Abstract
Objective: Although there is much evidence about the effects of particular housing conditions on health, less is known about the practices of public health inspectors (PHIs) in relation to minimizing or eliminating potential housing health risks. The purpose of this qualitative study was to illuminate the practices of PHIs in relation to types of biological and physical housing risks.
Method: This study used photo vignettes to focus on PHIs’ perceptions, options, and resultant interventions with regards to typical housing risks encountered by PHIs in northeastern Ontario. The vignettes represented two general categories of potential housing risks: biological exposures, and physical characteristics of housing. During a semi-structured interview, 34 PHI participants viewed the vignettes, assessed the housing hazard depicted in each, and described the most appropriate intervention. Traditional content analysis methods were used.
Results: The assessment of the physical housing hazards was fairly consistent among the PHIs. There seemed to be more variation in their assessment of risk associated with biological factors. Variation in responses was often explained by their different interpretations of the scope of the provincial legislation as well as local public health unit policies and practices.
Conclusion: This study demonstrated that PHIs’ assessment and responses to potential physical housing hazards were influenced by an interplay between variables related to residents, local service partners, organizational culture, and policy. The recommendations for action also range from specific public health unit protocol to broader research and policy advocacy initiatives. Collectively, the recommendations focus on strategies for optimizing the role of PHIs in reducing housing health risks in mid-size urban or rural areas.
Keywords: Housing, environmental health, health hazards, public health, rural health
Résumé
Objectif: Les preuves des effets de certaines conditions de logement sur la santé abondent, mais on en sait moins sur les pratiques des inspecteurs en santé publique (ISP) qui peuvent réduire ou éliminer les risques sanitaires potentiels des logements. Notre étude qualitative visait à éclairer les pratiques des ISP à l’égard des types de risques biologiques et physiques liés aux logements.
Méthode: À l’aide de vignettes photographiques, nous avons étudié les perceptions des ISP, leurs options et les interventions qui en résultent en ce qui a trait aux risques typiquement rencontrés dans les logements du Nord-Est de l’Ontario. Les vignettes représentaient deux grandes catégories de risques possibles dans les logements: les risques biologiques et les caractéristiques physiques du logement. Au cours d’un entretien semi-structuré, 34 ISP participants ont étudié les vignettes, évalué le risque présenté, puis décrit l’intervention la plus appropriée. Nous avons analysé le contenu de ces entretiens par les méthodes classiques.
Résultats: L’évaluation des dangers physiques des logements a été sensiblement la même d’un ISP à l’autre. Il semble y avoir plus d’écarts dans leur évaluation du risque associé aux facteurs biologiques. Les différences dans les interventions proposées s’expliquent souvent par leurs interprétations différentes de la portée des lois provinciales, et des politiques et des pratiques des bureaux de santé publique locaux.
Conclusion: L’étude démontre que les évaluations par les ISP et les interventions qu’ils proposent pour contrer les dangers physiques possibles dans les logements sont influencées par l’action réciproque de variables liées aux résidents, aux partenaires locaux dispensateurs de services, à la culture organisationnelle et aux politiques. Les mesures qu’ils recommandent varient aussi, allant de protocoles précis pour un bureau de santé publique à de vastes initiatives de recherche et de défense des politiques. Collectivement, les recommandations mettent l’accent sur des stratégies pour optimiser le rôle des ISP en vue de réduire les risques sanitaires des logements dans les agglomérations urbaines de taille moyenne et les régions rurales.
Mots clés: logement, santé, environnementale, dangers pour la santé, santé, publique, santé, en zone rurale
Footnotes
Conflict of Interest: None to declare.
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