Open houses and closed rooms: Tokelau housing in New Zealand

The migrant Tokelau community in New Zealand, through the Wellington Tokelau Association, is playing an active role in partnership with the Wellington School of Medicine to develop a research program to help improve the health of its people. The relationship between crowded homes and health was investigated in six focus groups. While cultural patterns were an essential part of Tokelau hospitality, the decision to "double up" households was often the result of "rational" economic decision making in relation to household expenditures such as rent and food. The implication for public health practitioners is that while overcrowding may be a health hazard for residents, the most effective solutions by the community are higher household income and more flexible housing designs that accommodate multifamily households.