Housing
Introduction
The home in which we live is the cornerstone of our lives and as such has an important impact on our health. The evidence to say that housing is an important determinant of health has long been established, with the quality of housing having major implications for people’s health. Good quality, suitable and affordable housing is vital to a person’s resilience, health and wellbeing. Housing is becoming increasingly important to health when considering urban growth, ageing populations and climate change.
Everyone, no matter their circumstances, deserves to live in a comfortable and safe home that is affordable to them, in a neighbourhood where they can work, play and access the services they need. Unfortunately, this is not the case today. There are enormous disparities in the quality of the built environment across the country. These differences are caused by, and reinforce, significant inequalities in the opportunities people have and their quality of life.
The UK has the oldest housing stock in Europe and is changing very slowly over time. This is largely due to the legacy of dwellings built during the industrial revolution, which still form the backbone of our urban areas today. While still widely valued, these homes present challenges in making them healthy, safe and suitable for the future. Furthermore, too few of the right homes are built in the right places in England. For many years the supply of homes has not kept pace with demand. This has contributed to housing being unaffordable in many places, unsuitable in others and in some places both. Housing affordability has worsened across all English regions over the last two decades, with some places lacking the right mix of homes and tenures to meet local need.
Nationally, government policy has also reflected the need for more affordable, decent and safe housing mainly through the development of new homes. For example, the Social Care Reform White Paper 2022 recognises that our homes are crucial to our residents having the best possible opportunities to stay healthy and well. Furthermore, the Levelling Up White Paper 2022 states that it is “unacceptable that so many, particularly in the parts of the country most in need of levelling up, are living in non-decent homes, and some in conditions that pose an immediate risk to their health”. Furthermore, recent evidence on the quality of housing and implications for health has led to the development of policies such as the Decent Homes Standard in the UK and a drive to promote a focus on and develop the understanding of the intricate relationship between housing quality and health.
Why is it important to Population Health?
The need for warm, dry, safe and secure housing is essential to allow us to lead healthy independent lives. There is a significant body of evidence that where you live – your home, housing circumstances and your neighbourhood – can affect your physical and mental health, and wellbeing. Further to this, the evidence demonstrates a correlation between poor quality housing and poor health outcomes. Improved housing conditions can save lives, prevent disease, increase quality of life, reduce poverty, and help mitigate climate change. Additionally, poor quality housing is not equally distributed within society, with the greatest burden observed in individuals from lower socioeconomic groups and amongst older adults.
The relationship between housing and health can broadly be categorised into three main areas:
- Unhealthy and Unsafe Homes: Hazards associated with the ‘bricks and mortar’ impact e.g. cold, damp, and disrepair.
- Unsuitable Homes: The home environment does not meet the needs of a household or household member e.g. small or large households (under-occupation and overcrowding), disabled people, people whose health and care needs change, for example as they grow–up and get older.
- Precarious Housing and Homelessness: The household is living at risk of homelessness, or is homeless.
Poor condition housing is known to have significant impact on health and wellbeing, particularly for people who spend a lot of time at home (e.g. children and older people). Housing that is cold, damp, or overcrowded can also impact on people’s ability to access and sustain employment. Some people have no home at all, or unstable housing, and this is detrimental to mental and physical health in a multitude of ways. For example, affordability and overcrowding are associated with increased stress, anxiety and depression in children and adults. Communities need to be well planned and linked so that people can live well.
The Derbyshire Population Health Approach
The Derbyshire Population Health Approach focuses on prevention, population health, evidence-informed practices, causes, and collaboration. It emphasises proactive measures to prevent health issues, tailors interventions to specific populations, incorporates evidence-informed practices, addresses underlying causes, and promotes collaboration for effective action.
When considering the topic of housing within The Derbyshire Population Health Approach:
• Prevention
Supporting our vulnerable population to live in well-planned and healthy homes is one of five priorities within the Derbyshire Health and Wellbeing Strategy. Derbyshire should be a place that understands what makes a home healthy, and that works with planning and housing stakeholders to ensure a healthy housing stock. The development of a better understanding of local population, housing and health needs to inform future planning and housing initiatives should underpin a wider preventative approach to improve health through housing.
• Population
Housing-related health inequalities follow a social gradient, therefore work to improve population health outcomes must include a focus on improving outcomes for those in the poorest health; those living in insecure, poor quality, unaffordable housing, and those without access to suitable accommodation. Housing will become increasingly important to health due to demographic changes, with people worldwide now living longer and the pace of population ageing being much faster than it was in the past. In Derbyshire we acknowledge that we have an ageing population, and therefore as a system we must come together to ensure our housing stock meets this challenge to prevent the increased likelihood that our residents will fall, increasing the risk of injury, stress and isolation.
• Evidence
It is important to acknowledge that the national evidence base of ‘what works, for whom and when’ in relation to housing-related interventions is very limited in comparison with the available evidence for health care interventions. However, the local evidence base is building through the collaborative work with system partners resulting in recently published documents such as the Derbyshire Housing Health Impact Assessment 2023 which highlighted large differences in the likelihood of homes to contain serious hazards to health and wellbeing between different areas of the county. A series of recommendations were put forward, which when developed into tangible actions, will aim to address the health inequalities brought on by poor quality housing in the county.
• Causes
A major issue with the evidence that shows a correlation between poor housing and poor health, is the difficulty in determining or proving the direction of this relationship. However, housing is a key determinant of health - with poor quality or unsuitable housing intrinsically linked to poor health. Poor or unsuitable housing conditions continue to cause preventable deaths, illness, and accidents; they contribute to health inequalities, impact on how long people can expect to live and the overall quality of their lives. The pandemic has highlighted and intensified existing housing problems and exposed the impact that poor quality and overcrowded accommodation has on population health. The private rental sector is the least stable and rents are at their highest ever level. Tenants have been more impacted than people who have a mortgage in terms of arrears, and individuals who live in more deprived communities are experiencing housing payment arrears. Tenants are also more likely to live in poor housing conditions compared to homeowners. Increased living costs are resulting in more people being at risk of losing their home.
• Collaboration
In Derbyshire a Housing and Health Systems Group operates as a coalition of partners who share good practice and expertise around housing and health, as well as explore external investment opportunities and work towards a joined-up system. The partnership aims for housing to be appropriate, healthy, safe, warm, secure and affordable to meet people’s needs throughout their life course. The group is represented by Derbyshire Local Authorities, NHS, and the Fire and Rescue Service and provide system leadership across the wide range of stakeholders who play a part in ensuring well-planned and healthy homes and support the system to understand the scope for prevention.
Latest Derbyshire Data
Trend Data
Derbyshire Quilt
Prevalence Maps of Derbyshire
The maps below illustrate Lower Super Output Areas (LSOAs) and Middle Super Output Areas (MSOAs) for Derbyshire. LSOAs and MSOAs are geographical divisions used for statistical purposes, allowing for more detailed analysis of local data. In these maps, you can explore various health indicators and data for Derbyshire, providing valuable insights into the area’s health and wellbeing.