Synthesizing the links between secure housing tenure and health for more equitable cities.

Millions of households in rich and poor countries alike are at risk of being unwilfully displaced from their homes or the land on which they live (i.e., lack secure tenure), and the urban poor are most vulnerable. Improving housing tenure security may be an intervention to improve housing and environmental conditions and reduce urban health inequalities. Building on stakeholder workshops and a narrative review of the literature, we developed a conceptual model that infers the mechanisms through which more secure housing tenure can improve housing, environmental quality, and health. Empirical studies show that more secure urban housing tenure can boost economic mobility, improve housing and environmental conditions including reduced exposure to pollution, create safer and more resourced communities, and improve physical and mental health. These links are shared across tenure renters and owners and different economic settings. Broader support is needed for context-appropriate policies and actions to improve tenure security as a catalyst for cultivating healthier homes and neighbourhoods and reducing urban health inequalities in cities.

Lighting in the Home and Health: A Systematic Review.

Poor housing is an important determinant of poor health. One key aspect of housing quality is lighting. Light is important for visual performance and safety, and also plays a vital role in regulating human physiological functions. This review aims to synthesise existing evidence on the relationship between lighting in the home and health and recommends areas for future research. Three databases were searched for relevant literature using pre-defined inclusion criteria. Study quality was assessed using the Newcastle Ottawa Scale. Extracted data were qualitatively synthesised according to type of lighting (natural light, artificial light and light at night) and stratified by broad health domains (physical, mental and sleep health). Of the 4043 records retrieved, 28 studies met the inclusion criteria. There was considerable heterogeneity in light exposure metrics used and specific health outcome assessed by the studies. Lighting in the home can negatively affect health but the current evidence base is limited to a small number of studies in different domains of light and health. Further research surrounding specific health outcomes is required to better inform housing quality assessments and lighting practises in the home.

Severe Spinal Cord Injury Causes Immediate Multi-cellular Dysfunction at the Chondro-Osseous Junction.

Spinal cord injury is associated with rapid bone loss and arrested long bone growth due to mechanisms that are poorly understood. In this study, we sought to determine the effects of severe T10 contusion spinal cord injury on the sublesional bone microenvironment in adolescent rats. A severe lower thoracic (vertebral T10) spinal cord injury was generated by weight drop (10 g×50 mm). Severely injured and body weight-matched uninjured male Sprague-Dawley rats were studied. At 3 and 5 days post-injury, we performed histological analysis of the distal femoral metaphysis, TUNEL assay, immunohistochemistry, real-time PCR, and western blot analysis compared to uninjured controls. We observed severe hindlimb functional deficits typical of this model. We detected uncoupled remodeling with increased osteoclast activity in the absence of osteoblast activity. We detected osteoblast, osteocyte, and chondrocyte apoptosis with suppressed osteoblast and chondrocyte proliferation and growth plate arrest due to spinal cord injury. We also detected altered gene expression in both whole bone extracts and bone marrow monocytes following spinal cord injury. We conclude that spinal cord injury results in altered gene expression of key regulators of osteoblast and chondrocyte activity. This leads to premature cellular apoptosis, suppressed cellular proliferation, growth plate arrest, and uncoupled bone remodeling in sublesional bone with unopposed osteoclastic resorption.