Children's respiratory health in the context of housing and other social determinants in Rosengård: a cross-sectional study in an immigrant neighbourhood in Sweden

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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 not only of
dampness and mould in the apartments, but also with information on numerous other
behavioural and social determinants of health.
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.
In order to sustainably address health inequalities rooted in complex webs of social,
economic, and behavioural determinants, the health system needs to move beyond
interdisciplinary towards intersectoral cooperation.
Original languageEnglish
Place of PublicationLund
PublisherAvdelningen för Arbets- och miljömedicin, Lunds Universitet
Number of pages63
Volume05/2014
Publication statusPublished - 2014 May

Subject classification (UKÄ)

  • Public Health, Global Health, Social Medicine and Epidemiology

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