By Alicia Mortlock, THCA Member and Tenant of Social Housing
This blog reflects on the intersections between housing, health, and community resilience in light of new government proposals. While increased funding and reforms such as Awaab’s Law promise safer homes, the real opportunity lies in recognising social housing as a foundation for community health and wellbeing. Current approaches risk overlooking tenant voices and the systemic inequalities embedded in diverse neighbourhoods. By embracing community-led solutions, housing providers could become catalysts for reducing health inequity and building stronger, healthier futures.
A Glimmer of Optimism in New Health Reforms
Wes Streeting’s 10 Year Health Plan has given me cautious optimism about the proposed reforms. Increased funding, improved coordination between services and measures to address health inequalities could significantly improve the lives of social housing residents who have been particularly vulnerable to the widening inequalities in health and social care.
It hasn’t always been like this. Some of you may have been raised in social housing. You might have witnessed its former impetus for wellbeing and resilience at a time when social housing and its tenants played a proud and vital role in the health and subsequently the wealth of the nation.
Health Standards and Housing Reform
Housing Minister Matthew Pennycook has also been busy over the summer, releasing four consultations, one of which focuses on reforming the Decent Homes Standard. It aims to introduce new requirements that improve the safety and health of homes, many of which were constructed before current building regulations were established.
The Decent Homes Standard has been the significant framework responsible for ensuring minimum standards in homes for the last 25 years. To be deemed ‘decent,’ 29 potential health and safety risks are assessed using a ‘sliding scale’ that considers the likelihood and severity of hazards identified by the Housing Health and Safety Rating System (HHSRS). Poor housing conditions are known to worsen existing health issues and create new ones, contributing to respiratory diseases, mental health disorders, and fall-related injuries. These health impacts often result in costly treatments. According to a 2020 report from the Building Research Establishment, more than 2.2 million homes in England present at least one Category 1 hazard, which poses serious health risks. The financial burden of these risks on the NHS in England is estimated to be around £1.4 billion each year.
Tenant voices and tragedy-driven change
The conversation surrounding the empowerment of social housing tenants following the Grenfell tragedy has been extensive, focusing on giving us a stronger voice about how housing providers operate and respond to issues such as disrepair. While this initiative has seen varying levels of success, it’s important to highlight that governments have also actively engaged with informed social housing tenants in the policy-making process. We have contributed to discussions on reforms, including those related to the Decent Homes Standard. Unfortunately, our involvement came too late to prevent the tragic consequences that led to the establishment of Awaab’s Law, named after the young boy who lost his life as a result. Awaab’s Law is set to be implemented this autumn, promising better results in addressing issues related to damp and mould. It will ultimately address that wide range of hazards identified by the HHSRS, except overcrowding.
Inequalities, neglect and community breakdown
So why do I still feel that Streeting and Pennycook are on the verge of missing one of the most exciting opportunities to empower communities, improve health and wellbeing, and reduce health inequity since social housing was established by the Addison Act 106 years ago?
The failure of previous measures to tackle increasing inequalities has led to disadvantaged communities becoming neglected ‘dumping grounds’ for unresolved health and social issues. It’s not merely a question of the amount of funding allocated but rather how that funding is utilised. A fundamentally different approach is necessary – one that encourages us to look beyond the issues we are comfortable addressing and consider a broader perspective on the challenges we face. Neglect of our communities has led to a rise in significant problems, particularly the increase in tenant-on-tenant abuse and anti-social behaviour, which can adversely affect health just as much as damp and mould.
Ethnic, diversity and inclusion (EDI) policies, which aim to foster fairness, respect, and enhance inclusivity, often fall short in addressing the conflicting health and social needs of increasingly diverse communities. They are ‘paper tigers’. In the social housing sector, where success is gauged by specific performance outcomes, there is a noticeable reluctance to engage in the open-ended conversations necessary to address the significant impact of inadequate services related to issues such as addiction and mental ill-health. These issues further complicate community cohesion, especially given the strong connection between these challenges and the experiences of insecure housing and homelessness.
Living the reality of health inequality
Living on a social housing estate previously labelled ‘Crimefields,’ I see the impact of systemic failures amplified by a decade of austerity. My neighbourhood, located in a relatively affluent area of Suffolk, starkly illustrates the widening gap in health inequality. The carrier bags filled with food bank packages and canned goods serve as a clear indicator of poverty. Food banks, initially meant for short-term relief, have struggled to provide fresh produce or balanced meals. As a result, we are now facing serious health risks, particularly among children who have grown up in this environment and are contending with issues of both obesity and malnutrition.
It’s not all bad news. When I first arrived here eight years ago, our lives were shadowed by some troubling realities. Taxi drivers catered to late-night revellers, transporting them to neighbours who were drug dealers and sex workers, survivors of a community care system that had long since neglected its responsibility to actually care.
Nowadays, tenant-facing staff at my housing association share an ethos of supporting and safeguarding tenants who are experiencing short-term or extended periods of vulnerability. They are all trained to signpost us to services based on the notion that they can often be the first person to notice when things are going wrong, especially for the increasing number of us who live alone.
Towards community-centred housing and health
It can be congruous that, at a time when we really need our landlords to focus on using the money from our rents to make ‘bricks and mortar’ improvements to our homes, we are increasingly reliant on them to plug the gaps in health and social care. No longer just housing providers, but ambassadors of community care.
The 10 Year Health Plan may supplant this mishmash of care emerging from our communities. I hope not. Instead, the first signs of the resurgence of community-centric social housing should be celebrated with better funding for those who already live and work here.
