Identifying potentially unhealthy housing conditions in Rosengård – a cross-sectional study in immigrant households with small children in Sweden
Abstract: The social determinants of health form a complex and dynamic web, shaping both population and individual health and disease. The built environment and especially human dwellings influence health in many ways. Associations between factors such as dampness, mould growth, heating/insulation, and crowding on the one hand and respiratory health and infectious diseases on the other hand have been studied in several populations. In Sweden, social and health inequalities have slowly been increasing. The linkages between them have however not been characterized in detail. In this cross-sectional study, the apartments of families of children with respiratory symptoms living in a socially disadvantaged immigrant neighbourhood in Malmö, in which the incidence of bad housing was known to be high, were assessed for potentially harmful housing-related exposures. This information was correlated with subjective questionnaire-based assessments of dampness and mould in the apartments. While agreement between objective and subjective assessments was generally only fair, the questions performed better at excluding relevant exposures. The utility of screening questions related to housing is related to the prevalence of the exposure in the population and to the default plan of action. A case is made for interdisciplinary home visits to be the default option in families of children with respiratory symptoms. The overall prevalence of other contributory factors that are potentially harmful to health was high in this population; potentially protective factors were distributed unevenly as well. Factors related to the built environment cannot and should not be seen in isolation, as they often co-vary with other social determinants of health. Housing is however an important pathway along which social inequalities translate into health inequalities.
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