Housing and health in an informal settlement upgrade in Cape Town, South Africa

Taking a socio-ecological perspective the World Health Organisation recognizes that housing comprises four interrelated dimensions—the physical structure of the house, the home, the neighbourhood infrastructure and the community. Housing related health vulnerability arises when residents are exposed to poor conditions in any one of these dimensions and augmented when two or more co-exists. Regardless the relationship between housing and health in the global south remains largely under explored; in particular there has been little focus on health outcomes resulting from upgrading of informal settlements. Applying this framework we report from an in situ upgrading of the informal settlement of Imizamo Yethu in Cape Town, South Africa. Data gathered from surveys are used to determine whether differences in each of these dimensions exist between housing type; both formal upgrades and shacks. Results show that whilst no significant differences exist in self-reported physical health, residents of formal housing are less likely to report mental health issues, have a stronger sense of belonging and report greater satisfaction with both neighbourhood and home than shack residents. However, these contested spaces are not easily interpreted and community tension, exclusion and disadvantage highlight the complex interactions between each of the interrelated dimensions and policies regarding housing intervention. The paper highlights the complex relationship between housing and health that is often lost in simplistic measures of housing when outcomes related to the indoor environment alone are considered.