Health, housing and community – making the links

In this, the 70th anniversary of the founding of the National Health Service, healthcare and its costs are at the top of the domestic political agenda.

HCI report launch

Yet access to good quality healthcare is only one of the key factors in determining health and wellbeing.

While the NHS has been central to improving both the health and wellbeing of the nation, health inequalities persist that cannot be explained by differentials in access to healthcare.

That’s why Black Country Housing Group, along with partners Coventry University, Family Kitchen, M-E-L Research, Nehemiah UCHA, People’s Health Trust and the West Midlands Combined Authority (WMCA), supported the Human City Institute’s 8th annual lecture on 7th February, delivered by Professor Sir Michael Marmot, the world’s pre-eminent expert on how health inequalities are brought into being, and perpetuated by poor housing and deprived neighbourhoods.

The lecture was accompanied by a new HCI report ‘The Power of Place: Health Inequalities, Housing and Community in the West Midlands Conurbation’, which maps key health, housing and neighbourhood data in BCHG’s home region.

The report draws on Marmot’s seminal work around the social determinants of health and the social gradient, whereby poverty, socio-economic status and inequality generally impact on mortality and morbidity rates.

Poor health and lost years of life are strongly correlated to the primacy of poor and overcrowded housing, concentrations of deprived households, high levels of fuel poverty, and poor air quality. Non-decent housing in deprived communities ensures poorer health and shorter lives, and it costs the NHS £1.4bn every year.

Males living in the most deprived areas of the West Midlands conurbation die, on average, 9.1 years before those living in the most affluent neighbourhoods.

For women, life expectancy is 7.9 years lower between the ‘best’ and ‘worst’ areas.

It is no coincidence that we use the word ‘poorly’ as a commonplace for ‘ill’. Being poor kills; it shortens life, heightens morbidity, threatens wellbeing and lowers quality of life.

Where we are born is still the major indicator of how we do in life and how healthy we are.

‘Place’ is very important in determining our health and wellbeing. And at the centre of ‘place’ is housing.

The West Midlands, like most other regions across England, has its share of housing problems, including rising homelessness and rough sleeping, and an increasing use of temporary accommodation.

Housing associations, local councils, the West Midlands Combined Authority and the community sector are working together to tackle homelessness and housing need.

For example, Andy Street, the WMCA Mayor, has established the Homelessness Taskforce, headed by the St Basils homelessness charity, a member of the West Midlands Housing Association Partnership, alongside BCHG.

At BCHG we have years of experience in community and social investment to alleviate some of the root causes of health inequalities related to housing and deprived communities.

But what is needed is a recalibration of public policy at national level to improve the health of all communities.

We must acknowledge how inequalities are constructed and persist, with solutions going beyond NHS provision alone, as important as this remains.

Primarily, we need to tackle a lack of decent and affordable housing, poverty and wider inequalities, to ensure that the health and wellbeing of all are enhanced.

Sir Michael’s lecture and HCI’s report are food for thought, and make important contributions to highlighting key health and housing issues in the West Midlands.