Transcript
24th May 2011Birmingham Social Housing Partnership
Jim McManusJoint Director of Public Health
Housing and Health: Context, Inequalities and Impact across the
Lifecourse
Coverage
• Health Inequalities – the context • Housing and health evidence - inequalities• What can be done? – impact across the Lifecourse
• LIVING IN FUEL POVERTY DOUBLES YOUR RISK OF CLINICAL DEPRESSION
• OVERCROWDING AND INFANT MORTALITY
History
• 145 Years of Public Health in Birmingham :
• Sir Alfred Hill, Birmingham’s First Medical Officer of Health, 1866-1903
• Housing work was a key plank of Birmingham’s early public health strategies
Life Expectancy by Ward
Birmingham by Cadbury Neighbourhood Classifications
• Understanding these as drivers and intervening variables
• Transit or Escalator– move to less deprived areas
• Isolate – move to equally or more deprived areas
An Example - Direct
An Example - Indirect
The Basics
• Where individuals live is strongly related to their health
• Difficult to isolate specific factors as housing is strongly linked with income, employment and other social circumstances
• A strong relationship can be established between poor housing and various health disorders
Key Points
• Housing does not operate in isolation to deliver benefits and other service providers also have a role to play.
• While physical housing conditions influence health, the wider neighbourhood context including factors such as unemployment, educational attainment etc, may well be of greater importance in determining health.
Learning the lessons from theNational Audit Office 2010not on course!
Healthy Housing
• Design• Quality of housing• Thermal Standards• Sustainability• Environment • Safety & Security• Anything else you can think of?
Unhealthy Housing
• Morbidity and mortality: High morbidity and mortality rates are observed where housing conditions are substandard.
• Psychosocial effects: The sense of isolation felt by persons living in the upper floors of high buildings is now well known to have harmful effects.
EFFECTS OF POOR HOUSING
• Respiratory infections : common cold , tuberculosis , influenza , bronchitis , whooping cough, streptococcal infections, gastrointestinal illnesses.
SKIN INFECTIONS
•
Mosquitoes,houseflies,fleas and bugs
Plague
Health Improvement
Health Protection
Commissioning priorities, Evidence, acting when evidence is silent, making it work, supporting implementation
Ensuring we have the right frameworks in place
Long term, medium term, short term impacts
What would an approach look like?
FALLS PREVENTION
Service Quality andImprovement
Timeframes of impact/yield
Years0 1 5 10 15
Planning Frameworks and Core Strategies
Education
Vitamin Supplements
Decent Homes
Air Pollution
Primary Care
Air Pollution
Decent Homes
Reducing Worklessness
Primary Care
Elements of a Strategy
Housing Quality and affordability
The Lives people lead The Environment and amenities
•Decency standards•Thermal efficiency•Fuel Poverty•Financial Exclusion•Issues for social care and health care supported by housing (independence, falls prevention, telecare)
•Quality of Education•Life skills•Self-Efficacy•Accessibility•Social Isolation•Social Inclusion
•GreenCleanSafe•Environmental cues for healthy living
This is about doing Housing in a public health supporting way,NOT making housing staff health workers
Further Resources
• Evidence briefing (Birmingham)• Primary Care Document (BCC)• NICE Paper• http://www.cieh.org/policy/good_housing_good_health.html • http://www2.warwick.ac.uk/fac/cross_fac/healthatwarwick/resear
ch/devgroups/whocc/healthhousing_papers/ • http://www.cih.org/policy/papers21.htm• AN ODD ONE -
http://www.ukessays.com/essays/geography/housing-and-health.php
• http://www.housing.org.uk/policy/older_and_vulnerable_people/housing_and_health.aspx
Thank you!
Jim.mcmanus@birmingham.gov.uk
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