Housing and Institutional

Health
Definitions

The WHO Expert Committee defined housing as:

•The physical structure that man uses for shelter and the
environs of that structure including all necessary services,
facilities, equipment and devices needed or desired for the
physical and mental health and social well-being of the family
and individual.

• Every family and individual has a basic right to a decent home

and a suitable living environment.
 Definitions…
• Substandard housing is said to exist when
there are 1.51 or more persons per room in a
dwelling unit, when the dwelling unit has no
private bath or is dilapidated, or when the
dwelling unit has no running water.
 Definitions…
• A slum is ‘‘a highly congested, usually urban,
residential area characterized by deteriorated
unsanitary buildings, poverty, and social
disorganization’’

• In which dwellings lack private inside toilet and

bath facilities, hot and cold running water,
adequate light, heat, ventilation, quiet, clean air,
and space for the number of persons housed.
 Definitions…

• It is also a heavily populated area in which

housing and other living conditions are
extremely poor.

• A blighted area is an area of no growth in

which buildings are permitted to deteriorate.
• It has no use either for agricultural or
recreational purpuses
 Housing and health problems
Global
• 25% of world’s population, and 60% of
population in developing countries lack basic
housing.
• 15% the USA population and one third of the
entire developed countries population live in
substandard housing.  
 Housing and health problems
Housing and Health effects

• The effect is indirectly observed

• Hard to prove a cause and effect relationships
• Mainly observed in slum and substandard housing

• Classical example is the health survey on housing in

USA in 1945/1956 showed that there had been an
increased morbidity and mortality in substandard
housing as compared to the standard houses
 Basic Housing Principles
• The WHO adopted healthful housing criteria are as
follows.

1. Fundamental physiological needs

• Adequate living space, clean air, ventilation, indoor

lighting (natural day light and artificial light).
• Maintenance of thermal comfort
• Protection against excessive noise  
 Basic Housing Principles
2. Protection against diseases (contagion)

• Safe water supply

• Safe human waste disposal
• Safe solid waste management
• Liquid waste and storm water management.
• Personal & domestic hygiene
• Safe food hygiene
• Vector and rodents control  
 Basic Housing Principles
3. Protection against accidents (injuries,
poisoning)

• Structural features and furnishings safety: protection

against falls, collapse, and other mechanical injuries
• Chemical safety
• Electrical control & safety provisions
• Fire control & safety provisions and need for escape
• Protection against gas poisoning, e.g., CO
• Traffic accidents  
 Basic Housing Principles
4. Reducing Psychological and social stress

• Adequate living space, properly lit and ventilated

• Reinforcement of personal and family security
• Provisions of recreational sites for children and elders
• Access to community amenities: market, transport,
offices, etc
• Provision of clean air, water, and free of noise
environment
 Basic Housing Principles
5. Improving the Housing environment

• Access to security and emergency service: fire,

rescue, emergency medical service

• Access to social services: health service, school,

cultural centers, communication, water supply,
waste disposal, etc
 
 Basic Housing Principles
6. Protecting the population at special risk:

• High risk population groups: children, women,

elders, the sick and disabled

• Those who live in substandard housing: urban

slams, squatter settlements

• Displaced and mobile population

 Public health importance of
Housing
• Increased infections due to overcrowding and lack
of basic sanitary facilities leading Respiratory, GIT,
skin, and eye infections

• Increased infestation with rats, bed bugs, lice, flies,

mosquitoes
• Increased accidents: falls, fire

• Social problems: Juvenile delinquency, alcoholism,

prostitution, narcotics, etc.
Poor Housing →

→ Poor Health
 Institution Sanitation
Definition
• An institution is a complete property with
building, facilities, and services having a social,
education, or religious purpose.

• This includes schools, colleges and universities,

hospitals, nursing homes, homes for the aged, day-
care centers, jails and prisons, reformatories, and
the various types of federal, state, city, and county
welfare, mental, and detention homes or facilities.
 Hospitals and Nursing Homes

• Hospital-acquired, or nosocomial infections

results.

• The majority of nosocomial infections are

endemic.

• They may affect not only the patient who

develops the infection but also other patients,
the hospital staff, and the community as well.
 Hospitals and Nursing Homes
• The hospital is expected to provide an environment that will
expedite the recovery and speedy release of the patient.
•
• Carelessness can introduce contaminants and infections that
delay recovery and may overburden the weakened patient,
thereby endangering the patient’s survival.

• The most frequently reported pathogens:

• Escherichia coli,
• Staphylococcus aureus
• Pseudomonas aeruginosa
• Klebsiella spp.
• Enterobacter spp.
 Hospitals and Nursing Homes
• Basic to the prevention of nosocomial
infections are hygienic medical, nursing, and
staff practices

Including frequent
• hand washing
• equipment sterilization
• food, water, plumbing, air, laundering, linen handling,
and house keeping including
– floor cleaning to suppress dust,
– the prevention of overcrowding
 Schools, Colleges, and Universities

• These institutions should have all facilities that

are found in the community.
• Health service facilities
• Environmental health facilities
• Recreational facilities
• Other facilities
 Correctional Institutions

• Correctional institutions include short-term jails,

long-term prisons, and various types of detention
facilities.

• The health care services may include primary

health care services, secondary care services,
health care services for women offenders, mental
health care, dental care, environmental concerns,
nutrition and food services, pharmacy services,
health records, evaluation services, and staffing.
 Day-Care Centers
• Day-care centers provide an environment for
children of an age conducive to the spread of:
• Respiratory
• Contact
• Water, and food borne diseases
• They can also lead to other disease
complications.
 Day-Care Centers
• Diapering and food preparation and service are
critical activities requiring scrupulous
cleanliness and frequent hand washing.

• Enteric and respiratory disease transmission

via the fecal–oral route and by intimate contact
is more common among children in a day-care
center.
 Day-Care Centers
• Multiple pathogen infection is not uncommon.
• Cryptosporidium spp.
• Giardia lamblia
• Entameoba histolytica
• Salmonella
• Shigella sonnei
• E. coli (toxic strain), and
• Enteroviruses
 Day-Care Centers
• The increased interest and private, federal, and
state support of day-care centers and their
consequent expansion make their regulation an
important public health function.

• Here is an opportunity to apply known

preventive measures, including frequent hand
washing, hygiene, food sanitation, separation
of ill children, and education of staff and
management, in disease transmission and