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It’s time to recognise the link between housing and health

There needs to be a renewed focus on how good quality homes can act as an effective public health intervention.

By Richard Blakeway

Sixteen housing ministers in 14 years exemplifies the merry-go-round nature of Whitehall, especially as the man currently holding the post, Lee Rowley, is doing so for the second time.

And while this is happening, long-term housing policy goals are not always being set or even made, with the last 30 years showing how much housing can be constrained to the political ideology of any current government or minister. But if we look back in history, the most impactful interventions have been from health ministers, Christopher Addison and Aneurin Bevan to name just two. The shock of sometimes appalling housing and health conditions inspired those interventions and led to huge changes in civil society, such as the creation of social housing and the National Health Service.

Unfortunately, many of the shocking aspects of what they saw are still present today in our housing, even if not at the same scale. How is it that in the 21st century there are families with windows boarded up or windows they have been unable to close for years? Or children living in damp and mould, with different generations sleeping on floors or confined to one room, with water cascading down the walls every time it rains? Or a disabled person unable to get through doorways in their own home for many years, while home adaptations are not progressed?

Every week, we investigate cases like this where the intimate link between housing and health is present, but absent in policymaking or on-theground operations. This means risk assessments are not being done, reasonable adjustments are missed and communication between health and housing bodies is ineffective.

Yet the scale of what we are seeing is unprecedented; we’ve completed 1,000 formal investigations over the past two months, and 22,000 remedies to put things right over the past year. But the health implications of these housing conditions go beyond the physical. In some of the most severe cases we see it is not uncommon for residents to be talking of severe stress, anxiety and even suicide.

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As part of our report on attitudes, respect and rights, we called for a new royal commission – a major formal public inquiry – into health and housing. A royal commission is independent of government and not impeded by politics. It can take evidence under oath and has powers greater than a judge-led inquiry. We believe this commission could consider the role of public money, presenting a single view of welfare, health and housing spend – given the siloed approach that has existed across government for too long.

We know this would be a success because in areas where we see pockets of good practice, residents report being happier and landlords have fewer issues. For example, one social landlord has a “social prescribing” service. This enables GPs, nurses and other primary care professionals to refer people to a range of local, non-clinical services to support their health and well-being. The landlord commissioned an independent evaluation of this, finding that, of those who were supported, more than 90 per cent showed a positive change in mental well-being.

Social housing arose from a royal commission in the 1880s which envisioned healthier lives as well as new homes. There needs to be a renewed focus on housing as a public health intervention – let’s do this and give social housing the platform it needs to grow once more.

This article first appeared in a Spotlight print report on Healthcare, published on 17 May 2024. Read it in full here.

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