Amy Clair

Housing is increasingly recognised as an essential social determinant of health. But how do housing conditions, access and affordability shape health and wellbeing? And what does this mean for research, policy, and practice? Join editors and contributors to the forthcoming Palgrave Handbook of Housing and Health (2027) to discuss the latest research on why housing matters for health. The panel will examine how housing influences physical, mental and community health in various contexts, and provide valuable insights into creating healthier and more equitable cities and communities. This panel will bring together in conversation Amy Clair , Associate Professor and Deputy Director of the Australian Centre for Housing Research at Adelaide University; Emma Baker , Professor of Housing Research at Adelaide University and Founding Director of the Australian Centre for Housing Research; Namesh Killemsetty , Associate Professor and Director of the School of Government at Maharashtra Institute of Technology-World Peace University (MIT-WPU), Pune in India; Trivess Moore , Associate Professor in the School of Property, Construction and Project Management, RMIT University, Australia; Shenjing He , Lady Edith Kotewall Professor in the Built Environment and Head of the Department of Urban Planning and Design at the University of Hong Kong; and Becky Tunstall , Prof Emerita of Housing at the University of York and Visiting Professor at the Centre for Social Exclusion at LSE, UK.

Reproductive Justice is an intersectional feminist activist movement and epistemological framework for documenting, understanding, and responding to reproductive oppression. The Reproductive Justice movement asserts that all people have the right to (1) not have a child; (2) have a child; (3) parent children with dignity in safe and healthy environments; and (4) bodily autonomy. As a movement rooted in international human rights, Reproductive Justice has since been applied to understand reproductive oppression in various contexts around the globe. Consistent access to secure, affordable, suitable housing is crucial to the realization of Reproductive Justice. In this paper, we focus on housing in the UK as an example, identifying how policy decisions shape the ability to access adequate housing with consequences for Reproductive Justice, particularly for marginalized people.

Over the last decade there has been a renewed interest in identifying exactly how aspects of the residential built environment “get under the skin” and affect the health of not only those who dwell within, but reside and commute among, disorderly and deteriorating buildings. In parallel, across the different disciplines that constitute the neighbourhood effects literature, there is a growing acknowledgement that unpacking the “black box” of the phenomenon will require a principled theoretical approach that proposes plausible causal pathways between the area-level neighbourhood context and individual-level health; that is a concerted effort to answer not only the “why?” (ultimate) question, but the “how?” (proximate) question, too. Building on Wilson and O’Brien’s explicitly evolutionary construct of Community Perception, we introduce Jos Brosschot’s Generalised Unsafety Theory of Stress to propose and test a novel account of the causal pathway we believe residential maintenance plays between a place and its people. We use C-reactive protein (CRP), a biomarker associated with infection and stress, alongside information relating to neighbourhood maintenance, demographic characteristics, and health behaviours, all drawn from the UK Household Longitudinal Study. Hierarchical multiple regression models estimate CRP for exposure to poor maintenance conditions, controlling for known predictors and confounders. Results indicate that poor maintenance is associated with elevated CRP. Residential maintenance matters to people’s physical health. Future work will look to further elucidate the proximate mechanisms that underlie this pathway, in the hope that it will lead to impactful evidence-based policy proposals.

Background Numerous aspects of housing are associated with health. However, the pathways between housing and health, particularly the psychosocial elements of housing, are less well understood. Epigenetic information alongside social survey data offers an opportunity to explore biological ageing, measured using DNA methylation, as a potential pathway through which housing affects health. Methods We use data on housing and DNA methylation from the UK Household Longitudinal Study, linked with prior survey responses from the British Household Panel Survey, covering adults in Great Britain. We explore the association between epigenetic ageing and housing circumstances, both contemporary and historical, using hierarchical regression. Results We find that living in a privately rented home is related to faster biological ageing. Importantly, the impact of private renting (coefficient (SE) 0.046 years (0.011) vs owned outright, pConclusion Our results suggest that challenging housing circumstances negatively affect health through faster biological ageing. However, biological ageing is reversible, highlighting the significant potential for housing policy changes to improve health.

Recent crises have underscored the importance that housing has in sustaining good health and, equally, its potential to harm health. Considering this and building on Howden-Chapman’s early glossary of housing and health and the WHO Housing and Health Guidelines, this paper introduces a range of housing and health-related terms, reflecting almost 20 years of development in the field. It defines key concepts currently used in research, policy and practice to describe housing in relation to health and health inequalities. Definitions are organised by three overarching aspects of housing: affordability (including housing affordability stress (HAS) and fuel poverty), suitability (including condition, accessibility and sustainable housing) and security (including precarious housing and homelessness). Each of these inter-related aspects of housing can be either protective of, or detrimental to, health. This glossary broadens our understanding of the relationship between housing and health to further promote interdisciplinarity and strengthen the nexus between these fields.

Ensuring housing affordability while controlling government expenditure is a concern in many countries. In the UK support for private renters is delivered via an income-related housing benefit calculated using the Local Housing Allowance. As part of a programme to reduce government spending the support provided by the Local Housing Allowance was significantly reduced in 2011, and ongoing changes to its uprating have further reduced its value. These changes have raised concerns about the suitability of homes people receiving the allowance can afford. Using a natural experiment approach by applying matching and difference-in-difference methods to housing stock data from the English Housing Survey, this research finds a statistically significant 5% increase in overcrowding for housing benefit recipients following the changes to the Local Housing Allowance, equivalent to approximately 75,000 additional households living in overcrowded conditions. Longer-term results show that overcrowding continued to increase as changes to the uprating system further reduced the value of housing benefit. The decision to reduce the Local Housing Allowance and sever its relationship with actual rents has therefore reduced the ability of recipients to access suitable housing which will have had important implications for health and well-being, particularly during the COVID-19 pandemic.

Food bank use in Great Britain has risen substantially over the last decade. The considerable socioeconomic disadvantage of the food bank user population has been documented, but little research has examined whether housing problems intersect with insecure food access. Using data from 598 households accessing assistance from twenty-four food banks operating in Great Britain in 2016–2017, we found that nearly 18 per cent of households were homeless, with more having experienced homelessness in the past twelve months. Renters from both the private and social rented sectors were also overrepresented in the sample. Households in both private and social rented housing reported high rates of rent arrears and poor conditions; those in private housing were also more likely to live in homes with damp, to have moved in past year, and to be worried about a forced move in future. Overall, housing problems are widespread among food bank users; policy interventions are needed.

Background The link between housing and health is well established and long-standing, however much of the evidence relies on self-reported health measures. While these are useful, the availability of biomarker data allows us to add to this evidence using objective indicators of health. Methods In this paper, we use C-reactive protein (CRP), a biomarker associated with infection and stress, alongside information relating to housing details, demographic characteristics and health behaviours taken from the UK Household Longitudinal Study. Hierarchical linear regression models estimate CRP for individual housing characteristics, and all available housing characteristics, controlling for confounders. Results Results indicate that housing tenure, type, cost burden and desire to stay in current home are associated with CRP. Private renters have significantly higher (worse) CRP than owners with a mortgage. In terms of housing type, respondents living in detached homes had lower CRP than those in semidetached or terraced houses, or those living in flats. Housing cost burden is associated with lower CRP, although further analysis indicates that this is the case only for low-income renters. Desire to stay in current home is significantly associated with higher CRP. Conclusions A number of housing characteristics were associated with CRP. These results further support an important role for housing in health.

There are concerns that the recovery from the Great Recession in Europe has left growing numbers of people facing precarious housing situations. Yet, to our knowledge, there is no comparative measure of housing precariousness in contrast to an extensive body of work on labour market precariousness. Here, we draw on a comparative survey of 31 European countries from the 2012 wave of European Union Survey of Income and Living Conditions to develop a novel housing precariousness measure. We integrate four dimensions of housing precariousness: security, affordability, quality and access to services, into a scale ranging from 0 (not at all precarious) to 4 (most precarious). Over half of the European population report at least one element of housing precariousness; 14.7 percent report two dimensions and 2.8 percent three or more (equivalent to ~15 million people). Eastern European and small island nations have relatively greater precariousness scores. Worse precariousness tends to be more severe among the young, unemployed, single and those with low educational attainment or who live in rented homes and is associated with poor self-reported health. Future research is needed to strengthen surveillance of housing precariousness as well as to understand what policies and programmes can help alleviate it.