"Freedom to move through the house": How a healthy housing initiative improves quality of life in Aotearoa New Zealand.

OBJECTIVE: This study explores experiences of the Healthy Housing Initiative (HHI). Aimed at children at risk of housing-related illness, the HHI package includes the provision of items such as curtains, heaters, bedding, and insulation, advocacy to encourage landlords to install improvements, and education and advice to help people optimise their home environment. METHODS: We conducted semi-structured, in-depth interviews with 20 people living in rental housing who received the HHI intervention. RESULTS: Participants felt heard and supported by HHI assessors. They reported that the intervention increased the warmth and dryness of the home, improved their respiratory and mental health, reduced their bills, and enabled the use of more parts of their home. However, some continued to live in cold and damp conditions due to structural inadequacies and energy poverty. CONCLUSIONS: The qualitative evidence presented in this study shows how health-focussed interventions also benefit quality of life. IMPLICATIONS FOR PUBLIC HEALTH: This research emphasises that healthy housing interventions can yield extensive benefits by adopting a holistic and home-based approach. Such interventions have the potential to create improvements in individuals' lives far beyond health.

He Kainga Oranga: reflections on 25 years of measuring the improved health, wellbeing and sustainability of healthier housing.

This paper reflects on the influences and outcomes of He Kainga Oranga/Housing and Health Research Programme over 25 years, and their impact on housing and health policy in Aotearoa and internationally. Working in partnership particularly with Maori and Pasifika communities, we have conducted randomised control trials which have shown the health and broad co-benefits of retrofitted insulation, heating and remediation of home hazards, which have underpinned government policy in the Warm Up NZ-Heat Smart programme and the Healthy Homes Standards for rental housing. These trials have been included as evidence in the WHO Housing and Health Guidelines and led to our designation as a WHO Collaborating Centre on Housing and Wellbeing. We are increasingly explicitly weaving Maori frameworks, values and processes with traditional Western science.

A principles framework for taking action on Maori/Indigenous Homelessness in Aotearoa/New Zealand.

OBJECTIVE: The objective of this research was to develop a principles framework to guide action on Maori/Indigenous homelessness in Aotearoa incorporating Rangatiratanga (Maori self-determination), Whanau Ora (Government policy that places Maori families at the center of funding, policy and services) and Housing First. METHOD: Three pathways were identified as creating opportunities for action on Maori homelessness: Te Tiriti o Waitangi/Treaty of Waitangi is the Maori self-determination pathway; Whanau Ora, a government-sponsored policy supports whanau/family as the pathway for Maori wellbeing and disparities reduction; and Housing First, an international pathway with local application for homelessness that is being implemented in parts of Aotearoa. The potential opportunities of the three pathways shaped interviews with authoritative Maori about Maori principles (derived from the three pathways) for addressing Maori homelessness. Twenty interviews were conducted with Maori experts using Kaupapa Maori research processes, eliciting advice about addressing Maori homelessness. A principles framework called Whare Oranga was developed to synthesise these views. RESULTS: Addressing Maori homelessness must be anchored in rights-based and culturally aligned practice empowered by Maori worldviews, principles and processes. Te Tiriti o Waitangi, which endorses Maori tribal self-determination and authority, and Whanau Ora as a government obligation to reduce inequities in Maori homelessness, are the foundations for such action. Colonisation and historical trauma are root causes of Maori homelessness. Strong rights-based frameworks are needed to enact decolonisation and guide policy. These frameworks exist in Tino Rangatiratanga/Maori self-determination and Whanau Ora. CONCLUSION: Whare Oranga: An Indigenous Housing Interventions Principles Framework was developed in Aotearoa/New Zealand to end Maori homelessness. Future research is needed on the practical application of this framework in ending Maori homelessness. Moreover, the use value of the Whare Oranga Framework as a workable approach to ending homelessness in other indigenous populations is yet to be considered.

Service usage by a New Zealand Housing First cohort prior to being housed.

BACKGROUND: The Ending Homelessness in New Zealand: Housing First research programme is evaluating outcomes for people housed in a Housing First programme run by The People's Project in Hamilton, New Zealand. This baseline results paper uses administrative data to look at the scope and duration of their interactions with government services. METHODS: We linked our de-identified cohort to the Integrated Data Infrastructure (IDI). This database contains administrative data on most services provided by the New Zealand Government to citizens. Linkage rates in all datasets were above 90%. This paper reports on the use of government services by the cohort before being housed. We focus on the domains of health, justice and income support. RESULTS: The cohort of 390 people had over 200,000 recorded interactions across a range of services in their lifetime. The most common services were health, justice and welfare. The homeless cohort had used the services at rates far in excess of the general population. Unfortunately these did not prevent them from becoming homeless. CONCLUSION: These preliminary findings show the homeless population have important service delivery needs and a very high level of interaction with government services. This highlights the importance of analysing the contributing factors towards homelessness; for evaluation of interventions such as Housing First, and for understanding the need for integrated systems of government policy and practice to prevent homelessness. This paper also provides the baseline for post-Housing First evaluations.