Poor housing, good health: a comparison of formal and informal housing in Johannesburg, South Africa

Int J Public Health. 2011 Dec;56(6):625-33. doi: 10.1007/s00038-011-0269-1. Epub 2011 Jun 21.

Abstract

Objectives: This study aimed to investigate the relationship between housing, demographic, socio-economic, social factors and health, in poor urban communities in Johannesburg, South Africa.

Methods: Data were drawn from a survey of 1,427 households in Johannesburg. The outcome health variable was a composite measure of chronic ill-health. Housing variables included type of housing, tenure and access to services. Multivariate regression analysis assessed the relationship between housing and health, after adjustment for demographic, socio-economic and social factors.

Results: The prevalence of chronic health problems was 25.1% (95% CI 22.8-27.6%). Factors independently associated with the risk of chronic ill-health among household heads included older age (OR, 3.06 [2.37-3.95]), female gender (OR, 2.83 [2.01-3.97]), long-term residence (OR, 2.01 [1.10-3.67]), unemployment (OR, 0.49 [0.36-0.67]), and living in formal housing (OR, 0.66 [0.45-0.98]).

Conclusions: The health of the household heads residing in informal housing was significantly better than in formal housing. Explanations for this counter-intuitive finding include the fact that the informal housing dwellers were younger and recent migrants (the 'healthy migrant' phenomenon). Policy implications of the results are identified.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Chronic Disease / epidemiology
  • Cross-Sectional Studies
  • Female
  • Health Status*
  • Health Surveys
  • Housing / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Poverty*
  • Prevalence
  • Sex Factors
  • Socioeconomic Factors
  • South Africa / epidemiology
  • Urban Population
  • Young Adult