The links between bad housing and ill-health always seem obvious to anyone who has worked in the housing sector. Although controlling the spread of disease was a major factor in the surge of interest in the housing conditions of the working classes a century ago, even the advent of ‘joined-up policy making’ in modern times has failed to establish the case that spending on improving housing could be an important factor in preventing ill-health and reducing the requirement to spend on health care.
If your job involves being in and out of other people’s homes you tend to see the effects of bad housing daily but it still seems to be a poorly evidenced area of policy. It’s good then that there has been more interest in this topic recently.
A recent report by the Parliamentary Office of Science and Technology pulls together a lot of evidence from multiple sources and shows in particular the importance of the Decent Homes programme. Conditions linked to non-decent housing include: cardiovascular diseases; respiratory diseases; rheumatoid arthritis; depression and anxiety; nausea and diarrhoea; infections; allergic symptoms; hypothermia; physical injury from accidents; food poisoning. The report also points out that “Proposals to stop providing social tenancies for life may also decrease security of tenure which could lead to an increase in mental health problems”. Overall, the report says, the detrimental effect of poor housing costs the Health Service over £600m a year.
Yesterday, Shelter Cymru published research conducted by themselves and the Building Research Establishment (BRE) which estimated that poor housing costs the NHS in Wales around £67m a year. It calculates the costs to the NHS of treating accidents and illnesses caused by problems in the home such as unsafe steps, electrical hazards, excessive cold, damp and mould. If you include other disbenefits of poor housing, such as children’s poor educational attainment and reduced life chances, the wider bill to society is estimated to be even greater at around £168m a year. Shelter say this is the first time a definitive financial cost has been placed on poor housing, emphasising that the economic case for improving bad housing in Wales is as strong as the moral case. They also point to the progress made in housing under Aneurin Bevan, when housing policy was firmly located in the health department.
The report estimates that the payback time in health care savings of bringing all housing up to acceptable condition would be 22 years, but that in some areas it would be much less, for example investment in addressing dangerous stairs would be paid back in 5.7 years.
Taking the argument one step further, the resident-controlled housing association WECH has done ground-breaking research showing the beneficial effect that empowerment can have on well-being, thereby reducing ill-health. Their research shows that, although WECH residents experience high levels of deprivation, they are happier and more engaged because they collectively own their estates and feel a much stronger sense of belonging to their neighbourhood.
As Labour embarks on its housing policy review, it will be important to avoid a silo approach to housing policy. The external benefits of housing investment deserve to be at the top of the agenda.