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The link between housing and health

The causal link between poor housing conditions and poor health outcomes is long established. The early Nuisances Removal and Disease Prevention Act 1846 is attributed with starting the process of defining unfit living accommodation by setting out procedures for the removal of ‘nuisances’ to curb cholera spread. Further public health acts followed in 1848, 1872 and 1875 to establish sanitary authorities and require new housing to have proper drainage and running water.

Housing conditions can impact physical and mental health in various ways. The independent Marmot Review (2010) said housing is a ‘social determinant of health’, meaning it can affect physical and mental health inequalities throughout life. The Marmot Review 10 Years On – Health Equity in England, recorded an expansion in research on the relationship between poor housing and health:

Poor-quality housing harms health and evidence shows that exposure to poor housing conditions (including damp, cold, mould, noise) is strongly associated with poor health, both physical and mental. The longer the exposure to poor conditions, including cold, the greater the impact on mental and physical health. Specific physical effects are morbidity including respiratory conditions, cardiovascular disease and communicable disease transmission, and increased mortality. In terms of mental health impacts, living in non-decent, cold or overcrowded housing and in unaffordable housing has been associated with increased stress and a reduction in a sense of empowerment and control over one’s life and with depression and anxiety. Children living in overcrowded homes are more likely to be stressed, anxious and depressed, have poorer physical health, attain less well at school and have a greater risk of behavioural problems than those in uncrowded homes.

The cost of poor housing to the NHS

The impact of poor housing goes wider than the actual inhabitants as conditions incubated in unhealthy housing may spread, with costs ultimately borne by health and social care services. The Building Research Establishment (2021) estimates the cost to the NHS of treating those affected by poor housing as £1.4bn per year. The most costly issue to the NHS relates to excess cold.

Fuel poverty and cold homes 

The rise in energy prices has led to an increased focus on the link between cold homes and health. A report published in 2022 by the Institute of Health Equity (PDF) notes:

Homes that are cold due to fuel poverty exacerbate health inequalities. Cold homes can cause and worsen respiratory conditions, cardiovascular diseases, poor mental health, dementia, hypothermia and problems with childhood development. In some circumstances, health problems may be exacerbated to a degree that they may cause death.

Evidence and impact of the pandemic

The covid-19 pandemic, with multiple lockdowns requiring people stay at home, is thought to have exacerbated health issues associated with poor housing and revealed additional challenges for those living in certain types of accommodation, such as houses in multiple occupation. The Health Foundation (2020) said:

The pandemic has highlighted the health implications of housing. Poor housing conditions such as overcrowding and high density are associated with greater spread of COVID-19, and people have had to spend more time in homes that are overcrowded, damp or unsafe. The economic fallout from the pandemic may lead to an increase in evictions.

The reading list

This reading list draws together reports and other material demonstrating the relationship between housing and health.

It covers literature on the links between housing and major medical conditions; the impact of different types of housing on health; and the various collaborative partnerships in place working to combat these issues.

The list comprises a selection of publications, it is not intended to be an exhaustive list.

The Library is not responsible for either the views or accuracy of external content.

Other Parliamentary Housing and Health resources include:

Commons Library briefing, CBP-07328, Housing conditions in the private rented sector (England).

Commons Library briefing, CBP-01917, The Housing Health and Safety Rating System (HHSRS).

Parliamentary Office of Science and Technology, Health in Private-Rented Housing, 04 April 2018

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