Maria Gatto, from the National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Health Housing, discusses the relationship between housing condition and psychological distress.
A sizeable number of people in the UK have chronic respiratory health problems (around 12 million) and an even greater number are estimated to live in homes with damp and mould (around 15 million according to new data from Health Equals).
Given that living in damp housing is known to trigger symptoms in people with poor respiratory health, this constitutes a critical public health problem.
However, there is little research on how living in damp conditions impacts resident’s mental health. Importantly, little research exists on how living in damp conditions might impact the mental health of people in poor respiratory health who are more vulnerable to the negative health effects of exposure.
This has relevance to developing targeted healthy housing policy – for example, government supported priority remediation of damp in homes of people with asthma.
To address this critical research gap, we set out to examine the effects of damp housing on mental health, and test if this association was stronger for people with chronic respiratory conditions.
What we studied
Using data from the British Household Panel Survey (BHPS), we examined the degree to which psychological distress is associated with exposure to damp housing. In other words, houses with condensation, a leaky roof, damp walls and/or floors or rot in windows and/or floors.
We chose to do this for people aged 16 years and older over a 12-year period.
Why is data from the British Household Panel Survey useful?
The BHPS is one of few longitudinal datasets worldwide that includes both validated mental health screening tools (for example, the General Health Questionnaire) and measures of damp housing exposure for the general population (rather than just a single group). As such, we were able to examine exposure and impacts over time.
Comparable, national, population-level datasets such as the Housing, Income and Labour Dynamics in Australia (HILDA) survey, do not currently contain physical housing condition variables.
Additionally, the BHPS includes four different indicators for damp housing, as opposed to a single more generalist question on, for example, whether your home has visible mould.
This meant we could approximate severity of exposure and assess the impact of different types and combinations of dampness exposures, with one example being condensation versus rot.
What we found
1. Overall, exposure to dampness increases the risk of psychological distress
People who became exposed to damp housing had a 9% increased risk of psychological distress compared with people who were not exposed. For every additional dampness indicator reported, people’s risk of psychological distress increased by 4%.
We suspect a range of factors are involved in this association.
2. Condensation is the strongest risk factor for psychological distress
Among all the dampness indicators, condensation consistently proved to be the strongest predictor of psychological distress. This was the case for condensation alone, as well as for condensation combined with other dampness indicators.
This could be due to condensation being the most common exposure among the indicators, but it also could be that it is the most consistently visible exposure, making its presence more stressful compared with the less obvious exposures.
3. People living with a chronic respiratory condition are at greater risk of psychological distress
When we compared the link between damp housing and psychological distress in people with or without a chronic respiratory condition, the risk for people living with a chronic respiratory condition was three times that for people in good respiratory health.
Why? We think several factors could explain our findings.
First, because home dampness increases the risk of asthma exacerbations, the increased symptom burden and stress of managing symptoms may induce psychological distress.
It is also likely that just being aware of one’s housing conditions may be enough to cause stress anxiety over the potential for exacerbations and symptoms.
There may also be a connection with the medications people take to manage respiratory flare-ups which have psychological side effects.
It therefore may be a vicious cycle of exposure to dampness, respiratory flare ups, medication use, and fear of potential future repercussions of one’s housing conditions.
What are the implications?
Exposure to damp housing was found to negatively affect mental health overall, but more so for people living with a chronic respiratory condition.
Our results suggest that interventions focused on remediating dampness in homes are best targeted first towards people living with conditions such as asthma and chronic obstructive pulmonary disease (COPD), as those interventions may show a twofold benefit on both their physical and mental health.
What’s next?
More research is needed in this area.
Other groups—such as renters, people living on low incomes or minorities—may also be more vulnerable to mental health effects from damp housing, which warrants further investigation.
We also need more information as to why damp housing affects mental health. This area could also benefit from intervention studies looking at the physical and mental health effects of remediating damp housing (for example removal of visible mould or installation of efficient ventilation systems).
To try and fill some of these gaps, we are currently conducting qualitative research focused on the experience of living in mould-affected rental housing.
Read more
The research presented in this blog post is based on two recent open-access publications (overall and respiratory associations) that can be accessed online.
These works were co-authored by Ang Li, Erika Martino, and Rebecca Bentley at the National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Healthy Housing, Melbourne School of Population and Global Health at the University of Melbourne.
About the author
Maria Rosa Gatto is a PhD candidate and research fellow at the NHMRC Centre of Research Excellence, Melbourne School of Population and Global Health, the University of Melbourne.
Her research used mixed methods to quantify and explain the link between mould-affected housing and mental health.
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