Severe housing deprivation affects about 34,000 New Zealanders. Housing is a key determinant of health but we know very little about the way that Pacific families cope with their built environments (i.e. the family home) especially when someone in the family receives a ‘home-based’ public service like home dialysis or home detention. These services are cheaper than institutional services and are likely to continue to grow exponentially in New Zealand and internationally because of the rising costs of health care and the alarming rates of non-communicable diseases. However, we need to understand more about the impacts of these services on families who at the same time experience serious issues of household crowding and other less favourable outcomes that are associated with home-based services such as fuel poverty, lack of indoor storage, minimal spatial heating and issues of waste disposal. This study will investigate the drivers and barriers of 340 households.