Housing and Social Justice: Health
26th May 2022
The Health Equity Commission for Cumbria and Lancashire is preparing to present their recommendations to our leaders of Public Health. They see addressing poor housing as one of the most significant ways to reduce health inequality.
We were fortunate to have Tammy Boyce from the Institute of Health Equity (IHE) with us as we discussed Housing and Health at the latest of our open conversations looking at Housing and Social Justice (on 11 May 2022). The IHE is responsible for the Marmot Review, Fair Society, Healthy Lives (2010) and the 10-year appraisal of progress – or lack of progress - made since (2020). It has taken that work forward in 2021 through the Health Equity Commission for Cumbria and Lancashire; a comprehensive investigation of the causes and consequences of health inequality in our population. ACTion with Communities in Cumbria (ACT) has taken part in Commission Workshops on the links between housing and health.
The poor quality of our housing stock is a barrier to good health for many people. The biggest problem areas affect both physical and mental health. They include cold and damp; overcrowding; and poor condition generally. Clearly, the current crisis for many people to meet the cost of heating their homes will add to the problem.
Respected charity, National Energy Action states that there were 8,500 deaths caused by cold homes in winter 2019-2020. Urgent action is required to address both the causes and effects of this appalling statistic, particularly in light of additional financial pressures on low income households.
The Commission also recognizes the huge health and social benefits of the connections and networks around a home; it’s not just bricks and mortar. Community cohesion; opportunities for employment and education; and access to green space are all factors which contribute to better health outcomes.
Our audience of Housing Association, Local Authority and Public Health representatives were interested in sharing ideas on how health and housing sectors can work better together. There seem to be opportunities for thinking more holistically about new housing development, how it can create healthy communities ‘by design’. There is also more which can be done to ensure that recovery from medical intervention is not held up because of poor quality housing.
Given that 80% of the homes we will be living in in 2050 are already built, there is a pressing need to upgrade our existing stock to meet warm, decent (and net zero carbon) standards. If poor housing stock is making people ill the economic argument for fixing the problem is strong, because ill people can’t work.
Throughout this exploration is an underlying theme of poverty. People do not choose to live or continue staying in housing which is insecure or bad for their health; there is no alternative that they can afford. Our housing market is now completely off-kilter with average incomes. Failure to replace ‘right to buy’ homes with affordable rental properties for the next generation, the boom in second homes, buy-to-let and the Airbnb market compound the difficulties for those on low or insecure incomes.
ACT recently did a small survey, gathering observations about shifts in our housing mix in the past 12 months. Many responses echoed the concern that working people on average local incomes are being priced out of their rental homes by the financial reward of the holiday market – and even where homes are available on an ‘affordable’ basis to rent or buy, the formula for affordability at 80% market value leaves them far beyond the reach of many local workers.
But there is ambition to make change happen. Event participants looked to what they could do straight away – for example support people to access available grants for home improvements (insulation and draft proofing) to reduce associated health problems. And then they looked to where they could influence others. Joining up thoughts about a healthy workforce and good housing stock to reduce pressure on the health service could be a conversation to bring to our Local Economic Partnership, in tandem with health commissioners, housing associations and public health professionals.
One of the suggestions of the Health Equity Commission is that housing associations could take on more of a ‘community anchor’ role, in partnership with health commissioners, providing a supportive and responsive role for tenants, addressing issues before their health needs escalate, and certainly when they are, for example, returning from a stay in hospital.
The economic case has already been made that it is more expensive to look after sick people than it is to fix their poor housing. Spending money preventatively will be a hard-sell in the current climate, but better understanding of the impact poor housing is having on our workforce, our healthy life expectancy and our mental health may help convince people to take another look.
You can watch the session in full here:
For more information about the work of the Health Equity Commission for Lancashire and Cumbria follow this link: https://www.healthierlsc.co.uk/hec Their recommendations are not yet published.
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