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Housing and Health – The Connections (and why the Government is looking in the wrong place for a solution to the housing crisis)

Peter Ambrose Visiting Professor in Housing Studies Health and Social Policy Research Centre University of Brighton, England

Socialist Health Association Camden 23 February 2008


Establishing housing/health links •

It is not easy – the medical profession often uses a different standard of proof

Health status is an outcome of a large set of factors

Best to argue that good housing is a necessary but not sufficient condition for good health

Well-designed chronological ‘intervention’ studies give best chance to demonstrate the relationship

But these are difficult to carry out


The Stepney ‘Health Gain’ Study 1995-2001 •

Contracted to assess the health gain from the SRB1 renewal of two estates

Sample of households surveyed for self-reported health before and after the area improvement

Self-reported ‘illness days’ fell from 35% of all person/days to 7%

These findings, and the connection to housing quality, backed up by professional opinion in the area

Project judged as one of 19 acceptable ‘intervention’ studies from 30,000 assessed (MRC Project at Glasgow University)


Other recent empirical work •

Stepney study found that better housing was linked to huge health improvement – but increased housing costs causing stress and problems

So ‘healthy housing’ means affordable housing!

Work on households with low incomes in Brighton and Hove showed the extent of stress caused by high housing costs – as did study of debt levels in Brighton and Hastings

Current study of SE region for UNISON showing 76% of households say high living/housing costs affecting health and these are households in top third of income range!


So what is happening here? •

1993 to 2004:

Recent survey - nurses cannot afford to buy in 97% of towns surveyed (was 43% in 2001)

Nationwide ratio of house prices to gross annual earnings historically 2.5 to 4.0 – was over 6.0 in London for 14 quarters to late 2006

gross earnings index +59.1% house price index +306.8%


Deep orange areas – house prices = more than 8x earnings


How over-lending has produced the problem In the 1980s the Thatcher Governments deregulated the finance sector = huge flow of house purchase credit – House Purchase Debt outstanding 1980 – if updated to 2007 at general inflation – if allow for expansion of OO volume

= £53bn = £154bn = £192bn

– actual 2007 House Purchase Debt = £1000bn+ = £800+ bn ‘excess’ House Purchase Debt - Has risen from 23% to 80% of GDP


House prices, consumer prices and earnings since 1980


NB - The effects of prices on rent levels •

Two connecting mechanisms between price levels and rent levels: - since 2000 new ‘social’ rent-setting formula has taken capital values into account - in private rented sector the proprietors look for a competitive level of net return on capital values of properties

Result - from 1980 to 2003 average % of male earnings taken by rents has risen: Public sector Not for profit sector Private sector

+ 93% + 37% +122%


Heavy long-term mortgage debt means… – long term exposure to interest rate risks – constraints on making private pension provision – effect on work/life balance? (NB UK long working hours and EU Working Time Directive issue) – effects on age of bearing first child? (future NHS costs) – more reliance on non-parental childcare (both parents working – connection to UNICEF Report findings?) – more stressful complications on relationship break-up – effects on organised labour’s bargaining capacity – mortgage repayments maybe continuing into retirement?

all these can have adverse effects on health and welfare and generate public costs


…and the Government’s response? •

Simply increase supply by a target amount that most agree is not enough

Use the words ‘affordable’ and ‘social housing’ without realistic definition in terms of household finances – we need precise definitions!

And what if output goes up by 1% per year but the flow of lending increases by 5% per year (as it is at present)?

A HOLISTIC policy required that takes steps to regulate lending as well as increasing supply

And we need to measure the health and other costs of NOT adopting rational long-term housing policies


Thanks for listening


Health and Housing