Tackling Homelessness and Rough Sleeping
- 04 April 2017
- Posted in: Healthcare
The environment in which we live can influence our health. Substandard housing and poor living conditions can significantly impact on health and wellbeing in a negative way. Latest figures reveal that homelessness and rough sleeping are on the rise with a 51% increase in the number of people living on the streets during the last two years. What needs to be done to reverse this trend and ensure that everyone has a safe place to stay?
In October 2016 Shelter published results against a new standard in housing. The standard assesses property against 39 criteria to ascertain whether the home is acceptable to secure the residents’ wellbeing. Shelter found that one in ten fall short of the standard with 73% of those that failed being in London. A fifth of the properties failed due to poor conditions such as cold, damp, pests and safety hazards.
It is well accepted that inadequate housing is a contributory factor to increased risk of developing preventable diseases including; respiratory conditions, cardiovascular disease, cancer and mental health issues. Over a quarter of adults living in poor conditions report having fair, bad or very bad health, whilst children are twice as likely to also have fair, bad or very bad health as compared to children living in better conditions. The association between health and bad housing is most acutely apparent amongst the elderly population. Pensioners who live in poor housing are a third more likely to have fair, bad or very bad health as compared to rest of the population.
Poor design, inferior construction and inadequate maintenance create housing related hazards and impacts adversely on safety. This increases the risk of accidents and injury and can ultimately require NHS treatment and social care intervention. In some European countries accidents that happen in the home account for more deaths than road collisions.
The urban environment plays a role in health across the whole of the local community. Noise and air pollution, a lack of green spaces and recreational facilities, plus limited mobility and transport options can exasperate the situation and contribute further to health inequalities.
A briefing from the Building Research Establishment (BRE) has calculated that the annual cost of poor housing to the NHS is at least £1.4bn. This is a significant increase and represents more than double the previous estimate of £600m in 2010 and suggests that the impact of poor housing on health is on a par with smoking. The indication is that the risks of falls and cold homes have the greatest impact on NHS costs, however, the report signifies that making cost-effective improvements to the homes of more vulnerable people will deliver considerable public health gains and budget savings.
The Care Act 2014 lays out the need for greater cooperation and integration between agencies who are responsible for providing for those in need of care and support. It places emphasis on improved collaboration between health and social care services to deliver outcome centred support to meet individual needs. To encourage improved coordination across health and housing a Memorandum of Understanding (MoU) has been established between government and its agencies such as; NHS England, Public Health England, the Homes and Community Agency, plus partners from the housing sector including trade and professional bodies. The MoU sets out a ‘shared commitment to joint action across government, health, social care and housing’ and will ‘promote the housing sector’s contribution to health’.
As part of the NHS 5 Year Forward View (5YFV) to improve population health, NHS England has turned its attention to ambitious plans to improve health through the built environment. Recognising that 200,00 new homes need to be built each year in England, the 5YFV made a commitment to improve public health with greater integration between services as part of the shaping new places process. The Healthy New Towns programme aims to factor in health and wellbeing into the design and build of new homes and communities. Ten schemes have been identified to create ‘healthy new towns’ involving more than 76,000 home and 170,000 residents.
At the Housing and Health: Working in Partnership conference we will discuss how these initiatives and others are developing to create a closer, more effective working relationship between housing services and the health and social care system.
