Private Sector housing conditions: influencing health and wellbeing across the generations

Abstract

The private housing sector presents some of the worst housing conditions and most vulnerable occupants. Dr Jill Stewart and Anneyce Knight from the University of Greenwich look at interventions to assist those seeking evidence to contribute to health promotion activities The private housing sector (owner occupied and privately rented) comprises the majority of UK tenure and presents some of the worst housing conditions and most vulnerable occupants. Appropriate interventions can be highly effective in maintaining the physical, mental/emotional health and wellbeing of occupants and it is increasingly important to use evidence based practice in enhancing housing conditions through local plans and commissioning priorities.1,2 Poor housing in England costs over £600 million a year and the total cost to society may exceed £1.5 billion per year, providing compelling evidence for intervention.3 Good strategic approaches can help promote financial, social and environmental benefits of private sector housing renewal with a positive impact on health and wellbeing. 4 For example, improving housing can improve public health, children's education, older people's sense of security and general wellbeing as well as community sustainability. As funding is cut, it is increasingly important for local authorities and their partners to demonstrate cost effectiveness, potential for health and wellbeing improvement and likely health gain of interventions so that both social and private sector housing receive their fair share of resources. Prioritising children's housing conditions is important in order to address health inequality and bring about physical and mental health/wellbeing benefits.1,5 Children born into decent housing and environments are more likely to enjoy and maintain positive mental health and resilience to illness, including opportunities for quality social interaction. However, many families experience the constant threat of eviction; exposure to other residents with mental health, drug and alcohol problems; damp housing giving rise to asthma and related respiratory disease; lack of freedom to play in safety; and the risk of missing out on regular health care or education for frequent movers.6 Overcrowding is of particular importance in leading to problems in physical and social development as well as reduced educational attainment.7 At the opposite end of the spectrum, as people are living longer their housing needs and their ability to address these needs changes.8 One irony in the owner occupied sector is that owners may have a major capital resource, but have little to spend day to day. They may be anxious and lack understanding of equity release schemes or home loans to fund housing maintenance, repair, adaptations or improvements as well as changing social care needs. Whilst arguably those in the social housing sector have their housing and social needs met to some extent, many private sector residents risk missing out on support regimes due to poverty, social isolation and other difficulties as they 'age in place'. Older people are most likely to occupy poor housing and require home care although many wish to remain independently in their own homes for as long as possible. As the numbers reaching older age increases, so does the number of those living with progressive conditions such as dementia which in turn leads to associated higher risks of home accidents, as well as declining living environment through reduced maintenance. As housing conditions deteriorate around an ageing occupier(s), it is can also be challenging to 'design in' features that could help improve quality of life and wellbeing for occupiers and their carers, such as space for visitors, gas caps, lower windows for those who are less mobile or bed-ridden, colour coding to help avoid confusion and there is a need for new and emerging models of housing and health care services for older people.9 Fuel poverty in private sector housing has proven particularly challenging to address, due in part to this housing sector generally being older and more disparate, and not enjoying the benefits of large scale capital investment as social housing. …