Can Housing Improvements Cure or Prevent Health Conditions?

One of the policy interventions that GoWell is studying is improvement works to people’s homes, carried out by their social landlord/factor.  We have previously studied the impacts of such works upon the overall physical health and mental health of the occupants.  But a recent review of the evidence in this area suggested that housing improvements could have their greatest impacts when targeted at those in most need, for example those with pre-existing health problems.   For this reason we turned our attention to the impacts of housing improvements upon self-reported health conditions.

GoWell is almost unique in being able to break down the package of housing improvement works into its main constituent elements.  For this study we focused on four housing improvement works (new kitchen and bathroom and rewiring; central heating; new front door; fabric works to buildings) and six health conditions lasting twelve months or more (respiratory conditions; circulatory problems; digestive/abdominal problems; migraines and persistent headaches; skin conditions and allergies; and stress, anxiety and depression).   

Using GoWell’s longitudinal survey data, matched with property records from Glasgow Housing Association (Wheatley Group) we tested associations between the four housing improvements and the six health conditions, during the period 2006 to 2011.  Looking firstly at people who already had one of the health conditions, we tested twelve pathways between the four housing improvements and recovery from the conditions.  Secondly, looking at people who did not report the health conditions to start with, we tested 17 pathways whereby the housing improvements might prevent the onset of health conditions.   To our knowledge, this kind of analysis, testing plausible pathways between housing improvements and health conditions in two directions, has never been attempted before.

Our study found evidence to support three of the pathways between housing improvements and health conditions.  Where people had received fabric works to their buildings (including new roof, insulation and over-cladding) they were more likely to recover from stress, anxiety or depression.  Where people had received either fabric works or central heating works, they were more likely to recover from circulatory conditions such as high blood pressure.  We found no evidence that housing improvement works prevented the onset of new health conditions.

The research is available in this open access article in BMC Public Health: Can housing improvements cure or prevent the onset of health conditions over time in deprived areas? and is summarised in GoWell Briefing Paper 24: Health effects of housing improvements.