Health and housing consequences of climate-related disasters: a matched case-control study using population-based longitudinal data in Australia

Background Understanding the role of how people are housed in reducing the long-term health and housing effects of climate-related disasters is crucial given our changing climate. We examine long-term health and housing trajectories and health effects of climate-related disasters in relation to housing vulnerabilities over a decade. Methods We conducted a matched case-control study using longitudinal population-based data from the Household, Income and Labour Dynamics in Australia survey. We included data from people whose homes had been damaged by climate-related disasters (eg, flood, bushfire, or cyclone) between 2009 and 2019 and matched control cohorts with similar sociodemographic profiles who had not been exposed to disaster-related home damage during this period. We included data from de-identified individuals with at least 1 year of data before disaster and 3 years after disaster. One-to-one nearest neighbour matching was performed on the basis of demographic, socioeconomic, housing, health, neighbourhood, location, and climate characteristics 1 year before disaster. Conditional fixed-effects models for matched case-control groups were used to assess health trajectories, using eight quality-of-life domains on mental, emotional, social, and physical wellbeing, and housing trajectories, using three housing aspects of cost (ie, housing affordability and fuel poverty), security (ie, residential stability and tenure security), and condition (ie, housing quality and suitability). Findings Exposure to home damage from climate-related disasters had significant negative effects on people's health and wellbeing at disaster year (difference between exposure and control groups in mental health score was -2 center dot 03, 95% CI -3 center dot 28 to -0 center dot 78; in social functioning score was -3 center dot 95, -5 center dot 57 to -2 center dot 33; and in emotional wellbeing score was -4 center dot 62, -7 center dot 06 to -2 center dot 18), with some effects lasting for 1-2 years after disaster. These effects were more severe for people who had housing affordability stress or were living in poor quality housing before the disaster. People in the exposure group had a slight increase in housing and fuel payment arrears following disasters. Homeowners had increased housing affordability stress (1 year after disaster: 0 center dot 29, 95% CI 0 center dot 02 to 0 center dot 57; 2 years after disaster: 0 center dot 25, 0 center dot 01 to 0 center dot 50), renters had a higher prevalence of acute residential instability (disaster year: 0 center dot 27, 0 center dot 08 to 0 center dot 47), and people who were exposed to disaster-related home damage had a higher prevalence of forced moves than did the control group (disaster year: 0 center dot 29, 0 center dot 14 to 0 center dot 45). Interpretation Findings support the need for recovery planning and resilience building to consider housing affordability, tenure security, and housing condition. Interventions might require divergent strategies for populations in different precarious housing circumstances, and policies should target long-term housing support services for highly vulnerable groups. Copyright (c) 2023 The Author(s). Published by Elsevier Ltd.

Automated summary

This study examines the long-term health and housing effects of climate-related disasters on individuals in Australia. The findings show that such disasters have significant negative effects on mental, emotional, social, and physical wellbeing, especially for those who are already vulnerable due to housing affordability stress and poor housing quality.