Published: 12 December 2013
Authors: Baker, M., McDonald, A., Shang, J., & Howden-Chapman, P.
Infectious disease attributable to household crowding in NZ: A systematic review and burden of disease estimate rates
The incidence of serious infectious diseases (IDs), notably respiratory, skin and enteric infections, is increasing in New Zealand (NZ). Ethnic and socioeconomic inequalities are large and rising, with markedly higher rates of IDs for Māori and Pacific peoples relative to European/Other. It is important to identify factors that may be contributing to this burden of disease, particularly factors that can be modified.
Household crowding is a plausible risk factor for transmission of IDs. Exposure to household crowding is very unequal across ethnic groups in NZ. The 2006 Census showed that for children <15 years, exposure to extreme crowding (2+ bedroom deficit) was 9.9% for Māori and 20.9% for Pacific children compared with 1.8% for European/Other.
As recently as 2001, a Ministry of Social Policy review of the effects of household crowding on health concluded that the evidence was inconclusive and more research was needed. This study therefore aimed to review the literature and summarise the evidence linking household crowding to IDs to provide a base for estimating the impact of exposure to household crowding on rates of serious IDs in NZ.