Robb, Katharine, Rowana Ahmed, John Wong, Elissa Ladd, and Jorrit de Jong. “Substandard housing and the risk of COVID-19 infection and disease severity: A retrospective cohort study.” SSM - Population Health 25 (March 2024): 101629.

What’s the issue?

Following the peak of the COVID-19 pandemic, researchers continue to investigate the factors related to the spread of disease—and how city leaders can better respond before, during, and after such crises. Housing conditions, for example, can play a role in infectious disease risk. Substandard housing—which might feature poor ventilation, overcrowding, and dampness—can create an environment favorable to respiratory disease.

So, did poor housing conditions lead to more—and more severe—cases of COVID-19 infection during the pandemic?

What does the research say?

Researchers from the Bloomberg Center for Cities at Harvard University and the MGH Institute of Health Professions studied the connections between poor housing conditions and COVID-19 infection and severity during the first year of the pandemic. They combined city housing data with healthcare data for residents of Chelsea, Massachusetts—a densely populated city with high levels of substandard housing.

The researchers found that:

  • Living in substandard housing was linked to higher COVID-19 infection risk, even after adjusting for factors like age, income, and race.
  • This increased risk was only observed during lockdown and early reopening; after stay-at-home restrictions lifted there was no difference in COVID-19 risk between residents of substandard versus adequate housing.
  • Substandard housing was not linked to greater risk of severe COVID-19 disease.
  • Leaders can leverage city housing data for pandemic response and longer-term solutions.

They conclude, “The results demonstrate the value of combining cross-sector datasets to yield new insights and solutions. Existing city data can be leveraged to identify and prioritize 1) high-risk areas for future pandemic response activities, and 2) for longer-term solutions that address social determinants of health through safe and affordable housing.”

Get smart & reliable public policy insights right in your inbox.