Bad Housing Is Harming the Health of One Fifth of England's Renters

Home is where most feel safest. For Eleanor, who rarely wants to come home, this is not the case. With her young family – a son, 11, and daughter, six – she lives in a one-bedroom flat, and the overcrowding is taking its toll. “It’s affecting my mental health. It’s affecting the children, too. I’m just so tired of it all,” says the 29-year-old.

The sofa in the living room of their socially rented home is sometimes Eleanor’s bed, sometimes it’s her son’s. Either way, it is far from an ideal bedroom setup. And with her son starting secondary school, Eleanor is well aware of how desperately he needs his own room to have space to study, grow and thrive. 

For Eleanor, the burden of having to write complaints about her family’s housing conditions while living in them manifests as stress, anxiety, low mood and poor sleep. She’s withdrawn from seeing people and socialising because she says she can no longer “wear a mask”. Pretending everything is fine got too much. Eventually, a doctor handed her a prescription for antidepressants, while her daughter is often tearful and her son has been referred to a specialist because he started sleepwalking.

“It’s very depressing,” she says. “You can’t run anywhere. You know there’s no escape or anywhere to take yourself out of it. It’s all well and good trying to make the best, but I’ve been doing that for such a long time.”

The pandemic has put our homes and their influence on our physical and mental health under the spotlight. One study by experts at the University of Birmingham showed that ethnic minority COVID-19 patients from UK areas with high levels of household overcrowding and poor housing quality faced an increased risk of being admitted to hospital, suffering from pneumonia and needing treatment in intensive care.

Dr Marina Soltan, a lead author of the study, has been calling for household overcrowding and housing quality to be considered among the risk factors for hospital admission. 

“When reviewing patients in the clinical environment, the hidden socioenvironmental risk factors to which patients have been exposed may not be immediately obvious and may not be scored in the risk triage process, yet may be important risks to consider,” she says. “Clinical risk tools need to be reflective of socioenvironmental risk factors. This work [the study] has implications for how we train healthcare professionals to recognise and work towards narrowing the gap on health inequalities.”

Now, Shelter has exposed the wider impact of the worsening housing emergency in England, with new research showing that the physical and mental health of one in five renters (22 percent) is being harmed by poor housing. That means people in 1.9 million households across the country are being made sick precisely because of the place where they should feel most comfortable and safe.

Among the problems are damp and mould, which affect 26 percent of renters; being unable to heat their homes, also affecting 26 percent; struggling to pay rent (21 percent); and fear of eviction (19 percent). People facing any one of these issues are three times more likely to say their housing situation is harming their health than those who are not.

Krystalrose, 27, has endured both housing insecurity and the scourge of dangerous mould. Fungus crept along the walls of the privately rented one-bed flat where she was raising her young daughter. Then they were evicted. “I tried to make the last place we lived in a home, but I was living on the edge the whole time,” she says. “The mould ruined my daughter’s cot, and we both became ill because of it. While I’m glad we’re out of there, it was stressful being evicted – we did nothing wrong.”

The landlord had used a Section 21 eviction, meaning they did not have to give a reason, and Krystalrose was forced to move through no fault of her own. Receiving universal credit made the search for a new place to live all the more difficult. Six in ten landlords either bar or prefer not to let to people who receive benefits, despite such discrimination being ruled unlawful.

As the family was about to become homeless, the local council helped Krystalrose find another private rental, which she accepted without even a viewing. “I thought we were going to be out on the streets. It’s made me really depressed and anxious; I’m on antidepressants because of how stressed I’ve been. I’m lucky the council helped us find a new home. But I’m scared we might have the same problems again. All I want is a home where we can feel safe and comfortable – a feeling my daughter has never known since she was born. There needs to be more safe and affordable homes for families like mine so our children can live their best lives.”

As alarming as the findings in Shelter’s research may be, the link between health and housing is nothing new, and the NHS has long been spending billions of pounds on treating people with illnesses linked to living in cold, damp and dangerous conditions. 

In 2018, a group of health, social care and housing organisations came together with government to commit to a memorandum of understanding (MoU) to improve health through the home. Burcu Borysik, the Royal Society for Public Health’s (RSPH) head of policy and public affairs, was a partner to the MoU. 

“The MoU made it very clear that the quality of the housing people have access to has a direct link to their health,” she says. “We have seen studies about, for example, damp in housing resulting in respiratory diseases, COPD [lung conditions] and exasperating asthma. We also found that the quality of housing has an impact on broader wellbeing and mental health.”

Dr Amy Clair, a social policy researcher who focuses on housing, health and wellbeing at the University of Essex, has seen that impact borne out in her own work. In a 2019 analysis, she found higher levels of C-reactive protein, a biomarker associated with infection and stress, in the blood of private renters’ than in homeowners. “That was indirectly showing that factors associated with private renting, particularly things like insecurity and lower quality [housing], were linked to [poorer] health compared with other tenures,” she explains.

Clair’s findings are echoed in Shelter’s research. In a separate poll of private renters since the start of the pandemic, 39 percent said their housing worries left them feeling stressed and anxious, while 22 percent said the problems made them physically sick. A further 21 percent of those asked said housing issues had negatively affected their performance at work. As Clair puts it: “If your safe place isn’t safe, that’s going to undermine your baseline wellbeing and mental health.”

All this comes at a time when 1.6 million people in the country are waiting for mental health support or treatment. Vicki Nash, head of policy, campaigns and public affairs at Mind, says: “Shelter’s worrying report shows the impact poor and unstable housing has on our mental health. Everyone deserves a safe, affordable, stable and suitable place to live, not somewhere which makes us feel ‘hopeless’ and worsens our mental health. Social issues such as jobs, housing and benefits play a huge role in the nation’s mental health. Addressing the underlying causes of poor mental health can prevent people from being pushed into poverty, allow people to live independently and reduce the need for more intensive support further down the line.”

Whether poor housing is affecting a person’s mental or physical health, or both, it’s clear this is a mammoth problem that won’t be fixed overnight. “If all unhealthy or poor housing were to be taken off the market tomorrow, where will people live?” says Borysik.

Shelter has long been calling for private renting reform, and is urging government to bring forward the introduction of a renters’ reform bill to protect tenants, alongside other measures to help fix the UK’s housing emergency. 

Polly Neate, the charity’s chief executive, says: “The cost of poor housing is spilling out into overwhelmed GP surgeries, mental health services and hours lost from work. The new housing secretary [Michael Gove] must get a grip on the housing crisis and tackle a major cause of ill health. 

“Listening to the calls flooding into our helpline, there is no doubt that health and housing go hand in hand. Yet, millions of renters are living in homes that make them sick because they are mouldy, cold, unaffordable and grossly insecure. The stress and suffering that comes with not knowing if you can pay your rent from month to month, or if you will face eviction, is huge. 

“The government can ease the pressure on renters’ health now by providing targeted grants to clear rent arrears built up during the pandemic, and by making good on its promise to reform private renting. But ultimately the housing crisis will never be cured until we build the decent social homes that more people need to live a healthy life.”

A Department for Levelling Up, Housing and Communities spokesperson said: “Everybody deserves to live in a decent and safe home – that’s why we’re cracking down on rogue landlords who rent out unsafe accommodation and have given councils robust enforcement tools, including fines of up to £30,000 and banning orders. The new secretary of state is clear that we must go further and our reforms of the rental sector will deliver a fairer system for all.”

The National Residential Landlords Association declined to comment.