Housing: introduction

Housing affects health

Housing has an important influence on health and wellbeing through several routes:

• Affordability: 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. Many households in Scotland rely on benefits to meet their housing costs; principally Housing Benefit for social housing, and Local Housing Allowance in the private rented sector.
• Fuel poverty: A significant proportion of households in Scotland struggle to afford fuel, putting them at risk of experiencing cold and damp housing, or having to make difficult choices between heating and other vital expenditures. Whether a household experiences fuel poverty is determined by the energy performance of the dwellling, the cost of fuel, how the household uses fuel, and household income.
• Quality: e.g., overcrowding. Although improvements in housing in the 20th century reduced overcrowding, it remains an issue for many families.
• Local environment: housing influences where people live, and by extension the physical and social environments that they experience, and their access to employment opportunities. See the Physical Environment and Social Environment sections of the ScotPHO website.
• Independence: housing that meets people’s independent living needs can help with enabling health care at home rather than in hospitals and care homes, preventing accidents, and keeping people active.
• Inequalities: The relationship between health and housing is largely driven by the unequal distribution of income, wealth and dependency on welfare.  As a result, housing is one of the factors that contributes to health inequalities.

Housing pressures

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, there has been substantial growth in the Private Rented Sector in recent decades: most markedly in younger age groups, but many people, including families, rely on the private 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, 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.

Housing and wellbeing

The Commission on Housing and Wellbeing, established by Shelter Scotland in 2013, published ‘A blueprint for Scotland’s future’ in 2015. This evidence-based assessment of the importance of housing for general wellbeing made 47 recommendations, which were summarised in a briefing note. The recommendations cover how to develop a housing system which contributes to eight different types of wellbeing – housing as ‘home’, community, employment, income, health, education, and environmental sustainability.