Dr. Nevil Pierse is deputy director of He Kainga Oranga/Housing and Health Research Programme. Originally a statistician by training, his current work is done in partnership with a wide variety of stakeholders including government and community organisations, and is focused on the design and implementation of randomised trials in the home and community. His previous studies have shown the benefits of efficient home heating and insulation, which was instrumental in the $300 Million EECA, Warm Up New Zealand, Heat Smart programme. Nevil’s other previous work includes the HRC funded Home Injury Prevention Intervention, which showed that simple home repairs and modification reduced the number of falls in homes by 27%. He was part of the group awarded the 2014 NZ Prime Ministers prize for Science. He is currently working on the Well Homes study which looks at home interventions to prevent rehospitalisation of children with respiratory disease. Nevil current leads the 'Ending Homelessness in New Zealand: Housing First' MBIE funded research programme and our Well Homes research project.
Housing And Health
Housing is a key social determinant of health. Much of New Zealand’s housing stock is old cold, damp and getting worse. Deferred maintenance is common and endemic in private rental housing.
Our previous randomised control trials have found that insulation, heating and injury prevention have all resulted in health benefits. We also showed a 4:1 Benefit to cost ratio from Warm Up NZ: Heat Smart programme, which showed a significant reduction in hospitalisation.
Well Homes is a community partnership approach to improving housing for whānāu of children hospitalised with housing sensitive hospitalisations. Well Homes partners Regional Public Health, Tū Kotahi Māori Asthma Trust, Sustainability Trust and He Kāinga Oranga collectively provide a partnership based housing service for eligible whanau of children hospitalised with housing sensitive hospitalisations.
From 2000 to 2014 a total of 88,712 housing sensitive hospital admissions occurred, for 67,918 unique children. 86.2% of these children were rehospitalised and 802 died. The odds of Rehospitalisation was 3.60 (3.55-3.66) times higher and the odds death were 10.44 (9.18-11.86) higher than for children admitted for other causes.
Health services struggle to deal with the underlying drivers of ill-health. Where housing is the underlying cause of disease, discharging the patients to the same housing is a poor solution.