PhD defence: Evaluating health effects of holistic housing renovations: A systems perspective

Socioeconomic health inequalities persist, also in the Netherlands. One important but often overlooked factor is housing. Poor housing conditions – such as dampness, mould, and structural problems – can harm physical and mental health. Socioeconomically vulnerable households are disproportionately exposed to unhealthy living conditions, reinforcing existing health inequalities. 

This PhD thesis investigates how “holistic housing renovation” may impact the health and wellbeing of residents. Holistic housing renovation combines physical improvements to social housing with social and socioeconomic support for residents, such as practical assistance during the renovation, and help with financial, social, or care-related issues. The idea is that this combination provides greater and more lasting health benefits. 

A small-scale, detailed, intensive evaluation with professionals and residents shows that renovation initially causes additional stress due to noise and dust disturbances, disruption, and temporary relocations, especially for households already facing multiple challenges. After renovation, positive changes occur: residents feel prouder of their homes and experience fewer housing-related problems, enjoy greater living comfort, and benefit from a healthier indoor climate. These improvements can contribute to better health in the long term. 

Timing proves crucial. Before and during renovation, residents mainly need practical support to reduce renovation-related stress. Broader social or financial support is more desirable afterward, when residents have more mental space for it. Investing in support during renovation also provides opportunities for municipalities and welfare organizations to connect with residents and build trust, which contributes to the acceptance of other types of assistance after renovation. 

The research demonstrates that collaboration between housing corporations, municipalities, health and social welfare professionals, and residents is essential. Strong intersectoral partnerships help to better understand and strengthen the health impacts of policies in other domains. Investing in health during renovation requires a broader, integrated perspective – and can help reduce health inequalities. In this way, holistic housing renovation provides a concrete example of a health-in-all-policies approach in practice.