HEALTH _ HOUSING IN BROMLEY

							HEALTH & HOUSING IN BROMLEY

Poor   

housing: poses a health risk that is the same magnitude as smoking affects 33% of all homes in Bromley particularly affects vulnerable groups, such as the very young, the elderly and those suffering long-term ill-health  can lead to falls and serious injury  contributes to poor mental health

Background Shelter to keep us warm and safe is a fundamental requirement for human survival but in a society where most people do have a roof over their head, the quality of that housing still has a huge impact on health. The 1996 English House Condition Survey showed that 1,522,000 UK dwellings did not meet the required fitness standards. For many already deprived communities, the only housing available is substandard. The social and physical characteristics of the surrounding area are also vital in maintaining good health. The fact that poor quality accommodation is often situated in impoverished surroundings with few local amenities contributes further to making vulnerable individuals housebound. ‘A decent home is one which is wind and weather tight, warm and has modern facilities’ Under the Government’s Decent Homes Standard, a home is defined as ‘decent’ if it:  Is fit for habitation and meets the minimum requirements defined in the Fitness Standard.  Is in a reasonable state of repair.  Has reasonably modern facilities.  Provides a reasonable degree of thermal comfort, with efficient heating and effective insulation. Housing in Bromley In Bromley there are about 130,000 dwellings, of which approximately 83% are in owner occupation. The Council no longer owns any housing and all social housing is supplied through registered social landlords. The council carries out a housing condition survey and an energy efficiency survey every 5 years. Building Research Establishment data from 2005 indicates that approximately 33% of private sector dwellings in the Borough fail the Governments Decent Homes Standard. Reasons for failure to meet the standard in the Borough are set out in the following table:

Fails to provide a reasonable degree of thermal comfort

25%

Fails the minimum Fitness Standard Is in a state of disrepair Lacks reasonably modern facilities

3% 9% 4%

Properties in poor condition are more likely to be occupied by older people, or those on low household incomes. The number vulnerable households occupying non-decent dwellings highlights inequalities across the borough. Vulnerable households are four times more likely to occupy non-decent dwellings if they live in certain wards within the borough, illustrated below:

According the House Condition Survey 2000, 93% of homes in the Borough are without cavity wall insulation and 10% of dwellings have no loft insulation. A recent study in the British Medical Journal reported that insulating existing houses led to a significantly warmer, drier indoor environment and resulted in improved selfrated health, self-reported wheezing, days off school and work, and visits to GPs as well as a trend for fewer hospital admissions for respiratory conditions. Health effects of poor Housing Falls Home accidents caused by environmental hazards are most common among older people and very young children, especially in low income households. Most fatal falls are on stairs/steps among people aged 75 plus. 1.22 million people were victims of a fall in their own home in 2002. Of the reported falls, 378,123 were experienced by people aged over 65 and 36% of those falls resulted in a fracture (ROSPA, 2002), There are more than 3000 deaths each year among people aged 65+ due to falls (HSE, 2001), In 2001, the combined NHS and social care costs for a single hip fracture in the UK were estimated to be over £20,000 (NOS, 2001) Cold Housing The main cause in Bromley of homes not meeting the Decent Homes Standard is lack of thermal insulation. This leads to cold homes, fuel poverty and related ill health.

What is Fuel Poverty? Fuel poverty occurs when a household cannot afford sufficient energy for health and comfort. This can be due to:    Low household income Inadequate or expensive heating Insufficient thermal insulation

A household is regarded as fuel poor if it needs to spend more than 10% of its income on fuel to heat the home properly.

Cold homes can cause or worsen hypothermia, asthma attacks, heart attacks, strokes or deep vein thrombosis, respiratory illness, arthritis, accidents and mobility problems, mental health conditions and sickle cell related problems. Damp homes and condensation may promote mould growth and dust mites, causing respiratory problems, especially among young children, older people and allergy sufferers. Dampness and cold are also associated with mental health problems. Housing design and environment Housing type such as high rise, floor level or housing quality have all been linked to mental health. High rise living can be associated with poorer mental health impact on children and mothers because of lack of play space and social isolation. Young mothers are particularly at risk and studies have shown that women in their early 20s are 3 times more likely to consult a GP for mental health problems if they live in flats. The general design of a neighbourhood, access to communal areas and especially access to natural spaces have also been found to affect mental health and wellbeing. Children with ADHD have fewer behavioural problems when they spend more time in natural settings, low income housing areas in London with less access to private gardens have higher prevalence of depression. Inaccessible public spaces both indoors and outdoors can discourage physical activity and social participation, and may impair mental health and access to services and amenities. What is being done in Bromley? Coldbusters This is a LB Bromley grant scheme designed to provide loft insulation, cavity wall insulation and central heating systems. The grant maximum is £4000 and residents have to be in receipt of a qualifying benefit. It is only available to homeowners or private tenants.

Handyman Scheme The council-run handyman scheme started in 2005 and was developed in order to facilitate timely hospital discharge and help to eliminate hazards that might eventually result in a property becoming unfit or non-decent, reduce the number of accidents in the home, as well as help vulnerable people remain in their own home. Typical works include the provision of hand rails, securing loose floor coverings, improved security or very minor repairs that householders may risk injury in carrying out. The scheme has been very popular and successful, uses local contractors, and provides effective falls-prevention work.

Staying Put Staying Put is a Council scheme aimed at providing help and advice to elderly and disabled residents in deciding what home improvement work needs to be carried out, help with finding a builder, advice and assistance whilst works are in progress and in obtaining finance from a suitable source. Energy Local Area Agreement The Energy Local Area Agreement Project Plan will ensure that all eligible homes have loft and cavity wall insulation installed and where possible bring them up to the Decent Homes Standard. The Decent Homes Standard specifies a good standard of repair with appropriate heating and insulation and reasonable facilities. A programme of publicity, discounts and grants will be used to encourage the installation of loft and cavity wall insulation in non-decent housing occupied by vulnerable people. The projects will focus on the private rented and owner occupied sectors. This is primarily due to the fact that recent research has shown that the worst housing conditions are found in these sectors and the social housing sector have their own targets to meet under the Decent Homes Standard by 2010 Warm Front This is a Central Government grant scheme designed to provide loft insulation, cavity wall insulation and central heating systems. The grant maximum is £2700 and residents have to be disabled, have a young family or be over 60 and be in receipt of a qualifying benefit. It is only available to homeowners or private tenants. Energy Efficiency Commitment Eight utility suppliers have a target from the Government to achieve energy savings. These companies offer various schemes to install loft insulation and cavity wall insulation. If residents are on a benefit, the insulation measures are usually installed free of charge. What are the gaps? Handyman Scheme The future funding of the Handyman Scheme beyond late-2007 is not known.

Referral pathways It is important to identify opportunities and processes which can be used to target vulnerable households and reduce health inequalities. Referrer training Health professionals and other agencies, who frequently visit people in their own homes, are in a unique position to identify vulnerable households and raise awareness of available assistance. Training of professional referrers will ensure awareness of project and the schemes available to residents to help them improve their living conditions.