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Health, the new frontier of housing policies

@Sergio Grazia

Housing is a sensitive point of public policy, not to say a failure. Housing is an increasingly heavy burden of purchasing power and, it seems, unchecked despite a ” crazy money “. A healthy mind in a healthy habitat? Chronicle of intensity.

The construction sector champion of greenhouse gas emissions, strong tensions in cities and tourist areas, rigidities in the face of the needs to relocate activities and housing, difficulties in adapting old housing faced with the needs of today…

Add to this list societal issues, overcrowding in certain dwellings and poor housing, fuel poverty, the relegation of populations to underserved areas and ghettoization, etc. Many issues to manage simultaneously, to which one should be added: health.

Our health is largely conditioned by environmental factors. More than two-thirds of non-communicable diseases depend on it, whether cardiovascular or metabolic diseases, cancers or even chronic respiratory problems.

Housing plays a significant role here. Housing, places of work and leisure, local public spaces contribute to a large extent to all the exposures to which our organisms, our bodies, are subjected. The term exposome covers this field of medical research, which appeared about fifteen years ago to understand the effects of all the environmental factors that accumulate in us throughout our lives: what we breathe, what that we ingest, the radiation, the noise, the landscape, the multiple influences to which we are exposed, have effects, good or bad, on our physical and mental health, they combine with each other and produce cocktails that often leave science destitute.

Habitat is at the heart of the matter, whether in terms of locations, the design and organization of premises, the lifestyles to which it invites, the materials used, the methods and practices of maintenance and maintenance. ” Housing therefore remains a major determinant of health. “, indicates the High Committee of Public Health. This is enough to add intensity to housing policies!

Various organizations and many works are devoted to housing and institutions adapted to different pathologies, such as ” therapeutic coordination apartments “. The law sets requirements for accessibility for people with reduced mobility. Recent attention has focused on the effects of aging. It is then a question of facing problems, in a predominantly defensive position, to reduce or avoid the health problems (in the sense of the WHO) of fragile populations.

Why not go further, and design a habitat which, in addition to its primary function of reception and living space, becomes a public health auxiliary? The hygiene movement of the last century provided an initial response, but it was essentially a question of combating infectious diseases. It is a first step, always mainly defensive.

How to be offensive to promote good health and not just prevent disease? How to enrich the hygienist component, of technical inspiration, with a sensitive, affective dimension, which would make it possible to obtain broad support from the inhabitants?

On the mental level, the fight against loneliness requires a layout favorable to meetings, convenience stores, public spaces, benches, etc. The quality of the urban landscape, the calm or the animation depending on the case, the treatment of pedestrian paths, illustrate the margins of maneuver on the exterior development side. This may encourage active mobility. Cycling saves money on social security.

The rehabilitation of the staircase in the offices, where the spontaneous tendency would be rather to the elevator even for one floor, is an example of a simple measure in the tertiary sector. It is an ergonomics of the external and internal paths that pushes us to ” to move », as the official advertisements encourage us to do.

An urban planning climatic is another avenue for promoting health. Streets oriented according to the prevailing winds, both to evacuate and disperse pollution and to provide pleasant microclimates. An overall plan allowing access to the sun as much as possible, providing for the presence of water, fountain, river bank, pond, etc. and a vegetation source of appeasement, provider of shade, favorable to the quality of the air, to the reception of birds (but beware of allergies and not to slow down the dispersion of pollutants).

In buildings, the regulations give indications for the health aspect. It is obviously desirable to do more, especially for access to daylight, essential for morale, and the renewal of air, ventilation, essential for good health, but also to avoid air conditioning, which is good neither for human health nor for the planet.

Energy poverty is a social and health problem. It is expensive in terms of health, but also absenteeism, schooling, family and social situations. A cost which has been estimated in the United Kingdom to be heavier than that of thermal renovation work. It is also on the side of uses and behaviors that the effort must be made, on the way of living, essentially linked to habits and cultures. A healthy habitat in line with the lifestyles of the occupants, and an awareness of the latter, of hard and soft.

The search for co-benefits is consubstantial with sustainable development. The double dividend. Housing and housing more broadly have a great responsibility for health. A transversal approach is necessary, beyond the partitions that had to be set up to facilitate the action but which ended up being watertight.

Our daily environment, largely in premises, determines our health, and our lifestyles, which are themselves directly related to our health. The separation of powers has led housing policies to meet minimum requirements, to do no harm. The recognition of a goal health ambitious program integrated into housing and urban planning policies would be a major step towards sustainable development.

Dominique Bido
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