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Evidence about the effectiveness of Healthy Homes training: The Bristol Evaluation

In 2001 Bristol Care & Repair commissioned an independent evaluation into the healthy homes assessment training pilot project. The resulting report, Repairs on Prescription and Healthy Homes Assessment, provides information and anecdotal evidence of the impact training has made upon front line health and social care staff in Bristol. A copy of the report can be downloaded in pdf format here.

Healthy Homes, Healthier Lives: Evidence of the link between housing conditions and health

There is a growing body of evidence highlighting the key relationship between poor housing and risks to health. Some circumstances give rise to a range of debilitating illnesses, whilst cold, damp housing is often indicated as a major factor in excess winter deaths.

Summary of common housing faults & their impact on health

Damp, condensation and mould growth:

  • Asthma
  • Bronchitis
  • Other respiratory problems
  • Arthritis & rheumatism
  • Mental health problems such as depression
Cold homes:

  • Respiratory illness
  • Cardiovascular conditions
  • Hypothermia
  • Increased risk of accidents and falls
  • Impaired mental function
  • Mental health problems including depression and isolation
  • Rheumatism and arthritis
Defective & inadequate electrical wiring

  • Risk of injury caused by electric shocks or house fires
  • Risk of accident or injury if circuits fuse or trip frequently and if sockets and switches are inadequate or poorly located
  • Trip hazards caused by trailing wires and extension cables
  • Mental health problems - worry about fire risk
Defective Gas Appliances of Coal Fire

  • Carbon Monoxide poisoning
  • Risk of explosion in case of gas
  • Fire hazard from blocked chimneys or flues
For a copy of the training notes which give an overview of the causes of these conditions and possible remedial actions click here

Policy Context

  • Most older and disabled people wish to be supported to live in the general housing stock; and a key part of health and social care policy is to support this wish. There are national government targets with regard to increasing the number of people supported to remain living in their own homes (e.g. DH/ Treasury public service agreement target for older people's services- 30% of total being supported by Social Services should be supported to live in their own home by 2006).

COMMENT: It is fundamental that the homes which older people are supported to live in are warm, comfortable, of a decent standard and suitably adapted to meet their needs.

  • In order to achieve National Service Framework for Older People Standard 6 (Falls Reduction) targets, the three major factors affecting falls will have to be addressed - multiple medication, environmental improvements (e.g. Grab rails, home lighting etc), and muscle tone (DTI evidence based).

COMMENT: The removal of home hazards is an essential action in terms of improving the housing conditions for older people who wish to remain in their home.

  • Undertaking essential adaptations in people's homes can make or break a person's ability to live independently, findings backed by the Audit Commission.

COMMENT: Finding ways to deliver adaptations faster and more effectively is an important aspect of promoting independence.

  • Older and disabled people, and people from black and minority ethnic (BME) communities, are disproportionately represented in poor housing (English House Conditions Survey/ Survey of English Housing, ODPM).

COMMENT: This has an impact on the higher incidence of health problems within BME communities.

  • There has been a large growth in the level of owner occupation (up from 59% to 71% in two decades), particularly amongst lower income groups (50% of all low income households are now owner-occupied). Many face problems with the maintenance and adaptation of those homes.

COMMENT: This could have an impact on people's health and ability to stay put in their own homes as they age.

  • There is a national policy drive towards greater integration of services and cross sector working, particularly in health and social care, with the single assessment process being an important element of this.

COMMENT: Ensuring that housing needs are an integral part of that assessment is a stated objective of the revised process.

For information about housing services that improve health see the Care & Repair England Report 'Healthy Homes, Healthier Lives'

Supported by:
The Rayne Foundation The Change Agent Team Housing LIN.