High-rise health: a qualitative study of the effect of social housing improvements on the health and wellbeing of residents in high-rise flats

Abstract

BackgroundThe UK Government has committed to bringing all social housing up to a reasonable standard (the Decent Homes standard). Improvement in health is cited as a primary motivation for this policy, but little published research into the actual rather than anticipated health effect of this intervention exists. This qualitative study aimed to explore residents' views of Decent Homes improvement work in relation to their health and wellbeing. MethodsExternal (insulation and double glazing) and internal (rewiring, new kitchen and bathroom, central heating) improvements were made to 103 socially rented flats in three high-rise blocks, in Jarrow, South Tyneside, UK, between February, 2012, and October, 2013. During March and April, 2014, semi-structured interviews were completed with 11 self-selected residents from a sampling frame of all residents who had the home improvement work and participated in a before-and-after survey (n=65). Data saturation was reached, and interviewed residents were representative in terms of sociodemographic and health characteristics to those surveyed. Data were analysed thematically following the Framework method (NVivo, version 10). FindingsThe housing intervention increased people's feelings of positivity towards their homes, thereby improving dimensions of psychosocial wellbeing. Residents reported warmer homes and reduced heating costs. Perceived safety improved, with residents citing modifications as making them less anxious about falls. The housing intervention also facilitated the adoption of healthy behaviours, with residents citing examples of: placing restrictions on smoking within the home because of pride in their wallpaper; cooking from scratch rather than relying on microwave meals because of the increased kitchen work surface space; and putting money saved in heating costs towards purchasing higher quality foods. InterpretationIn an area with limited research, this qualitative study provides insight into the perceived health effect of social housing improvements in a deprived area and represents an area for extended research. The housing improvements positively affected perceived health in the domains of warmth, safety, and psychosocial wellbeing, and might also have had indirect benefits in facilitating the adoption of healthy behaviours. FundingSS is funded by the National Health Service through Health Education North East. Transcription costs and thank you acknowledgements for participants were funded by South Tyneside Council. The funders had no role in data collection, analysis, or interpretation.