Housing: introduction

Housing has an important influence on health and wellbeing through several routes, including affordability; quality; fuel poverty; and the role of housing as home within a community. Overcrowding is another important aspect of housing quality. Although improvements in housing in the 20th century reduced overcrowding, it remains an issue for many families.  A significant proportion of households in Scotland struggle to afford fuel, putting them at risk of experiencing cold and damp housing, or conversely having to make difficult choices between heating and other vital expenditure.  This is particularly the case for those with low incomes.

Moreover, the costs of housing influence where people live, the size and quality of the home that they can afford, and how much money they have left, after housing costs, to support their health and wellbeing. Housing costs can negatively affect mental health through anxiety and stress associated with factors such as rent or mortgage payments or fuel bills.

The relationship between health and housing is largely driven by the – unequal - distribution of income, wealth and dependency on welfare.  Owing to this, housing is one of the factors that contributes to health inequalities.

Higher and more economical housing standards, have the potential to help improve health outcomes and reduce health inequalities.  The extent to which Scotland is committed to tackling health inequalities via housing is reflected in Scotland’s Public Health Priority 1 – a Scotland where we live in vibrant, healthy and safe places and communities. This dedication is also reflected in the Local Housing Strategy: Guidance 2019 which recommends that ‘everyone should have access to an affordable, safe, and warm home’.   This focus on housing is not new, instead, it is returning public health back to its historical origins.

The availability of quality housing, designed and sited to meet people’s needs, and that people can afford, is an increasingly important challenge. Changing demographics, coupled with market drivers such as the ‘right to buy’ (which has reduced social housing stock) and investment in buy-to-let (which has increased the number of small-scale landlords), have resulted in an ongoing need for more high quality and affordable housing in Scotland. Related to this, the distribution of housing tenures in Scotland has changed in the last few decades. There has been substantial growth in the Private Rented Sector. Although the increased share of tenure that is most pronounced in younger age groups, many people, including families, rely on that sector to provide their home. It is vital that housing supply is able to meet demand and that all tenures provide good quality, affordable homes, to meet different needs.

Housing also affects health and wellbeing by influencing where people live, and by extension the physical and social environments that they experience, and their access to employment opportunities. More information on how neighbourhood and community affect health and wellbeing is available in the Physical Environment and Social Environment sections of the ScotPHO website.

Housing also has a role to play in supporting independent living; housing that meets people’s needs can help with enabling health care at home rather than in hospitals and care homes, preventing accidents, and keeping people active.

Housing, through its availability and affordability, is part of the complex set of factors that cause homelessness. More information on this critical issue, and the profound impact of homelessness on health (and health services), can be found in our Homelessness section.