Why the Home Is At the Centre of Any Healthy Living Environment

Health really begins where people live. We spend most of our lives (over 90%) indoors with the time we spend in our homes accounting for most of that time. The surroundings we expose ourselves to each day will therefore have a direct influence on both physical and mental health. Poor air quality, for example, can exacerbate respiratory problems. The stress of meeting increased energy bills can take a toll on people’s mental health and the consequence of underheating severely impacts physical wellbeing. On the flip side our warming summers (and spring as we have just seen) make overheating a real health risk as well.

This means that social housing providers and their delivery partners are operating at the intersection of housing, health and sustainability. We are building increased knowledge on how buildings operate and perform, and these should feed into strategy and design approaches. Social housing has a central role to play in creating healthier places and as landlords, housing providers do more than simply manage buildings.

What do we need/could we do next?

We need homes that are safe, warm and well ventilated. In both new build and retrofit programmes, we must consistently deliver homes that meet these standards and recent proposed legislation through the Decent Homes and Future Homes Standards is providing a proposed direction of travel. Residents’ relationship with the home has also evolved. It is no longer just shelter, but a place to work, rest and thrive. That shift brings with it new expectations.

It is not just within the four walls where the focus must be. The immediate external environment matters too, including access to green space, services and active travel solutions.

Getting the fundamentals right first time

There are important lessons emerging as the sector evolves. The increased focus on damp and mould, driven in part by Awaab’s Law, has reinforced the importance of ventilation and the consequences of getting it wrong. As investment accelerates, there is a risk that insufficient attention to these fundamentals could result in the need to retrofit ventilation solutions at a later stage adding cost, disruption and avoidable risk. We need to be focusing on getting it right and getting it right first time.

This reinforces the need to prioritise quality, sequencing and performance. Installing ventilation as an early measure, ensuring systems are defect-free at handover, and providing residents with clear, practical information are all straightforward steps that can significantly improve outcomes. Beyond installation, there is also a need to strengthen post-works evaluation and build a clearer understanding of in-use performance over time.

A healthy home is also not just one that is technically compliant. It is important that they support comfort, dignity and wellbeing as well. A home cannot really be considered healthy if residents are forced to choose between warmth, affordability and comfort.

Housing, health, planning and sustainability are often treated separately despite being deeply interconnected. We are seeing providers looking for a more holistic approach to strategic asset management because there is an inherent risk in them operating in a siloed approach with Residents do not experience housing, health and infrastructure separately so the services that support them should not also.

How can we overcome this?

The housing sector talks a lot about the importance of collaboration. When we are looking through a health lens, collaboration and partnership is the only way it can be delivered effectively. To create truly healthy living environments, it is essential that we see collaboration between housing providers, local authorities, health services, community groups, energy providers, and the supply chain that delivers on all of this. Poor coordination can undermine the investment that is made in this area. Healthy places are created through systems thinking, that produces system solutions rather than in isolated interventions.

The combination of what is happening within the home, alongside the conditions and infrastructure of the wider neighbourhood interacts to shape residents’ physical health, mental wellbeing, social connection and therefore long-term life outcomes seeking to address inequalities that social housing residents often struggle against.

Because of this connection, healthier living environments can only be truly achieved by employing a joined-up approach. The home and neighbourhood are inseparable when measuring the health of the living environment. One cannot compensate the other, rather they are complementary to each other.

Sadly, disadvantaged communities are more vulnerable to experiencing health risks through a combination of factors such as poor housing, excess pollution, a lack of access to green space, weaker infrastructure and the availability of limited services. These disadvantages only compound over time, which is why a joined-up strategy to address health and wellbeing is required, because isolated interventions in separate areas rarely address the cumulative effect of inequality.

The risk of leaving the hardest homes behind

This risk is not evenly distributed. A proportion of homes will remain outside of mainstream retrofit programmes, whether due to technical complexity, cost constraints or regulatory exemptions such as MEES. These properties risk becoming the ‘silent sufferers’ of any transition, where residents continue to experience poor thermal performance, inadequate ventilation and associated health impacts despite wider investment across the sector. 

Our changing climate is exacerbating the challenges of creating healthier living environments. With our need to retrofit a large volume of our social housing stock, it points towards a need to broaden horizons and look beyond a house-by-house approach to one of a place-based delivery that can improve health outcomes.

The decarbonisation of housing cannot be delivered effectively through a one-size-fits-all, top-down approach driven nationally. The built environment (including social housing) is inherently local, with each neighbourhood possessing a different housing stock, age, construction type, density, heat demand, income profile, and existing infrastructure. This is where local placemaking becomes a strategic lever.

National policy can set targets. What it cannot do is specify how each place gets there. This requires local knowledge and intelligence.

Decarbonisation in social housing is also not just a carbon reduction exercise. It can help address fuel poverty as well and a local approach helps target the most inefficient homes, design interventions that reduce energy bills whilst ensuring residents are engaged, informed, and supported through any transition.

The Warm Homes Plan recognises a need for local delivery, and in programmes that are being delivered under government funding whole-street and whole-estate approaches are becoming the norm.

Ultimately, this is about scale. The real retrofit challenge is delivering high-quality work fast enough and at sufficient volume to meet the sector’s needs in England to 2030 and the UK’s wider climate targets. A place-based approach supports this by focusing investment and asset management by geography rather than by stock type. But it has to be the right strategy and this is why it needs to be produced by those that understand housing and the local conditions.

By adopting these themes, we can start to address inequality in social housing. If we treat retrofit as more than energy efficiency and as a health intervention that can help cut NHS costs, save lives and improve mental health, and improve educational outcomes and productivity, then the economic case shifts. It also positions social housing as a partner in health and place-making because home is where we lay the foundations for life success. So the health of that home is something we cannot afford to overlook.