It has long been known that there is a strong relationship between poor housing conditions and poor health outcomes. Householders in fuel poverty are more likely to be living in cold, draughty and/or damp homes, which are physically harder to heat and have unsatisfactory heating systems.
This suggests that the fuel poor should be at a higher risk of negative health experiences. While links to specific conditions such as asthma and broader outcomes such as excess winter mortality have been established, there is still a shortage of research on the impact of inferior housing on other widespread illnesses, such as COPD.
Better evidence on the cost to health services could provide further support for tackling poor housing, but the data could also function as a predictor for an increased risk of COPD.
Key research Question
The study aimed to determine whether a positive relationship could be established between the indoor living conditions and the observable health status and mortality rates of patients diagnosed with COPD.
Summary of activity
Quantitative measurements were collected from the homes of 80 patients with COPD predominantly living in east London with an average age of 66. These comprised a mix of data on the dwelling (temperature and humidity) and personal medical information (e.g. lung function).
Questionnaires were also completed with each patient to record quantitative information on aspects of their property (age, heating type, fuel expenditure, prevalence of mould and damp, etc.) and other related topics such as their ventilation behaviours. Data from the study were then compared with existing figures for seasonal mortality and ongoing information on quality of life and health collected from the patients involved in the research.
A strong association was detected between self-reported levels of damp and higher humidity and both the number and the severity of COPD symptoms. Increased ventilation, which led to lower internal temperatures, also worsened these symptoms – however, it was not possible to pinpoint the exact causation and interaction of these factors. Patients in older properties in poor repair had more symptoms. These factors have implications for strategic planning by local authorities and health services, particularly in relation to social housing managed by public services.
A more detailed study is necessary to demonstrate the causal connections between poor housing and the health of COPD patients, i.e. one that can consider the relative contributions of different elements (e.g. damp, humidity and ventilation). Any such study should include a control element.
Other research should focus on the causes of specific symptoms and potential sources of infection, which could be useful for the development of new medicines to prevent COPD from being aggravated.