1
|
Christoforou R, Pallubinsky H, Burgholz TM, El-Mokadem M, Bardey J, Rewitz K, Müller D, Schweiker M. Influences of Indoor Air Temperatures on Empathy and Positive Affect. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:323. [PMID: 38541322 PMCID: PMC10969910 DOI: 10.3390/ijerph21030323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 04/09/2024]
Abstract
The consequences of climate change are already visible, and yet, its effect on psychosocial factors, including the expression of empathy, affect, and social disconnection, is widely unknown. Outdoor conditions are expected to influence indoor conditions. Therefore, the aim of this study was to investigate the effect of indoor air temperature during work hours on empathy, positive and negative affect, and social disconnection. Participants (N = 31) were exposed, in a cross-over design, to two thermal conditions in a simulated office environment. Questions on empathy and social disconnection were administered before and after the exposure to each condition, while affect was measured throughout the day. Subjective thermal sensation and objective measures of mean skin temperature were considered. The results indicated a significant difference in empathy (F(1, 24) = 5.37, p = 0.03, with an η2 = 0.126) between conditions. Participants reported increases in empathy after exposure to the warm condition compared to the cool condition, in which reductions in empathy were reported. Although the same pattern was observed for positive affect, the difference was smaller and the results were not significant. Thermal sensation had a significant effect on changes in empathy too (F(1, 54) = 7.015, p = 0.01, with an R2 = 0.115), while mean skin temperature had no effect on empathy (F(1, 6) = 0.53, p = 0.89, with an R2 = 0.81). No effects were observed for positive and negative affect and social disconnection. Longitudinal studies are needed to support these findings.
Collapse
Affiliation(s)
- Rania Christoforou
- Healthy Living Spaces Lab, Institute for Occupational, Social and Environmental Medicine, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany
| | - Hannah Pallubinsky
- Healthy Living Spaces Lab, Institute for Occupational, Social and Environmental Medicine, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6211 KL Maastricht, The Netherlands
| | - Tobias Maria Burgholz
- Institute for Energy Efficient Buildings and Indoor Climate, E.ON Energy Research Center, RWTH Aachen University, 52074 Aachen, Germany
- Heinz Trox Wissenschafts gGmbH, 52074 Aachen, Germany
| | - Mahmoud El-Mokadem
- Institute for Energy Efficient Buildings and Indoor Climate, E.ON Energy Research Center, RWTH Aachen University, 52074 Aachen, Germany
| | - Janine Bardey
- Healthy Living Spaces Lab, Institute for Occupational, Social and Environmental Medicine, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany
- Heinz Trox Wissenschafts gGmbH, 52074 Aachen, Germany
| | - Kai Rewitz
- Institute for Energy Efficient Buildings and Indoor Climate, E.ON Energy Research Center, RWTH Aachen University, 52074 Aachen, Germany
| | - Dirk Müller
- Institute for Energy Efficient Buildings and Indoor Climate, E.ON Energy Research Center, RWTH Aachen University, 52074 Aachen, Germany
- Heinz Trox Wissenschafts gGmbH, 52074 Aachen, Germany
| | - Marcel Schweiker
- Healthy Living Spaces Lab, Institute for Occupational, Social and Environmental Medicine, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany
| |
Collapse
|
2
|
Siegel EL, Lane K, Yuan A, Smalls-Mantey LA, Laird J, Olson C, Hernández D. Energy Insecurity Indicators Associated With Increased Odds Of Respiratory, Mental Health, And Cardiovascular Conditions. Health Aff (Millwood) 2024; 43:260-268. [PMID: 38315917 DOI: 10.1377/hlthaff.2023.01052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Energy insecurity, defined as the inability to meet household energy needs, has multiple economic, physical, and coping dimensions that affect health. We conducted the first citywide representative survey of energy insecurity and health in a sample of 1,950 New York City residents in 2022. We compiled ten indicators that characterize energy insecurity as experienced in New York City housing settings and then examined associations between number and types of indicators and health conditions. Nearly 30 percent of residents experienced three or more indicators, with significantly higher levels among Black non-Latino/a and Latino/a residents compared with White non-Latino/a residents, renters compared with owners, recent immigrants compared with those living in the United States for longer, and those in households with children compared with those with no children. Residents with three or more indicators of energy insecurity had higher odds of respiratory, mental health, and cardiovascular conditions and electric medical device dependence than residents with no indicators. Our study demonstrates that broadening the understanding of energy insecurity with context-specific metrics can help guide interventions and policies that address disparities relevant to health and energy equity.
Collapse
Affiliation(s)
| | - Kathryn Lane
- Kathryn Lane, New York City Department of Health and Mental Hygiene, New York, New York
| | - Ariel Yuan
- Ariel Yuan, New York City Department of Health and Mental Hygiene
| | | | - Jennifer Laird
- Jennifer Laird, Lehman College-City University of New York, New York, New York
| | - Carolyn Olson
- Carolyn Olson, New York City Department of Health and Mental Hygiene
| | | |
Collapse
|
3
|
Janssen H, Ford K, Gascoyne B, Hill R, Roberts M, Bellis MA, Azam S. Cold indoor temperatures and their association with health and well-being: a systematic literature review. Public Health 2023; 224:185-194. [PMID: 37820536 DOI: 10.1016/j.puhe.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/18/2023] [Accepted: 09/07/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE The study aimed to identify, appraise and update evidence on the association between cold temperatures (i.e. <18°C) within homes (i.e. dwellings) and health and well-being outcomes. STUDY DESIGN This study was a systematic review. METHODS Seven databases (MEDLINE, Embase, Cochrane Database of Systematic Reviews, CINAHL, APA PsycInfo, Applied Social Sciences Index and Abstracts, Coronavirus Research Database) were searched for studies published between 2014 and 2022, which explored the association between cold indoor temperatures and health and well-being outcomes. Studies were limited to those conducted in temperate and colder climates due to the increased risk of morbidity and mortality during winter in those climatic zones. Studies were independently quality assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. RESULTS Of 1209 studies, 20 were included for review. Study outcomes included cardiovascular (blood pressure, electrocardiogram abnormalities, blood platelet count), respiratory (chronic obstructive pulmonary disease symptoms, respiratory viral infection), sleep, physical performance and general health. Seventeen studies found exposure to cold indoor temperatures was associated with negative effects on health outcomes studied. Older individuals and those with chronic health problems were found to be more vulnerable to negative health outcomes. CONCLUSION Evidence suggests that indoor temperatures <18°C are associated with negative health effects. However, the evidence is insufficient to allow clear conclusions regarding outcomes from specific temperature thresholds for different population groups. Significant gaps in the current evidence base are identified, including research on the impacts of cold indoor temperatures on mental health and well-being, studies involving young children, and the long-term health effects of cold indoor temperatures.
Collapse
Affiliation(s)
- H Janssen
- World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Wrexham, LL13 7YP, UK.
| | - K Ford
- College of Human Sciences, Bangor University, Wrexham, LL13 7YP, UK
| | - B Gascoyne
- London Metropolitan University, London, N7 8DB, UK
| | - R Hill
- World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Cardiff, CF10 4BZ, UK
| | - M Roberts
- World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Cardiff, CF10 4BZ, UK
| | - M A Bellis
- World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Wrexham, LL13 7YP, UK; Faculty of Health, Liverpool John Moores University, L2 2ER, UK
| | - S Azam
- World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Cardiff, CF10 4BZ, UK
| |
Collapse
|
4
|
Barlow CF, Daniel L, Bentley R, Baker E. Cold housing environments: defining the problem for an appropriate policy response. J Public Health Policy 2023; 44:370-385. [PMID: 37516807 PMCID: PMC10484804 DOI: 10.1057/s41271-023-00431-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 07/31/2023]
Abstract
Researchers across disciplines are increasing attention to cold housing environments. Public health, environmental and social sciences, architecture, and engineering each define and measure cold housing environments differently. Lack of standardisation hinders our ability to combine evidence, determine prevalence, understand who is most at risk--and to formulate policy responses. We conducted a systematic, cross-disciplinary review of literature to document the measures used. We examined benefits and limitations of each approach and propose a conceptualisation of cold housing: where temperature is too low to support optimal health and wellbeing of inhabitants, measured using one or a combination of economic, 'objective', or subjective approaches. More accurate data on home temperatures for all population groups, combined with an understanding of factors leading to cold homes, will enable appropriate policy response to reduce adverse health effects and costs. Policies targeting better building standards and energy subsidies both improve temperature conditions in housing environments.
Collapse
Affiliation(s)
- Cynthia Faye Barlow
- The Australian Centre for Housing Research, Faculty of Arts, Business, Law and Economics, University of Adelaide, Adelaide, SA 5005 Australia
| | - Lyrian Daniel
- UniSA Creative, University of South Australia, Adelaide, SA 5000 Australia
| | - Rebecca Bentley
- The Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010 Australia
| | - Emma Baker
- The Australian Centre for Housing Research, Faculty of Arts, Business, Law and Economics, University of Adelaide, Adelaide, SA 5005 Australia
| |
Collapse
|
5
|
Howden-Chapman P, Crane J, Keall M, Pierse N, Baker MG, Cunningham C, Amore K, Aspinall C, Bennett J, Bierre S, Boulic M, Chapman R, Chisholm E, Davies C, Fougere G, Fraser B, Fyfe C, Grant L, Grimes A, Halley C, Logan-Riley A, Nathan K, Olin C, Ombler J, O’Sullivan K, Pehi T, Penny G, Phipps R, Plagman M, Randal E, Riggs L, Robson B, Ruru J, Shaw C, Schrader B, Teariki MA, Telfar Barnard L, Tiatia R, Toy-Cronin B, Tupara H, Viggers H, Wall T, Wilkie M, Woodward A, Zhang W. He Kāinga Oranga: reflections on 25 years of measuring the improved health, wellbeing and sustainability of healthier housing. J R Soc N Z 2023. [DOI: 10.1080/03036758.2023.2170427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- Philippa Howden-Chapman
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Julian Crane
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Michael Keall
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Nevil Pierse
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Michael G. Baker
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Chris Cunningham
- Research Centre for Hauora & Health, Massey University, Wellington, New Zealand
| | - Kate Amore
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Clare Aspinall
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Julie Bennett
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Sarah Bierre
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Mikael Boulic
- School of the Built Environment, Massey University, Auckland, New Zealand
| | - Ralph Chapman
- School of Geography, Environment and Earth Sciences, Te Herenga Waka, Victoria University of Wellington, New Zealand
| | - Elinor Chisholm
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Cheryl Davies
- Tu Kotahi Māori Asthma Trust, Wainuiomata, Lower Hutt, New Zealand
| | - Geoff Fougere
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Brodie Fraser
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Caro Fyfe
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Libby Grant
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Arthur Grimes
- Motu Economic and Public Policy Research, Wellington, New Zealand
| | - Caroline Halley
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Amber Logan-Riley
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Kim Nathan
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Crystal Olin
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Jenny Ombler
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Kimberley O’Sullivan
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Tiria Pehi
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Guy Penny
- EMPlan Services Ltd, Wellington, New Zealand
| | - Robyn Phipps
- Faculty of Architecture and Design Innovation, Te Herenga Waka, Victoria University of Wellington, Wellington, New Zealand
| | - Manfred Plagman
- Building Research Association of New Zealand, Porirua, New Zealand
| | - Edward Randal
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Lynn Riggs
- Motu Economic and Public Policy Research, Wellington, New Zealand
| | - Bridget Robson
- Eru Pomare Māori Health Research Centre, University of Otago, Wellington, New Zealand
| | - Jacinta Ruru
- Faculty of Law, University of Otago, Dunedin, New Zealand
| | - Caroline Shaw
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Ben Schrader
- Stout Research Centre, Te Herenga Waka, Victoria University of Wellington, Wellington, New Zealand
| | - Mary Anne Teariki
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Lucy Telfar Barnard
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | - Ramona Tiatia
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | | | - Hope Tupara
- Research Centre for Hauora & Health, Massey University, Wellington, New Zealand
| | - Helen Viggers
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| | | | - Marg Wilkie
- Research Centre for Hauora & Health, Massey University, Wellington, New Zealand
| | - Alistair Woodward
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Wei Zhang
- He Kāinga Oranga/Housing and Health Research Programme, University of Otago, Wellington, New Zealand
| |
Collapse
|
6
|
Williams PJ, Cumella A, Philip KEJ, Laverty AA, Hopkinson NS. Smoking and socioeconomic factors linked to acute exacerbations of COPD: analysis from an Asthma + Lung UK survey. BMJ Open Respir Res 2022; 9:9/1/e001290. [PMID: 35853736 PMCID: PMC9315910 DOI: 10.1136/bmjresp-2022-001290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/27/2022] [Indexed: 11/25/2022] Open
Abstract
Background Understanding the factors driving acute exacerbations of chronic obstructive pulmonary disease (COPD) is key to reducing their impact on human health and well-being. Methods 5997 people with COPD, mean 66 years, 64% female, completed an online survey between December 2020 and May 2021 about living with COPD, developed by the charity Asthma + Lung UK. Results The 3731 (62.2%) survey participants reporting frequent (≥2/year) exacerbations were more likely to smoke (adjusted OR (AOR) 1.70, 95% CI 1.470 to 1.98), have lower annual household income (≤£20 000 (AOR 1.72, 95% CI 1.36 to 2.17), live in a cold and damp home (AOR 1.78, 95% CI 1.50 to 2.11) and report previous occupational exposure to dust, fumes and chemicals. Smokers were more likely to report attending hospital to manage their most recent acute exacerbation of COPD compared with ex-smokers (AOR 1.25, 95% CI 0.99 to 1.59). Discussion Strategies to improve COPD outcomes must address issues of deprivation and social justice.
Collapse
Affiliation(s)
- Parris J Williams
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | | | - Anthony A Laverty
- Department Primary Care and Public Health, Imperial College London School of Public Health, London, UK
| | | |
Collapse
|
7
|
Ryti NRI, Korpelainen A, Seppänen O, Jaakkola JJK. Paradoxical home temperatures during cold weather: a proof-of-concept study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:2065-2076. [PMID: 32852609 PMCID: PMC7658083 DOI: 10.1007/s00484-020-01998-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 02/16/2020] [Accepted: 08/27/2020] [Indexed: 06/11/2023]
Abstract
There is substantial epidemiological evidence on the associations between cold weather and adverse health effects. Meteorological alarm systems are being developed globally, and generalized protective advice is given to the public based on outdoor exposure parameters. It is not clear how these shared outdoor exposure parameters relate to the individual-level thermal exposure indoors, where the majority of time is spent. We hypothesized a priori that there are opposite correlations between indoor and outdoor temperatures in residential apartments. Apartments were classified into 3 categories according to their response to declining outdoor temperature: under-controlled apartments cool down, controlled apartments maintain constant indoor temperature level, and over-controlled apartments warm up. Outdoor and indoor temperatures were measured in 30-min intervals in 417 residential apartments in 14 buildings in Kotka, Finland, between February and April 2018 with outdoor temperatures ranging from - 20.4 °C to + 14.0 °C. Different apartment types were present in all buildings. Floor and orientation did not explain the divergence. Indoor temperatures below the limit value + 20 °C by building code occurred in 26.2%, 7.9%, and 23.6% of the under-controlled, controlled, and over-controlled apartments, some in conjunction with increasing outdoor temperatures. Indoor temperatures above the limit + 25 °C occurred but were more rare. This proof-of-concept study demonstrates that while the home environment may be a source of thermal stress during cold weather, generalized advice for adjusting the heating may lead to paradoxical exposures in some cases. More elaborate conceptualizations of everyday thermal exposures are needed to safely reduce weather-related health risks using shared meteorological alarm systems.
Collapse
Affiliation(s)
- Niilo R I Ryti
- Center for Environmental and Respiratory Health Research (CERH), Faculty of Medicine, University of Oulu, PO Box 5000, FI-90014, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Anton Korpelainen
- Center for Environmental and Respiratory Health Research (CERH), Faculty of Medicine, University of Oulu, PO Box 5000, FI-90014, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | | | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research (CERH), Faculty of Medicine, University of Oulu, PO Box 5000, FI-90014, Oulu, Finland.
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
| |
Collapse
|
8
|
Oliveras L, Artazcoz L, Borrell C, Palència L, López MJ, Gotsens M, Peralta A, Marí-Dell’Olmo M. The association of energy poverty with health, health care utilisation and medication use in southern Europe. SSM Popul Health 2020; 12:100665. [PMID: 33195789 PMCID: PMC7645633 DOI: 10.1016/j.ssmph.2020.100665] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/05/2020] [Accepted: 09/07/2020] [Indexed: 11/28/2022] Open
Abstract
Energy poverty (EP) is defined as the inability of a household to secure a socially and materially required level of energy services in the home. The main objective of this study was to analyse the association between EP and distinct indicators of health status, health services utilisation and medication use in southern Europe, using the city of Barcelona as a case study. We conducted a cross-sectional study using the data of the Barcelona Health Survey for 2016 (n = 3519, 53.3% women). We calculated EP percentages according to age, country of birth and social class. We analysed the association between EP and 26 health-related indicators through prevalence ratios (PR), and quantified the impact of EP on health at the population level by calculating the percentage of population attributable risk (PAR%). In Barcelona, 13.3% of women and 11.3% of men experienced EP. The most frequently affected groups were people born in low- and middle-income countries, those from more disadvantaged social classes, and women aged 65 years and older. We found a strong association between EP and worse health status, as well as higher use of health services and medication. For example, compared with women without EP, those with EP reported poor mental health 1.9 (95% CI: 1.6-2.4) times more frequently. Compared with men without EP, those with EP reported poor mental health 2.1 (95% CI: 1.6-2.8) times more frequently. The combination of high EP prevalence and the strong association between EP and negative health outcomes resulted in high PAR%, indicating the striking impact of EP on health and health services at the population level. EP is an important public health problem in southern European urban contexts that should be included in policy priorities in order to address its structural causes and minimise its unfair and avoidable health effects.
Collapse
Affiliation(s)
- Laura Oliveras
- Agència de Salut Pública de Barcelona, Lesseps 1, 08023, Barcelona, Catalonia, Spain
- Institut D'Investigació Biomèdica Sant Pau (IIB Sant Pau), Sant Quintí 77, 08041, Barcelona, Catalonia, Spain
- Department of Experimental and Health Sciences. Universitat Pompeu Fabra, Doctor Aiguader 88, 08003, Barcelona, Catalonia, Spain
| | - Lucia Artazcoz
- Agència de Salut Pública de Barcelona, Lesseps 1, 08023, Barcelona, Catalonia, Spain
- Institut D'Investigació Biomèdica Sant Pau (IIB Sant Pau), Sant Quintí 77, 08041, Barcelona, Catalonia, Spain
- Department of Experimental and Health Sciences. Universitat Pompeu Fabra, Doctor Aiguader 88, 08003, Barcelona, Catalonia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Carme Borrell
- Agència de Salut Pública de Barcelona, Lesseps 1, 08023, Barcelona, Catalonia, Spain
- Institut D'Investigació Biomèdica Sant Pau (IIB Sant Pau), Sant Quintí 77, 08041, Barcelona, Catalonia, Spain
- Department of Experimental and Health Sciences. Universitat Pompeu Fabra, Doctor Aiguader 88, 08003, Barcelona, Catalonia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Laia Palència
- Agència de Salut Pública de Barcelona, Lesseps 1, 08023, Barcelona, Catalonia, Spain
- Institut D'Investigació Biomèdica Sant Pau (IIB Sant Pau), Sant Quintí 77, 08041, Barcelona, Catalonia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - María José López
- Agència de Salut Pública de Barcelona, Lesseps 1, 08023, Barcelona, Catalonia, Spain
- Institut D'Investigació Biomèdica Sant Pau (IIB Sant Pau), Sant Quintí 77, 08041, Barcelona, Catalonia, Spain
- Department of Experimental and Health Sciences. Universitat Pompeu Fabra, Doctor Aiguader 88, 08003, Barcelona, Catalonia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Mercè Gotsens
- Agència de Salut Pública de Barcelona, Lesseps 1, 08023, Barcelona, Catalonia, Spain
- Institut D'Investigació Biomèdica Sant Pau (IIB Sant Pau), Sant Quintí 77, 08041, Barcelona, Catalonia, Spain
| | - Andrés Peralta
- Agència de Salut Pública de Barcelona, Lesseps 1, 08023, Barcelona, Catalonia, Spain
- Health Inequalities Research Group, Employment Conditions Knowledge Network (GREDS-EMCONET). Department of Political and Social Sciences. Universitat Pompeu Fabra, Ramon Trias Fargas 25-27, 08005, Barcelona, Catalonia, Spain
- Johns Hopkins University - Pompeu Fabra University Public Policy Centre, Ramon Trias Fargas 25-27, 08005, Barcelona, Catalonia, Spain
| | - Marc Marí-Dell’Olmo
- Agència de Salut Pública de Barcelona, Lesseps 1, 08023, Barcelona, Catalonia, Spain
- Institut D'Investigació Biomèdica Sant Pau (IIB Sant Pau), Sant Quintí 77, 08041, Barcelona, Catalonia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| |
Collapse
|
9
|
A Review of the Relation between Household Indoor Temperature and Health Outcomes. ENERGIES 2020. [DOI: 10.3390/en13112881] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This paper provides a review of research that addresses the relationship between indoor temperatures and health outcomes, taking into consideration studies that focus heat or cold exposure within the household context. It aims to extend previous research by considering both indoor temperatures from existing housing, and empirical studies that focus on energy efficiency measures and subsequent health impacts. To achieve this aim, a literature review was undertaken, combining engineering and health databases. The review established that, overall, inadequate indoor temperatures are associated with poor health status, whereas energy efficiency measures have been associated to improved indoor temperatures and occupant’s health namely regarding cardiovascular, respiratory and mental health disorders. These health conditions are among the most prevalent non-communicable diseases (NCD). The review also highlighted the need for more empirical studies with an extended timeframe to deal with climate change challenges. It underlined the potential advantages of the convergence between health and energy efficiency studies, for better modelling and planning.
Collapse
|
10
|
Miyake F, Odgerel CO, Mine Y, Kubo T, Ikaga T, Fujino Y. A Prospective Cohort Study of Bedroom Warming With a Heating System and Its Association With Common Infectious Diseases in Children During Winter in Japan. J Epidemiol 2020; 31:165-171. [PMID: 32147645 PMCID: PMC7878713 DOI: 10.2188/jea.je20190312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Customarily, bedrooms in Japan are left unheated. Although several studies have reported that the use of a heating system has positive outcomes on respiratory infection and asthma, the preventive effect of heating systems against infectious diseases in children is not well known. Methods We conducted a cohort study using two questionnaire surveys, one before the winter season in November, 2018 and the second after winter in March, 2019. Participants were 155 children who did not use a heating system in the bedroom and 156 children who did. Results Having a heated bedroom with a heating system was associated with decreased odds for the frequency of cold (≥3 times) (adjust odds ratio [AOR] 0.35; 95% confidence interval [CI], 0.19–0.65), duration of fever (≥3 days) (AOR 0.38; 95% CI, 0.22–0.66), duration of medicine for a cold (≥3 days) (AOR 0.91; 95% CI, 0.87–0.95), hospital visit due to cold (≥3 days) (AOR 0.54; 95% CI, 0.31–0.94), absence from school or nursery (≥3 days) (AOR 0.43; 95% CI, 0.27–0.70), influenza infection (AOR 0.43; 95% CI, 0.26–0.71), and gastroenteritis (AOR 0.39; 95% CI, 0.21–0.72). Influenza vaccination reduced the odds of influenza infection (AOR 0.36; 95% CI, 0.22–0.59) and absence from school or nursery (≥3 days) (AOR 0.62; 95% CI, 0.39–0.99). Conclusion This study implies that the heating of bedrooms may have a preventive effect against infections among children. Broader dissemination of this knowledge in Japan will require cultural change through public health awareness.
Collapse
Affiliation(s)
- Fuyu Miyake
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health
| | - Chimed-Ochir Odgerel
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health
| | - Yuko Mine
- Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health
| | - Tatsuhiko Kubo
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health.,Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University
| | - Toshiharu Ikaga
- Department of System Design Engineering, Faculty of Science and Technology, Keio University
| | - Yoshihisa Fujino
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health
| |
Collapse
|
11
|
A Pervasive Healthcare System for COPD Patients. Diagnostics (Basel) 2019; 9:diagnostics9040135. [PMID: 31581453 PMCID: PMC6963281 DOI: 10.3390/diagnostics9040135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 09/17/2019] [Accepted: 09/26/2019] [Indexed: 11/21/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is one of the most severe public health problems worldwide. Pervasive computing technology creates a new opportunity to redesign the traditional pattern of medical system. While many pervasive healthcare systems are currently found in the literature, there is little published research on the effectiveness of these paradigms in the medical context. This paper designs and validates a rule-based ontology framework for COPD patients. Unlike conventional systems, this work presents a new vision of telemedicine and remote care solutions that will promote individual self-management and autonomy for COPD patients through an advanced decision-making technique. Rules accuracy estimates were 89% for monitoring vital signs, and environmental factors, and 87% for nutrition facts, and physical activities.
Collapse
|
12
|
Angelini V, Daly M, Moro M, Navarro Paniagua M, Sidman E, Walker I, Weldon M. The effect of the Winter Fuel Payment on household temperature and health: a regression discontinuity design study. PUBLIC HEALTH RESEARCH 2019. [DOI: 10.3310/phr07010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundThe Winter Fuel Payment (WFP) is a non-NHS population-level policy intervention that aims to reduce cold exposure and enhance the health and well-being of older adults. Labelling this cash transfer as ‘winter fuel’ has been shown to lead to increased household energy expenditure, but it is not known if this expenditure produces warmer homes or health benefits.ObjectivesFirst, the association between indoor temperature and health was established to identify the outcome measures most likely to be affected by the WFP. Then, whether or not receiving the WFP is associated with raised household temperature levels and/or improved health was assessed.DesignRandom and fixed effects regression models were used to estimate the link between ambient indoor temperature and health. A regression discontinuity (RD) design analysis exploiting the sharp eligibility criteria for the WFP was employed to estimate the potential impact of the payment.SettingThe sample was drawn from the English Longitudinal Study of Ageing (ELSA), an observational study of community-dwelling individuals aged ≥ 50 years in England.ParticipantsAnalyses examining the association between household temperature and health had a maximum sample of 12,210 adults aged 50–90 years. The RD analyses drew on a maximum of 5902 observations.InterventionThe WFP provides households with a member who is aged > 60 years (up to 2010, from which point the minimum age increased) in the qualifying week with a lump sum annual payment, typically in November or December.Main outcome measuresDifferences in indoor temperature were examined, and, following an extensive literature review of relevant participant-reported health indicators and objectively recorded biomarkers likely to be affected by indoor temperature, a series of key measures were selected: blood pressure, inflammation, lung function, the presence of chest infections, subjective health and depressive symptom ratings.Data sourcesThe first six waves of the ELSA were drawn from, accessible through the UK Data Service (SN:5050 English Longitudinal Study of Ageing: Waves 0–7, 1998–2015).ResultsResults from both random and fixed-effects multilevel regression models showed that low levels of indoor temperature were associated with raised systolic and diastolic blood pressure levels and raised fibrinogen levels. However, across the RD models, no evidence was found that the WFP was consistently associated with differences in either household temperature or the health of qualifying (vs. non-qualifying) households.LimitationsThe presence of small effects cannot be ruled out, not detectable because of the sample size in the current study.ConclusionsThis study capitalised on the sharp assignment rules regarding WFP eligibility to estimate the potential effect of the WFP on household temperature and health in a national sample of English adults. The RD design employed did not identify evidence linking the WFP to warmer homes or potential health and well-being effects.Future workFurther research should utilise larger samples of participants close to the WFP eligibility cut-off point examined during particularly cold weather in order to identify whether or not the WFP is linked to health benefits not detected in the current study, which may have implications for population health and the evaluation of the effectiveness of the WFP.FundingThe National Institute for Health Research Public Health Research programme.
Collapse
Affiliation(s)
- Viola Angelini
- Faculty of Economics and Business Economics, University of Groningen, Groningen, the Netherlands
| | - Michael Daly
- Management Work and Organisation, Stirling Management School, University of Stirling, Stirling, UK
| | - Mirko Moro
- Economics Division, Stirling Management School, University of Stirling, Stirling, UK
| | - Maria Navarro Paniagua
- Department of Economics, Lancaster University Management School, Lancaster University, Lancaster, UK
| | - Elanor Sidman
- Management Work and Organisation, Stirling Management School, University of Stirling, Stirling, UK
| | - Ian Walker
- Department of Economics, Lancaster University Management School, Lancaster University, Lancaster, UK
| | - Matthew Weldon
- Department of Economics, Lancaster University Management School, Lancaster University, Lancaster, UK
| |
Collapse
|
13
|
Armstrong B, Bonnington O, Chalabi Z, Davies M, Doyle Y, Goodwin J, Green J, Hajat S, Hamilton I, Hutchinson E, Mavrogianni A, Milner J, Milojevic A, Picetti R, Rehill N, Sarran C, Shrubsole C, Symonds P, Taylor J, Wilkinson P. The impact of home energy efficiency interventions and winter fuel payments on winter- and cold-related mortality and morbidity in England: a natural equipment mixed-methods study. PUBLIC HEALTH RESEARCH 2018. [DOI: 10.3310/phr06110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
England, and the UK more generally, has a large burden of winter- and cold-related mortality/morbidity in comparison with nearby countries in continental Europe. Improving the energy efficiency of the housing stock may help to reduce this, as well as being important for climate change and energy security objectives.
Objectives
To evaluate the impact of home energy efficiency (HEE) interventions on winter- and cold-related mortality/morbidity, including assessing the impact of winter fuel payments (WFPs) and fuel costs.
Design
A mixed-methods study – an epidemiological time-series analysis, an analysis of data on HEE interventions, the development and application of modelling methods including a multicriteria decision analysis and an in-depth interview study of householders.
Setting
England, UK.
Participants
The population of England. In-depth interviews were conducted with 12 households (2–4 participants each) and 41 individuals in three geographical regions.
Interventions
HEE interventions.
Main outcome measures
Mortality, morbidity and intervention-related changes to the home indoor environment.
Data sources
The Homes Energy Efficiency Database, mortality and hospital admissions data and weather (temperature) data.
Results
There has been a progressive decline in cold-related deaths since the mid-1970s. Since the introduction of WFPs, the gradient of association between winter cold and mortality [2.00%, 95% confidence interval (CI) 1.74% to 2.28%] per degree Celsius fall in temperature is somewhat weaker (i.e. that the population is less vulnerable to cold) than in earlier years (2.37%, 95% CI 0.22% to 2.53%). There is also evidence that years with above-average fuel costs were associated with higher vulnerability to outdoor cold. HEE measures installed in England in 2002–10 have had a relatively modest impact in improving the indoor environment. The gains in winter temperatures (around +0.09 °C on a day with maximum outdoor temperature of 5 °C) are associated with an estimated annual reduction of ≈280 cold-related deaths in England (an eventual maximum annual impact of 4000 life-years gained), but these impacts may be appreciably smaller than those of changes in indoor air quality. Modelling studies indicate the potential importance of the medium- and longer-term impacts that HEE measures have on health, which are not observable in short-term studies. They also suggest that HEE improvements of similar annualised cost to current WFPs would achieve greater improvements in health while reducing (rather than increasing) carbon dioxide emissions. In-depth interviews suggest four distinct householder framings of HEE measures (as home improvement, home maintenance, subsidised public goods and contributions to sustainability), which do not dovetail with current ‘consumerist’ national policy and may have implications for the uptake of HEE measures.
Limitations
The quantification of intervention impacts in this national study is reliant on various indirect/model-based assessments.
Conclusions
Larger-scale changes are required to the housing stock in England if the full potential benefits for improving health and for reaching increasingly important climate change mitigation targets are to be realised.
Future work
Studies based on data linkage at individual dwelling level to examine health impacts. There is a need for empirical assessment of HEE interventions on indoor air quality.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 6, No. 11. See the NIHR Journals Library website for further project information.
Collapse
Affiliation(s)
- Ben Armstrong
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Oliver Bonnington
- Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Zaid Chalabi
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Michael Davies
- Institute for Environmental Design and Engineering, University College London, London, UK
| | | | - James Goodwin
- Design School, Loughborough University, Loughborough, UK
- Energy Institute, University College London, London, UK
| | - Judith Green
- Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
- Department of Global Health and Social Medicine, King’s College London, London, UK
| | - Shakoor Hajat
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Ian Hamilton
- Energy Institute, University College London, London, UK
| | - Emma Hutchinson
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Anna Mavrogianni
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - James Milner
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Ai Milojevic
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Roberto Picetti
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Nirandeep Rehill
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Clive Shrubsole
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Phil Symonds
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Jonathon Taylor
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Paul Wilkinson
- Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
14
|
Hicks A, Healy E, Sandeman N, Feelisch M, Wilkinson T. A time for everything and everything in its time - exploring the mechanisms underlying seasonality of COPD exacerbations. Int J Chron Obstruct Pulmon Dis 2018; 13:2739-2749. [PMID: 30233164 PMCID: PMC6130531 DOI: 10.2147/copd.s146015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Across Europe, COPD affects 23 million people leading to annual health care costs of ~€25.1 billion. This burden is particularly severe during winter months in association with the peak incidence of exacerbation events. Seasonal variation in the health status of patients with COPD places additional and often critical pressure on already strained health care resources. COPD exacerbations are characterized by worsening day-to-day symptoms of an individual and often triggered by respiratory infections, but the process by which this occurs in a seasonal fashion is likely to be multifactorial. In this review, we discuss recent population studies that highlight the impact of seasonality in COPD and review the proposed biological mechanisms underlying this. An appraisal of the role of the host susceptibility and response, environmental triggers and the biology of respiratory pathogens is detailed. The impact of each aspect is considered, and an integrated model of the context for the whole individual and society in general is explored.
Collapse
Affiliation(s)
- Alexander Hicks
- Clinical and Experimental Sciences, University of Southampton - Faculty of Medicine, Southampton General Hospital, Southampton, UK, .,Southampton NIHR Respiratory Biomedical Research Centre, Southampton General Hospital, Southampton, UK, .,National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) Wessex, Southampton General Hospital, Southampton, UK,
| | - Eugene Healy
- Clinical and Experimental Sciences, University of Southampton - Faculty of Medicine, Southampton General Hospital, Southampton, UK,
| | - Natasha Sandeman
- Clinical and Experimental Sciences, University of Southampton - Faculty of Medicine, Southampton General Hospital, Southampton, UK,
| | - Martin Feelisch
- Clinical and Experimental Sciences, University of Southampton - Faculty of Medicine, Southampton General Hospital, Southampton, UK, .,Southampton NIHR Respiratory Biomedical Research Centre, Southampton General Hospital, Southampton, UK,
| | - Tom Wilkinson
- Clinical and Experimental Sciences, University of Southampton - Faculty of Medicine, Southampton General Hospital, Southampton, UK, .,Southampton NIHR Respiratory Biomedical Research Centre, Southampton General Hospital, Southampton, UK, .,National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) Wessex, Southampton General Hospital, Southampton, UK, .,Wessex Investigational Sciences Hub, University of Southampton - Faculty of Medicine, Southampton General Hospital, Southampton, UK
| |
Collapse
|
15
|
Poortinga W, Rodgers SE, Lyons RA, Anderson P, Tweed C, Grey C, Jiang S, Johnson R, Watkins A, Winfield TG. The health impacts of energy performance investments in low-income areas: a mixed-methods approach. PUBLIC HEALTH RESEARCH 2018. [DOI: 10.3310/phr06050] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundCold homes and fuel poverty contribute to health inequalities in ways that could be addressed through energy efficiency interventions.ObjectivesTo determine the health and psychosocial impacts of energy performance investments in low-income areas, particularly hospital admissions for cardiorespiratory conditions, prevalence of respiratory symptoms and mental health status, hydrothermal conditions and household energy use, psychosocial outcomes, cost consequences to the health system and the cost utility of these investments.DesignA mixed-methods study comprising data linkage (25,908 individuals living in 4968 intervention homes), a field study with a controlled pre-/post-test design (intervention,n = 418; control,n = 418), a controlled multilevel interrupted time series analysis of internal hydrothermal conditions (intervention,n = 48; control,n = 40) and a health economic assessment.SettingLow-income areas across Wales.ParticipantsResidents who received energy efficiency measures through the intervention programme and matched control groups.Main outcome measuresPrimary outcomes – emergency hospital admissions for cardiorespiratory conditions, self-reported respiratory symptoms, mental health status, indoor air temperature and indoor relative humidity. Secondary outcomes – emergency hospital admissions for chronic obstructive pulmonary disease-related cardiorespiratory conditions, excess winter admissions, health-related quality of life, subjective well-being, self-reported fuel poverty, financial stress and difficulties, food security, social interaction, thermal satisfaction and self-reported housing conditions.MethodsAnonymously linked individual health records for emergency hospital admissions were analysed using mixed multilevel linear models. A quasi-experimental controlled field study used a multilevel repeated measures approach. Controlled multilevel interrupted time series analyses were conducted to estimate changes in internal hydrothermal conditions following the intervention. The economic evaluation comprised cost–consequence and cost–utility analyses.Data sourcesThe Patient Episode Database for Wales 2005–14, intervention records from 28 local authorities and housing associations, and scheme managers who delivered the programme.ResultsThe study found no evidence of changes in physical health. However, there were improvements in subjective well-being and a number of psychosocial outcomes. The household monitoring study found that the intervention raised indoor temperature and helped reduce energy use. No evidence was found of substantial increases in indoor humidity levels. The health economic assessment found no explicit cost reductions to the health service as a result of non-significant changes in emergency admissions for cardiorespiratory conditions.LimitationsThis was a non-randomised intervention study with household monitoring and field studies that relied on self-response. Data linkage focused on emergency admissions only.ConclusionAlthough there was no evidence that energy performance investments provide physical health benefits or reduce health service usage, there was evidence that they improve social and economic conditions that are conducive to better health and improved subjective well-being. The intervention has been successful in reducing energy use and improving the living conditions of households in low-income areas. The lack of association of emergency hospital admissions with energy performance investments means that we were unable to evidence cost saving to health-service providers.Future workOur research suggests the importance of incorporating evaluations with follow-up into intervention research from the start.FundingThe National Institute for Health Research Public Health Research programme.
Collapse
Affiliation(s)
| | - Sarah E Rodgers
- Farr Institute, College of Medicine, Swansea University, Swansea, UK
| | - Ronan A Lyons
- Farr Institute, College of Medicine, Swansea University, Swansea, UK
| | - Pippa Anderson
- Swansea Centre for Health Economics, College of Human and Health Sciences, Swansea University, Swansea, UK
| | - Chris Tweed
- Welsh School of Architecture, Cardiff University, Cardiff, UK
| | - Charlotte Grey
- Welsh School of Architecture, Cardiff University, Cardiff, UK
| | - Shiyu Jiang
- Welsh School of Architecture, Cardiff University, Cardiff, UK
| | - Rhodri Johnson
- Farr Institute, College of Medicine, Swansea University, Swansea, UK
| | - Alan Watkins
- Farr Institute, College of Medicine, Swansea University, Swansea, UK
| | - Thomas G Winfield
- Swansea Centre for Health Economics, College of Human and Health Sciences, Swansea University, Swansea, UK
| |
Collapse
|
16
|
Poortinga W, Jones N, Lannon S, Jenkins H. Social and health outcomes following upgrades to a national housing standard: a multilevel analysis of a five-wave repeated cross-sectional survey. BMC Public Health 2017; 17:927. [PMID: 29197356 PMCID: PMC5712147 DOI: 10.1186/s12889-017-4928-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 11/20/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While existing research indicates that housing improvements are associated with health improvements, less is known about the wider social and health benefits of meeting national housing standards, as well as those of their specific constituent measures. This study evaluates the impacts of a managed housing upgrade programme through a repeated cross-sectional survey design. METHODS A five-wave repeated cross-sectional survey was conducted over a seven-year period from 2009 to 2016 (n = 2075; n = 2219; n = 2015; n = 1991; and n = 1709, respectively). The study followed a managed upgrade programme designed to meet a national social housing standard over an extended period. The data were analysed from a multilevel perspective to take account of the time-dependent nature of the observations and differences in socio-demographic composition. RESULTS The installation of the majority of individual housing measures (new windows and doors; boilers; kitchens; bathrooms; electrics; loft insulation; and cavity/external wall insulation) were associated with improvements in several social (housing suitability, satisfaction, and quality; thermal comfort and household finances) and health (mental, respiratory and general health) outcomes; and analyses showed relationships between the number of measures installed and the total amount invested on the one hand and the social and health outcomes on the other. There were however a few exceptions. Most notably, the installation of cavity wall insulation was associated with poorer health outcomes, and did not lead to better social outcomes. Also, no association was found between the number of measures installed and respiratory health. CONCLUSIONS The study suggests that substantial housing investments through a managed upgrade programme may result in better social and health outcomes, and that the size of the improvements are proportionate to the number of measures installed and amount invested. However, there may be risks associated with specific measures; and more attention is needed for mechanical ventilation when upgrading energy efficiency of houses through fabric work. In addition to providing new evidence regarding the wider social and health outcomes, the study provides an analytical approach to evaluate upgrade programmes that are delivered over multiple years.
Collapse
Affiliation(s)
- Wouter Poortinga
- Welsh School of Architecture, Cardiff University, Bute Building, King Edward VII Avenue, Cardiff, Wales, CF10 3NB, UK. .,School of Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff, Wales, CF10 3AT, UK.
| | - Nikki Jones
- Welsh School of Architecture, Cardiff University, Bute Building, King Edward VII Avenue, Cardiff, Wales, CF10 3NB, UK
| | - Simon Lannon
- Welsh School of Architecture, Cardiff University, Bute Building, King Edward VII Avenue, Cardiff, Wales, CF10 3NB, UK
| | - Huw Jenkins
- Welsh School of Architecture, Cardiff University, Bute Building, King Edward VII Avenue, Cardiff, Wales, CF10 3NB, UK
| |
Collapse
|
17
|
Mu Z, Chen PL, Geng FH, Ren L, Gu WC, Ma JY, Peng L, Li QY. Synergistic effects of temperature and humidity on the symptoms of COPD patients. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:1919-1925. [PMID: 28567499 DOI: 10.1007/s00484-017-1379-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 05/06/2017] [Accepted: 05/08/2017] [Indexed: 06/07/2023]
Abstract
This panel study investigates how temperature, humidity, and their interaction affect chronic obstructive pulmonary disease (COPD) patients' self-reported symptoms. One hundred and six COPD patients from Shanghai, China, were enrolled, and age, smoking status, St. George Respiratory Questionnaire (SGRQ) score, and lung function index were recorded at baseline. The participants were asked to record their indoor temperature, humidity, and symptoms on diary cards between January 2011 and June 2012. Altogether, 82 patients finished the study. There was a significant interactive effect between temperature and humidity (p < 0.0001) on COPD patients. When the indoor humidity was low, moderate, and high, the indoor temperature ORs were 0.969 (95% CI 0.922 to 1.017), 0.977 (0.962 to 0.999), and 0.920 (95% CI 0.908 to 0.933), respectively. Low temperature was a risk factor for COPD patients, and high humidity enhanced its risk on COPD. The indoor temperature should be kept at least on average at 18.2 °C, while the humidity should be less than 70%. This study demonstrates that temperature and humidity were associated with COPD patients' symptoms, and high humidity would enhance the risk of COPD due to low temperature.
Collapse
Affiliation(s)
- Zhe Mu
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
| | - Pei-Li Chen
- Department of Respiratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fu-Hai Geng
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
| | - Lei Ren
- Department of Respiratory Medicine, Jing'an District Geriatric Hospital of Shanghai, Shanghai, China
| | - Wen-Chao Gu
- Department of Respiratory Medicine, People Hospital of Pudong District, Shanghai, China
| | - Jia-Yun Ma
- Department of Respiratory Medicine, No.3 People Hospital Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Li Peng
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
| | - Qing-Yun Li
- Department of Respiratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| |
Collapse
|
18
|
Quinn A, Shaman J. Health symptoms in relation to temperature, humidity, and self-reported perceptions of climate in New York City residential environments. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:1209-1220. [PMID: 28108783 PMCID: PMC5479711 DOI: 10.1007/s00484-016-1299-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 11/13/2016] [Accepted: 12/13/2016] [Indexed: 06/06/2023]
Abstract
Little monitoring has been conducted of temperature and humidity inside homes despite the fact that these conditions may be relevant to health outcomes. Previous studies have observed associations between self-reported perceptions of the indoor environment and health. Here, we investigate associations between measured temperature and humidity, perceptions of indoor environmental conditions, and health symptoms in a sample of New York City apartments. We measured temperature and humidity in 40 New York City apartments during summer and winter seasons and collected survey data from the households' residents. Health outcomes of interest were (1) sleep quality, (2) symptoms of heat illness (summer season), and (3) symptoms of respiratory viral infection (winter season). Using mixed-effects logistic regression models, we investigated associations between the perceptions, symptoms, and measured conditions in each season. Perceptions of indoor temperature were significantly associated with measured temperature in both the summer and the winter, with a stronger association in the summer season. Sleep quality was inversely related to measured and perceived indoor temperature in the summer season only. Heat illness symptoms were associated with perceived, but not measured, temperature in the summer season. We did not find an association between any measured or perceived condition and cases of respiratory infection in the winter season. Although limited in size, the results of this study reveal that indoor temperature may impact sleep quality, and that thermal perceptions of the indoor environment may indicate vulnerability to heat illness. These are both important avenues for further investigation.
Collapse
Affiliation(s)
- Ashlinn Quinn
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA.
| | - Jeffrey Shaman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| |
Collapse
|
19
|
McCormack MC, Paulin LM, Gummerson CE, Peng RD, Diette GB, Hansel NN. Colder temperature is associated with increased COPD morbidity. Eur Respir J 2017; 49:49/6/1601501. [PMID: 28663313 DOI: 10.1183/13993003.01501-2016] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 03/25/2017] [Indexed: 11/05/2022]
Affiliation(s)
- Meredith C McCormack
- Johns Hopkins University School of Medicine, Pulmonary and Critical Care Medicine, Baltimore, MD, USA .,Co-first authors
| | - Laura M Paulin
- Johns Hopkins University School of Medicine, Pulmonary and Critical Care Medicine, Baltimore, MD, USA.,Co-first authors
| | - Christine E Gummerson
- Johns Hopkins University School of Medicine, Pulmonary and Critical Care Medicine, Baltimore, MD, USA
| | - Roger D Peng
- Johns Hopkins Bloomberg School of Public Health, Dept of Biostatistics, Baltimore, MD, USA
| | - Gregory B Diette
- Johns Hopkins University School of Medicine, Pulmonary and Critical Care Medicine, Baltimore, MD, USA
| | - Nadia N Hansel
- Johns Hopkins University School of Medicine, Pulmonary and Critical Care Medicine, Baltimore, MD, USA
| |
Collapse
|
20
|
Thomson H, Snell C, Bouzarovski S. Health, Well-Being and Energy Poverty in Europe: A Comparative Study of 32 European Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E584. [PMID: 28561767 PMCID: PMC5486270 DOI: 10.3390/ijerph14060584] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 05/22/2017] [Accepted: 05/26/2017] [Indexed: 11/16/2022]
Abstract
Despite growing pan-European interest in and awareness of the wide-ranging health and well-being impacts of energy poverty-which is characterised by an inability to secure adequate levels of energy services in the home-the knowledge base is largely British-centric and dominated by single-country studies. In response, this paper investigates the relationship between energy poverty, health and well-being across 32 European countries, using 2012 data from the European Quality of Life Survey. We find an uneven concentration of energy poverty, poor health, and poor well-being across Europe, with Eastern and Central Europe worst affected. At the intersection of energy poverty and health, there is a higher incidence of poor health (both physical and mental) amongst the energy poor populations of most countries, compared to non-energy poor households. Interestingly, we find the largest disparities in health and well-being levels between energy poor and non-energy poor households occur within relatively equal societies, such as Sweden and Slovenia. As well as the unique challenges brought about by rapidly changing energy landscapes in these countries, we also suggest the relative deprivation theory and processes of social comparison hold some value in explaining these findings.
Collapse
Affiliation(s)
- Harriet Thomson
- School of Environment, Education and Development, University of Manchester, Manchester M13 9PL, UK.
| | - Carolyn Snell
- Department of Social Policy and Social Work, University of York, York YO10 5DD, UK.
| | - Stefan Bouzarovski
- School of Environment, Education and Development, University of Manchester, Manchester M13 9PL, UK.
| |
Collapse
|
21
|
Jevons R, Carmichael C, Crossley A, Bone A. Minimum indoor temperature threshold recommendations for English homes in winter – A systematic review. Public Health 2016; 136:4-12. [DOI: 10.1016/j.puhe.2016.02.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 01/29/2016] [Accepted: 02/11/2016] [Indexed: 12/31/2022]
|
22
|
Quality of life and its association with direct medical costs for COPD in urban China. Health Qual Life Outcomes 2015; 13:57. [PMID: 25972271 PMCID: PMC4429937 DOI: 10.1186/s12955-015-0241-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 04/02/2015] [Indexed: 11/10/2022] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death worldwide. Few studies have focused on the quality of life (QoL) associated medical costs for COPD in China. Methods A cross-sectional survey of 678 COPD patients was conducted in four major cities (Beijing, Shanghai, Guangzhou and Chengdu), China, in 2011. Data on socio-demographic information, health conditions and medical costs were collected through a face-to-face interview combined with medical record searching. The EuroQol (EQ-5D) health questionnaire was applied to assess the QoL of COPD patients. Results Among 678 patients with COPD, nearly 40% had difficulties in mobility, usual activities and pain/discomfort, one third had various degrees of anxiety/depression, and one fifth had difficulties in self-care. The COPD patients had a median utility score of 0.768 and a median visual analog scale score of 70. The degree of difficulties in any dimensions significantly increased, and utility and health scores decreased with severity of the disease. Age, gender and disease severity were significantly associated with the quality of life after taking other covariates into consideration. Poorer QoL was a significant indicator of higher direct medical costs for COPD patients. Conclusion Impaired quality of life was significantly linked to increased medical costs for COPD patients and could be an important measure for policy- and decision-making in COPD care.
Collapse
|
23
|
Hamilton I, Milner J, Chalabi Z, Das P, Jones B, Shrubsole C, Davies M, Wilkinson P. Health effects of home energy efficiency interventions in England: a modelling study. BMJ Open 2015; 5:e007298. [PMID: 25916488 PMCID: PMC4420956 DOI: 10.1136/bmjopen-2014-007298] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To assess potential public health impacts of changes to indoor air quality and temperature due to energy efficiency retrofits in English dwellings to meet 2030 carbon reduction targets. DESIGN Health impact modelling study. SETTING England. PARTICIPANTS English household population. INTERVENTION Three retrofit scenarios were modelled: (1) fabric and ventilation retrofits installed assuming building regulations are met; (2) as with scenario (1) but with additional ventilation for homes at risk of poor ventilation; (3) as with scenario (1) but with no additional ventilation to illustrate the potential risk of weak regulations and non-compliance. MAIN OUTCOME Primary outcomes were changes in quality adjusted life years (QALYs) over 50 years from cardiorespiratory diseases, lung cancer, asthma and common mental disorders due to changes in indoor air pollutants, including secondhand tobacco smoke, PM2.5 from indoor and outdoor sources, radon, mould, and indoor winter temperatures. RESULTS The modelling study estimates showed that scenario (1) resulted in positive effects on net mortality and morbidity of 2241 (95% credible intervals (CI) 2085 to 2397) QALYs per 10,000 persons over 50 years follow-up due to improved temperatures and reduced exposure to indoor pollutants, despite an increase in exposure to outdoor-generated particulate matter with a diameter of 2.5 μm or less (PM₂.₅). Scenario (2) resulted in a negative impact of -728 (95% CI -864 to -592) QALYs per 10,000 persons over 50 years due to an overall increase in indoor pollutant exposures. Scenario (3) resulted in -539 (95% CI -678 to -399) QALYs per 10,000 persons over 50 years follow-up due to an increase in indoor exposures despite the targeting of pollutants. CONCLUSIONS If properly implemented alongside ventilation, energy efficiency retrofits in housing can improve health by reducing exposure to cold and air pollutants. Maximising the health benefits requires careful understanding of the balance of changes in pollutant exposures, highlighting the importance of ventilation to mitigate the risk of poor indoor air quality.
Collapse
Affiliation(s)
- Ian Hamilton
- UCL Energy Institute, University College London, London, UK
| | - James Milner
- Department of Social & Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Zaid Chalabi
- Department of Social & Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Payel Das
- UCL Institute for Environmental Design and Engineering, University College London, London, UK
| | - Benjamin Jones
- Department of Architecture and Built Environment, University of Nottingham, Nottingham, UK
| | - Clive Shrubsole
- UCL Institute for Environmental Design and Engineering, University College London, London, UK
| | - Mike Davies
- UCL Institute for Environmental Design and Engineering, University College London, London, UK
| | - Paul Wilkinson
- Department of Social & Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
24
|
Shi ZY, Dong T. Coupling effect on thermal comfort in a typical cubicle-based office with personalized floor diffuser control. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2015; 2014:840-3. [PMID: 25570090 DOI: 10.1109/embc.2014.6943722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A typical office layout with cubicles, in which occupants have their own control of the micro-environment by adjusting supply air flow rate of the floor diffuser, is numerically investigated for the impact of the discrepancy in personal thermal sensation preference on thermal comfort. The comparison among different scenarios indicates that whether the local thermal comfort is significantly affected by the neighboring cubicle (coupling effect) depends on whether the doorway is closed or not whereas the "openness", of upper space has no influence on such coupling effect but observably on the thermal comfort. The effect of thermoregulation is also presented and compared with conventional constant heat flux assumption for the occupants.
Collapse
|
25
|
Donaldson GC, Wedzicha JA. The causes and consequences of seasonal variation in COPD exacerbations. Int J Chron Obstruct Pulmon Dis 2014; 9:1101-10. [PMID: 25336941 PMCID: PMC4199860 DOI: 10.2147/copd.s54475] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The time of year when patients experience exacerbations of chronic obstructive pulmonary disease is a much-overlooked feature of the disease. The higher incidence of exacerbations in winter has important consequences for patients in terms of increased morbidity and mortality. The seasonality also imposes a considerable burden on already-overloaded health care services, with both primary care consultations and hospital admissions increasing in number. The seasonality of exacerbations varies with latitude, and is greater in more temperate climates, where there may be less protection from outdoor and indoor cold exposure. The precise causes of the seasonality are unknown, but thought to be partly due to the increased prevalence of respiratory viral infections circulating in cold, damp conditions. Increased susceptibility to viral infection may also be a mechanism mediated through increased airway inflammation or possibly reduced vitamin D levels. The seasonality of exacerbations informs us about the triggers of exacerbations and suggests possible strategies to reduce their number.
Collapse
Affiliation(s)
- Gavin C Donaldson
- Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - Jadwiga A Wedzicha
- Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, UK
| |
Collapse
|
26
|
McAllister DA, Morling JR, Fischbacher CM, MacNee W, Wild SH. Socioeconomic deprivation increases the effect of winter on admissions to hospital with COPD: retrospective analysis of 10 years of national hospitalisation data. PRIMARY CARE RESPIRATORY JOURNAL : JOURNAL OF THE GENERAL PRACTICE AIRWAYS GROUP 2014; 22:296-9. [PMID: 23820514 PMCID: PMC6442821 DOI: 10.4104/pcrj.2013.00066] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background: Admission to hospital with chronic obstructive pulmonary disease (COPD) is associated with deprivation and season. However, it is not known whether deprivation and seasonality act synergistically to influence the risk of hospital admission with COPD. Aims: To investigate whether the relationship between season/temperature and admission to hospital with COPD differs with deprivation. Methods: All COPD admissions (ICD10 codes J40-J44 and J47) were obtained for the decade 2001–2010 for all Scottish residents by month of admission and 2009 Scottish Index of Multiple Deprivation (SIMD) quintile. Confidence intervals for rates and absolute differences in rates were calculated and the proportion of risk during winter attributable to main effects and interactions were estimated. Monthly rates of admission by average daily minimum temperatures were plotted for each quintile of SIMD. Results: Absolute differences in admission rates between winter and summer increased with greater deprivation. In the most deprived quintile, in winter 19.4% (95% CI 17.3% to 21.4%) of admissions were attributable to season/deprivation interaction, 61.2% (95% CI 59.5% to 63.0%) to deprivation alone, and 5.2% (95% CI 4.3% to 6.0%) to winter alone. Lower average daily minimum temperatures over a month were associated with higher admission rates, with stronger associations evident in the more deprived quintiles. Conclusions: Winter and socioeconomic deprivation-related factors appear to act synergistically, increasing the rate of COPD admissions to hospital more among deprived people than among affluent people in winter than in the summer months. Similar associations were observed for admission rates and temperatures. Interventions effective at reducing winter admissions for COPD may have potential for greater benefit if delivered to more deprived groups.
Collapse
Affiliation(s)
- David A McAllister
- Centre for Population Health Sciences, The University of Edinburgh, Medical School, Edinburgh, UK
| | | | | | | | | |
Collapse
|
27
|
Development and initial validation of the Observer-Rated Housing Quality Scale (OHQS) in a multisite trial of housing first. J Urban Health 2014; 91:242-55. [PMID: 24477427 PMCID: PMC3978156 DOI: 10.1007/s11524-013-9851-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Quality of housing has been shown to be related to health outcomes, including mental health and well-being, yet "objective" or observer-rated housing quality is rarely measured in housing intervention research. This may be due to a lack of standardized, reliable, and valid housing quality instruments. The objective of this research was to develop and validate the Observer-Rated Housing Quality Scale (OHQS) for use in a multisite trial of a "housing first" intervention for homeless individuals with mental illness. A list of 79 housing unit, building, and neighborhood characteristics was generated from a review of the relevant literature and three focus groups with consumers and housing service providers. The characteristics were then ranked by 47 researchers, consumers, and service providers on perceived importance, generalizability, universality of value, and evidence base. Items were then drafted, scaled (five points, half values allowed), and pretested in seven housing units and with seven raters using cognitive interviewing techniques. The draft scale was piloted in 55 housing units in Toronto and Winnipeg, Canada. Items were rated independently in each unit by two trained research assistants and a housing expert. Data were analyzed using classical psychometric approaches and intraclass correlation coefficients (ICC) for inter-rater reliability. The draft scale consisted of 34 items assessing three domains: the unit, the building, and the neighborhood. Five of 18 unit items and 3 of 7 building items displayed ceiling or floor effects and were adjusted accordingly. Internal consistency was very good (Cronbach's alpha = 0.90 for the unit items, 0.80 for the building items, and 0.92 total (unit and building)). Percent agreement ranged from 89 to 100 % within one response scale value and 67 to 91 % within one half scale value. Inter-rater reliability was also good (ICCs were 0.87 for the unit, 0.85 for the building, and 0.93 for the total scale). Three neighborhood items (e.g., distance to transit) were found to be most efficiently rated using publicly available information. The physical quality of housing can be reliably rated by trained but nonexpert raters using the OHQS. The tool has potential for improved measurement in housing-related health research, including addressing the limitations of self-report, and may also enable documenting the quality of housing that is provided by publicly funded housing programs.
Collapse
|
28
|
Garin N, Olaya B, Miret M, Ayuso-Mateos JL, Power M, Bucciarelli P, Haro JM. Built environment and elderly population health: a comprehensive literature review. Clin Pract Epidemiol Ment Health 2014; 10:103-15. [PMID: 25356084 PMCID: PMC4211137 DOI: 10.2174/1745017901410010103] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 07/17/2014] [Accepted: 08/02/2014] [Indexed: 04/15/2023]
Abstract
Global population aging over recent years has been linked to poorer health outcomes and higher healthcare expenditure. Policies focusing on healthy aging are currently being developed but a complete understanding of health determinants is needed to guide these efforts. The built environment and other external factors have been added to the International Classification of Functioning as important determinants of health and disability. Although the relationship between the built environment and health has been widely examined in working age adults, research focusing on elderly people is relatively recent. In this review, we provide a comprehensive synthesis of the evidence on the built environment and health in the elderly.
Collapse
Affiliation(s)
- Noe Garin
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona. Dr Antoni Pujades, 42, 08830, Sant Boi de Llobregat, Bar-celona, Spain
- Fundació Sant Joan de Déu. Santa Rosa, 39-57, 08950. Esplugues de Llobregat, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM. Monforte de Lemos 3-5. Pabellón 11. 28029 Madrid, Spain
| | - Beatriz Olaya
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona. Dr Antoni Pujades, 42, 08830, Sant Boi de Llobregat, Bar-celona, Spain
- Fundació Sant Joan de Déu. Santa Rosa, 39-57, 08950. Esplugues de Llobregat, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM. Monforte de Lemos 3-5. Pabellón 11. 28029 Madrid, Spain
| | - Marta Miret
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM. Monforte de Lemos 3-5. Pabellón 11. 28029 Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid. Arzobispo Morcillo s/n 28029 Madrid, Spain
- Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IP). Diego de León, 62, 28006. Madrid, Spain
| | - Jose Luis Ayuso-Mateos
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM. Monforte de Lemos 3-5. Pabellón 11. 28029 Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid. Arzobispo Morcillo s/n 28029 Madrid, Spain
- Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IP). Diego de León, 62, 28006. Madrid, Spain
| | - Michael Power
- Instituto de Salud Carlos III; Department of Clinical Psychology, School of Health in Social Science, University of Edinburgh, Edinburgh EH8 9AG, UK
| | - Paola Bucciarelli
- Scientific Directorate, Neurological Institute Carlo Besta, Milan, Via Celoria 11, Italy
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona. Dr Antoni Pujades, 42, 08830, Sant Boi de Llobregat, Bar-celona, Spain
- Fundació Sant Joan de Déu. Santa Rosa, 39-57, 08950. Esplugues de Llobregat, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM. Monforte de Lemos 3-5. Pabellón 11. 28029 Madrid, Spain
- Address correspondence to this author at the Parc Sanitari Sant Joan de Déu, Universitat de Barcelona. Dr Antoni Pujades, 42, 08830, Sant Boi de Llobregat, Barcelona, Spain; Tel: +34 936406350; Fax: +34 935569674;
E-mail:
| |
Collapse
|
29
|
Viggers H, Howden-Chapman P, Ingham T, Chapman R, Pene G, Davies C, Currie A, Pierse N, Wilson H, Zhang J, Baker M, Crane J. Warm homes for older people: aims and methods of a randomised community-based trial for people with COPD. BMC Public Health 2013; 13:176. [PMID: 23442368 PMCID: PMC3608967 DOI: 10.1186/1471-2458-13-176] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 02/05/2013] [Indexed: 11/16/2022] Open
Abstract
Background Chronic Obstructive Pulmonary Disease (COPD) is of increasing importance with about one in four people estimated to be diagnosed with COPD during their lifetime. None of the existing medications for COPD has been shown to have much effect on the long-term decline in lung function and there have been few recent pharmacotherapeutic advances. Identifying preventive interventions that can reduce the frequency and severity of exacerbations could have important public health benefits. The Warm Homes for Elder New Zealanders study is a community-based trial, designed to test whether a NZ$500 electricity voucher paid into the electricity account of older people with COPD, with the expressed aim of enabling them to keep their homes warm, results in reduced exacerbations and hospitalisation rates. It will also examine whether these subsidies are cost-beneficial. Methods Participants had a clinician diagnosis of COPD and had either been hospitalised or taken steroids or antibiotics for COPD in the previous three years; their median age was 71 years. Participants were recruited from three communities between 2009 to early 2011. Where possible, participants’ houses were retrofitted with insulation. After baseline data were received, participants were randomised to either ‘early’ or ‘late’ intervention groups. The intervention was a voucher of $500 directly credited to the participants’ electricity company account. Early group participants received the voucher the first winter they were enrolled in the study, late participants during the second winter. Objective measures included spirometry and indoor temperatures and subjective measures included questions about participant health and wellbeing, heating, medication and visits to health professionals. Objective health care usage data included hospitalisation and primary care visits. Assessments of electricity use were obtained through electricity companies using unique customer numbers. Discussion This community trial has successfully enrolled 522 older people with COPD. Baseline data showed that, despite having a chronic respiratory illness, participants are frequently cold in their houses and economise on heating. Trial Registration The clinical trial registration is http://NCT01627418
Collapse
Affiliation(s)
- Helen Viggers
- He Kainga Oranga/Housing and Health Research Programme, University of Otago, PO Box 7343, Wellington, Wellington South, New Zealand.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Sossai K, Gray M, Tanner B. Living with chronic obstructive pulmonary disease: experiences in northern regional Australia. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2011. [DOI: 10.12968/ijtr.2011.18.11.631] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Kate Sossai
- Dept of Communities (Queensland Government), Disability and Community Care Service Centre, Far North Queensland Region, Cairns, Queensland, Australia
| | - Marion Gray
- School of Health and Sport Sciences, Faculty of Science, Health and Education, University of Sunshine Coast, Queensland, Australia
| | - Bronwyn Tanner
- School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Queensland, Australia
| |
Collapse
|
31
|
Eisner MD, Blanc PD, Omachi TA, Yelin EH, Sidney S, Katz PP, Ackerson LM, Sanchez G, Tolstykh I, Iribarren C. Socioeconomic status, race and COPD health outcomes. J Epidemiol Community Health 2011; 65:26-34. [PMID: 19854747 PMCID: PMC3017471 DOI: 10.1136/jech.2009.089722] [Citation(s) in RCA: 154] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Although chronic obstructive pulmonary disease (COPD) is a common cause of death and disability, little is known about the effects of socioeconomic status (SES) and race-ethnicity on health outcomes. METHODS The aim of this study is to determine the independent impacts of SES and race-ethnicity on COPD severity status, functional limitations and acute exacerbations of COPD among patients with access to healthcare. Data were used from the Function, Living, Outcomes and Work cohort study of 1202 Kaiser Permanente Northern California Medical Care Plan members with COPD. RESULTS Lower educational attainment and household income were consistently related to greater disease severity, poorer lung function and greater physical functional limitations in cross-sectional analysis. Black race was associated with greater COPD severity, but these differences were no longer apparent after controlling for SES variables and other covariates (comorbidities, smoking, body mass index and occupational exposures). Lower education and lower income were independently related to a greater prospective risk of acute COPD exacerbation (HR 1.5; 95% CI 1.01 to 2.1; and HR 2.1; 95% CI 1.4 to 3.4, respectively). CONCLUSION Low SES is a risk factor for a broad array of adverse COPD health outcomes. Clinicians and disease management programs should consider SES as a key patient-level marker of risk for poor outcomes.
Collapse
Affiliation(s)
- M D Eisner
- Division of Occupational and Environmental Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143-0111, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|