People’s housing circumstances and home environment impacts on people’s health and wellbeing. The home environment is also important for enabling access to other health improvements like employment, social networks, essential services, and green spaces. The Director of Public Health’s annual report 2019/20 states that personal outcomes and opportunities are also shaped as much as where we live as who we are.
‘Our home is not just a dwelling place. It should be a place of comfort, shelter, safety & warmth. . . it is the main setting for our health throughout our lives.’ Source: Public Health Matters (October 2015) Bringing Together Housing and Health
The Decent Home Standard is a minimum standard that council and housing association homes must comply to. However, in 2019 1 in 5 homes did not meet the decent home standard in England.
A healthy home must be:
- Affordable and offer a stable and secure base
- Able to provide for all the household’s needs
- A place where we feel safe and comfortable
- Connected to community, work and services
Shockingly, the annual cost of poor housing was said to be £1.4 billion in 2019/20 – and this is only the effect to the NHS alone! (Source: The Director of Public Health’s annual report 2019/20)
Please see above for a diagram showing the link between housing and health taken from The Director of Public Health’s annual report 2019/20)
Living in a cold home – impact on health
Living in a cold home can lead to a range of poor health outcomes including lung and heart disease, falls and poor mental health. It is also associated with additional winter deaths. People who are especially vulnerable to the cold, include: those aged 65 and over, babies and pre-school children, those who are pregnant, those on a low income who cannot afford to adequately heat their home, those with existing health conditions, those with poor mental health; and people with physical disabilities.
Living in an overheated home – impact on health
The health harms from overheating will become a greater issue with the ageing population, increased urbanisation / densification, and climate change. Significant impacts on occupant health and behaviour of overheating can include dehydration, heat cramps, water retention e.g., swollen ankles, dizziness and fainting, heat rash as well as falls and accidents. It can also exacerbate existing health conditions. Vulnerable people are most effected by excess heat like older people, children, infants, people with dementia or learning disability with an inability to adapt, care home residents and those living alone and socially isolated.
Childhood accidents – impact on health
Accidents in and around the home are a leading cause of preventable death and are a major cause of ill health and serious disability for children under five years old. Childhood accidents are generally caused by several factors including: the physical environment in the home, overcrowding, the availability of safety equipment, being unfamiliar with surroundings (e.g. visiting friends or relatives), child development, the knowledge and behaviour of parents and carers (including literacy), levels of supervision/ distraction and new consumer products in the home.
Falls in older people – impact on health
Every year one in three people aged over 65 trip or fall. The cost of falls to the NHS is estimated to be more than £2b per year (figures from 2019). Poor households conditions can increase the risk of slips and falls like loose fittings of carpets and rugs, stairs, hazards posted by hoarding and lack of grab rails in toilets and bathrooms.
Overcrowding – impact on health
Overcrowding is defined as one or more of the following: two children over the age of 10 of different sexes sharing a bedroom, parents having to share a bedroom with a child, more than two people in one bedroom and kitchens and living rooms being used as bedrooms. Overcrowding causes poor emotional and mental wellbeing and also lower educational attainment in children. Many children in overcrowded homes struggle to do their homework. Overcrowded conditions can also lead to increased risk of infectious diseases. In 2019, it was reported that 12% of children in England lived in overcrowded homes with just under half of these sharing a bedroom with an adult. In more than a quarter of overcrowded homes adults are forced to sleep in kitchens, bathrooms or hallways because of the lack of space. Overcrowding is far more common in low income households including for those placed in emergency and temporary accommodation. Building regulations do not set minimum room standards which needs to be tackled. Furthermore, homes converted from former commercial premises under permitted development rights have been noted as having the smallest floor spaces of any dwelling type.
Indoor air quality – impact on health
The health effects of poor indoor air quality include asthma, chronic obstructive pulmonary disease (COPD), respiratory irritation, and vascular problems23. Mould or damp can exacerbate asthma in children and lead to increased rates of GP appointments as well as hospital attendances and admissions for respiratory tract infections as well as for uncontrolled asthma. It has been shown that getting rid of damp and mould can reduce the respiratory symptoms and that well-designed, ventilated, and well-maintained buildings are important to prevent and control moisture. Indoor smoking has a range of health harms on those in the house that do not smoke and include childhood wheezing, asthma, other respiratory disease, ear infection, cardiovascular disease and sudden infant death syndrome. Poor indoor air quality can be caused by:
- Passive smoking
- Mould, damp and cold
- Wood burning
- Biological materials like house dust mites
- Carbon monoxide by badly managed gas appliances
- Solvents seeping from plastic, paints, and furnishings
- Asbestos
- Poor ventilation
Hoarding – impact on health
Hoarding within the home is most often caused by an occupier having a hoarding disorder. This is where someone acquires an excessive number of items and stores them in a chaotic manner, usually resulting in unmanageable amounts of clutter. The items can be of little or no monetary value or use. A hoarding disorder can affect a persons’ life in multiple ways. They may be unlikely to have visitors which can cause isolation and loneliness. Risks to health from hoarding include falls, fire, and neighbourhood nuisance and pest infestations29. One in four domestic fire-related deaths can be linked to hoarding.
Fire – impact on health
In the UK, there is a four-fold risk of death in a fire in homes that do not have a functioning smoke alarm and two fires a day are started by heaters. Faulty electrics (appliances, wiring and overloaded sockets) cause around 6,000 fires in the home across the country every year. It is recommended that everyone has regular appliance checks, smoke alarms in working order and are aware of potential hazards brought on by candles, smoking, heaters, cooking and poorly maintained electrics.
Mental wellbeing – impact on health
The charity MIND has summarised the key impacts of housing conditions that affect emotional and mental wellbeing:
- The physical condition of the property – damp, cold, dull homes have a negative impact on a person’s mental health
- Affordability of the property – living in expensive and unsecure housing can cause people a great deal of stress, thus impacting negatively on their mental health.
- Overcrowding – overcrowding is strongly linked with depression, anxiety and stress
- Local environment – If the neighbourhood is in disrepair, with a lack of green spaces and poor facilities this can affect mental health, as can the perception (and in some cases, the reality) of high rates of crime, sense of safety and noise.
Crime – impact on health
Feeling safe and secure in our homes is essential for good emotional and mental well-being. Crime and the fear of crime can threaten this in many ways.
Services and access – impact on health
The following are strongly linked to good health and well-being:
- access to green spaces
- safe walking and cycling routes connecting our homes to essential services
- local services including shops, libraries, leisure facilities, schools, GP and community pharmacists
- communal spaces to meet other people and socialise
In contrast, the following are linked to poor health and also to higher rates of obesity:
- residential areas with poor networks into local communities
- lack of green spaces
- lack of safe pedestrian routes
- lack of access to affordable healthy food
- proliferation of hot fast food takeaway outlets
The Hampshire Homes Hub (which is part of Action Hampshire) helps improve people’s living conditions in Hampshire by encouraging rural affordable homes and community led homes. We work in urban and rural parts of the county and are here to encourage local people to come together to meet their own housing needs or the housing needs of people in their community.
If you are interested in finding out more about the work we do, please contact our Community Led Housing Officer, Mags Wylie, T:07801 699913 E: mags.wylie@actionhampshire.org
