For some, the guidance to stay at home has meant more time with loved ones, catching up on DIY projects and a newly found appreciation for afternoons in the garden. For some, lockdown at home has been a positive change for their wellbeing.
However, lockdown has not been experienced in the same way by all. In the same way that certain groups have disproportionately been hit by the spread and worst outcomes of Covid-19, these same groups are often disproportionately impacted by the measures taken to control it. Those living in the 4.3 million homes that do not meet the minimum requirements defined by the government’s Decent Homes Standard, and the near 800,000 people living in homes that are overcrowded, are living through lockdown with a very different perspective.
Living in a home that does not provide a safe, warm and stable environment has profound impacts on health and wellbeing. Cold and damp conditions are associated with a range of negative health effects including the development and worsening of respiratory and cardiovascular conditions.
While living in non-decent homes has created significant problems during the summer months, the prospect of further restrictions and winter approaching indicates a greater challenge is ahead. Last year, a fifth of all excess winter deaths were attributed to cold housing. With the lockdown delaying essential works to improve the energy efficiency of homes, and the economic strain predicting more people living in fuel poverty struggling to heat their homes, there is a risk of a perfect storm this winter.
The health effects of living in poor housing during the pandemic is beginning to be unveiled. In a recent survey, nearly a third of adults reported to have had mental or physical health problems during lockdown because of the condition of, or lack of space in, their home. Analysis from the New Policy Institute has shown that overcrowded households have increased risk of both the transmission and worst outcomes of Covid-19. The top five most crowded areas in the country have seen 70 per cent more coronavirus cases than the least crowded. The unavoidable close proximity and shared facilities is the optimal environment for the virus to spread, and becomes a particularly lethal mix where a high proportion of over-70s are sharing with younger families.
The likelihood of living in a home that is overcrowded is not random. Data from the Office for National Statistics show that people from Black and ethnic minority groups are more likely to live in homes that have fewer bedrooms than needed; 30 per cent of Bangladeshi households compared to 2 per cent of White British households are overcrowded. This existing inequality is one explanation for the disproportionate Covid-19 outcomes faced by these groups.
Although the effects of Covid-19 on the relationship between housing and health are still emerging, the evidence that poor housing leads to poor health is not new information. Various policy initiatives have been implemented, including a Health and Housing Memorandum of Understanding. The solutions are well evidenced too. Of course, there is no silver bullet, but it is not an insurmountable challenge. We know the condition of our housing stock needs to improve. We also know that integrating housing, health, and care, at both strategic and delivery levels, works to prevent ill health. We only need to look towards the Healthy New Towns programme to see the potential of closer working between the housing, planning, and health sectors.
The issue of housing-related health inequalities has been swept under the carpet for far too long. We need to ensure that there is greater alignment with housing and health partners and truly live up to the expectations set in the memorandum. The pandemic and subsequent lockdown has magnified this unequal relationship and it is time to act to prevent further casualties.