Background: The Swedish housing stock generally maintains a high standard. However, earlier policies prioritized quantity and rapid housing
Background: The Swedish housing stock generally maintains a high standard. However, earlier policies prioritized quantity and rapid housing production targeting a younger population, over policies that require accessible housing design. With an aging population, evidence-based policies supporting ageing in place while managing societal costs are crucial. This thesis aimed to increase the knowledge of housing and housing policies as determinants of health among older people ageing in place. Additionally, it explored how simulation models can be used to analyse and compare consequences in terms of societal gains and costs for different large-scale measures and interventions.Material and methods: The study employed both qualitative and quantitative approaches, aligned with the evidence-based public health framework (EBPHF). Sub-study I (the study protocol) formulated a concise statement of the issue and outlined the development of simulation models. Sub-study II (the policy study) involved semi-structured interviews with key actors from five Swedish municipalities. In a subsequent research circle, those key actors, together with senior citizens and researchers, explored future policy solutions. Sub-study III (the literature review) conducted a systematic review of recent evidence on housing-health relationships among community-living older people. Sub-study IV (the simulation study) performed a cost-benefit analysis using Markov models to assess potential benefits of two new policies, compared to continuing with current policies.Results: The policy study revealed that current housing policies were considered insufficient for the ageing population’s needs. Future priorities suggested national coordination of housing accessibility policies and stricter building legislation. The literature review identified three key themes from 15studies: interventions targeting home modifications, non-intervention studies targeting indoor features, and non-intervention studies targeting entrance features. The overall quality of evidence was assessed as very low. The simulation study showed that new housing policies could prevent or delay ADL(Activities of Daily Living) dependence, allowing older people to remain living independently longer. The large-scale barrier removal policy demonstrated long-term cost-benefits over 20 years compared to current policies, while the home visit with preventive barrier removal policy did not.Conclusion: This thesis provides valuable insights into the impact of housing policies on older adults’ health while ageing in place. It emphasizes the need for a multisectoral approach to housing policies within the EBPHF. By addressing environmental barriers and enhancing housing accessibility, policymakers can create more effective strategies to support the population ageing in place, benefitting society as a whole.
