Transcript The WHO Housing and health policy
Slide 1
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 2
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 3
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 4
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 5
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 6
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 7
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 8
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 9
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 10
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 11
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 12
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 13
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 14
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 15
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 16
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 17
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 18
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 19
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 20
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 21
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 22
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 23
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 24
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 25
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 26
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 2
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 3
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 4
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 5
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 6
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 7
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 8
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 9
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 10
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 11
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 12
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 13
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 14
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 15
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 16
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 17
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 18
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 19
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 20
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 21
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 22
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 23
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 24
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 25
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health
Slide 26
The WHO
« Housing and Health policy »
Xavier Bonnefoy / Matthias Braubach
WHO-European Centre for
Environment and Health, Bonn Office
WHO European Centre for Environment and Health
Structure
• Housing and health – the challenging trends
• The WHO approach to housing and health
• Priority work areas
• WHO activities on housing and health
WHO European Centre for Environment and Health
The emerging problems (1)
Life expectancy has risen from 50 years
to 80 in less than a century, while the
exchange rate of the housing stock is at
ca. 1% per year
WHO European Centre for Environment and Health
Housing stock for Germany, 2050
Still to
be built
Already
existing
in 2005
WHO European Centre for Environment and Health
The emerging problems (2)
The number of people with physical
limitations living in their own
dwelling increases every year
WHO European Centre for Environment and Health
Accessible housing
European Disability Forum 2002:
% of population being limited in their daily activities due to
handicaps (based on Eurostat)
“A specific comment is to be made in the case of
Strongly
Strongly
Partially
limited
...and
housing.
Our research
highlights
the
high
level of
limited
–
4%
limited
– 9%
for the
inaccessibility
of22%
housing for many disabled people,
Not limited
popula-is close to 66%. The lack of accessibility
which
is
47%
tiononly due to architectonical barriers; financial
not
above in housing are quite important, in particular
barriers
65
because
of the
extra costs of adapting inaccessible
Partially
Not
limited –
years:
limited
dwellings.”
87%
31%
WHO European Centre for Environment and Health
Data provided by: European Disability
Forum / Eurostat
The emerging problems (3)
The world is facing a new energy
crisis, and Europe is not wellprepared for supporting the most
underprivileged (private households account
for ca. 50% of energy consumption)
WHO European Centre for Environment and Health
Excess winter deaths UK
Mortality (all causes) in relation to
the lowest point in summer
=> BLUE LINE: for coldest dwellings
=> RED LINE: for hottest dwellings
WHO European Centre for Environment and Health
Data provided by:
Dr Wilkinson et al. (2001)
The emerging problems (4)
In Europe, relevant regulations for
construction work, maintenance of the
housing stock, and rehabilitation
programs are mostly out of influence of
ministries of health
WHO European Centre for Environment and Health
Legal responsibility
Ministry of Housing /
Construction
Ministry of
Health
Building guidelines
Housing conditions
Health effects
Impact assessments
Law enforcement
Ministry of
Social Affairs
Ministry of
Environment
Ministry of Consumer Protection
WHO European Centre for Environment and Health
The emerging problems (5)
Poverty and inequalities are increasingly
affecting the housing market – social
segregation is rising while the public and
social housing stock is reduced or
privatized
WHO European Centre for Environment and Health
Poverty and housing (data for 2000)
Vandalism / crime
Households with
income under 60%
of median income
Damp / untight
roof
Inadequate
heating
Total population
Neighbourhood
noise
Households with
income over 140%
of median income
Crowding
%
0
5
10
15
20
WHO European Centre for Environment and Health
25
30
Source: Eurostat
The emerging problems (6)
Home safety issues are an underestimated
section of unintentional injuries and are
mostly relevant for vulnerable groups
such as children and elderly
WHO European Centre for Environment and Health
Unintentional injuries by causes
United Kingdom
Per year
France
Killed persons Injured persons Killed persons Injured persons
On the road
380
3600
In the home
4100
At work
1 500 000
317 000
2 700 000
700*
7600
9000
1 150 000
170 000
3 000 000
(*) among which 300 road accidents
EU-15 (2004):
130.000 fatalities (54% home and leisure)
Killer No. 1 for age group 1-45 years
More than 10% of all health care costs
WHO European Centre for Environment and Health
Data provided by: Min. of Health France / UK
Slide prepared by: Prof Ormandy / WHO
The emerging problems (7)
Urban patterns and residential
environments are often cardependent and provide little
opportunities for children to play or
for outdoor physical exercise
WHO European Centre for Environment and Health
Obesity and housing environments
Obesity is a normal response
to an abnormal environment
WHO European Centre for Environment and Health
Data / Pictures provided by:
Prof Moreno / CDC, USA / WHO ECEH Bonn
A new approach to
housing and health
Housing and health...
• is more than „sanitation, crowding and
indoor air quality“
• needs a much wider definition
• is not only a responsibility of the health or
housing ministry
• must integrate societal changes
WHO European Centre for Environment and Health
…I urge individuals, businesses,
and local and national
governments to take up the urban
environmental challenge…let us
create « green cities » where
people can raise their children
and pursue their dreams in a well
planned, clean and healthy
environment.
Kofi Annan, 05 June 2005
WHO European Centre for Environment and Health
The WHO approach (1)
Housing is...
WHO European Centre for Environment and Health
The WHO approach (2)
Sectoral and focused studies are needed, but often
not sufficient:
• Potential associations may be overlooked
• The relative importance of selected housing factors among other factors - is not clear
• The effect of multiple exposure (cocktail effect)
cannot be identified
• The interaction between dwelling and resident is
often underestimated
• Social and mental factors / outcomes often neglected
WHO European Centre for Environment and Health
The WHO approach (3)
Effective work on housing and health needs
to consider:
• The realistic experience of housing
• The relevance of a holistic approach bringing
together all housing areas and domains
• Work on cross-cutting issues dealing with
more than one aspect is to be prioritised
• Hard data and soft data is both needed to
reflect the impact of housing on health
WHO European Centre for Environment and Health
Priority work areas
Working areas touching or merging a variety of
housing aspects (technical, economic, architectural, material, user-related...) are e.g.:
• Noise exposure / home as place to sleep
• Energy efficiency / thermal comfort
• Indoor air quality, tightness, air exchange
• Architecture and design in relation to home safety
and accessibility
• Residential environment and leisure / transport
options
• Etc.
WHO European Centre for Environment and Health
Some priority work areas for CEE
• Maintenance of the housing stock
• Access to (social) housing
• Energy efficiency measures of the housing
stock (considering air quality issues)
• Residential environment / social stability
• Safety of housing to avoid home accidents
WHO European Centre for Environment and Health
The political response of WHO
Budapest ministerial declaration (Art. 14c)
- We call for initiatives and programmes aimed at providing
national and local authorities all over the region with
guidance for integrating health and environment concerns
into housing policies.
Children Environment and Health Action Plan for Europe
Priority 1: access to adequate sanitation
Priority 2: promoting safe, secure and supportive human
settlements to avoid accidents / injuries
Priority 3:ensure an environment with clean air
Vilnius housing and health symposium – final declaration
- We affirm that a decent home for all citizens is to be a
priority target for all national and local governments
WHO European Centre for Environment and Health
The technical response of WHO
- WHO Large Analysis and Review of European
housing and health Status (LARES survey)
- Housing and Health indicator set for the European
Environmental Health Information System
- Urban pests and health
- Legal framework of housing and health
- Child accident prevention
- Night noise guidelines
- Housing and Health Action Plan (Portugal)
- Environmental Burden of Disease for housing
- Longitudinal study on housing interventions
- Information brochures on housing-related topics
WHO European Centre for Environment and Health
Thank you!
Further information at
www.euro.who.int/housing
WHO European Centre for Environment and Health