Home truths
Tom Prendergast, senior data analyst at The Health Foundation, explains how linking property-level housing and individual-level health data can help address health inequalities.
Tom Prendergast (c) The Health Foundation
For too many people in the UK home is not a place of security and comfort but a driver of ill health, from damp and mould linked to respiratory illness to cold homes worsening chronic conditions.
Recent Health Foundation analysis of healthy life expectancy shows that people in the UK are living less of their lives in good health compared to a decade ago. Addressing the root causes of poor health and health inequalities is crucial, and decent housing is a key building block of good health. While the current Government has plans to improve housing in recent legislation such as the Renters’ Right Act and Awaab’s Law, their success relies on sufficient resources being made available for local implementation and enforcement.
Local authorities and ICBs need strong local intelligence on housing and health to targeted action effectively. In a new briefing from The Health Foundation’s Networked Data Lab (NDL), analytical teams in five areas of the UK linked property-level housing data to individual-level health data to analyse the quality of housing in their area and evaluate local housing interventions. The NDL’s work deepens our understanding of housing’s role in health and inequalities, as well as showing how we can use data to tackle these issues.
Housing’s role in health inequalities
NDL analysis in North West London ICB found Black or Black British people were more than twice as likely to be exposed to household damp and mould than White or White British people, even after accounting for socio-economic factors such as deprivation. These conditions are known to directly lead to worse health outcomes – the NDL found children who were exposed to damp and mould were significantly more likely to have respiratory and mental health conditions, while cohabitants in the same households had a higher likelihood of mental health issues compared to people living in other households.
The NDL team in Wales found private renters were four times more likely to be living in poor-quality housing compared to social renters, reflecting patterns also observed in England and Scotland. Poor housing conditions and the stress of unstable tenancies in this expanding sector have a tangible impact on health.
How we can work together for healthier homes
While the Renters Rights Act has huge potential to protect tenants, reduce unstable tenancies and remedy hazards in the home, its success will largely depend on the resources available for its enforcement by overstretched local authorities. The updated Decent Homes Standard is a particularly welcome step forward, but this will only apply to the private rental sector from 2035 onwards, pushing this pressing issue a decade down the line.
The Warm Homes Plan is similarly a prime opportunity for improving housing and population health. Fulfilling this potential will of course also rely on execution, ensuring costs are distributed fairly and improvements are completed to a high standard.
Meeting these ambitions will require co-ordinated local action and better targeting of limited resources. Local authorities and ICBs need robust evidence on whether interventions are working and where limited resources will be most efficiently deployed. This relies on effective data sharing to enable data to be linked. However, in many localities in the UK this linkage is prohibitively difficult due to high information governance barriers and rigid data sharing practices.
These barriers are solvable. Local authorities and ICBs can streamline local data sharing by creating multi-agency data-sharing agreements between providers, producing blanket Data Protection Impact Assessments that can cover multiple projects and embedding public health at the forefront of local authority strategy. Central Government should also provide clearer guidance on incorporating centrally held data on housing, such as Unique Property Reference Numbers (UPRNs), into local analyses. NDL Grampian’s work with Aberdeen City Council and the Aberdeen Health Determinants Research Collaboration (HDRC) shows these principles in action, where the NDL’s work has resulted in a long-term housing and health dataset for routine operations.
The benefits of data linkage can be immediate. For example, NDL Cheshire and Merseyside used linked housing and health data to identify areas in the Liverpool City Region with high health needs that had been underserved by the city’s retrofit programme. A ‘health needs’ tool has since been commissioned by the local authority to better target the programme, providing a model of how linked data can support the roll out of the Warm Homes Plan. NDL West Yorkshire supported the groundwork for the expansion of selective licensing regulations in Leeds by identifying areas with high rates of household hazards and high incidence of housing-related health issues, such as COPD. With Awaab’s Law bringing new requirements for social and private landlords to address hazards, gathering this evidence through linked data can help identify risks and enforce improvement before a tragedy strikes.
Improving the UK’s housing cannot wait. Against a background of constrained public resources and population health in decline, streamlining data linkage enables us to efficiently identify inequalities, evaluate housing improvement programmes and target interventions.
For our full list of recommendations, please see our briefing: Better Homes, Better Health: Insights from linking housing and health data.
