Effect of insulating existing houses on health inequality: cluster randomised study in the community
Open accessAbstract
OBJECTIVE: To determine whether insulating existing houses increases indoor temperatures and improves occupants' health and wellbeing. DESIGN: Community based, cluster, single blinded randomised study. SETTING: Seven low income communities in New Zealand. PARTICIPANTS: 1350 households containing 4407 participants. INTERVENTION: Installation of a standard retrofit insulation package. MAIN OUTCOME MEASURES: Indoor temperature and relative humidity, energy consumption, self reported health, wheezing, days off school and work, visits to general practitioners, and admissions to hospital. RESULTS: Insulation was associated with a small increase in bedroom temperatures during the winter (0.5 degrees C) and decreased relative humidity (-2.3%), despite energy consumption in insulated houses being 81% of that in uninsulated houses. Bedroom temperatures were below 10 degrees C for 1.7 fewer hours each day in insulated homes than in uninsulated ones. These changes were associated with reduced odds in the insulated homes of fair or poor self rated health (adjusted odds ratio 0.50, 95% confidence interval 0.38 to 0.68), self reports of wheezing in the past three months (0.57, 0.47 to 0.70), self reports of children taking a day off school (0.49, 0.31 to 0.80), and self reports of adults taking a day off work (0.62, 0.46 to 0.83). Visits to general practitioners were less often reported by occupants of insulated homes (0.73, 0.62 to 0.87). Hospital admissions for respiratory conditions were also reduced (0.53, 0.22 to 1.29), but this reduction was not statistically significant (P=0.16). CONCLUSION: Insulating existing houses led to a significantly warmer, drier indoor environment and resulted in improved self rated health, self reported wheezing, days off school and work, and visits to general practitioners as well as a trend for fewer hospital admissions for respiratory conditions.
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These indoor environment changes were sufficient to significantly improve the occupants' self-reported health and wheezing and reduce visits to doctors, days off work, and children's days off school.
“These indoor environment changes were sufficient to significantly improve the occupants' self-reported health and wheezing and reduce visits to doctors, days off work, and children's days off school (67).”
From Review of the Impact of Housing Quality on Inequalities in Health and Well-Being (2023) · cites this paper as [67]
The NZ Housing, Insulation and Health Study, a clustered intervention RCT conducted in 2001-2002 on retrofitted insulation in 1,350 households, resulted in a significant increase in indoor temperatures and a decrease in humidity in the insulated houses, as well as savings in energy consumption relative to control houses.
“The NZ program was augured by the Housing, Insulation and Health Study, a clustered intervention RCT conducted in 2001-2002 on the impact of retrofitted insulation in 1,350 households, which resulted in a significant increase in indoor temperatures and a decrease in humidity in the insulated houses, as well as savings in energy consumption relative to control houses.”
From Review of the Impact of Housing Quality on Inequalities in Health and Well-Being (2023) · cites this paper as [67]
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- Authors
- Howden-Chapman, P., Matheson, A., Crane, J., Viggers, H., Cunningham, M., Blakely, T., Cunningham, C., Woodward, A., Saville-Smith, K., O'Dea, D., Kennedy, M., Baker, M., Waipara, N., Chapman, R., & Davie, G.
- Affiliations
- University of Otago (NZ)
- Building Research Association of New Zealand (NZ)
- Massey University (NZ)
- University of Auckland (NZ)
- Ministry for the Environment (NZ)
- Victoria University of Wellington (NZ)
- ORCID
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2007-02-26
- Volume
- 334
- Issue
- 7591
- Pages
- 460
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC1808149
- OpenAlex
- W2126515835
- Cited by
- 521
- References
- 35
- Citations by year
- 2026: 27 · 2025: 24 · 2024: 26 · 2023: 27 · 2022: 21 · 2021: 37 · 2020: 26 · 2019: 33 · 2018: 22 · 2017: 38 · 2016: 30 · 2015: 21 · 2014: 24 · 2013: 30 · 2012: 28
- FWCI
- 25.41
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Ministry of Māori Development
- Topics
- Physical Sciences › Environmental Science › Pollution › Energy and Environment Impacts
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
- Physical Sciences › Engineering › Building and Construction › Building Energy and Comfort Optimization
- Keywords
- house insulation, indoor temperature, relative humidity, health disparities, low-income households, self-rated health, wheezing, energy consumption, general practitioner visits, hospitalization, respiratory diseases, housing conditions, New Zealand
- MeSH terms
- Absenteeism, Adult, Analysis of Variance, Environment Design, Family Practice, Health Status, Heating, Hospitalization, Housing, Humans, New Zealand, Patient Acceptance of Health Care, Poverty Areas, Socioeconomic Factors, Temperature, Cluster Analysis, Single-Blind Method, Sick Leave
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