LIT_045: Riggs et al. (2021) — Environmental Burden of Disease from Unsafe & Substandard Housing, NZ 2010–2017

LIT_045: Riggs et al. (2021) — Environmental Burden of Disease from Unsafe & Substandard Housing, NZ 2010–2017

Source

doi:10.2471/blt.20.263285 — original publication (opens in a new tab; the file is not redistributed)

Summary

Riggs, Keall, Howden-Chapman & Baker (2021), in the Bulletin of the World Health Organization, quantify the cost of New Zealand’s unsafe and substandard housing. Focusing on the four most relevant conditions — crowding, cold, dampness/mould and fall-injury hazards — they estimate the annual hospitalisation burden, deaths and public-sector cost using population attributable fractions applied to government hospitalisation, ACC injury-claim and mortality data. The headline is a direct public-sector cost of about **NZ141 million per year** and around **229 deaths annually** (societal cost ≈ NZ1 billion), with damp and mouldy housing the single largest contributor. This is the primary study behind the burden figures the wiki previously carried via the Howden-Chapman review (LIT_044); for Neobiome Intelligence it is the evidential backbone of the avoided-cost (health-investment) case for high-performance, healthy housing.

Key claims

- claim: "Riggs, Keall, Howden-Chapman & Baker (2021) estimated New Zealand's burden of disease from unsafe and substandard housing for 2010–2017, focusing on crowding, cold, dampness/mould and fall-injury hazards; they used population attributable fractions with existing exposure–response relationships, applied to government hospitalisation data, ACC no-fault accident claims and mortality data, and valued deaths using value-of-a-statistical-life measures."
  source_location: "Abstract (Objective, Methods); §Methods"
- claim: "Annual hospital nights attributable to housing conditions: household crowding 806; cold homes 1,834; dampness and mould 36,649. Home injury hazards resulted in 115,555 accident claims annually. Damp and mouldy housing accounted for a substantial proportion of the total burden."
  source_location: "Abstract (Findings); §Results"
- claim: "Direct public-sector costs attributable to these housing conditions were approximately NZ$141 million annually (US$100 million). An estimated 229 deaths annually were attributable to adverse housing, with the cost to society from these deaths around NZ$1 billion (US$715 million)."
  source_location: "Abstract (Findings); §Results"
- claim: "Context (NZ): in a 2018–2019 government survey of 12,000 households, 34% of New Zealanders reported homes sometimes/always damp and 36% reported mould; 2020 temperature measurements in ~6,700 homes found one-third had an average daytime indoor temperature below 18°C; in 2018 approximately half (388,310) of the 785,063 new fall-injury claims occurred in the home."
  source_location: "§Introduction"
- claim: "Conclusion: improving people's living conditions could substantially reduce total hospitalisation costs and potentially improve quality of life."
  source_location: "Abstract (Conclusion)"

Neobiome Intelligence relevance

• I01 — the avoided-cost / health-investment case (primary-sourced). The NZ141m/yr direct public-sector cost and ~229 deaths/yr (≈NZ1bn societal) are now from the primary study, not a review LIT_045. This is the quantitative backbone for treating high-performance, healthy build cost as health investment — the economic counterweight to the capex premium in CR_017.
• healthy_housing + D04 — damp/mould is the dominant lever. Dampness/mould drives 36,649 of ~39,000 attributable hospital nights — overwhelmingly the largest contributor — confirming that moisture control (ventilation + warmth), not warmth alone, is the highest-impact habitat-health intervention LIT_045.
• Resolves RT_056 (the LIT_044 upstream primary).
• ⚠ Method caveat: these are modelled attributable burdens (population attributable fractions on existing exposure–response relationships), not directly measured outcomes — robust for an order-of-magnitude avoided-cost case, but cite as an estimate.

Research targets

Research gaps

• The avoided-cost per dwelling of moving from substandard to healthy housing (this study gives the national aggregate) — needed to put a per-home health-benefit figure alongside the per-dwelling capex premium in the model’s ④c building-standards economics.

Connections

Links to

Sources (2): CR_017 · LIT_044

Referenced by

Concepts (1): Healthy Housing — Warmth, Dryness & Wellbeing

EDT domains (1): D04: Sustainable Habitat & Building Technology

SSI indicators (1): I01: Financial & Economic Self-Sufficiency