Healthy Homes Initiative: Improving well-being and addressing health inequalities for New Zealanders

The Healthy Homes Initiative (HHI)¹ passed in 2016 ensures all New Zealanders have access to warm, dry, and healthy homes. The policy aims to tackle the health issues caused by inadequate housing, affecting lower-income, Māori and Pacific families, and young children.

Further policy description

The HHI is a program that works with families and multiple government agencies to create warmer, drier, and healthier homes. Once eligible families are identified (i.e., children who have health risks, low-income families, and pregnant people), they are offered a visit from a health and housing assessor to carry out a housing assessment and complete an individualized action plan. The assessor works with the families to undertake the required interventions, such as insulation, beds and bedding, repairs, ventilation, heating sources, support with energy bills, and alternative accommodation. Assessors may speak to the landlord to make improvements, and may refer the family to other services. For families living in public housing, the aim is to assess and complete interventions within 90 days.

Implementation

The HHI was established by the Ministry of Health (Te Whatu Ora) between December 2013 and March 2015² in response to New Zealand having had one of the highest rates of rheumatic fever in the developed world.³ Rheumatic fever is an inflammatory disease that can develop in children when strep throat or scarlet fever isn’t properly treated leading to permanent damage to the heart.  HHI initially targeted low-income families with children at risk of rheumatic fever in 11 regions among the North Island.⁴

In 2016, the breadth of the program was expanded to focus more broadly on providing warm, dry, and healthy housing to  pregnant people, and low-income families with young children and those known to have poor  health. In 2021, the government announced additional funding to expand the reach and impact of the program to the   whole country from July 1, 2022.

The program enjoys cross-agency support and works closely with government agencies such as Kāinga Ora Homes and Communities, the Ministry of Social Development, the Energy Efficiency Conservation Authority, and more recently, the Ministry of Business, Innovation and Employment along with  the third sector to enhance the service for families.

Cost

NZD 55.6 million (approximately USD 36.5 million) was spent between December 2013 and December 2021 on the HHI, the majority of which went to staffing the program.⁵ The government has invested a further NZD 30 million (approximately USD 19.3  million) to expand the initiative nationally.⁶ The amount spent differs from household to household depending on their needs.

Assessment

The HHI has been successful in reaching its target population and providing tangible benefits. As of October 2022, over 100, 000 interventions were made, helping a total of 142,000—or 86 percent of whom have been either Māori or Pacific people.⁷

People referred to the HHI are spending less time in hospital, have fewer general practitioner appointments and fewer prescriptions. Instead, children are spending more time in school and adults in employment. HHI reduces people’s chance of going to the hospital by nearly 20 percent and when people were hospitalized, these hospitalizations were shorter and less severe.⁸

As well as the improvement to families’ well-being, the HHI is an excellent return on government investment. The value of the social benefits from the HHI alone exceed the programme cost resulting in a return on investment within one year. The data also indicates that the benefits of the program are persistent and will accrue each year, making the investment worthwhile.

There is unambiguous evidence of broad improvements in well-being and of the HHI reaching low-income Māori and Pacific populations, effectively promoting equity in health and social outcomes.  The positive results demonstrated by the initiative have led to the decision to roll it out nationally.

Tags

• Aotearoa New Zealand
• Asia & Pacific
• Children & Youth
• Health
• High-Income Country
• Housing
• Indigenous Peoples
• Low-Income Groups
• Race & Ethnicity
• Universal