Introduction

The purpose of this paper will be to explore a possible research program related to substandard housing and its effects on the children. In this paper I will discuss the problem, literature found pertaining to the subject, proposed methodology to include study design, population, sampling methods, data collect, variable, data analysis, and limitations of the study.

Problem Statement

The overriding goal of the public health sector and all its stakeholders is to prevent disease and promote health, a universal mission that Stover and Bassett (2003) note concerns all the multiple parties involved in public health. However, substandard housing may be detracting from the achievement of public health’s noble goals in disease prevention and health promotion. The statistics on poor housing in the U.S. are alarming, with 6.1 million households living in overcrowded conditions while one out of every seven poverty-stricken families lived in extremely inadequate housing by 2004 (Joint Center for Housing Studies, 2013). With increasing wealth gaps and no recovery in housing cost burdens as of 2013, the quality of housing must have deteriorated significantly (Joint Center for Housing Studies, 2013). As of 2009, Thrivent Financial noted that more than 11 million Americans could have been facing worst case housing needs, of which 3.6 million were children, 1.6 million the elderly, and 1.3 million disabled individuals. From such observations, it is evident that any problems associated with substandard housing and living conditions would be quite significant and in need of urgent attention.

Meanwhile, a number of scholars have suggested that a correlation exists between substandard housing and health status. For example, Krieger and Higgins (2002) associated substandard housing conditions with health problems such as asthma, respiratory infections, lead poisoning, and injuries, leading to a conclusion that housing was a social determinant contributing to significant morbidity and mortality. Evans, Wells, Chan, and Saltzman (2000) suggested a link between housing and mental health, which would predict that people living in substandard places of residence would be at higher risks of developing mental health problems. In this case, the alarming statistics on substandard housing in the U.S. become more pertinent as they suggest a major public health challenge requiring urgent intervention. From these observations, public health practitioners should target housing quality improvements as a way of achieving healthy population goals. However, Ruel, Oakley, and Maddox (2010) pondered whether the noted relationship between poor housing and health might only occur because such housing projects attract a disproportionate population of the unhealthy poor. Here, the cause of poor health among people residing in poor houses might be among the population rather than because of the housing conditions.

As a result, the issue remains fuzzy, prompting efforts to establish or refute the link between housing and health authoritatively to inform public health practice. Conducting research in this topic will help establish short-term and long-term practice guidelines, including whether treatment and prevention of disease before and during residence is more urgent than improving housing conditions in the short-term. Through adding to the literature available on the link between housing standards and health, the study will inform and support evidence-based practice in public health. In case the null hypothesis is refuted, the current study will inform future research into how substandard housing causes poor physical and mental health, which represents a step beyond confirming a correlation between the two issues. Further, the study’s findings will add impetus to public health efforts to solve problems related to poor housing and health.

Research Question and Hypothesis

Does substandard housing in Owsley County, Kentucky predict poor physical and mental health in school age children?

Literature Review

Lack of Scientific Literature/studies pertaining just to Appalachia/Kentucky region: (possible site articles)

HYPERLINK “http://articles.philly.com/1994-08-19/news/25841565_1_outhouses-drinking-water-wooden-home”http://articles.philly.com/1994-08-19/news/25841565_1_outhouses-drinking-water-wooden-home

HYPERLINK “https://sites.google.com/a/cypanthers.org/appalachia-america-s-forgotten-people/Home/how-to-help”https://sites.google.com/a/cypanthers.org/appalachia-america-s-forgotten-people/Home/how-to-help

HYPERLINK “http://blog.wisteria.com/2009/11/christian-appalachian-project-december-2009/”http://blog.wisteria.com/2009/11/christian-appalachian-project-december-2009/

good stats in this article with references HYPERLINK “http://www.appalachiantransition.org/sites/ati/files/essays/Jim%20King%20Essay%20FINAL.pdf”http://www.appalachiantransition.org/sites/ati/files/essays/Jim%20King%20Essay%20FINAL.pdf

HYPERLINK “http://www.berea.edu/brushy-fork-institute/files/2012/06/Winter2001.pdf”http://www.berea.edu/brushy-fork-institute/files/2012/06/Winter2001.pdf

References addressing over all, but already used else where L

HYPERLINK “http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447157/”http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447157/

HYPERLINK “http://www.cdc.gov/nceh/publications/factsheets/healthyhomesinitiative.pdf”http://www.cdc.gov/nceh/publications/factsheets/healthyhomesinitiative.pdf

HYPERLINK “http://www.ncfh.org/docs/08%20-%20housing.pdf”http://www.ncfh.org/docs/08%20-%20housing.pdf

HYPERLINK “https://www.sandiego.gov/nccd/housing/substandard.shtml”https://www.sandiego.gov/nccd/housing/substandard.shtml

Study Design

For this particular study a prospective Cohort study would show to the most beneficial in order to study the effects of substandard housing and poor health. This is a significant approach that will provide a comprehensive analysis into the statistically significant difference in the housing standards and there correlative significance to poor health. This study design the assessment will start with the acknowledged cause of the final case, which is poor health, and significant observations are expected to be made with regard to the occurrence of poor health relative to the hypothesized causal agent, substandard housing. Continual contact with individuals would help facilitate more detailed and accurate information pertaining to the condition.

Study Population

The first step in starting up of this project is to identify the problematic areas. It is important to recognize which areas in a city have maximum sub standardized housing facilities, and how many people reside in these types of housing facilities.

Second step is to find out on what basis one can identify a facility as sub standardized. Each government has its own standards for identifying them. Sub standardized housing is one which does not meet the standards set by the government, concerning areas like:

Plumbing

Heating

Electrical set-ups

Ventilation

Thickness of the concrete walls

Quality of building materials used, etc.

Next is to list down all these facilities, in terms of their severity, ‘Most severe to least severe’, and prioritize them accordingly.

It is necessary to select the subjects of the study carefully, and plan the specific questions that need to be asked. Designing the questions would be done, after talking to some of these subjects generally, and gauging their reactions.

Sampling Method.

Samples will not be gathered through a simple random sampling

In part due to a need to screen out mitigating factors that may influence study such as a preexisting medical condition that is known to weaken the immune system and present higher incidence of illnesses. For the purpose of this study Representative samples would be appropriate due to its ability represent the specific characteristics of the target population.

Data Collecting and tabulation:

Any research is incomplete without specific and relevant data. Here, to recognize sub standardized housing facilities, the areas wherein the problem lies should be tabulated. Each housing facility would have their problems, thus there would be variable quantity when one housing facility would be compared with another.

Initially, before going to meet the subjects, all available data would be collected, with respect to what are the government standards for that particular area, what measures have been taken before to improve the facilities, etc. This can be done by visiting government archives or the data available with the municipal corporation of that area.

A tabulation of data to be collected further would be helpful in sorting them out finally, and deciding a method to improve them.

A table, like the one given below, would be helpful in sorting out variable/non-variable parameters in the research.

Area of housing facility/Number Plumbing Electrical connectivity Sanitation Building materials used Ventilation

Another table can be put up to show the physical health’s, with specifically designed parameters like ‘could respond well to a particular question’, ‘Patients description of health’, etc.

Finally, these things can be graphically depicted, with a pie chart or pictographs, bargraphs, etc. for easier understanding of the research.

Variables

Limitations

This research is a descriptive study of how a sub-standardized housing can affect the normal physical and mental health of persons living in them. It does not provide ideas about what measures can be taken to improve these facilities, or how permission has been granted to build these facilities initially.