1. The Health and Wellbeing Profile for Hackney and the City 2009: Housing Hackney Better Homes Partnership, 17 th December 2009 Vicky Hobart Public Health, NHS City and Hackney

2. Overview Our population Health and well being priorities Housing and health: Access to housing Security of tenure Housing conditions Local neighbourhood/community Individual behaviour Role of the planning system Role of the partnership

3. The population of Hackney Population of 223,364 –young population, high birth rate –ethnically diverse –deprivation and affluence Life-expectancy –women 82 years –men 75 years 1 in 4 residents smoke 1 in 3 children obese or overweight 28% consume 5+ portions fruit & veg daily More than half the population does not participate in sport or exercise regularly

4. Health and wellbeing priorities Read the Health and Well-being profile Longer male life expectancy will be a key indicator of success

5. Housing and health

6. In priority need- for a home or housing related support? Nowhere to stay, vulnerable or inappropriately housed in temporary accommodation Older people Disability Families Poor mental health Recent release from institution (prison, armed forces, care)

7. Access Household composition in Hackney (2009)

8. Tenure Changes in housing tenure in Hackney and the City (2001 to 2008)

9. Housing conditions Average number of people per household across Hackney and the City (2008)

10. Neighborhood and community Active travel Public transport Crime & fear of crime Anti social behaviour Visual appeal Access: healthy food, culture & leisure, green space Community facilities and health services Social capital and neighbourliness

11. Care outside hospital

12. The planning system Collaboration between health and planning authorities Shared evidence base Core strategy and Local Development Frameworks Investment strategies Planning contribution priorities Health impact assessment, strategic environmental assessment and sustainability appraisal

13. Evidence base Mental health density and lack of an ‘escape’, design (including high rise and deck access dwellings), physical distress (including vandalism and poor maintenance), housing quality (eg damp), fear of crime, and neighbourhood noise. Obesity and cardio-vascular disease walking and cycling ways connect homes with schools, workplaces and shops; improving accessibility to open and green spaces and sport and leisure facilities; and removing environmental barriers to enable residents in deprived areas to become physically active Respiratory diseases modify both the total volume of traffic and congestion of traffic at specific locations. This may have a preventative effect on cardio- respiratory disease, saving the NHS an estimated £1,400 to £2,500 per admission to hospital avoided. Excess winter (cold) and summer (heat) related deaths ensure that measures are incorporated into the layout of a development to reduce the heat island effect and to improve insulation. Injuries Spatial planners can introduce area-wide traffic calming measures that reduce child injury rates, and address inequalities. ‘Home zones’ can support new or existing neighbourhoods become accessible for community use eg play, walking and cycling. Road bypasses decrease accident rates, but the evidence that new major urban roads can impact on local road networks and accidents is less strong. Injuries and falls in the home are a common and significant risk for older people, and falls cause 4% of injury deaths in older age groups. Simple behavioural and environmental adaptations can reduce the risk of trips and falls in the home, but the evidence of effects of wider environmental adaptation in the home is weak.

14. To do list… Housing related support (SP) Environmental Health Care closer to home Case studies Specific data

15. Role of the partnership Develop the local evidence base Balance unmet need and future demand Potential for further joint commissioning? Identify priorities for Health Impact Assessment Shape how we deliver strategic priorities: Sustainable community strategy & LAA, Core strategy, Health Strategy Take up opportunities & manage risk Future of supporting people programme Care outside hospital

16. Key messages Acute levels of housing need in Hackney But much achieved in recent years Housing is a fundamental determinant of health and well being Access to a home and/or housing related support is key to improving health outcomes, achieving independence (and reducing health and social care costs) Huge opportunity for collaboration between health and borough planners

17. Next steps Comments by Friday 15 th January to anna.garner@chpct.nhs.uk Or vicky.hobart@chpct.nhs.uk