Latest housing research: the link between the housing and health crises

Insight21.03.257.15 AM by Abigail Davies

Abigail Davies, head of policy, strategy and impact at the Regulator of Social Housing and Thinkhouse Editorial Panel member, explores two reports that analyse the positive impact housing provision can have on social and health equity

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Abigail Davies, head of policy, strategy and impact at the RSH, explores two reports that analyse the positive impact housing can have on social and health equity #UKhousing

Reports curated by Thinkhouse this month covered a broad range of subjects, including homelessness, Black and minority ethnic representation, improving property condition, the profile of future customers, tenancy sustainment and the role of district councils in new housing supply. Several focus on the social impacts of housing provision that can, or should, be achieved through different approaches to delivery.

Building health equity: the role of the property sector in improving health is a detailed report by the Institute of Health Equity (IHE). The voice of Sir Michael Marmot, renowned for his work on the social determinants of health, runs strongly through this work.

The report starts with the premise that both health and housing are in crisis – referring in particular to trends in life expectancy, long-term ill health, housing supply, affordability and quality – and that inequalities of experience between rich and poor and between different communities are widening. It highlights the economic and social costs of these crises, and shows that they are driven by economic and social inequalities.

Housing is a key determinant of health outcomes. The report describes the many complex interrelated features of the housing system that impact the homes and places provided and in turn drive the undesirable outcomes described. The authors propose “a collaborative way forward, engaging the property sector and national and local governments to drive systemic change on how we build homes, design neighbourhoods and foster communities with health and equity at the core”.

The report illustrates how changes to multiple aspects of the way housing is provided can lead to improvements in both health and health equity now and for decades to come. It does this in a clear and accessible way, placing particular focus on what the property sector (investors, developers and operators) can do, why the sector will benefit from working differently, and how the resourcing and reform of legislative and regulatory frameworks can incentivise and support the sector.

The section on placeshaping highlights the value of prioritising health and health equity in approaches to the development and operation of housing. It considers the positive benefits that flow from the provision of amenities (services, access to nature, transport connectivity and community space) with new supply and highlights the drain on existing resources where these are not provided. It also emphasises the value of co-production, diverse communities and preparing for environmental change.

The authors recommend that independent ‘post-occupancy evaluations’ should be carried out and published for all developments. The Assessing the social impact of build to rent developments on residents and local communities report by the Quality of Life Foundation (QLF) is based on this type of evaluation.

The foundation explores the effects of three London apartment schemes on the health and well-being of residents and the wider community. It considers how different characteristics, including scale and location, inform the outcomes. It also makes recommendations for how future build-to-rent (BTR) schemes can maximise positive social effects, especially health equity.

Development features to consider

The findings illustrate resident and community perceptions of empowerment, neighbourhood safety, affordability, pollution, connection to nature, access to healthy food and leisure amenities, risk of overheating, ease of getting around and community mix. These are all features that the IHE report suggests the property sector should be actively contributing to.

Information is given on the profile of residents surveyed: 54% have an annual household income over £75,000, 98% have a university degree and 80% work full time. This made me think about ‘proportionate universalism’ advocated by the IHE as a means to tackle the social gradient seen in health and housing outcomes ie outcomes decline along the scale from the most to least advantaged. Proportionate universalism means action is needed along the gradient to improve health for everyone, with resources targeting the greatest need. The BTR schemes and residents profiled were towards the higher end of that gradient.

Overall, the QLF research finds positive impacts on health and well-being from BTR schemes due to the inclusion of managed communal spaces and activities, blue and green infrastructure, and accessible transport.

Areas of potential impact flagged for improvement primarily relate to location and building design. These include access to affordable shops, food options, summer overheating, resilience to climate change, and incidence of crime and noise. It was noticeable that the recommended ways to drive these improvements echo the IHE’s comments on the need for collaboration between the property sector, local government and communities to achieve the desired actions and associated outcomes.

These two reports use quite distinct methods to explore the need and potential for housing to contribute positively to health outcomes. In reading them together, it was interesting to see recommended practices in them applied and to note areas of consensus about next steps.

Abigail Davies, head of policy, strategy and impact, Regulator of Social Housing, and member, Thinkhouse Editorial Panel