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The Watcombe Housing Study: the short term effect of improving housing conditions on the health of residents


Objective: To assess the short term health effects of improving housing.

Design: Randomised to waiting list.

Setting: 119 council owned houses in south Devon, UK.

Participants: About 480 residents of these houses.

Intervention: Upgrading houses (including central heating, ventilation, rewiring, insulation, and re-roofing) in two phases a year apart.

Main outcome measures: All residents completed an annual health questionnaire: SF36 and GHQ12 (adults). Residents reporting respiratory illness or arthritis were interviewed using condition-specific questionnaires, the former also completing peak flow and symptom diaries (children) or spirometry (adults). Data on health service use and time lost from school were collected.

Results: Interventions improved energy efficiency. For those living in intervention houses, non-asthma-related chest problems (Mann–Whitney test, p = 0.005) and the combined asthma symptom score for adults (Mann–Whitney test, z = 2.7, p = 0.007) diminished significantly compared with control houses. No difference between intervention and control houses was seen for SF36 or GHQ12.

Conclusions: Rigorous study designs for the evaluation of complex public health and community based interventions are possible. Quantitatively measured health benefits are small, but as health benefits were measured over a short time scale, there may have been insufficient time for measurable improvements in general and disease-specific health to become apparent.

  • BTS, British Thoracic Society
  • GHQ, general health questionnaire
  • SAP, standard assessment procedure
  • SF36, 36 item short form health survey
  • housing
  • health service utilisation
  • quality of life
  • respiratory illness
  • community participation

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