An analysis of a healthy housing initiative and its implications for public policy

Abstract

The NSW Ministry of Health has implemented the NSW Housing for Health (HfH) program since 1997, to improve home hardware to support householders practice safe and healthy living. Using program data from 1998-2017 this PhD thesis aimed to assess: if Aboriginal community housing in NSW functions to provide an environment that supports householders to practice safe and healthy living; if any changes in housing functionality over time are associated with the NSW HfH program; the financial cost of the program to bring Aboriginal community housing up to a minimum standard of functionality that supports householders to practice safe and healthy living; how a comprehensive economic analysis could be undertaken that includes the associated health, social, economic and intangible benefits generated from the NSW HfH program, and; the future challenges climate change presents for Aboriginal populations in NSW including implications for community housing and public policy.

The thesis reviews literature on housing as a social determinant of health and quantifies the program’s impact on improving house functionality. It identifies social, demographic and geographic factors influencing housing conditions in NSW, and details associated fix-work costs with changes over two decades. A scoping literature review found very few international economic evaluations explicitly consider health improvements, and none with the equivalent scope of HfH. A protocol for an ex-post cost-benefit analysis is proposed to quantify and monetise a broad range of benefits potentially associated with the NSW HfH program. Using publicly available socio-demographic, meteorological, and climate data, and future climate projections, the thesis quantifies climate change impacts on NSW Aboriginal populations and outlines considerations for health and adaptation planning. Recommendations address the NSW Health HfH program, the broader community housing sector, and strategies to support climate resilience.