Mould, Asthma and the Rent
The Ngata whānau - two adults and four children aged 3, 7, 11 and 14 - rent a three-bedroom house for $520 a week. Their combined income is about $900 a week after tax, so rent takes 58%. The two middle children both have diagnosed asthma; last winter the 7-year-old was admitted to hospital for two nights and the whānau made four GP visits for inhalers and chest infections. The boys sleep in a converted sleepout with no extractor fan and visible black mould along the ceiling and window frames. The landlord's response to a written complaint was to "open a window when you cook and shower." The whānau have moved three times in two years and the 11-year-old has changed schools twice. A drier, warmer four-bedroom house has come up at $640 a week, 20 minutes further from work and school. The whānau has $1,800 in savings.
1. Explain how housing is acting as a determinant of health for this whānau. Use specific details from the situation.
Read the worked answer
Housing is a determinant here because it sets conditions the whānau cannot easily change. The sleepout has no extractor fan and visible mould, and damp, cold housing is a well-established trigger for asthma and chest infections. The 7-year-old's two-night admission and four GP visits are the measurable cost. Rent at 58% of income leaves little for heating, bedding, inhaler repeats or a dehumidifier, and it also limits the ability to move - the whānau have moved three times in two years. School changes for the 11-year-old add social and educational costs. The landlord's "open a window" response shifts responsibility onto the tenant.
A strong answer separates the proximal cause (mould) from the distal causes (rent levels, the rental market, enforcement of the Healthy Homes standards, income adequacy). It also notes that the whānau's choices are real but constrained: they are not choosing damp housing over dry housing, they are choosing between $520 and $640, and the gap is $120 a week they do not have. That is a structural choice, not a failure of effort.
2. The whānau must decide whether to stay and push the landlord or move to the drier house. Recommend a course of action and justify it, referring to both short-term and long-term wellbeing.
Read the worked answer
Stay and push the landlord, with a dated paper trail - but only with a clear time limit. Reasoning: moving to $640 takes rent to about 71% of income, which creates a new health risk (less money for food, heating and transport) plus another school change for the 11-year-old. The current house can be made materially better: written notice citing the Healthy Homes standards, a request to repair and ventilate the sleepout, and a referral to a renters' service or Tenancy Services if nothing happens. The 7-year-old's admission is evidence to include in that notice.
The limit matters: if the landlord does not act within, say, eight weeks, the calculation changes, because another winter in the sleepout is a predictable harm. At that point the $640 house - after checking any accommodation supplement - may be the better trade. The decision should be reviewed against a stated trigger rather than made once. A good answer names its criteria: the children's health, the rent-to-income ratio, and school stability - and accepts that no option is risk-free.