Well at Home Project. Well at Home Partnership project NHS Funded Aim to improve health & well-being Targeted interventions Vulnerable residents Across.

Well at Home Project

Well at HomePartnership projectNHS FundedAim to improve health & well-beingTargeted interventionsVulnerable residentsAcross tenuresSeveral phases – currently work with GPs.

Assessing Housing ConditionsHealth & Safety Rating System (HHSRS).Looks at health impact of property deficiencies.

Range of 29 hazards – 4 groups:Physiological PsychologicalProtection against infectionProtection against accidents

PsychologicalMost of the hazards can have a psychological

component e.g. Excess Cold4 specific hazards where effects on mental

health are recognised:Crowding and spaceEntry by intrudersLightingNoise

Crowding“Lack of space and overcrowded conditions have

been linked to a number of health outcomes, including psychological distress and mental disorders, especially those associated with a lack of privacy and childhood development. Crowding can result in an increased heart rate, increased perspiration, reduction of tolerance, and a reduction of the ability to concentrate.”

Entry by IntrudersPotential effects are the fear of a possible burglary

occurrence or recurrence; the stress and anguish caused by a burglary; and injuries caused to occupants by an intruder.

The most common harm suffered as a result of burglary, or fear of burglary, is emotional stress, with 28% of victims being affected “very much”, 31% “quite a lot”, and 24% “just a little”.

LightingThe health conditions which can be caused by inadequate light

include:a) Depression and psychological effects caused by a lack

of natural light or the lack of a window with a view.b) Disturbance by intrusive artificial external lighting at night.c) Eye strain from glare and a lack of adequate light (natural or

artificial).d) Flicker caused by certain types of artificial light causes

discomfort and may cause photo convulsive reactions to those susceptible.

Noise“The best understood effects of noise are psychological

disturbances and physiological changes resulting from annoyance and sleep disturbance. Typical health effects are stress responses, sleep disorders and lack of concentration. Headaches, anxiety and irritability are also associated with noise induced stress, and the effects of sleep disturbance may affect mood the following day. Extreme psychological outcomes include suicide, and assault due to aggravation over noise.”

Cumulative HazardsMore than a single hazard, can cause

compounded psychological effects on occupiers.

Examples:Excess Cold and damp & mould growth. Dampness in a basement associated with poor

lighting.Crowding and mould growth (condensation)

Holistic HealthOften; the psychological effects on health are

not fully recognised, or admitted.This is likely to lead to no treatment or

mistreatment.Psychological stress can lead to related

physical symptoms.GPs don’t routinely think about the home as a

health determinant when treating patients.

Well at Home ProjectAims to take a holistic view of health:

Physical healthHome environment (deficiencies)

Key is visiting patients in their homesUndertaking an HHSRS assessment.Assessing their wider circumstances and

health stressors.Then offer appropriate solutions with

advocacy.

Well at Home 2012/13Currently working with GP practice in Lisson

Grove/New Elgin Practice.Raising awareness of health & housing link.Educating health professionals on scope of

HHSRS hazards.Encouraging referrals of vulnerable patients

where home environment is implicated in poor health.

Questions?Contact details:

Martin TurnerChartered Environmental Health PractitionerResidential Environmental Health TeamWestminster City Council020 7641 [email protected]