How and to what extent is health considered in English housing policy: a thematic analysis of national Government housing policy documents since 2010

Abstract

BackgroundPoor housing is detrimental to health. In England, around one in five homes fail decent homes criteria. The aims of this study were to map changes within English policy affecting housing for lower income households and explore the extent that health features in government housing documents. MethodsWe did an analysis of English housing policy documents between May 12, 2010, and Aug 1, 2019. English language UK Government publications on housing policy strategy, guidelines, consultations, and committee reports were included. The search was not comprehensive. Rather, we sought key policy documents by searching GOV.UK, consulting stakeholders, and checking citations. After identifying the main housing policies introduced during this period, we used thematic analysis to examine if and how health and health inequalities were considered in these policy documents. Findings71 documents were identified in our search. Each covered housing policies related to one or more of the following policy areas: social housing (n=34), supported housing for elderly and disabled people and people in housing crisis (n=35), private rented sector (n=8), home ownership (n=15), and healthy places (n=7). We identified the following health-related themes: focusing on vulnerable populations, temporary versus long-term health issues, health and housing welfare entitlement, environmental exposure to health and safety hazards, insecure housing, and the contribution of housing to healthy places and communities. Many policy documents distinguished between people requiring long-term sheltered or supported housing (typically focusing on elderly and disabled people) and people susceptible to acute housing crises requiring short-term interventions. Policy documents were less detailed on the health impacts housing policies could have on the wider population, including policy discussions of public expenditure constraints, welfare restrictions, and short-term tenancies. A few policy documents from 2017 onwards made some reference to the stress and harms of short-term and insecure housing—notably private rented homes—and the overall housing market has been described by the government as broken. InterpretationSince 2010, housing policy documents typically considered health in the context of public expenditure and social and supported housing. Wider population health impacts of housing policies received less attention. Recent changes in rhetoric should be monitored for their sustainability and health impacts. FundingNational Institute for Health Research (NIHR) School for Public Health Research (grant no PD-SPH-2015).