Public health implications of poor housing

Introduction

Aibor and Olurunda (2007) define house as a building or premises constructed within the laid down building regulations to accommodate persons and their effects, and it must possess all the  necessary sanitary conveniences, providing comfort shelter, privacy, protecting and elongating life and preventing diseases. The World Health Organization (WHO) stated that house is the physical structure that man uses for shelter including all the necessary facilities, services, equipment and devices needed or desired for physical, mental, health and social well being of the individual.

Housing has an important role to play in every part of human being. It promotes human health if the house is suitable for its occupants. Poor houses are built all over the world due to certain factors. The National Housing Federation (NHF) (2007) charged with housing and mental health issues defined poor housing as dwellings that are cold and damp, overcrowded or badly designed and built.

Poor housing can therefore be described in terms of individual premises in relation to the physical condition and at a community level in terms of lack of community facilities, crime levels, employment and social support network (Thomson, 2002). Poor housing is an immediate environmental stressor that plays a major role in the psychological well being of residents both at an individual and community level. Increase in population results in housing inadequacy and sky-rocking prices of housing (Burus, 2011). Lack of technology makes people to settle in slums. Troubled area of the world, political disasters, civil wars and suicide bombing are other causes of poor housing. People should settle for standard housing (Umoru, 2001).

Olorunda, Olowoparija, Onojeharbo, Keme, Ogene, Adams (2007) stated that the nature of housing in rural areas is generally of bad conditions e.g. absence of infrastructures and bad environmental sanitation condition in Nigeria. These result to indiscrimination, dumping of human waste, soil contamination, water and food contamination, paved way for high incidence rate of communicable disease, e.g. tuberculosis, measles etc.

The physical conditions of a house like cracked walls, leaky roof, etc. could lead to symptoms and illness such as asthma, arthritis etc. Secondly, lack of personal hygiene which can also lead to disease condition. World Health Organisation (WHO, 2000) is of the opinion that overcrowding and poor ventilation is of a great problem in public health which leads to sustainability and proliferation of outbreak of airborne disease, breeding and infestation of vermin.

A house should satisfy the needs of inhabitants such as privacy, normal family life cleanliness and conveniences and provision of adequate protection against communicable disease, accident, and other condition.

Conceptual framework

World Health Organisation (WHO, 2000) defined housing as the physical structure including all the necessary facilities, services, equipment and devices needed or desired for physical, mental and social well-being of the family or individual. Housing units are designed for the habitation of a maximum number of inhabitants, if this number is exceeded; the housing unit automatically becomes a common problem or feature of fast developing society of the world today. Overcrowding results when the vacant floor available for each adult is less that fifty square feet.

The fundament physiological needs of adults are adversely interrupted since there is inadequacy of privacy and each of opportunity for normal family and community level. West African Health Examination Board (WAHEB)(1991), defines a house as a man made physical structure which is designed to meet specific purpose of man (shelter) which contributes to his health and existence.  A house could be residential, office (a place of work), shopping complex or factory depending on the need for which it is intended. The purpose for which it is intended will determine the type of facilities to be provided within the structure. The house should be sited in a suitable environment such that it will enable live a healthy life and make them undertake their various tasks with pleasure and reasonable comfort.

Umoru (2001) defined housing as the process of providing a large number of residential buildings on a permanent basis with adequate physical infrastructure and social services in planned, decent, safe and sanitary neighbourhood to meet the basic and special need of the population. The United Nations group of experts on housing and urban development defined housing as the environment in which a family, the basic unit in the society must develop. The continued further that housing is not a shelter or household facilities alone, but comprises a number of facilities, services and utilities which link individuals and their families to the community in which it involve. From the above, housing is not just a commodity but a combination of goods and services that facilitates and enhance good living.

Types of house/building

According to Damy (2010), the type of houses includes;

• Bungalow
• Duplex
• Single storey building
• Multi-storey building

Types of house can also be basically classified into Type A, B, C and Type D housing depending on the sanitary conveniences and the necessary requirement it possess with regard to housing authority specifications.

 Type A building

These are buildings that have the entire qualities essential for the comfort of man and his family. This type of house is sited in a good soil free from any kind of pollution and away from highway. The walls are cement plastered and the floor is supported with damp proof course (DPC). They are well concrete and cement plastered with adequate rooms in standard size measurement. The roof is made of durable materials and this type of house meet up with 100% of public health requirement (Aibor and Olorunda, 2006).

Type B building

This type of building is sited on good soil less of pollution, constructed with strong and impervious materials, strong walls and the floors are well constructed. Type B building meets up with 70% requirement of type A building. They require some little amendment and provision to make them meet up with the standard of type A building.

Type C building

These are houses constructed with mud. They are old and located in less desirable areas and need extensive renovation (Barber, 2009). The sanitary and health requirement are almost absent or partially provided.

Type D building

Barber (2009) stated that these buildings are made to serve temporarily. They are not constructed with durable materials. The condition of these houses is very poor in nature. They lack space, poor ventilation and no planning as well as being liable to cause an epidemic of disease. They are constructed with wood, bamboo, raffia or corrugated iron sheets and do not comply with the existing regulations or building adoptive bye-law.

The building adoptive bye-law

1. No building shall be erected except according to full working drawing and site plan approved by the health office, the works supervisor and town planning authority on four copies of such plans submitted by the owner.
2. No person shall build or erect any dwelling house so that the area covered by the building, together with that of all out houses appertaining there to shall exceed one half of the total area of the site.
3. There shall be an open space not less than five feet, six inches in width between any building boundaries of the site.
4. Every new wall shall have a proper damped proof course consisting of mortar mixed in the proportion of three parts of sand to one part of cement and laid to a thickness of at lest one and one-half damped proof course shall be laid below the level of the floor and at a minimum height of six inches above the surface of the adjoining ground.
5. The floor of any bathroom with fixed bath or the permanent sanitary fitting shall be of concrete with cement screened or other non – absorbent surface.
6. No drain shall normally be laid so that it passes through or under any building or portion thereof.
7. No person shall let or occupy any new building until the drainage thereof including disposal of surface water shall have been completed to the satisfaction of a health officer.
8. No person shall let or occupy any building until suitable latrine accommodation and approved by a health officer has been provided.
9. The disposal of domestic water and effluent shall be planned and executed to the satisfaction of a health officer. Waste water may be discharged into properly constructed soak away pit of adequate size filled with stones which are covered to a depth of not less than nine inches by packed earth adequately prevented from filling the space between stones.
10. No living room in any way shall have less than one hundred and twenty square feet of floor area an average height less than nine feet and width of less than eight feet.
11. Every room shall contain at least one window in one wall opening directly to the external air and the total of the window or window in any one room clear of the frames shall be equal to at least one eight of the floor area of the room. In addition, every room must have provision for cross ventilation in the form of either a second window or large ventilation in one of the other walls and this may open onto an internal corridor if the latter is ventilated at both ends.
12. On the completion of any building and before occupation thereof, the building shall be inspected by a health officer and the works supervisor on whose recommendation the council, or if it is so delegates, the town planning authority shall issue a certificate to the owner of the building stating that the building has been completed according to approved plans and is fit for occupation (Public Health Law Cap. 134, 1976).

Causes or factors responsible for poor housing

1. Lack of funding: Lack of funding has consequently reflected itself in the type of houses the masses can afford. With little income, many have been forced into shared accommodation whereby several poor families all live under one roof (Susan, 2003).
2. Ignorance: Ignorance and technical negligence on the part of the builders have led to proliferation of poor housing even though there are enough funds for the house; they lack knowledge of house planning before building. Failure to take into consideration the type of soil the building will be sited upon. Due to corruption, they purchase undesirable materials for the construction and after some time, the house may have signs of dilapidation which can result to one problem or the other (Omoru, 2011).
3. Lack of supervision: The neglecting attitude of the health officers towards housing inspection is very poor and one of the factors responsible for poor housing (Umoru, 2001) further stated that when regular and thorough inspection are vividly carried out in a pattern that is suitable. I will remind house owners their duties to pay attention in maintenance of their houses including provision of necessary facilities in the house.
4. Nonchalant attitude of the inmates: Most of the inmates who are living in rented homes have unusual attitude in terms of maintenance of the environment in which they inhabit. Instead of practising good housekeeping in the environs, they neglect to report any defect in the building because they are not the owner. Most inmates contribute to poor housing due to violent within their household (Federal Ministry of Environment FME, 2006).

Identification of poor housing in a community

According to Balchin (2008), a lot of ways have been brought into existence on how to identify houses that are poorly built. They include:

1. Broken floor: Poor housing is associated with broken floor within the house and this comes from the usage of undesirable materials on floating the floor of the building. The floor breaks easily and results to dust which can harbour micro-organism that cause disease condition among the inmates of the building.
2. Poor lighting: Absence of lighting is usually attached with poor houses in the rural areas and mostly riverine communities lack light in the building. People suffering from light deprivation are more likely to experience depression as well as eye strain, accident, etc.
3. Dilapidated building: It is a common problem especially in the rural area where non-durable materials are being used in construction of buildings. Dilapidation occurs when a building is in a state of disrepair and maintenance for a long period of time and this can lead to destruction of life and properties.
4. Leaky roof: Some poor houses usually go with leaky roofs and this is caused by localized damage of the aesthetics such as crack or blustered area of some part of the roof which can result to flooding within the house, leading to climatic factor and destruction of properties.
5. Lack of drainage system: Absence of drainage is usually common in a community. It is a problem that may exist from the start and develop over time due to inferior materials in construction of drains and lack of proper supervision coupled with maintenance of drainage system which cause flooding in the community.

Problems associated with poor housing

According to Smart (2005), the following are problems associated with poor housing;

• Odour nuisance
• Pollution of source of water supply
• Communicable diseases
• Accident
• Fire hazard
• Rodent infestation

Public health implication of poor housing

Health and social care are important area of service delivery and both have long established traditions in working with other sector organization. Damy (2010). He went further to state that some of the health and implication of poor housing are;

• It leads to air and noise pollution.
• High prevalence of diseases
• Poor housing leads to accidents
• Poor housing leads to excessive heat and cold
• Homelessness and insecurity.
• Poor educational attachment deprivation.

1. Air and noise pollution: When there are no adequate windows and doors in a house, it interferes with the normal air exchanging in a dwelling resulting to pollution. Also, houses that are constructed and located near factories, airports, roads or land prone to flooding are exposed to noise pollution and this may result to deafness, conjunctivitis, lungs cancer, hearing loss etc. All these occur as a result of receiving and inhaling dangerous fumes released from automobile and other chemical equipment used in such establishments.
2. High prevalence of diseases: Poor housing design triggers the occurrence and spread of diseases e.g. poor surface drainage in the house with stagnant pools encourage the breeding of mosquitoes and other disease carrying vectors which attack and transmit diseases to humans in their cause of feeding. Overcrowding and ill-ventilation also serves as a route in the transmission of respiratory or infectious disease such as tuberculosis, asthma, influenza, etc.
3. Accident: Most injuries and poisoning in a house is as a result of poor condition of the home, such as presence of dilapidated walls, cracked walls, broken floor etc. which result in vehicular accident, drowning, falls, accidental burning. These effects can also occur as a result of lack of different activities e.g. sitting-rooms, dining rooms, toilet, bathroom, etc.
4. Excessive heat and cold: Poor housing design causes exposure to excessive heat during the day and cold in the night. This is as a result of absence of ceiling or sagging ceiling and absence of DPC in the house as a result of stress, the occupier exercise during the night, his social activities are been disrupted in attention to make up for the loss sleep.
5. Homelessness and insecurity: The use of non-durable material in houses has resulted to many structural failures which expose the occupier to inclement weather and lack of security. The risk of violent attacks are high in poor houses compared to well built environment not only directly impacts our health, but also factor in less direct complex ways into the health of individuals residing in single family homes, housing projects, blocks, neighbourhoods and entire cities and communities. Homelessness causes depression when it occurs, the individual capability towards performing his social activities are reduced to residential environment, but can also found in commercial environments as far as housing is concerned.
6. Poor educational attainment and deprivation: The poor design and the materials used for constructing a house (school) often can render the environment unconducive for learning especially during extreme weather condition. These factors have serious health implications with attendant social and economic consequences including school absenteeism. Most children in poor house are more likely to underachieve in school compared with those from organised and improved areas.

Standard qualities and requirements of a good house

According to FME (2006), a good house should possess the following qualities and meet up with standard requirements which are stated below.

1. The site on which the building shall be sited should environmentally friendly.
2. Materials should be of adequate standard, durable and not pose danger to health.
3. The environment (internal and external) should be spacious enough to accommodate few properties and prevent overcrowding.
4. A damp proofed course and a smooth floor
5. Proper drainage system.
6. Sanitary conveniences with safe disposal of human waste.
7. Good natural and artificial ventilation system.
8. Good natural and artificial lighting.
9. Adequate wholesome water supply.
10. Provision for refuse storage.
11. Regular supervision of the premises to note any defect.
12. Cleanliness of the community/environment to ensure proper sewage management and use of sanitary dustbin for refuse collection.

Attitude of people towards poor housing accommodation in the community

The term attitude in this context denotes the way of thinking and behaviour of people in relation to poor housing accommodation. It refers to the way of thinking and behaviour of the public towards poor ventilation and overcrowding (Omotola, 1999). Umoru (2001) stated that ignorance and technical negligence on the part of builders and house owners are responsible for increase in poor housing accommodation in our society.

Osuide (2004) observed that the poorest people in a community are usually found living in squatter settlements and slums. This according to him is due to poverty. He also stated that the general public are not fully aware of the problems caused by poor housing. He also identified the unco-operative attitude of the public, industry owners, environmental health officers towards good housing sanitation as the major problem facing poor ventilation and overcrowding in Nigeria. This has led to shortage of dwelling housing unit characterised by disease, moral delinquency and the impairment of aesthetic values.

Roles of individuals, community and government in ensuring good housing

The public specifically or communities/government or individuals have vital roles to play to ensure good housing that will promote health (Fabuwa, 2002), further stated that a good housekeeping programme should be policy effective, inspection and continuous supervision and enforcement of housekeeping rules. These policies should be the co-operation of all and sundry to attain desired standard of housekeeping. Individuals should always inspect their areas for unnecessary defects within the building and the entire environment in order to put in place any defect sanitation and materials that may be injurious should be put into salvaging (Olorunda et al., 2007)

Housing inspection by environmental health officer is to promote good health. Secondly, it is an effective way of discovering conditions that are hazardous to the environment (Obomeokpere, 2008).

Ways of reducing the effect of poor housing in a community

According to Federal Ministry of environment (2006), regular inspection of community basically housing inspection is a way of reducing the effects of poor housing in a community. House and its environs should be inspected regularly to detect faults responsible for poor housing and renovate it to avoid disaster in the environment.

Individuals within the community should be health educated on the hazards associated with poor housing. Awareness campaign should be created for them to know the importance of good housekeeping, usage of quality materials and engagement in community sanitation (Cromady, 2004).

More resources should be made available by individuals or government to reduce exposure of the public to diseases and renovation of building. Enforcement of laws regarding good housekeeping should be implemented to arouse the interest of the public in ensuring good housing for their benefits.

Benefits of good housing

A lot have been confirmed in respect to good housing in terms of benefits which include the following;

1. Reduce property damage by improving maintenance.
2. Prevention of certain communicable diseases attached to poor housing.
3. It leads to a better hygienic condition towards improving the health standard of the community members.
4. Reduction of fire disaster in relation to good installation of electric wires.
5. Creation of suitable environment for human dwelling if the steps to standard house are followed chronologically (Handlex, 2007).

References

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