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September 2003, Vol 93, No. 9 | American Journal of Public Health 1471-1477
© 2003 American Public Health Association

REVIEWING THE EVIDENCE

Healthy Housing: A Structured Review of Published Evaluations of US Interventions to Improve Health by Modifying Housing in the United States, 1990–2001

Susan C. Saegert, PhD, Susan Klitzman, DrPH, Nicholas Freudenberg, DrPH, Jana Cooperman-Mroczek, BS and Salwa Nassar, BS

Susan C. Saegert is with the Department of Psychology, City University of New York (CUNY) Graduate Center, New York City. Susan Klitzman and Nicholas Freudenberg are with the Program in Urban Public Health, Hunter College, CUNY, New York City. Jana Cooperman-Mroczek is a doctoral student in the Department of Psychology, CUNY Graduate Center. Salwa Nassar is with the Center on AIDS, Drugs, and Community Health, Hunter College.

Correspondence: Requests for reprints should be sent to Susan Saegert, Director, Center for Human Environments, City University of New York Graduate Center, 365 Fifth Ave, New York, NY 10016 (e-mail: ssaegert{at}gc.cuny.edu).

We sought to characterize and to evaluate the success of current public health interventions related to housing.

Two reviewers contentanalyzed 72 articles selected from 12 electronic databases of US interventions from 1990 to 2001. Ninety-two percent of the interventions addressed a single condition, most often lead poisoning, injury, or asthma. Fifty-seven percent targeted children, and 13% targeted seniors. The most common intervention strategies employed a one-time treatment to improve the environment; to change behavior, attitudes, or knowledge; or both. Most studies reported statistically significant improvements, but few (14%) were judged extremely successful.

Current interventions are limited by narrow definitions of housing and health, by brief time spans, and by limited geographic and social scales. An ecological paradigm is recommended as a guide to more effective approaches.




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