Housing as a social determinant of health: a contemporary framework

Housing is a key social determinant of health. Healthy housing is affordable, suitable, and secure. It is characterised by warmth, dryness, and proper ventilation; free from hazards such as mould and toxins; accessible to occupants with functional limitations; and provides foundational security. Conversely, exposure to unhealthy home environments can negatively affect respiratory and cardiovascular health, mental wellbeing, infectious disease transmission, and injury risk. Housing-focused health interventions and programmes offer a unique opportunity to bridge the gap between housing and health, potentially leading to improved population health outcomes across various domains. This Series paper integrates contemporary understanding of housing and housing systems into a social and economic determinants framework. We illustrate how housing systems contribute to poor health outcomes and health inequalities, providing a foundation for exploring housing's potential to support health across jurisdictions globally. Although our framework can be used to examine the relationship between specific housing hazards (eg, mould, cold, or heat) and health, its primary focus is on understanding how these hazards are generated and distributed through characteristics of the housing system (eg, building codes or housing finance). By addressing these housing system determinants, we propose an alternative approach to achieving healthier housing. This framework aims to support the strategic use of housing to promote good health for all populations.