House overcrowding disease fears

Overcrowding in homes is causing serious disease and death, with the issue needing urgent attention, researchers say.

Infectious disease from household overcrowding accounted for one in 10 admissions to New Zealand hospitals for the treatment of infectious diseases,  such as pneumonia, meningococcal disease and tuberculosis, a new study showed.

The researchers at the University of Otago Wellington campus released the findings this morning.

For Maori and Pasifika people, the figure jumped to one in five, research revealed.

Lead investigator Professor Michael Baker, who was assisted by Dr Andrea McDonald and He Kainga Oranga Housing and Health Research Programme colleagues with the research, said there was "a very real and urgent need to lower overcrowding as a first step to reducing serious diseases among New Zealand's most vulnerable populations.

"These studies provide consistent evidence that household crowding is an important risk factor for nine major categories of infectious disease - gastroenteritis, hepatitis A, Helicobacter pylori infection, pneumonia and lower respiratory infections, upper respiratory infections, Haemophilus influenzae disease, bronchiolitis, meningococcal disease and tuberculosis.

"Across these diseases, household crowding is estimated to cause more than 1300 hospital admissions a year in New Zealand, along with some deaths."

The study highlights large ethnic inequalities and is particularly relevant to child health, Baker said.

"Most of the diseases in the study have especially high rates in children. Children are more susceptible to meningococcal disease, gastroenteritis, pneumonia and most other infectious diseases, and our analysis shows that their risk is strongly associated with exposure to household crowding."

"In terms of ethnicity, the research shows that for European/Others, exposure to household crowding is estimated to cause 5 per cent of hospital admissions (in the nine disease groups examined). For Asian peoples, the figure is 13 per cent. For Maori the estimated contribution rises to 17 per cent, and for Pacific peoples it rises to 25 per cent."

The study was a significant step forward in understanding these huge ethnic inequalities, Baker said.

"Fundamentally what it reveals is a very real and urgent need to lower household crowding as a first step to reducing these serious diseases among our most vulnerable populations."

Interventions such as Housing New Zealand's Healthy Housing Programme in Auckland, Northland and Wellington, which focused on reducing crowding, improving housing conditions and linking households to health and social services, was successfully lowering hospitalisation rates for children in those areas, he said.

"The budget announcement to add 3000 new state house bedrooms and 500 new homes is promising, but considerably more social housing will be needed to have a significance impact on infectious diseases.

"New Zealand faces a severe shortage of affordable housing. The proportion of children exposed to household crowding has been rising in New Zealand.

''About 45 per cent of Pacific children and 28 per cent of Maori children are living in crowded houses, compared with 8 per cent of European/Other children.

''New Zealand needs a large-scale programme to construct thousands of additional social and affordable houses if it wants to reduce household crowding and prevent many cases of serious infectious disease."

The study was a world-first systematic review and analysis of global literature on crowding and infectious disease.

The findings were combined with housing data from the 1991, 1996, 2001 and 2006 censuses, and previous Health Research Council-funded University research showing a dramatic jump in admissions to New Zealand hospitals for infectious diseases over the last two decades.

The review started with almost 10,000 published studies from which researchers selected the most relevant and highest quality 350 reports.