Research capacity strengthening in health and care delivery through housing for chronic diseases

Abstract

BackgroundFrom all buildings, houses are where we spent most of our lives. The impact of housing conditions on health was evident during the COVID-19 pandemic. Despite the 2018 Astana Declaration placing integrated delivery of primary health care and public health services across all sectors, a framework that explores health and care in relation to housing remains unexplored. The aim was to determine relevant evidence gaps to building capacity in supportive housing-health care research about chronic diseases and multimorbidity, identify ongoing strains and offer potential solutions.MethodsAn integrative review was conducted through multiple systematic searches in electronic databases. We employed an interdisciplinary approach integrating several research fields -built environment, clinical and human physiology, environmental health, and public health and health care services- around chronic illness and multimorbidity to understand the depth and scope of linkages. Inductive content analysis was used to describe emerging domains from evidence meeting inclusion criteria.ResultsWe defined a multifaceted framework with priority eight building blocks for action: 1) expanding capacity for chronic care model into the primary care setting; 2) scaling up environmental determinants to cover residential spaces; 3) implementing acute methodologies for indoor environment risk assessment; 4) increasing clinical research applicability into built environment studies; 5) recognizing chronic conditions-promoting inflammation physiology; 6) qualifying reliable surrogate disease biomarkers in human monitoring; 7) enforcing technologies for new forms of outpatient care; and 8) renewing evidence-based healthcare design.ConclusionsFuture research needs to prioritise articulating these emerging insights through systematic, translational and multisectoral approaches to strengthen health and care delivery through housing design solutions for people living with chronic morbidity.Key messages Integrating the evidence-based design in future interventions may promote transformative changes in housing and public health programmes engaging primary healthcare services for chronic patients.This eco-biopsychosocial supportive framework informs practice to advance research capacity development in enabling health-conducive environments across various levels of care and health promotion.