Saegert SC, Klitzman S, Nicholas F, Cooperman-Mroczek J, Nassar S. Healthy housing: a structured review of published evaluations of US interventions to improve health by modifying housing in the United States, 1990-2001. American Journal of Public Health. 2003;93:1471-1477.
This review article characterizes and evaluates the success of public health interventions related to housing. Reviewers content-analyzed 72 articles of interventions conducted in the United States from 1990 to 2001. The reviewers' goals were to describe each intervention and its evaluation method, identify each study's strengths and limitations, and identify directions for future research, policy, and practice. Most of the interventions used one-time treatment attempts. Of the interventions reviewed, 92 percent addressed a single condition (usually lead poisoning, injury or asthma), 57 percent targeted children, and 13 percent targeted seniors. Most reported statistically significant results, though only 14 percent were judged to be extremely successful.
Results of the review indicate that current interventions are limited by narrow definitions of housing and health, brief time spans, and limited geographic and social scales. The authors recommend greater use of an ecological paradigm that incorporates increased focus on the social determinants of persistent disparities in health. A stronger focus on multilevel (individual, family, community, and/or state) determinants of health outcomes is also recommended as a more effective approach to health interventions as they relate to housing.
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