It is widely assumed that living in damp and draughty housing can seriously aggravate pre-existing health conditions, such as asthma. It is also expected that tackling such issues will lead to improved health among residents. However, to date very little research has been undertaken to determine if such measures do result in lower levels of morbidity. The new duties of partnership between local councils and health authorities also require greater coordination on issues such as housing and health, and establishing how to do this effectively is important.
In the mid-1990s, Cornwall and Isles of Scilly Health Authority granted £300k to six local authorities in the region to undertake improvements to social housing properties occupied by families with children diagnosed with asthma. This funding was used to fund new central heating systems with the express purpose of improving the health outcomes of children with asthma, which was a health priority in the area.
Key research Question
Two phases of research were completed. Part One investigated whether the retrofit programme resulted in a detectable improvement in the health of children previously diagnosed with asthma living in these properties. Part Two considered whether this indicated that investing NHS funds in domestic energy efficiency offered value for money as a preventive health measure.
Summary of activity
In Part One of the project, the researchers identified children with asthma living in social housing via data held by local health services. Using these data, local housing officers then completed a baseline questionnaire with parents, which collected quantitative data on a range of health symptoms and days lost from school owing to ill health, as well as details including the property type, heating system and presence of pets. This questionnaire was repeated at least three months after the installation of a new central heating system, and the energy rating was remeasured. Data on 72 children in 59 properties were captured via the initial and follow-up questionnaires.
In Part One, local housing officers also conducted assessments of damp and other household conditions and calculated the properties’ energy ratings.
In Part Two of the project, data were collected from GP records for 47 children in 41 households, and the number of contacts with health services and the amount of medication prescribed for a year before and a year after the intervention were recorded. The researchers completed a cost–benefit analysis of the impact of the intervention on the NHS and other services, as well as any differences in household fuel spend.
Part One: Significant reductions were noted in the frequency of all respiratory symptoms linked to damp housing and the time absent from school.
Part Two: Savings to the NHS were calculated to be £488.15 per household, which on its own exceeded the cost of the improvement works. An average reduction in fuel bills of £214.81 for each home and an increased value of £108.36 per pupil were also estimated.
Therefore, funding retrofit installations that improve the energy efficiency of social housing represents value for money for health services.
Paper 1: More coordination is needed between the health and housing sectors, and a national strategy is required to outline the relationship between housing and health. Further action is required to ensure that both social and private housing are included in projects and are not treated separately.
Paper 2: While investment does benefit households, the turnover in social housing populations should be taken into account when measuring impacts. Further research should be undertaken to verify the findings.