Michael Tornow: Healthy Homes for Scotland



Michael Tornow, senior health improvement officer with Public Health Scotland (PHS), introduces ‘Healthy Housing for Scotland’ – a briefing paper published by PHS which outlines evidence for how housing impacts on health and wellbeing and makes recommendations for further research.

In March the Scottish Government published Housing to 2040, Scotland’s first ever long-term national housing strategy. It sets out a route map for how, by 2040, everyone will have a safe, high-quality home that is affordable and meets their needs in the place they want to be.

The positive contribution that Housing to 2040 will have on improving health and tackling health inequalities in Scotland must not be underestimated.  Realising the right to adequate housing for communities across Scotland is central to the commitments in Housing to 2040 and upholding the right to housing is fundamental to realising the right to the highest attainable standard of physical and mental health. These rights are shared by all of us but communities across Scotland are not enjoying them equally – this is an injustice and we need to work together to address it.

With this in mind, Public Health Scotland has published Healthy Housing for Scotland, a briefing paper that aims to assist with impact assessing policy developments related to the Housing to 2040 strategy, locally and nationally. It also aims to support public health colleagues who are working locally, regionally and nationally with housing colleagues in the process of designing, implementing and evaluating policy decisions.

The briefing paper seeks to do this by outlining evidence for how housing impacts on health and wellbeing. Evidence informed policy development is key to tackling inequalities and ensuring that resources are used in a way that creates the most impact. Many policies, plans, proposals or decisions have the potential to impact on health and health inequalities.

Estimates vary, but it is widely accepted that health is largely shaped by factors beyond access to health care. Further, the factors that do influence health – the social determinants of health – which include housing, are connected intricately to the other determinants, for example employment, education and income. Building on this, we must consider the evidence base and opportunities to maximise on the impact that policy development can have on addressing inequality and upholding the right to health for communities. We also need to consider unintended consequences which can be negative if not properly scoped and assessed.

Our briefing paper draws on current evidence to set out the mechanisms and pathways for how housing can influence health and wellbeing. It offers an overview of available evidence which is relevant to the breadth of Housing to 2040 and focuses on priority themes including affordability, accessibility, house conditions, low carbon, energy efficiency and climate resilience, marginalised communities, homelessness, mental health and place and community.

Our paper has drawn on over 100 sources of evidence, including some published by CaCHE. Despite this evidence we conclude there is an imperative for public health colleagues, housing colleagues and academics to contribute to future research that builds on this. Housing to 2040 sets out an ambitious route map that sets a path for realising the right to housing but it will require innovation, new ideas and for us to learn as we go. Capturing this learning and using it to inform policy and practice is key to ensuring the future of housing policy is progressive, impactful and fair.

In particular, we suggest further research is needed on:

  • the impact of energy efficiency measures on health and wellbeing. For example, the experience and support needs associated with the use of indoor ventilation systems; the impact of improved energy efficiency on indoor air quality and the use of space and fuel in the home;
  • the impact of decarbonisation measures on health and wellbeing. For example, the impact of heat networks on households and communities;
  • how measures to adapt to climate change impact on health and inequalities, for example measures to mitigate against the risk of flooding;
  • the lived experience of how poor quality, inaccessible and insecure housing impacts on health and wellbeing across the lifecourse;
  • how current housing policy and practice impacts on how the right to housing is upheld for marginalised communities;
  • strengthening the causal links between access to private garden space and health and wellbeing;
  • what is the cost of changing from homogenous housing types and style to a mix of house size and styles and how does this affect affordability? and
  • what is meant by culturally appropriate housing in Scotland.

We look forward to supporting public health colleagues, housing colleagues and academics to make use of our briefing paper and for them to join us in making the call for healthy housing for Scotland.

To download our briefing paper-Healthy Housing for Scotland please visit our website here.

To discuss opportunities for continuing to strengthen the evidence base for how safe, high-quality homes that are affordable and meet the needs of our communities impacts on health and wellbeing please contact phs.healthandhousing@phs.scot

This article was originally published on the CaCHE website.



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