The "inverse housing law" and respiratory health

STUDY OBJECTIVE: To investigate whether there is a mismatch within Britain between climate severity and housing quality ("inverse housing law") and whether this mismatch is associated with respiratory health. DESIGN, SETTING AND PARTICIPANTS: Cross sectional observational study. Britain (Scotland, Wales and England). The 3023 male and 3694 female Health and Lifestyle Survey participants with valid data available on all relevant items. MAIN RESULTS: Geographical mapping shows a mismatch between climate severity and housing quality. Individual level analysis shows that lung function is associated with climate and housing, and their interaction, independently of cigarette smoking status. The physical quality of the housing seems to be most important to respiratory health in areas with harsh climate. CONCLUSIONS: Interpretation must be cautious because cross sectional data have been used to investigate processes that are longitudinal and, possibly, selective. Nevertheless, there does seem to be an "inverse housing law", such that some of the worst quality housing is found in areas with severe climate; and, on the balance of probabilities, this inverse housing law affects respiratory health.