How children's immune systems are affected by cold, damp housing

by Ruth Nichol / 22 May, 2017

Photo/Getty Images

A cold, damp house is the first link in a chain that leads from childhood sniffles to major health problems.

Dr Nikki Turner, the medical spokeswoman for the Child Poverty Action Group (CPAG), knows too well the critical role the home environment plays in staying warm and healthy.

“People are often surprised at how children get sick and then end up severely sick,” says Turner, an academic general practitioner and associate professor in the department of general practice and primary care at the University of Auckland. “Why, even when the best healthcare services are offered, are children still getting severely ill?”

The story of Ivy (below) is based on Turner’s experiences in general practice.

“No matter how well we deliver services in general practice, without improvement in other areas of her life, Ivy will still end up in hospital,” Turner says. “That’s what I’ve seen and that’s what breaks my heart.”

Dr Nikki Turner. Photo/Jane Ussher

Seven-year-old Ivy and her brother live with their parents, who are also looking after two extra children from the extended family. Ivy’s mother works in the evenings as a cleaner, but she is chronically ill. Her father works night shifts, but the work is not reliable and there are long periods when he is out of work.

The family has moved six times since Ivy was born. They live in a three-bedroom house with her aunty’s family. All the family members sleep, on mattresses on the floor, in one room, to stay warm over winter. Ivy has had eight admissions to hospital since birth: two for bronchiolitis (a wheezy chest infection) as a baby, two for pneumonia, one for asthma, one for a head injury, one for a skin infection and one for a tooth infection. Why has she ended up in hospital so many more times than other children?

First, infections spread more easily in a crowded environment, where there is close contact and it’s harder to maintain good hygiene and keep a distance from other members of the household who are sick.

Second, Ivy’s immune system does not respond to infections as well as those of other children. She will be very stressed by many factors including: a cold, mouldy house that makes fighting off infections harder; dietary deficiency resulting from poor nutrition as the family cannot afford consistently healthy food, including fresh fruit and vegetables; chronically inadequate income; poor parental health; and insecure housing with many house shifts.

Third, it can be difficult to get to the family GP early enough when she is unwell. The parents are working evening and night hours, and are also often unwell themselves, creating difficulty for good care and supervision for her after school and in holidays. The family has a car but because money is tight, it is often unwarranted or needing repairs.

A combination of all these factors means Ivy will repeatedly get sick and will need hospitalisation much more frequently than other children her age.

This article is an excerpt from 'In from the cold' in the May 27, 2017 issue of the New Zealand Listener.

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