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The effect of insulating existing houses on health inequality

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Summary:

This community based study utilised a randomised cluster design to determine whether insulating existing houses increased indoor temperatures and improved occupants’ health and wellbeing. The 1,350 households comprising 4,407 participants were based in seven low income communities in New Zealand. Whilst the energy consumption of insulated houses was 81% that of uninsulated homes, the relative humidity was lower (–2.3%) in those with insulation. Bedroom temperatures were warmer in insulated houses (0.5°C), with 1.7 fewer hours of temperatures below 10°C each day. There were also reduced odds of the following self reported measures in insulated homes: fair or poor health (OR 0.50; 95% CI 0.38-0.68); wheezing in the past three months (OR 0.57; 0.47-0.70); children absent from school (OR 0.49; 0.31-0.80); adults absent from work (OR 0.62; 0.46- 0.83). The occupants of insulated houses also reported less frequent GP visits (OR 0.73; 0.62-0.87) and fewer hospital admissions for respiratory conditions (OR 0.53; 0.22 to 1.29), although the latter was not statistically significant (p = 0.16).

Comment:
There are three major points to highlight in this paper. Firstly, it was a comprehensive study and many Mäori whanau/communities benefited as participants in the research. Ruth Nepia (Rakaipaaka) was instrumental in setting the study up prior to her passing in 2001 and I wish to acknowledge her hard work. Secondly the study found that avoidable deaths and hospitalisations for temperature related illnesses are a major and yet largely unrecognised problem in NZ. Finally, not having electricity or adequate heating has particularly serious consequences for our young, old and those people who are ill. The recent passing of Mrs Muliaga highlighted this. Hopefully appropriate changes in policy and practice result.
Reference: BMJ. 2007; 334:460
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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