Three features of the UK housing stock that are damaging our health

Countless idioms espouse the beloved relationship we have with our homes. But what happens when domestic bliss turns to hazardous abyss?

Alessandra Giusti looks at three common causes of ill health from our homes.

According to the NAO, one in five homes in England have been classed as ‘non-decent.’[1],[2],[3]
In other words, 4.7 million households fail the Government’s minimum benchmark for human habitation.
Even more staggeringly, 73 per cent of London-based study interviewees reported that their home failed to meet at least one criteria of the Living Home Standard[4] developed by housing charity Shelter and polling group Ipsos MORI.[5]

Instinctively, it seems obvious that living in substandard surroundings can have negative consequences for our health; studies demonstrating this link have been building for decades. But these empirical findings are even more shocking than one would expect, showing the detrimental impact poor quality housing can have, not only on physical health but also on mental and social wellbeing.

As a society, if we want to the keep the nation’s health tip-top we must invest in our housing stock. Particular attention should be paid to rectifying these three common causes of ill health:

1 ) The damp, the cold and the dingy

Epidemiological studies consistently demonstrate that living in damp housing is associated with a higher prevalence of poor health. If you are over retirement age, living in damp housing increases the likelihood of having fair health or worse by a third.[6] Damp causes dust mites and mould, which with repeated exposure can significantly worsen respiratory conditions such as asthma and induce other unwelcome symptoms such as wheezing, aches and pains, diarrhoea, nausea and headaches.[7] [8] [9]

Cold, poorly constructed homes also present a health risk. In fact, research suggests that cold is the main factor explaining the higher annual UK death rate between December and March.[10] [11] Good news is, under the Government’s Winter Fuel Payments scheme, if you or someone you live with are aged 60 or over, you are entitled to between £100 and £300 tax-free to help cover the cost of your energy bills this winter. [12]

Dark and dingy rooms are another unhealthy culprit. Light is an unsung hero, critical in regulating the body’s circadian system and improving sleep, decreasing fatigue, reducing depression and easing pain. [13] [14]

2 ) The poorly adapted

An estimated 1 in 6 households with an identified need for adaptations do not have the adaptation features they require, such as wide doorways, special aids to use bathrooms, entry phones or ramps. [15] Lift or stair-lift access for the elderly is particularly important given that in the home most injuries and deaths occur on the stairs.[16]

Aside from the risk of injury, reports show that elderly people living in these conditions face loss of independence and increased social isolation and anxiety.[17] [18] Yet it is often simple, low cost adaptations that can make a major difference to health and wellbeing.

3 ) The grey

It’s not just the inside of our house that can have a health impact but also the surroundings. Studies show exposure to green space near your home can greatly increase well-being.[19] [20] [21] For one thing, green space facilitates physical activity.[22] [23] For another, green space enhances air quality, with vegetation dampening the polluting impacts of road traffic and urban industries.[24]

Mental health has a particularly strong link with presence of nature, being associated with significantly lower symptoms of depression and anxiety.[25] [26] Salivary cortisol and EEG-measured brain waves have also linked green space directly to a reduction of stress and mental fatigue.[27] [28] On top of all that, green spaces provide a place for social interactions and creating a sense of community. [29] [30]

Making a house a home

Research connecting housing and health focuses where the evidence is strongest: the physical features of the home. But this tells only part of the story. We should recognise the full potential of the home as the sanctuary in which to bring together the blend of support needed for a happy and healthy life.

At Baxendale, we believe that integrating housing, health and social care can have a transformative impact on people’s lives. At its core, getting housing right can maximise people’s independence, minimise social isolation and alleviate pressures on healthcare services. With the annual cost of poor housing to the NHS estimated at a staggering £1.4bn,[31] there is every financial incentive to make housing quality a priority.

Sources

[1] https://www.nao.org.uk/wp-content/uploads/2017/01/Housing-in-England-overview.pdf  (Data from 2014)
[2] BRE analysis commissioned by PHE, from English Housing Surveys 2012/13 and 2013/14 combined
[3] A decent home: meets the current statutory minimum standard for housing; is in a reasonable state of repair; has reasonably modern facilities and services; provides a reasonable degree of thermal comfort.
[4] http://www.shelter.org.uk/__data/assets/pdf_file/0011/1287848/living_home_standard_full_report.pdf
[5] https://www.ipsos.com/sites/default/files/migrations/en-uk/files/Assets/Docs/Polls/shelter-living-home-standard-tables.pdf
[6] NatCen Social Research (2013). People living in bad housing – numbers and health impacts.
[7] Martin CJ, Platt SD and Hunt SM (1987). Housing Conditions and Ill Health, British Medical Journal, vol. 294 pp.1125-27
[8] Platt S, Martin C, Hunt S and Lewis C (1989). Damp Housing, Mould Growth and Symptomatic Health State, British Medical Journal, vol. 298 pp.555-59
[9] Ineichen B (1993) Homes and health: how housing and health interact, London: E and FN Spon.
[10] Aylin P, Morris S, Wakefield J, Grossinho A, Jarrup L, Elliott P. (2001) Temperature, housing, deprivation and their relationship to excess winter mortality in Great Britain. Int. J. Epidemiol. 30:1100–8
[11] Wilkinson P, Armstrong B and Landon M (2001) Cold comfort: The social and environmental determinants of excess winter deaths in England, 1986-1996, The Policy Press.
[12] Gov.uk
[13] Edwards, L., & Torcellini, P. (2002). A literature review of the effects of natural light on building occupants (Technical report). Golden, CO: National Renewable Energy Laboratory.
[14] IES, Illuminating Engineering Society (2008). Light and Human Health: An Overview of the Impact of Light on Visual, Circadian, Neuroendocrine and Neurobehavioral Responses. IES TM-18-08, 30 p.
[15] Provan B, Burchardt T, Suh E (2016) No Place like an accessible home. http://sticerd.lse.ac.uk/dps/case/cr/casereport109.pdf
[16] Templer J (1992) Staircase. London: MIT Press.
[17] Provan B, Burchardt T, Suh E (2016) No Place like an accessible home. http://sticerd.lse.ac.uk/dps/case/cr/casereport109.pdf
[18] https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/reports-and-briefings/health–wellbeing/rb_april15_vulnerability_resilience_improving_later_life.pdf
[19] De Vries S., Verheij R.A., Groenewegen P.P., Spreeuwenberg P. Natural environments-healthy environments? An exploratory analysis of the relationship between greenspace and health. Environ. Plan. A. 2003;35:1717–1732. doi: 10.1068/a35111.
[20] Public Health England, Improving Access to Green Spaces, 2014.
[21] Maas J., Verheij R.A., Groenewegen P.P., de Vries S., Spreeuwenberg P. Green space, urbanity, and health: How strong is the relation? J. Epidemiol. Community Health. 2006;60:587–592. doi: 10.1136/jech.2005.043125.
[22] Lackowycz, K. & Jones, A. P. 2014. Does walking explain associations between access to greenspace and lower mortality? Social Science & Medicine, 107, 9‐17.
[23]James, P., Banay, R.F., Hart, J.E. & Laden, F. 2015. A review of the health benefits of greenness. Current Epidemiology Reports, 2, 131‐142.
[24] Bowler, D. E., Buyung‐Ali, L., Knight, T. M. & Pullin, A. S. 2010a. Urban greening to cool towns and cities: A systematic review of the empirical evidence. Landscape and Urban Planning, 97, 147‐ 155.
[25] Berman M.G., Kross E., Krpan K.M., Askren M.K., Burson A., Deldin P.J., Kaplan S., Sherdell L., Gotlib I.H., Jonides J. Interacting with nature improves cognition and affect for individuals with depression. JAD. 2012;140:300–305. doi: 10.1016/j.jad.2012.03.012
[26] Kaplan S. The restorative benefits of nature: Toward an integrative framework. J. Environ. Psychol. 1995;15:169–182. doi: 10.1016/0272-4944(95)90001-2.
[27] Roe J.J., Aspinall P.A., Mavros P., Coyne R. Engaging the brain: The impact of natural versus urban scenes using novel EEG methods in an experimental setting. Environ. Sci. 2013;1:93–104.
[28] Roe J.J., Thompson C.W., Aspinall P.A., Brewer M.J., Duff E.I., Miller D., Mitchell R., Clow A. Green space and stress: Evidence from cortisol measures in deprived urban communities. Int. J. Environ. Res. Public health. 2013;10:4086–4103. doi: 10.3390/ijerph10094086.
[29] Maas J., van Dillen S.M.E., Verheij R.A., Groenewegen P.P. Social contacts as a possible mechanism behind the relation between green space and health. Health Place. 2009;15:586–595. doi: 10.1016/j.healthplace.2008.09.006.
[30] De Vries S, Van Dillen SM, Groenewegen PP, Spreeuwenberg P. Streetscape greenery and health: Stress, social cohesion and physical activity as mediators. Social Science & Medicine 2013; 94: 26-33.
[31] Building Research Establishment – https://www.bre.co.uk/filelibrary/pdf/87741-Cost-of-Poor-Housing-Briefing-Paper-v3.pdf

Alessandra Giusti

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