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Trevor Hancock: Healthy homes — the basics and beyond

As I have noted previously, in Canada we spend about 90 per cent of our time indoors, and according to a 1996 study, 65 per cent of our time is indoors at home and a further 10 per cent indoors at school or work.
The tent city at Regina Park in Saanich.

As I have noted previously, in Canada we spend about 90 per cent of our time indoors, and according to a 1996 study, 65 per cent of our time is indoors at home and a further 10 per cent indoors at school or work.

Thus, the environment of our buildings, and especially our homes, is enormously important for us. As Sir Winston Churchill remarked: “First we shape our buildings, then they shape us.”

So if we want healthy people, it would be a big help if we had healthy homes. Which raises the question: What is a healthy home? And an even more interesting question: How well are we doing at creating healthy homes? Let’s start with that first question.

There are some basic health functions a home needs to fulfil. In 1989, the World Health Organization published a set of principles for healthy housing. It has to protect us from the elements, keep us warm, dry and safe, and should keep out pests and noise. Also, it must not fall down or catch fire easily and must be well drained.

It must have a proper water supply, provisions for sewage and solid-waste removal, and “adequate provision for storing food, to protect it against spoilage and contamination.” Indoor air quality is also important (remember, 90 per cent of the time we are breathing indoor, not outdoor air), as are issues of overcrowding. These and other basic safety and health functions are the reason we have building codes.

Here we might stop and reflect on the extent to which housing that meets these basic health needs is not the case in Canada today. As Bernie Pauly and Katrina Barber noted two weeks ago in these pages (“Why worry about tent cities?” July 22), we have signed several international covenants, such as the International Declaration on Human Rights, which enshrine the right to shelter. One would think such shelter would have to meet the WHO’s basic principles.

But those living on the streets or in tent cities do not have these basic amenities. Indeed, when the medical health officer in Nanaimo recently used the Public Health Act to order the City of Nanaimo to provide clean water and sanitation to the tent city there, he was initially and deplorably met with outrage by some, including the mayor, who called the idea ludicrous.

Indigenous people in Canada are another group that lacks many of these basic housing needs. Statistics Canada reported last year that the 2016 census found that: “One in five Aboriginal people lived in a dwelling that was in need of major repairs;” for First Nations and Inuit, it was one in four people. “Major repairs” meant the housing had “defective plumbing or electrical wiring, [or was] needing structural repairs to walls, floors or ceilings.” The only good news was that the rate was down by two to 3.6 percentage points (depending on the group) since 2011.

These high rates among Indigenous people are the legacy of 150 years of Canadian government neglect and colonialist policies. For comparison, 6.5 per cent of dwellings overall in Canada needed major repairs, a bit less among owners, a bit more among renters. The rates for B.C. are much the same and are about one percentage point less in all categories in the Victoria region.

At the very least, a country as wealthy as Canada must ensure that everyone’s basic housing needs are met, that we all live in safe and healthy homes. But surely we should aspire to more than having housing that is not a threat to basic health. What is a health-enhancing home, one that improves our overall physical, mental and social well-being?

There are several aspects to this question. First, what — beyond the basics — makes a home physically healthy? What makes it mentally and socially healthy — the latter implying that a home does not stand alone, so how does it relate to other homes and people in our neighbourhood? And finally, given our concern for the state of the environment, how environmentally friendly are our homes — and how might they be better for the environment, as well as for us?

Next week, I will go deeper into some of the leading-edge ideas for creating healthier homes.

Dr. Trevor Hancock is a retired professor and senior scholar at the University of Victoria’s School of Public Health and Social Policy.