Mental health impact of adverse housing conditions on children and young people: A systematic review

There is increasing evidence that various components of adverse housing conditions may influence mental health outcomes for children and young people. A comprehensive review whether, and to what extent these exposures impact on children and young people's mental health is missing from the literature. To conduct a systematic review of the evidence regarding the association between adverse housing conditions (excluding homelessness) and mental health in children and young people aged 2–24 years. We searched peer-reviewed literature for relevant quantitative studies in electronic databases (MEDLINE, Embase, and PsycINFO), grey literature, and reference lists of identified articles published in English from January 2000. Risk of bias was assessed using the Navigation Guide, and results were described via a narrative synthesis. Thirty-four studies spanning 18 countries met our inclusion criteria. Adverse housing conditions were indicated by overcrowding, poor facilities or structural quality, no access to natural space at home (e.g., private or shared garden or balcony), energy poverty, mould or damp, indoor air pollution, and indoor noise. Children and young people's mental health was measured by self- or caregiver-reported emotional and behavioural problems, depression, stress, general well-being, quality of life (QoL), social competence, hyperactivity or inattention, and autism spectrum disorder (ASD) symptoms. Thirty-one of 34 studies (91.2 %) were rated as "low” to “probably high” risk of bias. Twenty-seven studies (79.4 %) found that adverse housing conditions were associated with mental health difficulties including emotional and behavioural problems, depression, hyperactivity symptoms and ASD symptoms, and reduced mental health competence in children and young people. Evidence predominantly suggests that overcrowding and mould or damp exposures are significantly associated with mental health problems. Adverse housing conditions have a negative impact on children and young people's mental health, particularly on emotional or behavioural problems and mental well-being. Future studies should use standardised and objective measures of adverse housing exposures and cohort study designs to determine any critical or sensitive periods of exposure. Policies to improve housing for families with children are likely to have mental health benefits for children and young people. Funding and registration: None; registered at PROSPERO: CRD42022373171. • This paper synthesises published research evidence on poor housing conditions and mental health in children and young people (CYP). • Adverse housing conditions such as mould or damp, overcrowding, and poor facilities or structural quality are associated with worse mental health in CYP. • The highest-quality evidence demonstrated a clear negative effect of mould or damp on mental health in CYP. • Future research should use standardised and validated exposure and outcome definitions.