What Does The Latest English Housing Survey Say About Health & Housing Quality?
The latest release of information from the English Housing Survey provides some insight on the relationship between housing quality and health. We will look at some of the key findings, and offer some thoughts, here.
What is the English Housing Survey?
The English Housing Survey or EHS is an accredited official statistic. It was first published in 1967 and is carried out annually.
The survey collects information on the quality and condition of homes, alongside the characteristics and housing circumstances of households. It is based on interviews with householders and property inspections. It takes in all tenures including owner occupied, social housing and the private rented sector (PRS).
The results of each EHS are published in instalments. This latest report is the third fact sheet based on findings from the 2023-24 EHS and it focusses on health and housing quality.
More information about the methodology used in the EHS can be found in the survey itself.
Key takeaways from the survey
Firstly, it is very important to point out that this release of information from the survey does not try to positively establish or quantify a link between health and housing quality. The report emphasises that age, income, lifestyle choices and genetics – and not purely housing quality – all have an impact on your health. It points out that the relationship is very complex.
However, a key takeaway from this survey is that households living in a poor quality home are more likely to contain at least one member with a long term health condition.
More significantly, the survey suggests that this was also the case a decade ago (in 2013-14). But over the last decade there appears to have been a decrease in housing quality and an increase in the number of those households where someone has a health condition.
The findings in more detail
Sections 1-3 of the survey look at the relationship between health and four housing quality issues – damp, the ability to keep warm in winter, Category 1 HHSRS (Housing Health and Safety Rating System) hazards and overcrowding – and how they have changed over time. (For the purposes of this report we will describe homes that perform poorly against the quality measures as poor quality homes.)
Sections 4 and 5 look at how the above measures vary by type of housing tenure (social, PRS etc.) and income. Sections 6 and 7 look at the impact on children.
Household health and change over time
In 2023-24 9.6 million or 39% of households in England said that they had at least one person with a health condition. This represented a gradual rise from 32% in 2013-14 and 35% in 2018-19.
The most common types of condition were mobility issues (56%), stamina issues including breathing or fatigue problems (45%) and mental health issues (38%).
Mental health issues showed the most significant rise, having more than doubled from 17% ten years previously. (This perhaps reflects the increasing recognition of mental health as a health issue in recent years.)
Housing quality and change over time
Damp
In 2023-24 1.3 million homes suffered from damp and in 600,000 of them at least one person had a health condition.
In percentage terms, 5% of households had an issue with damp. After being 4% in 2013-14 and an improvement to 3% in 2018-19 this was a notable and unwelcome reverse.
The report suggests the limits that Covid placed on repairing damp, plus sharply rising energy costs, have contributed to the increase in damp issues.
Ability to keep warm
In 2023-24 3.2 million households were unable to keep warm in winter and in 1.6 million of them at least one person had a health condition.
This meant that 13% of households reported trouble keeping warm. This compared to 12% in 2013-14 and 9% in 2018-19. (The survey asked whether people could keep comfortably warm in their living room during winter.)
Again this was an unwelcome reverse of an improvement in recent years. The report suggests cost of living increases have contributed to this. Forty five percent of people who had trouble keeping warm said this was due to the cost of heating their homes.
Hazards
In 2023-24 around 1.9 million homes had a Category 1 HHSRS hazard and 760,000 of these had an occupant with a health condition.
The proportion of households living in homes with Category 1 hazards has actually fallen consistently over the last decade. It was 12% in 2013-14, 10% in 2018-19 and 8% in 2023-24.
This is one of the few areas the report looked at where things have actually improved. However the report does not offer any explanation for this.
Overcrowding
In 2023-24 800,000 households were considered to be overcrowded and 449,000 had an occupant with a health condition.
However the actual the proportion of households living in overcrowded homes, at 3%, has not changed over the last decade.
Health in poor quality homes
The survey found that the health of people living in poor quality homes has declined – often quite considerably – over the last decade.
In damp homes, the proportion of households with a health condition rose from 33% in 2013-14 to 47% in 2023-24.
In homes where occupants were unable to keep warm, the proportion of households with a health condition rose from 39% in 2013-14 to 52% in 2023-24.
In homes with a Category 1 hazard, the proportion of households with a health condition rose from 30% in 2013-14 to 41% in 2023-24.
In overcrowded homes, the proportion of households with a health condition rose from 34% in 2013-14 to 55% in 2023-24.
The survey suggests these figures may reflect the generally increasing levels of ill health in the wider population over the decade, but does not provide any figures on this. Interestingly it points out that the prevalence of ill health has increased in good quality homes too – although not to the same extent.
Health and housing tenure
Damp
Damp housing association homes were most likely to have someone with a health condition (69%) followed by local authority (66%), PRS (49%) and owner occupied homes (35%).
Interestingly this pattern was broadly similar in homes without damp too – except that PRS homes without damp had much lower incidences of a health condition than those with (34%).
Ability to keep warm
In properties which were insufficiently warm housing association homes were most likely to have someone with a health condition (71%), followed by local authority homes (69%), PRS (48%) and owner occupied homes (41%).
Incidences of ill health where occupants could keep warm were substantially lower in all tenures.
Hazards
Local authority homes with a Category 1 HHSRS hazard were most likely to have someone with a health condition (66%) followed by housing association (64%), PRS (43%) and owner occupied (37%).
Overcrowding
Overcrowded housing association homes were most likely to have someone with a health condition (62%), followed by PRS (56%), local authority (53%) and owner-occupied (44%).
Homes that were not overcrowded had a lower incidence of ill health in all cases – except for housing association homes where there was little difference.
Household health and income
Overall households that had at least one member with a health condition were more likely to be on lower incomes.
In 2023-24 there were around 4.2 million households in the lowest income group (the lowest 20% for the purposes of this survey) and 49% of these had at least one person with a health condition. In the top income group (top 20% of incomes) there were 5.4 million households and just 27% of these had a health condition.
Damp
Across all households with a damp problem 54% of those in lower income households had a health condition, compared to only 23% in higher income households. Interestingly the differential was similar in households without damp.
Ability to keep warm
In cold households 60% had a health issue in lower income households, but only 27% in higher income households. There was a similar differential in households which were adequately warm however.
Even across lower income groups cold homes were more likely to contain a household member with a health condition (60%) than warm homes (46%).
The health of children and housing quality
Overall, in 2023-24, there were 6.6 million households with at least one dependent child. 1.3 million of these had at least one child with a health condition.
The most common health issues were problems socialising (572,000 households), learning problems (450,000), mental health (401,0000) and stamina (including breathing or fatigue) problems (303,000).
The incidence of children with health issues was more prevalent in the social rented sector (34%), followed by the PRS and owner occupied sector (both 17%).
The report provides a lot of data about the health of dependant children in households with quality issues. However, here are some of the key takeaways from this very extensive collection of data.
Damp
There were around 534,000 households with dependent children that had damp issues. 122,000 had at least one child with a health condition.
Child health problems in damp homes were higher in the social sector than the private sector.
Ability to keep warm
Around 1.1 million households with dependent children were not able to keep warm in winter. 352,000 had a child with a health condition.
Cold social homes were more likely to have children with health problems than cold private sector homes.
Hazards
There were around 578,000 households with dependent children living in homes that failed to meet the minimum HHSRS standard. Twenty two percent had at least one child with a health condition.
The incidence of child health issues in the social sector was twice as high as the private sector.
Some thoughts on the survey results
The survey starts out by suggesting that its aim is not to establish a clear link between housing quality and health.
But it is fair to say that it probably, whether intentionally or not, does establish a link.
People with poor health are more likely to live in poorer quality housing. This, in turn, is likely to exacerbate their poor health. And, although the link here is very hard to establish, issues like damp and inadequately warm homes seem to play a major part.
An important takeaway is that housing quality and health in all kinds of rented homes appear to be declining according to this survey. Although this might be partly explained by events in recent years, such as Covid and high cost of living rises, it is still not a very satisfactory situation.
It is notable that, broadly, the private rented sector performs better overall than the social rented sector. This is in direct contrast to what many local authorities would like us to believe – especially when they are proposing more licensing schemes. It is also at odds to some extent with the findings in the second release of the 2023-24 EHS data (see below).
Either way, the report makes out a strong case for the further improvement of housing standards. Interestingly, it exposes what is often a stark difference in the health of residents in homes with damp and inadequate heating and those who do not suffer from damp and have adequate heating. This might suggest that these are areas which could be targeted for improvement.
The upcoming introduction of Awaab’s Law in the social sector, and the Renters’ Rights Bill in the PRS, might help to address some of the issues relating to health and housing quality. But the results of this survey tend to suggest it will be a challenge.
What the English Housing Survey does confirm is that the relationship between housing and health is a very, very complex one. And that is, perhaps, part of the problem when trying to find a solution.
The latest findings from the English Housing Survey on health and housing can be found in full here.
Earlier in the year we discussed the second publication of findings from the latest EHS, which you can find here: Housing Standards Improving? Findings from the Latest English Housing Survey
