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“Housing and Public Health”

“Housing and Public Health”. Outcomes. Combination of poor housing conditions and low income can lead to detrimental lifestyle choices such as smoking or domestic violence Little research into health and housing Greater understanding of effect of anti-poverty strategies.

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“Housing and Public Health”

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  1. “Housing and Public Health”

  2. Outcomes • Combination of poor housing conditions and low income can lead to detrimental lifestyle choices such as smoking or domestic violence • Little research into health and housing • Greater understanding of effect of anti-poverty strategies

  3. Living in poor housing or being homeless are not just housing problems they have profound implications for the health of people in society

  4. Policy • Health of the Nation • No clarity on housing • Our Healthy Nation • Acknowledged social ,economic and environmental factors to health • Acheson Report • Recommended joined up government action including quality of housing, availability of social housing for less well off

  5. Who lives in poor housing? • More likely if • One parent families • Black and Asian minorities • Unemployed • Aged 16-24 years • Recent improvement in young and unemployed • Properties in poor condition occupied disproportionately by elderly

  6. In 1997 there were 2,100,000 houses owned by local authorities and housing associations that did not meet the decent homes standard. Local authorities had a £19 billion backlog of repairs and improvements

  7. Issues of Property Condition • Structure,fitness and amenities • Cold housing • Dampness • Indoor air quality • Infestation • Noise, insulation

  8. Effect of Poor housingPerceived wisdom • Excess winter deaths • Significantly higher where bedrooms seldom heated • Cold housing • Increased admissions for respiratory diseases, pneumonia, bronchitis, emphysema, heart disease

  9. BMJ Editorial Sep 04 • Lower socio-economic groups do not have excess winter mortality.(higher absolute rates) • They do not have cooler houses • Poverty is associated with poor home heating, but no increased risk • Is it due to behaviour, and brief exposure so affects all groups

  10. Effect of Poor housing • Damp homes • Wheeze and chronic cough 1.5 to 3 times normal rate • Air quality • Smoke • Carbon monoxide • Noise • Infestation

  11. Effect of Poor housing • Accidents • Falls (43% in under 5s) • Poor lighting,lack of handrails,poor stairs,straight stairs • Fires, burns,scalds • Old wiring, faulty heating, lack of fireguards

  12. Mental Health Problems • Housing density • Overcrowding • Study in women in West London • In children, higher rates of emotional problems

  13. Rough Sleepers • Mental health problems 11 times more likely • Chronic chest and breathing problems 3 times • Ulcers and skin wounds 3times • Joint problems 2 times • Sight problems 3 times

  14. Temporary Accommodation • Higher rate of chronic health problems (105%) • Higher rate of Acute health problems (78%) • Higher mental health problems (100%)

  15. Showing Influential Causes Increased risk of accidents Vandalism/Hooliganism Design of estate Burglaries Poor performance at work Groups of young people with nothing to do Fear of Crime/abuse Stress Anxiety Domestic Violence Single access point to estate Isolation of individuals in community Lack of facilities and services Reduced social contact Impaired childhood development

  16. Community Safety Difficulty moving from estate Poor appearance of estate Offenders evade capture Negative reputation of estate Single access point to estate Police approach obvious Stigmatisation Increased volume of traffic Poor bus service Isolation of Community Non-residents don’t visit Car Crime Vandalism Hooliganism Reduced social contact in community Poor diet Lack of facilities: shops, post office Isolation of individuals in community Groups of young people with nothing to do Unsafe play area Fire Service withdrawn Lack of primary + pre-school education facilities Impaired childhood development Siting of disabled units Poor lighting of football pitch Nuisance Lack of community participation Alleyways on estate Lack of play areas Fear of crime Loss of sleep Fear of abuse/intimidation Poor lighting on estate Burglaries Anxiety Increased risk of road traffic accidents Stress Irritability/tiredness Children on streets Poor family functioning Poor performance at work Domestic violence

  17. Local Facts 2003 • Average cost of house £175,733 • Income of £30,500 needed to purchase a flat • Average gross earnings £22,300 • Housing waiting list increased by 8% • 74% of single applicant assessed to be high housing need

  18. Care Trust • Commenced October 2002 • Comprises • All health services • Older people’s social work team,day care and home care • Local Authority Care Call

  19. Housing Provision • Social provision • Specialist Provision • Mother and Baby Unit • Women at risk • Difficult to house

  20. Housing Provision • Supported • Sheltered • Part 2 • Part 2.5 • Residential

  21. Types of support • Support tailored to meet needs • Home support; health and social care • Step up, step down flats • Community hospital support • Integration of health and social care • Generic workers

  22. Care Call • Historically alarm service • Expanded to incorporate tele-medicine • Falls • Wandering • Incontinence monitoring • Single point of access for health and social care services for elderly • Started with rapid assessment unit

  23. Community Schemes • Prompt home Care • Generic workers • Night owls • Tele medicine

  24. What is sheltered housing • 12 blocks • Warden managed ; part of Care Call • Variable dependency • Support • Social activities

  25. Extra Care Housing • Living at home, not in a home • Care tailored to individual need • Maintain or improve Independent living skills • Use technology to support at home

  26. Extra Care • Current sheltered housing • Young dementia • Secure environment and garden • Outreach day care • Tele link to Care Call

  27. Planning • Current position • Little integration of partners • Little recognition of health need • Need to move to • Integrated long term planning • Real needs assessment of health and social care needs • How? • LSP

  28. What else are we doing? • Fuel poverty energy champion 2003-04 • Public health advice and local needs assessments to Local Authorities housing strategies and Supporting People Programme • Develop a better referral system form Primary Care • Work with homeless team

  29. Need Further Work on • Planning applications to assess health need • Input into Housing Needs Assessment • Attend Housing Services meetings • Working with Health Visitors, Environmental Health Officers and Housing Officers on food hygiene and families living in poor quality housing

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