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Health Inequalities and Indoor Environments

Health Inequalities and Indoor Environments

How do indoor environments affect health inequalities, inequities and injustice?

Health inequalities are a crucial aspect of public health and a pressing societal challenge. Access to healthy indoor spaces that are optimised to promote health should be seen as a fundamental right for all. This special issue is a starting point for the built-environment and public health communities to identify many existing inequities in order to improve methodological approaches, share vocabularies between disciplines, and create new knowledge necessary to create a safe and healthy indoor environments for all. Equitable design could translate into prioritising air quality improvements in the homes of people suffering from respiratory conditions, introducing inclusive design elements for disabled people, or providing energy retrofit subsidies to low-income, fuel-poor households.

Guest editors: Anna Mavrogianni & Marcella Ucci

There is compelling evidence that aspects of indoor environments, e.g. thermal, visual, acoustic conditions and air quality, can adversely affect health, but the role of indoor environments in health inequalities is less understood.

One fundamental question for public health and built-environment research is understanding how and to what extent indoor environments act as effect modifiers of structural inequalities or of other intermediary factors (e.g. outdoor conditions). This would then help address the other fundamental question: which pathways or levers pertaining indoor environments may be most effective at removing inequalities and delivering health equity?

The terms 'health inequality', 'health equity' and 'social determinants of health' deserve explanation.  Health inequality refers to mapping and understanding health disparities and their root causes. This can refer to differences in health status (e.g. life expectancy) but also in access to or quality of healthcare services, as well as differences in risky health behaviours (e.g. smoking) and, more broadly, differences in the wider 'social determinants of health'. The latter are deeply intertwined with the notion of health inequalities, framing health as a social phenomenon and emphasising how an individual's (or a group's) position in society plays a central role in health inequities. The most important structural stratifiers and their proxy indicators include: income, education, occupation, social class, gender and race/ethnicity (WHO Commission on the Social Determinants of Health). Several 'intermediary determinants' shape health outcomes-these include 'material circumstances', such as indoor (and outdoor) environmental conditions where people live and work. The term 'equity' refers to the principles that should guide the identification of potential 'fair' solutions.

The papers published in this special issue illustrate what can be achieved by integrating different methods (e.g. building stock modelling and focus groups) and data sources (e.g. Energy Performance Certificates and mental health data). Beyond their specific findings, the papers are a significant and novel contribution to the literature by providing a blueprint for the successful synthesis of methods and materials originally produced by different disciplines and sectors, and discussing the challenges and opportunities of their respective study designs and approaches.

Table of contents

Health inequalities and indoor environments: research challenges and priorities [editorial]
M. Ucci & A. Mavrogianni

Assessing retrofit policies for fuel-poor homes in London
M. C. Georgiadou, D. Greenwood, R. Schiano-Phan & F. Russo

IAQ and environmental health literacy: lived experiences of vulnerable people
C. Smith, A. Drinkwater, M. Modlich, D. van der Horst & R. Doherty

Linking housing, sociodemographic, environmental and mental health data at scale
P. Symonds, C. H. Simpson, G. Petrou, L. Ferguson, A. Mavrogianni & M. Davies

Measuring health inequities due to housing characteristics
K. Govertsen & M. Kane

A population-level framework to estimate unequal indoor heat and air-pollution exposure
R. Cole, C. Simpson, L. Ferguson, P. Symonds, J. Taylor, C. Heaviside, P. Murage, H. Macintyre, S. Hajat, A. Mavrogianni & M. Davies

Latest Peer-Reviewed Journal Content

Journal Content

The unfitness of dwellings: why spatial and conceptual boundaries matter
E Nisonen, D Milián Bernal & S Pelsmakers

Environmental variables and air quality: implications for planning and public health
H Itzhak-Ben-Shalom, T Saroglou, V Multanen, A Vanunu, A Karnieli, D Katoshevski, N Davidovitch & I A Meir

Exploring diverse drivers behind hybrid heating solutions
S Kilpeläinen, S Pelsmakers, R Castaño-Rosa & M-S Miettinen

Urban rooms and the expanded ecology of urban living labs
E Akbil & C Butterworth

Living with extreme heat: perceptions and experiences
L King & C Demski

A systemic decision-making model for energy retrofits
C Schünemann, M Dshemuchadse & S Scherbaum

Modelling site-specific outdoor temperature for buildings in urban environments
K Cebrat, J Narożny, M Baborska-Narożny & M Smektała

Understanding shading through home-use experience, measurement and modelling
M Baborska-Narożny, K Bandurski, & M Grudzińska

Building performance simulation for sensemaking in architectural pedagogy
M Bohm

Beyond the building: governance challenges in social housing retrofit
H Charles

Heat stress in social housing districts: tree cover–built form interaction
C Lopez-Ordoñez, E Garcia-Nevado, H Coch & M Morganti

An observational analysis of shade-related pedestrian activity
M Levenson, D Pearlmutter & O Aleksandrowicz

Learning to sail a building: a people-first approach to retrofit
B Bordass, R Pender, K Steele & A Graham

Market transformations: gas conversion as a blueprint for net zero retrofit
A Gillich

Resistance against zero-emission neighbourhood infrastructuring: key lessons from Norway
T Berker & R Woods

Megatrends and weak signals shaping future real estate
S Toivonen

A strategic niche management framework to scale deep energy retrofits
T H King & M Jemtrud

Generative AI: reconfiguring supervision and doctoral research
P Boyd & D Harding

Exploring interactions between shading and view using visual difference prediction
S Wasilewski & M Andersen

How urban green infrastructure contributes to carbon neutrality [briefing note]
R Hautamäki, L Kulmala, M Ariluoma & L Järvi

Implementing and operating net zero buildings in South Africa
R Terblanche, C May & J Steward

Quantifying inter-dwelling air exchanges during fan pressurisation tests
D Glew, F Thomas, D Miles-Shenton & J Parker

Western Asian and Northern African residential building stocks: archetype analysis
S Akin, A Eghbali, C Nwagwu & E Hertwich

Lanes, clusters, sightlines: modelling patient flow in medical clinics
K Sailer, M Utley, R Pachilova, A T Z Fouad, X Li, H Jayaram & P J Foster

Analysing cold-climate urban heat islands using personal weather station data
J Taylor, C H Simpson, J Vanhatalo, H Sohail, O Brousse, & C Heaviside

Are simple models for natural ventilation suitable for shelter design?
A Conzatti, D Fosas de Pando, B Chater & D Coley

Impact of roofing materials on school temperatures in tropical Africa
E F Amankwaa, B M Roberts, P Mensah & K V Gough

Acceptability of sufficiency consumption policies by Finnish households
E Nuorivaara & S Ahvenharju

Key factors for revitalising heritage buildings through adaptive reuse
É Savoie, J P Sapinski & A-M Laroche

Cooler streets for a cycleable city: assessing policy alignment
C Tang & J Bush

Understanding the embodied carbon credentials of modern methods of construction
R O'Hegarty, A McCarthy, J O'Hagan, T Thanapornpakornsin, S Raffoul & O Kinnane

The changing typology of urban apartment buildings in Aurinkolahti
S Meriläinen & A Tervo

Embodied climate impacts in urban development: a neighbourhood case study
S Sjökvist, N Francart, M Balouktsi & H Birgisdottir

Environmental effects of urban wind energy harvesting: a review
I Tsionas, M laguno-Munitxa & A Stephan

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