Making the Links between Health and Housing Healthy Homes – Healthier Lives Sue Adams, Director of Care & Repair England

Housing and Health Priorities: Match or Mismatch? Understanding the housing world impetus: Understanding the housing world impetus: Number of new units, especially for key workers/ homeless/ families/ first time buyers/ regeneration of areas Number of new units, especially for key workers/ homeless/ families/ first time buyers/ regeneration of areas Standard of social rented housing: target of meeting Decent Homes Standard by 2010 Standard of social rented housing: target of meeting Decent Homes Standard by 2010 Private Sector Decent Homes Target (lesser) Private Sector Decent Homes Target (lesser)

Older People: Specific Housing Focus Extra Care Housing Focus Extra Care Housing Focus Reviewing Sheltered Housing Reviewing Sheltered Housing Supporting People Future Supporting People Future Equity Release and ‘Under occupation’ Equity Release and ‘Under occupation’ [Fuel Poverty – treated as outside housing?]

Housing and Health Priorities: Match or Mismatch? Understanding the health world impetus: Understanding the health world impetus: Hospital throughput? Hospital throughput? Medical model/ Clinical focus? Medical model/ Clinical focus? Target Driven? Target Driven? Public health and prevention agendas Public health and prevention agendas

Older People: Specific Health Focus National Service Framework for Older People – and now ‘New Ambition for Old Age’ National Service Framework for Older People – and now ‘New Ambition for Old Age’ Falls prevention Falls prevention Mental Health Mental Health Hospital Discharge Hospital Discharge

The Interconnections Housing quality and availability impacts upon health agenda and priorities: Housing quality and availability impacts upon health agenda and priorities: General health and well-being General health and well-being Health inequalities Health inequalities Support to live independently (care at or close to home Support to live independently (care at or close to home Health and safety risk factors Health and safety risk factors Hence demands on health services……….

A Decent Home – at the centre Safe, suitable, adapted home Maintaining independence Housing control and choice Health and wellbeing

Poor Housing – Health Impact Physical Accidents Accidents Falls Falls Electrocution Electrocution Carbon monoxide poisoning Carbon monoxide poisoning Hypothermia Hypothermia Respiratory problems Respiratory problems Bronchitis Bronchitis Rheumatism and Arthritis Rheumatism and Arthritis Increased risk of infection Increased risk of infection Cardiovascular conditions Cardiovascular conditionsEmotional Stress Stress Isolation Isolation Depression Depression

Injury and Accidents Health Risk Housing Link Health Policy Falls Most falls take place on stairs/ steps and involved people 75yrs+ NSF OP Home Accidents Burns, scalds, CO poisoning Prevention

Accidents and Falls Every day 8 people over 65 die from a fall Every day 8 people over 65 die from a fall 2.8 million falls a year by people over million falls a year by people over 65 67% of falls happen in the home 67% of falls happen in the home Hip fractures cost the NHS £1.7billion a year Hip fractures cost the NHS £1.7billion a year Falls cost NHS £570m pa Falls cost NHS £570m pa Target in the National Service Framework for Older People : Target in the National Service Framework for Older People : “ by 2010 the number of serious injuries from accidents will have reduced by at least one tenth”

Respiratory Illnesses Health Risk Housing Link Health Link Cardiovascular conditions Cold homes (23% additional deaths from Heart Attacks and Strokes during the winter months – the increase is greater among older people and people living in older properties.) Prevention Long Term Conditions Inequalities Inequalities

Rheumatism, Arthritis, Cancer Health Risk Housing Link Health Policy Rheumatism and Arthritis Cold, damp Long Term Conditions Cancers Smoking and environment link Radon exposure Inequalities

Respiratory Illnesses Health Risk Housing Link Health Policy Respiratory Illnesses including Asthma, bronchitis Damp, condensation Poor ventilation Long term conditions management PreventionInequalitites

Resources Health Risks and Health Inequalities in Housing: an Assessment Tool Prof. Tim Blackman, University of Durham, [Healthy Homes, Healthier Lives, C&RE]

Housing: Current Situation Housing: Current Situation 30% + of HH are Older People and 90% of OP live in general housing 30% + of HH are Older People and 90% of OP live in general housing 71% + owner occupation – half of the poor are now owner occupiers 71% + owner occupation – half of the poor are now owner occupiers 33% of older people’s homes fail the decent homes standard (approx 1.8 m) 33% of older people’s homes fail the decent homes standard (approx 1.8 m) The majority (c.70%) of these non decent homes are in the private sector The majority (c.70%) of these non decent homes are in the private sector

Older People and Poor Housing People over 75yrs, those who have lived in the same home for more than 30 years and black and minority ethnic (BME) groups (all ages) are more likely to live in poor housing, People over 75yrs, those who have lived in the same home for more than 30 years and black and minority ethnic (BME) groups (all ages) are more likely to live in poor housing, The older a householder is, the less likely they are to live in a home providing adequate heating and insulation (Decent Homes Standard). The older a householder is, the less likely they are to live in a home providing adequate heating and insulation (Decent Homes Standard). 34% of households with person 85+ fail on this standard, compared to 21% of under 65’s households (SW worst TC in the country) 34% of households with person 85+ fail on this standard, compared to 21% of under 65’s households (SW worst TC in the country)

Housing and Disability There is a strong link between social class and disability, esp. early onset ( ELSA, 2002 ) There is a strong link between social class and disability, esp. early onset ( ELSA, 2002 ) 60% (3.3 million) of older households contain someone with a limiting long term illness or disability ( EHCS ). 60% (3.3 million) of older households contain someone with a limiting long term illness or disability ( EHCS ). 26% of the 1.4m disabled people who need specially adapted housing were living in homes not suited to their needs (351,000 people) ( SEH 2003/4) 26% of the 1.4m disabled people who need specially adapted housing were living in homes not suited to their needs (351,000 people) ( SEH 2003/4)

Implications of these figures Growing numbers of poorer owner occupiers who are finding it difficult to afford to maintain or adapt their homes Growing numbers of poorer owner occupiers who are finding it difficult to afford to maintain or adapt their homes Policy agenda to help and support older and disabled people to live in their own homes, but often those homes need repair/ adaptation Policy agenda to help and support older and disabled people to live in their own homes, but often those homes need repair/ adaptation

Are we Planning Housing for an Ageing Population? Decent Quality of the Existing Stock Decent Quality of the Existing Stock Decent social rented Decent social rented Decent private (Housing Health and Safety Rating Scheme Links) Decent private (Housing Health and Safety Rating Scheme Links) Adaptation of the Existing Stock Adaptation of the Existing Stock Beyond DFGs – fast track adaptations, home from hospital, Home Improvement Agency potential Beyond DFGs – fast track adaptations, home from hospital, Home Improvement Agency potential New Build - Lifetime Homes New Build - Lifetime Homes

Improving Poor Homes Decent Homes in Private Sector targeted Policies/ HHSRS Decent Homes in Private Sector targeted Policies/ HHSRS Age Proof Decent Homes Improvements Age Proof Decent Homes Improvements Home Improvement Agencies and Handyperson Services Home Improvement Agencies and Handyperson Services

Healthier New Homes Future – proof developments Future – proof developments Lifetime Homes Location Low maintenance Fuel efficient Mix of Options Mix of Options

H&H Connected Initiatives Prevention technologies grant (£80m, 06-08) Prevention technologies grant (£80m, 06-08) Community matrons (3,000 new posts) Community matrons (3,000 new posts) Health trainers (initially 12 areas, £2.4m then national from 07) Health trainers (initially 12 areas, £2.4m then national from 07) Partnerships for Older People Projects (£60m, 06-08) Partnerships for Older People Projects (£60m, 06-08) Warm Front (£450m, 06-08) Warm Front (£450m, 06-08)

Healthy Homes, Healthier Lives Care & Repair England Project which: Aims to raise awareness of housing health links and the practical actions that can be taken to improve the housing conditions Aims to raise awareness of housing health links and the practical actions that can be taken to improve the housing conditions Training initiative, primarily for health sector Training initiative, primarily for health sector

Care & Repair England Care & Repair England Care & Repair England is a national charity established in 1986 to improve the housing and living conditions of older and disabled people. Care & Repair England is a national charity established in 1986 to improve the housing and living conditions of older and disabled people. Website: england.org.uk england.org.ukwww.careandrepair- england.org.uk