Background

The aim of the HHIs are to increase the number of at-risk children living in warm, dry and healthy homes and to reduce avoidable hospitalisations due to housing-related conditions.

The HHIs were established between December 2013 and March 2015 and cover 11 District Health Boards (DHBs) with a high incidence of rheumatic fever (including Auckland, Waitemata, Counties Manukau, Northland, Waikato, Hutt Valley, Capital & Coast, Lakes, Bay of Plenty, Hawke’s Bay and Hauora Tairâwhiti). Initially, the HHIs targeted low-income families with children at risk of rheumatic fever who were living in crowded households. The breadth of the programme was expanded in 2016 to focus more broadly on warm, dry and healthy housing for low-income families with 0 to 5 year-old children and pregnant women.(expanded eligibility criteria include: 0-5 year olds hospitalised with a specified housing-related indicator condition; families with children aged 0-5 years old for whom at least two of the social investment risk-factors; or pregnant women and newborn babies).

The HHIs identify eligible families, undertake a housing assessment and then work across agencies to facilitate access to a range of interventions to create warmer, drier, healthier homes, such as: insulation, curtains, and private/community/social relocation.  They also educate families how to change their behaviour and practices to keep a house warm and dry, and to reduce risks associated with household crowding.

Research Design

This project will use a basic case-control framework for the analysis; however, selecting good controls will be essential for providing accurate estimates of effectiveness.  Since there is limited information about housing conditions for those households that have not had an assessment, the selection of a control group becomes difficult.  The basic approaches likely to be used and some of the difficulties or limitations of these approaches are summarised in the table below.  The approach used for any given analysis will differ depending on the outcome and group under evaluation as well as the data used for the analysis.

For further information please contact Associate Professor Nevil Pierse by nevil.pierse@otago.ac.nz