The housing crisis is a public health crisis – renting is making people sick

Long before Britain had a welfare state, the impact of housing on health was an issue that preoccupied those campaigning for social reform. In 1901, Joseph Rowntree wrote about the “inadequate and insanitary” housing of the “struggling poor” and lamented the impact this was having on people’s health.
Today these concerns remain as relevant as they ever were. The housing charity Shelter recently found 60 per cent of renters in London – that’s equivalent to 1.5 million people – are forced to live with unacceptable conditions, including vermin-infested, damp or dangerous homes. In another report they warned more than one million children are currently living in poor quality rented homes across England, facing an increased risk of ill-health by up to 25 per cent during childhood and early adulthood.
Study after study continues to demonstrate a direct link between living in poor quality accommodation and mental health. NHS research found that, in comparison to the general population, people with mental health conditions are one and a half times more likely to live in rented housing, facing more instability, overcrowding and poorer conditions than homeowners.
When it comes to physical health, the evidence is just as compelling. Last year, researchers at the University of Essex were able to show that private renters are more susceptible to ill health than people with mortgages. In a cutting edge study Amy Clair and Amanda Hughes found that renters have higher levels of a biological marker known as C-reactive protein (CRP) than homeowners. CRP is found at higher levels in blood in response to stress, injury and infection and it can be an indicator of heart disease or chronic inflammatory conditions such as IBS or arthritis.
The housing crisis is a public health issue: bad housing makes people sick and it impacts other services. So why do we not treat it as one?
Robert Barr is the Liberal Democrat leader for Warrington Council and spokesperson on housing. Prior to this he had more than 20 years of experience on the boards of housing associations in the area. As he sees it, prevention is better than cure and investing in housing conditions can directly impact health services.
“We found that Clinical Commissioning Groups (CCGs) would fund us to carry out housing improvements such as better insulation and installing new boilers,” he tells i. “This was because doctors recognised that poor housing conditions – such as cold and damp – and the absence of a decent home is a health risk. Doctors would tell us that they were treating people with conditions that would keep recurring until their housing circumstances changed.”
In 2016 a BRE Trust report analysed one year of data and estimated that poor housing could be costing the NHS as much as £1.4bn a year. As a result, some CCGs such as Oldham and Sunderland have introduced “social prescribing” schemes where they funded the prescribing of home repairs and improved insulation with double glazing, new boilers and other insulation.
It makes sense. I’ve visited local council temporary accommodation covered in black mould and riddled with damp where young children are suffering with asthma which their mothers fear is being exacerbated by living conditions. I’ve spoken to a family with two disabled children who were sleeping in one bed because they had been made homeless by their landlord.
This year, a Shelter adviser told me they are regularly hearing from people with severe health problems who cannot be discharged from hospital because their poor quality homes might make their condition worse.
“Only recently, we worked with a family whose little girl wasn’t allowed to leave the hospital where she was being treated for cancer because the doctors couldn’t risk letting her go back to the single room in the shared house that the family lived in,” the adviser said. “Her treatment meant that she couldn’t be around lots of different people, and the doctors said the child’s health, and even her life, were being put at risk by their living conditions – an unimaginably frightening situation for any parent. So, the family turned to us for help approaching the council to try and find a more suitable place to live.”
The Chartered Institute of Housing has written at length about the role of housing in effective hospital discharge, noting that a patient not having somewhere suitable to go can drive up hospital bed occupancy rates, preventing beds being freed up for those who need to be admitted, and adding to pressures on already-stretched A&E departments.
Yet we so rarely talk about this aspect of the housing crisis. We are so focused on homeownership at the expense of social housing that we overlook the realities faced by millions of renters across the country.
If prevention is better than cure, we must address conditions in the private rented sector which is now home to many people who would once have lived in social housing. The housing crisis is not happening in isolation. It is the result of years of political neglect and it’s not only directly impacting other services but people’s health and life chances. What if we could prescribe good housing as part of a wider health and social care policy? After all, isn’t that what the huge council house building project of the last century did? Wasn’t this one of the founding principles of the welfare state?
Source: Inews