Key points

  • Living in an overcrowded household is associated with worse health outcomes. During the COVID-19 pandemic, it is also a potential route for transmission of infection.
  • People in lower income households are more likely to be in overcrowded accommodation than those in higher income households. They are also more likely to be in an overcrowded household with an adult aged over 75 or someone with a health condition.
  • People with lower incomes may be hit harder during the pandemic and associated lockdown in multiple ways, contributing to health inequalities.

What is overcrowding?

Overcrowding is measured by assessing the number of people in a household against a ‘bedroom standard’ of how many rooms they need based on age, sex, and relationship status of household members.

How many people live in overcrowded households?

On the basis of the English Housing Survey, around 810,000 households (3.5%) were overcrowded in 2017/18. This figure has been increasing steadily since 2003/04.

Households with lower income are more likely to be overcrowded. In the bottom fifth of the income distribution, 8% of households are overcrowded. This is compared to 3% of households in the middle of the income distribution, and less than 1% of households in the top fifth.

Those with the lowest incomes are also the most likely to both live in an overcrowded household and live with someone with a health condition or aged over 75 –  people identified by the government as being at higher risk of COVID-19. Over a third of those in overcrowded households in the bottom fifth of the income distribution are either themselves at higher risk from the virus or live with someone who is at higher risk, based on government definitions.

Why does overcrowding matter for health?

Overcrowding was an important social concern before the pandemic, and its importance has become clearer since.

There is some association between overcrowded households and health, which can be a source of psychological distress. For example, research suggests alleviating overcrowding reduces distress. Overcrowding can place strain on family relationships, reduce privacy and limit the space for children to study or play. It is likely that during the lockdown, the consequences of overcrowding have grown as large numbers of people are confined to their homes for longer periods of time.

There is also evidence from before the pandemic that overcrowding increases the spread of respiratory conditions. Recent research from the New Policy Institute has found a link between certain forms of overcrowding and the COVID-19 caseload, though further research is needed to understand this link fully.

The fact that overcrowding is more prevalent for those with lower incomes shows that people in these households will have more difficulty self-isolating if someone experiences symptoms of COVID-19, possibly increasing the spread of the infection.

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