Health and well-being outcomes from a non-health population-level intervention: the impact of home upgrades in Victoria, Australia

The Victorian Healthy Homes Program (VHHP) delivered home energy efficiency and warmth upgrades to 1000 low-income households in Victoria, Australia. As Australia’s first randomised control trial (RCT) on the relationship between the home environment and health outcomes in vulnerable older adults, this paper reports the health and wellbeing outcomes focussing three quality of life (QoL) instruments. The VHHP used a staggered, parallel-group clustered RCT. All households received a home upgrade either before (intervention group) or after (control group) winter (June-September) in 2018–2020. Three surveys: the SF-36, the EQ-5D-5L, and ASCOT measured self-reported QoL. Ordered logistic regression was conducted for categorical outcomes and Ordinary Least Squares regression for continuous outcomes. Survey outcomes were analysed before and after winter controlling for age, sex, location, and year. The intervention group experienced improved physical functioning, mental health and social care related QoL after winter relative to the control group. The main influential factor (from ASCOT) was the comfort and cleanliness of the accommodation. The intervention group also reported improvements in breathlessness and less time away from usual activities and were less likely to delay seeing a specialist. A modest investment in improving housing has important health and wellbeing benefits, especially for more vulnerable individuals. Improved mental health and social care related quality of life made individuals more comfortable in winter and these effects are likely to endure over time because the upgrade is permanent. Australian and New Zealand Clinical Trials Registry: ACTRN12618000160235. Registration date: 02 February 2018.