It makes sense to invest in improving housing rather than paying for the consequences of poor housing – damaged physical and mental health and reduced wellbeing and prosperity – through the NHS and other agencies.
This is among the conclusions of research commissioned by the BRE Trust, Public Health Wales and the Welsh Government into ‘the full cost of poor housing in Wales’, which also found that tackling poor housing conditions does not have to be expensive and has multiple benefits.
The full report can be downloaded.
Poor housing has been defined, for the purposes of this research, as a home that doesn’t meet the current minimum Welsh housing standards because it has one (or more) Category 1 Housing Health and Safety Rating System (HHSRS) hazard.
The HHSRS identifies defects in homes and evaluates their potential effect on the health and safety of occupants, visitors, neighbours and passers-by. A Category 1 hazard is a serious and immediate risk to health and safety (less serious hazards are Category 2).
There are 29 HHSRS hazards in four groups:
physiological – e.g. damp, cold, asbestos, carbon monoxide,
psychological – e.g. space, lighting, noise,
infection – e.g. pests, refuse, sanitation, drainage,
accident – e.g. falls, electrical hazards, fire.
Wales has the highest proportion of poor housing among the UK nations, largely due to its older housing stock, and the UK has the oldest housing stock of all EU member states. The older a dwelling is, the more likely it is to represent a health and safety risk. A home built before the First World War, for example, is seven times as likely to have a significant health and safety hazard than one built after 1980.
A model developed for this study, using statistical extrapolations from the BRE ‘cost of poor housing’ research, estimated that the UK had the highest health costs related to poor housing in the EU – lagging far behind countries such as Denmark which has a very high-quality housing stock.
While there has long been a recognised relationship between poor housing and poor health, the methodology developed by the BRE Trust, which underpinned the 2008 Cost of Poor Housing in Wales report, is perhaps the most rigorous attempt to measure the cost to the National Health Service (NHS) and society.
In 2016, BRE published an updated methodology, reflecting new knowledge and information, and incorporating the re-calculation of health benefits associated with energy efficiency improvements, and updated (2011) NHS treatment costs. The recent research into the 2017 costs of poor housing in Wales uses the updated methodology, and the most recent 2017 Welsh Housing Conditions Survey data.
The recently published report, The full cost of poor housing in Wales, is the latest to provide estimates of the cost of poor housing to the NHS in Wales. The key findings listed in the report are:
- In 2017, the total number of homes with at least one Category 1 hazard in Wales was an estimated 238,000, some 18% of the total housing stock.
- The most common Category 1 hazards relate to falls in the home and the consequences of living in cold housing.
- The cost of reducing the hazards in these poor homes to an acceptable level is estimated to average £2,455 per home – a total cost of £584 million for the whole stock.
- If remedial works were undertaken ‘up front’ to mitigate these Category 1 hazards, there would be an estimated benefit to the NHS of some £95 million per year.
- Remedial works to mitigate Category 1 hazards would pay for themselves in reduced NHS costs within 6 years. The costs of improving cold homes are some of the most expensive, but also the most effective in reducing costs to the NHS.
- These costs represent first year treatment costs to the NHS alone, following a housing related accident or diagnosis. The annual cost to the NHS represents around 10% of the full economic cost to society of leaving people living in unhealthy housing in Wales, which is estimated at £1bn per year.