Setting and measuring health outcomes for healthy homes

Over 80,000 homes per year are needed to meet the housing targets set for London and no-one underestimates the challenges associated with delivering these numbers, let alone ensuring these homes are healthy homes. But the opportunity for health and health equity is there, and our Network members are united in their commitment to making the most of the enablers which already exist as well as building local capacity to align housing and health for the benefit of communities.

We launched our third year of the Health and Housing Impact Network with a masterclass on setting and measuring health outcomes in new developments, including getting the right data from the right sources to build the case and track impact in the context of growth. In the first of three events with the common theme of delivering healthy homes at pace, we benefitted from the extensive experience of Dr Rosie Rowe, Research Capacity Lead at Ealing Council and previously lead for Healthy Place Shaping in Oxfordshire and Programme Director of Bicester Healthy New Town.

The masterclass was designed to respond to priorities identified by participants before and during the session. They wanted to learn how best to build in improvement measures at an early stage but also how to monitor these once a development was built and occupied. There was also strong interest in understanding how housing can support mental health (75% chose this).

Beyond risk mitigation to health improvement and reducing health inequalities

 “A public health approach to housing considers the interplay of individual, community and planetary indicators of wellbeing.” Dr Rosie Rowe

Public health’s holistic approach goes beyond risk mitigation to health improvement and addressing inequalities. It recognises that a range of housing-related outcomes are directly or indirectly related to health. These are achieved by considering the context of a development beyond the “red line” – not simply the housing itself. This is something we’ll be covering in our intensification masterclass in September. Register here.

This can be helpful in making the case to local authorities, developers and others for investing time and resources in tracking the health impacts of housing, including mental health. These wider determinants of health mean there is demonstrable alignment with other priorities and measures which are already used by councils, notably around climate change and community cohesion, alongside the more obvious physical health indicators, such as childhood obesity, or access to health services.

Selecting the right success measures

Relating health outcomes to wider priorities and measures is an important lesson from Rosie’s years of experience embedding health in housing development. The local Health and Wellbeing Strategy will both reflect these and inform them already, for example where the Local Plan contains policies around access to services or provision of walking and cycling infrastructure.

There are numerous sources of local, London-wide and national level data and established metrics on which to draw in order then to evidence where a difference has been made. Public Health colleagues are already working on these: they are ideally positioned to advise on which are most relevant and realistic to deploy for the housing development in question.

Public Health data sources

National

DHSC Fingertips (public health profiles and health trends) https://fingertips.phe.org.uk/

DCMS Community Life Survey https://docs.google.com/presentation/d/1MYN16UGryiySaXl1jN_qiCK0y85B6q6f/edit?slide=id.p25#slide=id.p25

GLA

Integrated Care systems London Housing Profile https://data.london.gov.uk/dataset/ics-london-housing-profile/

Understanding Londoners’ views on belonging and social isolation https://data.london.gov.uk/dataset/understanding-londoners–views-on-belonging–social-isolation-and-fairness/

Local (Ealing example)

Health Report for Ealing https://data.ealing.gov.uk/health-and-social-care/#/view-report/1835e7ef70a748c79aa478f386581700/___iaFirstFeature/G3

Health Inequalities Dashboard (including Building Blocks of Health) https://data.ealing.gov.uk/ealing-health-inequalities-dashboard/

In addition to these rigorously compiled datasets, neighbourhood or estate-level qualitative evidence is extremely valuable and can be quicker to collect. Stories about people’s experiences are especially likely to resonate with councillors representing their wards or on planning committees. And involving residents and neighbours in identifying assets as well as needs helps prioritise interventions and reduces the risk of perpetuating mistakes. They are then more likely also to engage in post occupancy evaluation.

Our masterclass on post occupancy evaluation and health focused on effective resident involvement for continuous improvement. Write up coming soon.

Purpose, pragmatism, politics, people … and positivity

In sum, the experience of Rosie and masterclass participants is one of positive thinking and recognising the opportunities which already exist to articulate a vision for healthy homes, demonstrate successes and learn for the future. Our main messages from the masterclass are:

• Local Plans are being updated, so now is the time to embed health.
• Identify corporate priorities which shape health, for example around climate change or community cohesion – and unite stakeholders around them.
• Use qualitative as well as quantitative data to make the case for healthy housing, especially to political decision-makers.
• Involve residents in health outcome priority setting and build relevant measures into post-occupancy evaluation plans from the start.
• Include public health asks in S106 agreements and bids for CIL funding, for example around active travel infrastructure and green space provision.
• Make it easy for developers to respond to these asks with good practice guides as well as formal policies.
• Know which datasets already exist to help select measures.
• Choose ones which are realistic to measure.
• Build and sustain relationships between planning, housing and public health to sustain the focus on health throughout, including supporting development managers.
• Share resources and expertise across planning, housing and public health throughout.

Supported by Impact on Urban Health

Get involved

Read our programme page to get to grips with our Building healthy homes at pace theme.

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