The relationships between housing quality and occupant health in Uganda

Construction for Health; Reversing the Impacts

The health of humans and the planet are the most vital contemporary issues and essential components of the Sustainable Development Goals (SDGs). Scientists and professionals strive for integrated, evolving, healthy, and sustainable solutions encompassing biodiversity and industrial ecology, while offering viable economic attainments. The building industry, especially construction, is an extensive economic counterpart that largely influences health on various levels. On a practical scale, most direct or indirect impacts on health are related to conventional construction systems (CCSs), particularly their materialisations and implementation methods. Therefore, from a global perspective, emerging technologies or remodelled methods to accomplish sustainable use, reuse, and recycling, and improving the planet’s health to ensure the wellbeing of its inhabitants, are crucial. The current research is part of a broader study on “programmable construction systems” (PCSs), concentrating on “programmable construction materials” (PCMs) for health. Therefore, issues are reviewed, relevancies are addressed, and health-oriented concepts are discussed. Example concepts of formulation and the simplified toolkit creations follow the problems’ sources in a case study, providing insight into the resulting multiscale impacts on real-life practices. The results prove the method’s potential and validate its simplicity and applicability through an abstract examination of a newly built case study. Finally, the summarised outcomes of other extensive studies on societal preferences also confirm the feasibility of the hypothesis (i.e., the healthy materialisation) also from a social perspective.

Family Health Behavior: Preventive Measures against Acute Respiratory Infections in Under-5 Children

BACKGROUND

The under-5 mortality rate in Indonesia is 32 per 1,000 live births, still higher than the SDG target. Acute respiratory infections (ARIs), as one of the leading causes of death, must be prevented. Arguments emerge concerning the association of home crowding, health behavior, and the incidence of ARI.

METHODS

A cross-section analysis with the Indonesia Demographic and Health Survey (IDHS) 2017 dataset is performed. Samples are restricted to 16,555 children aged 0-59 months who lived with their mother (eligible women interviewed) during the survey. For each of the variables observed during this study, missing data must be omitted as exclusion criteria. A 100 per cent answer rate was achieved. Logistic regression was used to determine ARI-associated factors, by examining the effect of each explanatory factor (independent variables) on the odds ratio of ARI (one dependent binary variable).

RESULTS

The prevalence of ARI was more common among children living in the poorest households (AOR 1.66; 95% CI, 1.20 - 2.28) and those exposed to indoor tobacco smoke pollution (AOR 1.27; 95% CI, 1.04-1.56). On the other hand, those aged 0-5 months (AOR 0.59; 95% CI, 0.43-0.82), living at home with improved sanitation (AOR 0.74; 95% CI, 0.61-0.89), and exclusively breastfed (AOR 0.85; 95% CI, 0.73-0.99) were less likely to have ARI.

CONCLUSIONS

Home crowding is not associated with ARI. Efforts should be focused on preserving family health behavior. The family functioned as a health-support system for their under-5 children by establishing an indoor tobacco smoking-free zone, practicing exclusive breastfeeding, and enhancing hygiene facilities.

Neighbourhood-level housing quality indices for health assessment in Dakar, Senegal

In sub-Saharan African cities, the dearth of accurate and detailed data is a major problem in the study of health and socioeconomic changes driven by rapid urbanization. Data on both health determinants and health outcomes are often lacking or are of poor quality. Proxies associated with socioeconomic differences are needed to compensate the lack of data. One of the most straightforward proxies is housing quality, which is a multidimensional concept including characteristics of both the built and natural environments. In this work, we combined the 2013 census data with remotely sensed land cover and land use data at a very high resolution in order to develop an integrated housing quality-based typology of the neighbourhoods in Dakar, Senegal. Principal component analysis and hierarchical classification were used to derive neighbourhood housing quality indices and four neighbourhood profiles. Paired tests revealed significant variations in the censusderived mortality rates between profile 1, associated with the lowest housing quality, and the three other profiles. These findings demonstrate the importance of housing quality as an important health risk factor. From a public health perspective, it should be a useful contribution for geographically targeted planning health policies, at the neighbourhood spatial level, which is the most appropriate administrative level for interventions.

Understanding the slum-health conundrum in sub-Saharan Africa: a proposal for a rights-based approach to health promotion in slums

Sub-Saharan Africa is the world's least urbanized region but is ironically also the region with the largest proportion of urban slum dwellers. However, there exists limited understanding of the impact of slums on health in the region. To address this knowledge gap, we conducted a systematic search in PubMed, Google, and Google Scholar to identify and review studies examining the slum-health relationship in sub-Saharan African cities. Subsequently, we performed thematic analysis of 40 studies to identify themes that explain the health impact of slums in the region. The majority of studies characterize slums as health-damaging settings, where poverty and unfavorable environmental conditions pose threats to public health and safety. Only a handful of studies suggest a beneficial relationship between slums and health, in such areas as affordable housing provision, employment generation, and community cohesion. We argue that the literature's overwhelming emphasis on the environmental risks of slums feeds into a neoliberal urban agenda that seeks to clear slums at the expense of their beneficial contributions to health. Accordingly, we advocate a shift in policy discourse, from static characterization of slums as health risks to a health-promotion agenda that emphasizes the housing and service rights of slum populations.

Effects of neighborhood building density, height, greenspace, and cleanliness on indoor environment and health of building occupants

The influences of indoor environment quality on occupant health have long been one of the main focuses in built environment and public health research. However, evidence to this effect has been inconsistent. Furthermore, previous urban studies have indicated the interaction between urban morphology and indoor environment. This study thus goes beyond indoor environment to investigate: i) the effects of neighborhood environment on occupant health; and ii) the mediating roles of indoor environment on the neighborhood environment and occupant health relationships. To achieve this aim, buildings located in different neighborhood environment in Hong Kong are selected. Data are collected by post-occupancy evaluation (occupant health), indoor environment assessment (thermal comfort, indoor air quality, ventilation, visual comfort, and acoustic comfort) and neighborhood environment assessment (neighborhood building density, building height, cleanliness and greenspace) through questionnaire survey. Through correlation analysis, regression modelling and Sobel test, it is found that: i) occupant health is significantly affected by neighborhood building height, building density and cleanliness; ii) the relationships between neighborhood environment and occupant health are significantly mediated by indoor environment, in terms of visual and acoustic comfort; and iii) neighborhood greenspace affects occupant health indirectly through influencing indoor air quality. To cross validate the results of the survey study, which is conducted using subjective data, objective measurements and analyses are further conducted. The objective study, echoing the survey study results, indicates that buildings with lower neighborhood building density and height, and cleaner neighborhood environment have better visual (higher illuminance level) and acoustic (lower noise level) performances.

Modeling and mapping the burden of disease in Kenya

Precision public health approaches are crucial for targeting health policies to regions most affected by disease. We present the first sub-national and spatially explicit burden of disease study in Africa. We used a cross-sectional study design and assessed data from the Kenya population and housing census of 2009 for calculating YLLs (years of life lost) due to premature mortality at the division level (N = 612). We conducted spatial autocorrelation analysis to identify spatial clusters of YLLs and applied boosted regression trees to find statistical associations between locational risk factors and YLLs. We found statistically significant spatial clusters of high numbers of YLLs at the division level in western, northwestern, and northeastern areas of Kenya. Ethnicity and household crowding were the most important and significant risk factors for YLL. Further positive and significantly associated variables were malaria endemicity, northern geographic location, and higher YLL in neighboring divisions. In contrast, higher rates of married people and more precipitation in a division were significantly associated with less YLL. We provide an evidence base and a transferable approach that can guide health policy and intervention in sub-national regions afflicted by disease burden in Kenya and other areas of comparable settings.

Living arrangement preferences and realities for elderly Chinese: implications for subjective wellbeing

This article investigates the determinants of preference for intergenerational co-residence and examines the effects of living arrangement concordance (i.e.having a match between preference and reality) on the subjective wellbeing (SWB) of older Chinese. Data were derived from the China Health and Retirement Longitudinal Study (CHARLS) national baseline conducted in 2011. This allows for two different measures of the affective approach to SWB: depression and happiness. This article found living arrangement preference is indicative of need, cultural norms and current living arrangement experiences. The results support the hypothesis of discrepancy theories that having living arrangement concordance improves older parents’ SWB (i.e.depressive symptoms and happiness). In addition, the previously predictive effects of the actual living arrangement on SWB lost significance when actual living arrangement and concordance were added simultaneously. Living in a preferred arrangement appears to be more important than living in a traditional arrangement from the point of view of older adults’ SWB. Programmes designed to improve wellbeing in later life should not assume that there is a one-size-fits-all model for all; instead, older people should be given more choices of living arrangements.

Correlation analysis of lung cancer and urban spatial factor: based on survey in Shanghai

BACKGROUND

The density of particulate matter (PM) in mega-cities in China such as Beijing and Shanghai has exceeded basic standards for health in recent years. Human exposure to PMs has been identified as traceable and controllable factor among all complicated risk factors for lung cancer. While the improvement of air quality needs tremendous efforts and time, certain revision of PM's density might happen associated with the adjustment of built environment. It is also proved that urban built environment is directly relevant to respiratory disease. Studies have respectively explored the indoor and outdoor factors on respiratory diseases. More comprehensive spatial factors need to be analyzed to understand the cumulative effect of built environment upon respiratory system. This interdisciplinary study examines the impact of both indoor (including age of housing, interval after decoration, indoor humidity etc.) and outdoor spatial factors (including density, parking, green spaces etc.) on lung cancer.

METHODS

A survey of lung cancer patients and a control group has been conducted in 2014 and 2015. A total of 472 interviewees are randomly selected within a pool of local residents who have resided in Shanghai for more than 5 years. Data are collected including their socio-demographic factors, lifestyle factors, and external and internal residential area factors. Regression models are established based on collected data to analyze the associations between lung cancer and urban spatial factors.

RESULTS

Regression models illustrate that lung cancer presents significantly associated with a number of spatial factors. Significant outdoor spatial factors include external traffic volume (P=0.003), main plant type (P=0.035 for trees) of internal green space, internal water body (P=0.027) and land use of surrounding blocks (P=0.005 for residential areas of 7-9 floors, P=0.000 for residential areas of 4-6 floors, P=0.006 for business/commercial areas over 10 floors, P=0.005 for business/commercial areas of 7-9 floors, P=0.043 for business/commercial areas of 4-6 floors). Indoor spatial factors include age of housing (P=0.003) and indoor humidity (P=0.000).

CONCLUSIONS

The findings support the hypothesis that both indoor and outdoor spatial factors are independently associated with lung cancer incidence. Certain principles based on the modeling results are proposed to revise the criteria for lung cancer screening of high-risk individuals. It also provides empirical evidence for urban planning and design to improve built environment with more thorough consideration of respiratory health.

Pathways among Caregiver Education, Household Resources, and Infant Growth in 39 Low- and Middle-Income Countries

Caregiver education is known to relate to the growth of children, but possible mediation mechanisms of this association are poorly characterized and generally lack empirical support. We test whether instructional capital (caregiver education) leads to improved infant growth through availability of physical capital (household resources) across a wide swath of low- and middle-income countries (LMIC). Using the Multiple Indicator Cluster Survey (MICS3), we explore relations among caregiver education, household resources, and infant (M age = .99 years) growth in 117,881 families living in 39 LMIC. Overall, household resources mediated 76% of the small association between caregiver education and infant growth. When disaggregated by countries characterized by low, medium, and high levels of human development (as indexed by average life expectancy, education, and gross domestic product), household resources mediated 48% to 78% of the association between caregiver education and infant growth. Caregiver education had effects on infant growth through household resources in countries characterized by low, medium, and high levels of human development; for girls and boys; and controlling for indexes of infant feeding and health.

Using formative research to design a behavior change strategy to increase the use of improved cookstoves in peri-urban Kampala, Uganda

Household air pollution from cooking with biomass fuels negatively impacts maternal and child health and the environment, and contributes to the global burden of disease. In Uganda, nearly 20,000 young children die of household air pollution-related pneumonia every year. Qualitative research was used to identify behavioral determinants related to the acquisition and use of improved cookstoves in peri-urban Uganda. Results were used to design a behavior change strategy for the introduction of a locally-fabricated top-lit updraft gasifier (TLUD) stove in Wakiso district. A theoretical framework—opportunity, ability, and motivation—was used to guide the research and behavior change strategy development. Participants consistently cited financial considerations as the most influential factor related to improved cookstove acquisition and use. In contrast, participants did not prioritize the potential health benefits of improved cookstoves. The theoretical framework, research methodology, and behavior change strategy design process can be useful for program planners and researchers interested in identifying behavioral determinants and designing and evaluating improved cookstove interventions.