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Dr Steve Rolfe from the University of Stirling and Dr Lisa Garnham from Glasgow Centre for Population Health report on their study of housing, health and wellbeing. This article originally appeared in Evidence, HQN's quarterly housing update produced in collaboration with UK Collaborative Centre for Housing Evidence and HSA.
The existing evidence base is very clear that housing has a significant impact on health and wellbeing. Homelessness and poor quality housing have been shown to damage physical and mental health in a range of ways.
However, there are also subtler, more complex ways in which housing can affect health, which are less well researched. We set out to examine some of these less tangible links between housing and health in a study that followed more than 70 tenants renting from three different social and private housing organisations in and around Glasgow over the first year of their tenancy.
Our data showed most tenants were experiencing a notable improvement in their health and wellbeing, as Figure 1 illustrates.
Through qualitative interviews, we discovered that the crucial factor for tenants was whether they felt at home in their new tenancy. And we found that there are four key foundations for this sense of home which housing organisations can deliver.
A good relationship
The tenants involved in our research told us how important it was to be able to deal with a named member of staff, who knows them personally and understands their situation. This was particularly true when tenants had had difficult experiences in the past:
“How can I describe it? I feel I have some good people in my life now that I can depend on and I feel very comfortable in the situation that I’m in right now. There’s no deception there, there’s no sleazy landlords, nothing like that.”
Where landlords built a positive relationship, this not only helped tenants to settle and feel at home, but also gave them confidence to get on with the rest of life – finding work, reconnecting with friends and family and trying new things.
Focus on property quality
Basic minimum standards are important, but the tenants in our study emphasised that the finishing touches are also crucial in making somewhere feel like home. However, people have different expectations, aspirations and capacities. Some tenants told us that they needed a property which was already well-furnished and decorated, while others wanted an empty shell to refurbish in their own style.
So, landlords need to understand these differences and give tenants the support they need. Where this goes wrong, it can undermine the whole tenancy, as with this tenant who moved into a property with damaged plasterwork:
“The walls in here are pretty bad and at one point I phoned the housing officer and I says to her, I’m going to have to give you that house back. That’s far too much work for me… I feel dead unsettled and anxious. I still can’t sleep at night in it.”
Sensitivity to all housing costs
Concerns about housing affordability tend to focus on rent levels or fuel poverty, overlooking other housing-related costs. Tenants told us how stressed they were by the costs of moving, furnishing and decorating their new property, and generally coping with the financial chaos of a new tenancy.
Again, landlords need to have a relationship with tenants, so that they can understand their financial situation. Where landlords were able to offer flexibility and support to tenants with paying the rent and managing other housing costs, this helped to sustain the tenancy – which not only contributes to tenants’ health and well-being, but also maintains rental income for landlords.
“The fact that they are looking out for my own wellbeing… helps me get through. I mean, money’s stressful, especially when it’s tight. So, when you know your landlord is not just… wanting the money through the door every month, he’s actually hoping that you’re okay and you’re able to afford it, it’s reassuring. It helps… keep the stress levels down.”
Offer choice in location
It may be cliché, but our research shows that location really is important. When tenants have a choice of where to live, it can make a real difference to their health and wellbeing. For some participants in our study the key factor was being close to friends and family, while for others it was more about peace and quiet:
“I’m 100% happier. I’m basically not depressed anymore, as soon as I moved out of that flat in [previous area] and moved here it was such a huge change… I want to go outside and meet people and stuff like that, whereas back there it was ‘I don’t want to go out, I just want to curl up in a ball, I’m dying for this to all go away’. So now it’s just like aye, bring on life!”
What does this mean in practice?
Clearly there are substantial challenges for all housing organisations in delivering these four foundations for the health and wellbeing of tenants. In order to address these challenges, we co-produced our final recommendations with housing professionals, policy makers and tenants.