Impact of Housing Quality on Acute Respiratory Infections in Flood-Prone Urban Settlements: A Mixed-Methods Study in Dukuh Kupang, Surabaya, Indonesia

Abstract Background: Housing quality is a critical determinant of respiratory health, particularly in flood-prone urban areas. In Dukuh Kupang, Surabaya, poor ventilation, high humidity, and overcrowding are suspected to elevate Acute Respiratory Infection (ARI) risk. This study examined the association between housing quality and ARI incidence to inform urban health interventions. Methods: A mixed-methods approach was applied, combining a household survey of 80 residents from 8 neighbourhood units with key informant interviews. Housing indicators included floor type, wall type, ventilation area, humidity, temperature, and occupancy density. ARI symptoms and severity were assessed through questionnaires and clinical records. Logistic regression tested statistical associations. Results: Over 62% of houses had inadequate ventilation, 55% had high humidity, and 48.8% had high occupancy density. ARI incidence reached 71.3%, with cough (90.0%) and fever (82.5%) most common. Poor ventilation was strongly associated with ARI (OR = 4.02, 95% CI: 1.78–9.08, p < 0.01). Conclusion: Poor housing quality significantly increases ARI risk in flood-prone settlements. Improving ventilation and indoor environments should be prioritized in public health strategies.