One of the most basic social determinants of health is the quality of housing. Social conditions that impact one’s health include housing, level of education, employment and earning potential and their physical environment.


On January 5th 2023, Nairobi Governor Johnson Sakaja received the Health Reforms Taskforce report. The Taskforce was appointed in September, 2022 to analyze the state of healthcare in Nairobi and come up with suitable recommendations. The report lists 6 key areas of concern and 50% of them are directly tied to housing and living conditions. These are; proper housing, access to clean water and sanitation.

Poor and sub-standard housing has been associated with respiratory diseases e.g asthma, cardiovascular diseases and the increased susceptibility to stresses leading to mental health challenges. Additionally, infectious diseases such as tuberculosis, influenza and diarrhea spread faster in low-income residential areas due to their congested nature. The limited access to clean water puts many Kenyans, particularly those living in high-density low-income areas, at greater risk of acquiring water borne diseases.

“Where you live may be the strongest predictor of your health. We are thinking more and more about housing as something that we need to be investing in & supporting to improve the health of our patients,” reckons Dr Megan Sandel, an associate professor at Boston University.

Sub-standard housing isn’t old houses neither is it rundown houses. These are housing units that pose a health risk to their occupants, neighbors and visitors if any. They are often characterized by inadequate safe drinking water, poor waste disposal infrastructure and intrusion of diseases vectors such as rats and insects into the housing units.

The poor state of oversight in the construction sector has led to the proliferation of such houses in the last five years. An audit conducted by the Nairobi Metropolitan Services and the National Building Inspectorate midway through 2022 concluded that 4,000 houses in Nairobi are unsafe for human habitation. An approximate 200 lives have been lost to collapsing buildings while a further 1000 have sustained injuries in the last five years.

Proper health standards, standardized architectural frameworks and proper urban planning for better housing of urban residents should be adopted and implemented. Cases of children developing rickets since their houses get no direct sunlight all year long as a result of building congestion, should never be the case. Any attempt by policy makers to refine the health sector should also heed to the housing conditions of the local citizens. Proper housing, sanitation and adequate access to clean and safe drinking water will save many an avoidable trip to the doctor.