfer of a cohort of mice to non-sterile housing for 2 months. At 24 months of age, the redox/immunologic status was evaluated by flow cytometry/ELISA. hAPOE4 females housed under non-sterile conditions exhibited: (1) higher neuronal and microglial oxygen radical production and (2) lower CD68+ microglia (brain) and CD8+ T cells (periphery) compared to sterile-housed mice. In contrast, hAPOE4 males in non-sterile housing exhibited: (1) higher MHCII+ microglia and CD11b+CD4+ T cells (brain) and (2) higher CD11b+CD4+ T cells and levels of lipopolysaccharide-binding protein and inflammatory cytokines in the periphery relative to sterile-housed mice. This study demonstrated that sterile vs. non-sterile housing conditions are associated with the activation of redox and immune responses in the brain and periphery in a sex-dependent manner. Therefore, housing status may contribute to variable outcomes in both the brain and periphery.

Housing Conditions and Health Implications for Migrant Agricultural Workers in Canada: A Scoping Review.

Migrant agricultural workers face various health inequities that have led to preventable illness and death. This paper investigates how material housing conditions have shaped physical and mental health outcomes for temporary foreign workers in Canadian agriculture. We conducted a scoping review of literature on migrant agricultural worker housing in Canada published between 2000-2022, analysing insights on the physical quality of workers' housing in relation to international frameworks on housing quality. Our review revealed a range of housing-related health risks, including: (1) Sanitation, food security, and water; (2) Thermal safety, electricity, and utilities; (3) Habitability of structure, air quality, and exposure to hazards; (4) Spacing, privacy, and co-worker relations and; (5) Geographic proximity to necessary services and social opportunities. Although housing has been increasingly recognized as a social determinant of health, little research examines how migrant farmworkers' accommodations shape their health outcomes, particularly in Canada. This scoping review provides timely insights and recommendations to inform research, policy, and public health interventions.

A happy home? Socio-economic inequalities in depressive symptoms and the role of housing quality in nine European countries.

BACKGROUND: This study examines the prevalence of and socio-economic inequalities in depressive symptoms in nine high-income European countries, focusing in particular on the role of housing quality. METHODS: Using the European Social Survey, a concentration index of depressive symptoms in each country is estimated. The role of housing quality is assessed by examining the risk factors associated with the concentration index, using the Recentred Influence Function method. To contextualise the housing quality results, other predictors of inequalities in depressive symptoms inequalities are also quantified and discussed. RESULTS: Our results indicate that inequalities in depressive symptoms are concentrated among poorer respondents both in each country and in total. Austria and Belgium have the lowest inequalities and France has the highest. No geographic pattern is evident. Housing problems are associated with higher inequalities in six of the nine countries in the sample. While no association is evident for indicators of socio-economic status such as years of education and income, financial strain is significant. CONCLUSIONS: This study is the first to estimate the degree of socio-economic inequality in depressive symptoms across European countries. The association between poor housing and poorer inequalities suggests that housing has a role to play lowering depressive symptoms inequalities.

Housing conditions affect enterocyte death mode and turnover rate in mouse small intestine.

Small intestinal enterocytes are continuously renewed. Shedding/death of enterocytes involves receptor-interacting protein kinase 1 (RIPK1)-dependent (but RIPK3-independent) necrotic death, but the regulatory mechanism of the processes is not fully understood. Here, we show that mouse housing conditions, such as the type of bedding material and the presence or absence of a Shepherd Shack, affect enterocyte turnover rate and determine whether enterocyte shedding/death is RIPK1-independent or -dependent. Mice housed with ALPHA-dri (αDri, hard paper chip) bedding material without a Shepherd Shack had a higher, largely RIPK1-dependent enterocyte turnover rate and higher blood corticosterone levels, suggesting the involvement of minor stress, whereas mice housed with αDri plus a Shepherd Shack or with Soft Chip had a lower, RIPK1-independent turnover rate and lower blood corticosterone levels. Corticosterone administration to a small intestine culture derived from mice housed with αDri plus a Shepherd Shack or with Soft Chip increased enterocyte shedding/death and turnover. By using kinase inhibitors and knockout mice, we showed that the switch from RIPK1-independent to RIPK1-dependent enterocyte shedding/death and turnover involves suppression of TANK-binding kinase 1. Our results demonstrate that housing conditions may cause minor stress, which alters the mode of enterocyte shedding/death and enterocyte turnover rate in mice.

Spatial Distributions of Diarrheal Cases in Relation to Housing Conditions in Informal Settlements: A Cross-Sectional Study in Abidjan, Côte d'Ivoire.

In addition to individual practices and access to water, sanitation, and hygiene (WASH) facilities, housing conditions may also be associated with the risk of diarrhea. Our study embraced a broad approach to health determinants by looking at housing deprivation characteristics as exposures of interest and confronting the latter's spatial distribution to that of diarrheal cases. We tested the hypothesis that the risk of diarrhea in informal settlements is not only associated with WASH services, but also with inadequate dwelling characteristics, and that their spatial distributions follow similar patterns. We designed a cross-sectional study and collected primary data through georeferenced household surveys in two informal settlements in Abidjan, Côte d'Ivoire. We used local join count statistics to assess the spatial distribution of events and multiple logistic regressions to calculate adjusted odds ratios between diarrhea and exposures. A total of 567 households were enrolled. We found that constant access to basic WASH services, non-durable building materials, cooking outdoors, and water service discontinuity were associated with higher risks of diarrhea in the general population. The spatial distribution of diarrheal cases coincided with that of dwelling deprivation characteristics. We observed significant heterogeneity within the study sites regarding the spatial distribution of diarrheal cases and deprived dwellings. Along with WASH infrastructure, communities also need dignified housing to effectively prevent diarrhea. We recommend that decision-makers acknowledge a "spectrum" of deprivation within the heterogeneous universe of informal settlements, adopting a site-specific approach based on high-resolution data to address diarrhea and improve people's well-being.

Housing situations and local COVID-19 infection dynamics using small-area data.

Low socio-economic status is associated with higher SARS-CoV-2 incidences. In this paper we study whether this is a result of differences in (1) the frequency, (2) intensity, and/or (3) duration of local SARS-CoV-2 outbreaks depending on the local housing situations. So far, there is not clear evidence which of the three factors dominates. Using small-scale data from neighborhoods in the German city Essen and a flexible estimation approach which does not require prior knowledge about specific transmission characteristics of SARS-CoV-2, behavioral responses or other potential model parameters, we find evidence for the last of the three hypotheses. Outbreaks do not happen more often in less well-off areas or are more severe (in terms of the number of cases), but they last longer. This indicates that the socio-economic gradient in infection levels is at least in parts a result of a more sustained spread of infections in neighborhoods with worse housing conditions after local outbreaks and suggests that in case of an epidemic allocating scarce resources in containment measures to areas with poor housing conditions might have the greatest benefit.

Different housing conditions for zebrafish: What are the effects?

Zebrafish is a popular experimental model in several research areas but little is known about the effects of using different strains or housing conditions. Poor control of genetic background and housing conditions could affect experimental results and data reproducibility. Here we investigated the effects of two possible sources of variation on zebrafish behaviour: fish origin and environmental parameters (light intensity, water temperature and noise). Zebrafish behaviour was then examined using the 'novel tank test', one of the most common paradigms used to assess anxiety-like behaviours in zebrafish. Our results show that an increase in light intensity alters fish behaviour, particularly freezing duration and distance from the bottom of the tank, indicating increased anxiety. Swimming activity increased at the lowest temperature (25 °C). However, different levels of background noise did not cause any significant changes in behaviour. Differences were also found between zebrafish strains and populations: while the AB strain from laboratory 1 was minimally influenced by variation in holding conditions, the AB strain from laboratory 2 was highly affected by changes in temperature, light, and background noise. Our study shows that variation in strains and holding conditions can significantly influence the results of behavioural testing and should be carefully considered in the experimental design and properly reported to improve data interpretation and reproducibility.

Increased dietary Trp, Thr, and Met supplementation improves growth performance and protein deposition of salmonella-challenged growing pigs under poor housing conditions.

Highly intensified rearing conditions and precarious sanitary management predispose pigs to immune system activation, altered amino acid (AA) metabolism, and decreased growth performance. Thus, the main objective of this study was to evaluate the effects of increased dietary tryptophan (Trp), threonine (Thr), and methionine + cysteine (Met + Cys) supplementation on performance, body composition, metabolism, and immune responses of group-housed growing pigs under challenging sanitary conditions. A hundred and twenty pigs (25.4 ± 3.7 kg) were randomly assigned to a 2 × 2 factorial arrangement, consisting of two sanitary conditions (SC, good [GOOD] or salmonella-challenge and poor housing condition [Salmonella Typhimurium (ST) + POOR]) and two diets, control (CN) or supplemented with AA (Trp, Thr, and Met + Cys:Lys ratios 20% higher than those of the CN diet [AA>+]). Pigs were followed during the growing phase (25-50 kg) and the trial lasted 28 d. The ST + POOR SC pigs were challenged with Salmonella Typhimurium and raised in a poor housing condition. The ST + POOR SC increased rectal temperature, fecal score, serum haptoglobin, and urea concentration (P < 0.05) and decreased serum albumin concentration (P < 0.05) compared with GOOD SC. Body weight, average daily feed intake, average daily gain (ADG), feed efficiency (G:F), and protein deposition (PD) were greater in GOOD SC than in ST + POOR SC (P < 0.01). However, pigs housed in ST + POOR SC fed with AA+ diet had lower body temperature (P < 0.05), increased ADG (P < 0.05) and nitrogen efficiency (P < 0.05), and a tendency for improved PD and G:F (P < 0.10) compared with CN diet fed pigs. Regardless of the SC, pigs fed AA+ diet had lower serum albumin (P < 0.05) and tended to decrease serum urea levels (P < 0.10) compared with CN diet. The results of this study suggest that the ratio of Trp, Thr, and Met + Cys to Lys for pigs are modified by sanitary conditions. Furthermore, supplementation of diets with a blend of Trp, Thr, and Met + Cys improves performance, especially under salmonella-challenge and poor housing conditions. Dietary tryptophan, threonine, and methionine supplementation can modulate immune status and influence resilience to sanitary challenges.

Immune system activation alters pigs' physiology and metabolism, increasing maintenance requirements and reducing voluntary feed intake and weight gain. Dietary functional amino acid supplementation (tryptophan, threonine, and methionine) is a strategy to support the immune system activation for immune components production, maintenance of the gut barrier integrity, and reduction of the oxidative status. Additionally, amino acid supplementation may mitigate growth performance losses. In this context, this study was conducted to investigate the effect of diets with or without tryptophan, threonine, and methionine supplementation on the performance and immune system activation of growing pigs under a sanitary challenge. The amino acid supplementation mitigated the immune system activation of challenged growing pigs and improved growth performance when compared to pigs fed diets with no supplementation. The functional amino acid supplementation may be an efficient nutritional strategy to optimize health and growth performance of immune-challenged pigs.

Housing conditions and changes in professional activity during lockdown and the risk of prevalent and incident depression: Findings from the CONSTANCES cohort.

BACKGROUND: Material conditions of lockdown and changes in regular functioning may have played a role on depressive manifestations. We aimed to examine the association between housing conditions and changes in professional activity and depression during the first COVID-19 outbreak in France. METHOD: Participants of the CONSTANCES cohort were followed online. A first questionnaire covered the lockdown period (assessing housing conditions and changes in professional activity), and a second the post-lockdown period (assessing depression using the Center of Epidemiologic Studies Depression-Scale (CES-D)). Incident depression was also estimated (with a previous CES-D measure). Logistic regression models were applied. RESULTS: 22,042 participants (median age 46 years, 53.2 % women) were included and 20,534 had a previous CES-D measure. Depression was associated with female gender, lower household income and past history of depression. A negative gradient between the number of rooms and the likelihood of depression was consistently observed (OR = 1.55 95 % [1.19-2.00] for one room, OR = 0.76 [0.65-0.88] for seven rooms), while a U-shape relationship was observed with the number of people living together (OR = 1.62 [1.42-1.84] for living alone, OR = 1.44 [1.07-1.92] for six persons). These associations were also observed with incident depression. Changes in professional activity were associated with depression (Started distance working (OR = 1.33 [1.17-1.50]). Starting distance working was also associated with incident depression (OR = 1.27 [1.08-1.48]). LIMITATION: A cross-sectional design was used. CONCLUSION: The consequences of lockdown on depression may vary depending on living conditions and changes in professional activity, including distance working. These results could help to better identify vulnerable people to promote mental health.

Situación de la iniciativa de vivienda saludable en Perú

VIVIENDA SALUDABLE: una vivienda que propicie por sus condiciones satisfactorias una mejor salud para sus moradores, lo cual implica reducir al máximo los factores de riesgo existentes en su contexto geográfico, económico, social y técnico, a fin de promover una adecuada orientación y control para su ubicación, edificación, habilitación, adaptación, manejo y uso de la vivienda por parte de sus residentes.

The moderating role of housing quality on concentrated poverty and asthma-related emergency department visits among Hispanics/Latinos.

BACKGROUND: Rates of asthma-related emergency department visits have been shown to vary significantly by place (i.e. neighborhood) and race/ethnicity. The moderating factors of asthmatic events among Hispanic/Latino-specific populations are known to a much lesser degree. OBJECTIVE: To assess the extent to which housing moderates the effect of poverty on Hispanic/Latino-specific asthma-related emergency department (ED) visits at an ecological level. METHODS: Using data from the Office of Statewide Health Planning and Development (OSHPD) and the 2016-2017 U.S. Census, a cross-sectional ecological analysis at the census tract-level was conducted. Crosswalk files from the U.S. Department of Housing and Urban Development were used to associate zip codes to census tracts. Negative binomial regression was used to estimate rate ratios. RESULTS: The effect of poverty on asthma-related ED visits was significantly moderated by the median year of housing structures built. The effect of mid-level poverty (RR = 1.57, 95% CI 1.27, 1.95) and high-level poverty (RR = 1.47, 95% CI 1.22, 1.78) in comparison to low-level poverty, was significantly greater among census tracts with housing built prior to 1965 in comparison to census tract with housing built between 1965 and 2020. CONCLUSION: Communities with older housing structures tend to be associated with increased Hispanic/Latino ED visits apart from affluent communities.

Early onset of care needs in the older population: The protective role of housing conditions.

Most older people wish to live in their own homes as they age and to have a choice over their housing and care situation. Housing has the potential to play a key role in promoting independence, delaying and/or preventing the onset of care needs and in influencing the level and type of care provision required. However, many older people live in homes that are not suitable for their comfort and needs. Our study focuses on older people living in non-specialist housing in England and aims to i) explore how housing characteristics cluster; and ii) investigate their association with an early onset of care needs. We used four waves of a large representative longitudinal sample of people aged 50 or over, covering the period 2012 to 2020. We performed Latent Class Analysis and a Cox regression survival model to provide answers to our research questions. We found that people living in poor housing conditions or living in social rented housing are more likely to experience early onset of care needs, which may lead to a higher demand for, and utilisation of, long-term care services. We believe that gaining a better understanding of the relationship between housing-related conditions and care needs is paramount from the preventative and service provision point of view, and is of relevance to policymakers, practitioners, and current and future adult long-term care users.

Gnotobiotic mice housing conditions critically influence the phenotype associated with transfer of faecal microbiota in a context of obesity.

OBJECTIVE: Faecal microbiota transplantation (FMT) in germ-free (GF) mice is a common approach to study the causal role of the gut microbiota in metabolic diseases. Lack of consideration of housing conditions post-FMT may contribute to study heterogeneity. We compared the impact of two housing strategies on the metabolic outcomes of GF mice colonised by gut microbiota from mice treated with a known gut modulator (cranberry proanthocyanidins (PAC)) or vehicle. DESIGN: High-fat high-sucrose diet-fed GF mice underwent FMT-PAC colonisation in sterile individual positive flow ventilated cages under rigorous housing conditions and then maintained for 8 weeks either in the gnotobiotic-axenic sector or in the specific pathogen free (SPF) sector of the same animal facility. RESULTS: Unexpectedly, 8 weeks after colonisation, we observed opposing liver phenotypes dependent on the housing environment of mice. Mice housed in the GF sector receiving the PAC gut microbiota showed a significant decrease in liver weight and hepatic triglyceride accumulation compared with control group. Conversely, exacerbated liver steatosis was observed in the FMT-PAC mice housed in the SPF sector. These phenotypic differences were associated with housing-specific profiles of colonising bacterial in the gut and of faecal metabolites. CONCLUSION: These results suggest that the housing environment in which gnotobiotic mice are maintained post-FMT strongly influences gut microbiota composition and function and can lead to distinctive phenotypes in recipient mice. Better standardisation of FMT experiments is needed to ensure reproducible and translatable results.

Skin morbidity in Indigenous children in relation to housing conditions in remote communities in Northwestern Ontario, Canada.

BACKGROUND: Elevated rates of eczema and skin infections in Canadian First Nation (FN) communities are of concern to families, community leaders and healthcare professionals. AIM: To determine whether skin morbidity was associated with indoor environmental quality factors in Canadian FN children living in remote communities. METHODS: We quantified indoor environmental quality (IEQ) in the homes of FN children aged < 4 years of age living in four remote communities in the Sioux Lookout region of Northwestern Ontario, Canada. We conducted a quantitative housing inspection, including measuring surface area of mould (SAM), and monitored air quality for 5 days in each home, including carbon dioxide and relative humidity and quantified endotoxin in settled floor dust. We reviewed the medical charts of participating children for skin conditions and administered a health questionnaire. Relationships between IEQ and skin infections or eczema were evaluated using multivariable regression. RESULTS: In total, 98 children were included in the descriptive analyses, of whom 86 had complete data and were evaluated in multivariate analyses for dermatological outcomes (mean age 1.6 years). Of these 86 children, 55% had made ≥ 1 visits to the local health centre (HC) for skin and soft tissue infections and 25.5% for eczema. Unexpectedly, annualized eczema visits were inversely associated with SAM (RR = 0.14; 95% CI 0.01-0.93). There was a trend suggesting an inverse relationship between endotoxin and HC encounters for eczema and skin and soft tissue infections. CONCLUSION: Skin infections were common in this population of FN children. IEQ did not appear to be associated with skin infections or eczema. Mould exposure appeared to be inversely associated with HC encounters for eczema, possibly related to complex microorganism-host interactions occurring early in life.

Rating enrichment items by female group-housed laboratory mice in multiple binary choice tests using an RFID-based tracking system.

Laboratory mice spend most of their lives in cages, not experiments, so improving housing conditions is a first-choice approach to improving their welfare. Despite the increasing popularity of enrichment, little is known about the benefits from an animal perspective. For a detailed analysis, we categorized enrichment items according to their prospective use into the categories 'structural', 'housing', and 'foraging'. In homecage-based multiple binary choice tests 12 female C57BL/6J mice chose between enrichment items within the respective categories over a 46-hour period. A new analyzing method combined the binary decisions and ranked the enrichment items within each category by calculating worth values and consensus errors. Although there was no unequivocal ranking that was true in its entire rank order for all individual mice, certain elements (e.g. lattice ball, second plane) were always among the top positions. Overall, a high consensus error in ranking positions reflects strong individual differences in preferences which could not be resolved due to the relatively small sample size. However, individual differences in the preference for enrichment items highlights the importance of a varied enrichment approach, as there does not seem to be one item that satisfies the wants and needs of all individuals to the same degree. An enrichment concept, in which the needs of the animals are central, contributes to a more specific refinement of housing conditions.

Impact of alternating overnight housing conditions on welfare measures in a bachelor group of western lowland gorillas (Gorilla gorilla gorilla).

Spatial parameters and design of overnight housing spaces can have significant influences on both nocturnal and diurnal behaviors of western lowland gorillas (Gorilla gorilla gorilla) in captivity. This is especially true for bachelor groups, as adult males have demonstrated a greater tendency to separate from conspecifics overnight. Additionally, previous studies have suggested that the social needs of individuals in bachelor units may shift over time. The bachelor unit at the Detroit Zoo is managed in a unique hybrid strategy in which the group is housed socially for three nights (either indoors or indoors with outdoor access), then separately on the fourth. A 2016 study of this group (n = 3) suggested that individuals had better welfare following social overnight housing as compared to solitary overnight housing. We aimed to reassess how overnight housing conditions affect individual welfare several years later. We revised a previously developed qualitative behavioral assessment tool that included 13 behavioral items spanning both positive and negative indicators of welfare. Animal care staff completed the assessment and collected a fecal sample every day for each gorilla for a period of 3 months. We used Kruskal-Wallis tests to analyze variation in behavioral items and FGMs between conditions. We then used generalized linear mixed models to identify whether overnight housing condition or other potentially confounding variables were driving observed variation in welfare indicators. We found significant variation demonstrating significantly better welfare indicators after being housed separately as compared to being socially housed indoors overnight. Although separate housing appears to be the ideal condition for this group at this point in time, if seasonality permits, social housing with outdoor access may be a feasible alternative to consistent overnight separation for these gorillas.