Over the past 5 years of my life, I have been a renter. My experience of living in rented accommodation has not often been great. Mould, damp, cramped conditions and absentee landlords aren’t unusual. Short-term tenancies have meant that I have moved house each year, with significant disruption and often a period of staying at friends’ houses in between tenancies. These conditions have at times had a significant impact on my own mental health, and that of my housemates.
It therefore seems obvious to me that housing conditions have a direct impact on health. Until recently however, these were considered very much as separate issues – with evidence, research and policy siloed into their respective fields. I’m glad the links between health and housing are being highlighted now.
A perfect opportunity for joined up thinking
Greater Manchester Housing Action (GMHA) is a coalition formed in the context of the deepening housing crisis in the region, to collectively develop people-first solutions to the region’s housing crisis. We at GMHA believe that more of this joined up thinking is necessary if we are to address the multiple social crises we face. The historic opportunity of regional devolution presents us with a chance to do just this.
It has long been known that there are links between mental and physical health and homelessness. According to the Health Needs Audit 2016, 78% of homeless people report a physical health condition – twice as many as the general population. A similar ratio exists for mental health, with 44% of homeless people having a diagnosis, compared to 23% of the general population.
It is also known that homelessness is a direct result of the housing crisis. A lack of social housing means that many on the lowest incomes are forced to find homes in the private rented sector where short term tenancies, rent hikes and the threat of no-fault evictions all make long-term security difficult. Shelter estimated last year that 78% of the rise in homelessness since 2011 is the result of evictions from private tenancies.
The impact of insecure housing on health: a study in Newham
Now an emerging strong body of evidence is focusing specifically on the impact of insecure housing on mental and physical health. Of all London boroughs, Newham has the highest number of residents in temporary accommodation. Participatory action research conducted by academics Kate Hardy and Tom Gillespie, working with campaigners from the London housing group Focus E15, revealed the extent to which this insecure housing affects people’s health.
The findings revealed that housing insecurity was leading to a dramatic rise in hidden homelessness, with 86% of respondents saying they had sofa surfed in the last 5 years. For those who were housed in temporary accommodation, the experience was often one approaching slum conditions, with families forced to share rooms and live in damp, poorly maintained properties.
A significant proportion of respondents had a disability (22%) or health condition (48%) which affected their housing needs. Mental health was the most common issue among respondents. 89% mentioned worsening mental health as a result of their housing situation and the number of those reporting suicidal thoughts was over twice that of the general population.
Out of borough displacements were found to have an intense impact on individuals’ health. A majority of respondents had either been offered housing outside of their borough (some as far afield as Newcastle) or asked to look for it themselves. The report revealed that some of the most vulnerable people in Newham are being forced to live in a state of permanent insecurity. These displacements are hugely disruptive – requiring changes of schools and jobs, for example – with significant effects on children as well as the mental health of adults.
What about health and housing nationally?
This is not just a London phenomenon. Research conducted by journalist Alex Turner for the Guardian last year revealed that this is happening across the UK. In Manchester, he revealed that between April 2016 and April 2017 at least 125 families were rehoused by the council outside of the city, in neighbouring boroughs such as Oldham and Rochdale.
Over the next year, GMHA will engage in research conducted by the University of Manchester to establish the degree to which this displacement process is taking place here, and how this affects health. This project will act as a point of comparison with Newham, and will add evidence to the important and growing body of work on housing and health.
Can devolution work in our favour in Manchester?
GMHA believes this research agenda comes at a crucial time in our region. Significant powers have been devolved, including housing and the region’s £6bn health and social care budget. There have been political changes too, most notably with the election of Andy Burnham to the regional mayoralty. Devolution has shaken up the landscape – new agendas and alliances are being brought to the fore. Paul Dennett, the new mayor of Salford, is making significant inroads in housing at the local level, for example bringing about the first construction of council houses in Salford for three decades. He is also leading the rewrite of the city’s housing strategy.
This moment therefore opens up a rare opportunity to take a different approach to housing in Greater Manchester. As is now clear, the impact of housing on health is undeniable. A holistic approach that considers the effects of insecure and low-quality housing would be truly innovative. Greater Manchester could, and should, lead the way in delivering a society that works for all – one with a healthy, happy and housed population.
Isaac Rose previously worked as a research assistant at Manchester Science Partnerships, where he saw first-hand how devolution was presenting opportunities to innovate in the region’s health and social care. He is now an organiser for Greater Manchester Housing Action, which campaigns for a progressive and just solution to the region's housing crisis.
Our next Healthy Lives infographic on how money and resources affect our health will be released on Tuesday 30 January.