Housing has an important impact on health and well-being: good quality, appropriate housing in places where people want to live has a positive influence on reducing deprivation and health inequalities by facilitating stable/secure family lives.  This in turn helps to improve social, environmental, personal and economic well-being.  Conversely, living in housing which is in poor condition, overcrowded or unsuitable will adversely affect the health and well-being of individuals and families.

The value of good housing needs to been seen as more than ‘bricks and mortar’. The Department for Communities and Local Government (DCLG, 2006) define a decent home as ‘a home that is warm, weatherproof and has reasonably modern facilities’. Failure to address the investment needs of poor housing conditions will have a detrimental impact on the occupiers’ health and well-being.

A decent, affordable home is an essential requirement for tackling health inequalities and reducing the burden on health and social care services and cost to the public purse.

This topic includes homelessness and fuel poverty.

This topic is most closely linked with:


Last updated: 2013-04-05 14:19:45
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1. What are the key issues?

  • The Homes and Communities Agency (HCA) is main funding agency for new affordable housing. The HCA has received significantly reduced funding in the current Comprehensive Spending Review (CSR) period compared with previously. For the previous CSR period, 2008–11, the Affordable Homes Programme was £8.4bn over a three-year period.
  • The current CSR period is over four years, and the national total of unallocated resource is £1.8bn, marking a significant reduction compared to 2008–11. Ring-fenced budgets for Mortgage Rescue, Empty Homes, Traveller Pitch Funding and the Homeless Change Programme add a further £410m to the resource available.

Older people’s housing

  • Capital funding needs to be identified for the development of housing with care and support. Partnership working with registered providers will be required.
  • The capital costs of housing with care and support will need to take into account the costs of acquiring a site, as well as the development costs of the scheme itself. There may, however, be low cost or free land where existing residential care or sheltered housing sites are utilised.
  • The capital costs of developing housing with care and support can be significant and the opportunity to co-locate other services into these developments is being explored to improve viability.


Last updated: 05/04/13

2. What commissioning priorities are recommended?

Prioritise the delivery of affordable housing
above the requirement for significant capital receipts on disposal of surplus land.

Apply systematically the council’s planning powers
to include affordable housing and housing with care and support within private housing developments.


Last updated: 05/04/13

3. Who is at risk and why?

An ageing society poses great challenges for appropriate housing. Most homes and communities have not been designed to meet people’s changing needs as they get older. Inclusive housing and wider environmental design is key to people’s health and well-being, and the suitability of the built environment plays a critical role in the provision of social care and health services. This demographic change needs to be considered when planning homes and neighbourhoods.

Although overall life expectancy has been increasing for both men and women, the number of years spent with a limiting illness or disability has also been increasing. According to the ONS, in 1981 men could expect to spend 12.8 years of their life with a limiting illness or disability and women 16 years.  By 2007, these figures had risen to almost 14 and 17 years respectively. Such changes in life expectancy are anticipated to have an impact on the demand for care in later life (Measuring unmet needs for social care amongst older people, September 2011).

Approximately 30% of people over 65 fall each year, and for those over 75, the rates are higher. Between 20% and 30% of those who fall suffer injuries that reduce mobility and independence and increase the risk of premature death (World Health Organisation Health Evidence Network, 2004).

The greatest burden of excess winter mortality is among older people (County Durham and Tees Valley Public Health Network, 2006, Institute for Health Equity, 2011).

There are over 1.6 million children in the UK living in housing that is overcrowded, temporary, run down, damp or dangerous.  Children living in overcrowded housing are up to 10 times more likely to contract meningitis.  Children in unfit and overcrowded homes miss school more frequently due to illness and infections. Poor housing conditions increase the risk of severe ill health or disability up to 25% during childhood and early adulthood. Children living in bad housing are significantly more likely to suffer respiratory problems. Living in bad housing as a child leads to a higher risk of low educational achievement. This in turn has long term implications for economic well-being in adulthood due to an increased likelihood of unemployment or working in low paid and insecure jobs (Shelter, 2006a).

Homeless children are more likely to show signs of behavioural problems such as aggression, hyperactivity and impulsivity.  Nearly half of young male offenders on remand and 42% of young female offenders sentenced have experienced homelessness (Shelter, 2006a).

An increased duration of living in overcrowded accommodation is significantly associated with children feeling unhappy about their own health.  An increased duration of living in accommodation in poor condition is significantly associated with being bullied in or out of school, getting into trouble with the police and having long-standing illness, disability or infirmity (Shelter, 2011).

The Institute for Fiscal Studies (2011) predict significant increases in poverty among children and working-age adults by 2013/14 as a result of the government’s tax and benefit reforms, including cuts in Local Housing Allowance (LHA).

There are no gender-specific housing issues.  However, women have greater life expectancy than men and it is likely that any deficits in appropriate housing suitable for older single occupancy will affect more women than men.

Socioeconomic status
Households in poverty live in dwellings with damp problems more often than the general population (12% and 8% respectively).

Damp problems occur in 8% of all households but in 15% of ethnic minority households.

Nationally, homelessness in April to June 2011 was 17% higher than the same quarter of 2010.  There were 48,330 households in temporary accommodation on 30 June 2011.

There is a strong overlap between experiences of more extreme forms of homelessness and other support needs, with nearly half of service users reporting experience of institutional care, substance misuse, and street activities (such as begging) , as well as homelessness. Traumatic childhood experiences such as abuse, neglect and homelessness are part of most street homeless people’s life histories.  Most complex needs were experienced by homeless men aged 20-49, and especially by those in their 30s (Joseph Rowntree Trust, 2011).

The life expectancy of homeless people is 30 years less than the rest of the population.  On average, homeless people live until the age of 47, and for homeless women, it is further reduced to just age 43. They are consistently less likely to take up routine screening, health checks, and vaccinations and it is essential to engage this group with existing public health programmes.  Ill health is more likely within homeless households, including those in temporary accommodation.  School absenteeism is more prevalent amongst children in homeless households; and they are more prone to delayed development of communication skills (Shelter, 2006b).

Homelessness is linked to nutritional deficiencies, and obesity is increasingly common (Food Standards Agency, 2007).  Rough sleeping is accepted to be inherently harmful to good health, and either contributes to, or exacerbates, health problems such as physical and mental health issues, and drug and alcohol misuse (Crisis, 2011; Department of Health, 2010).

Housing conditions and types
Almost 5 million UK dwellings (21%) had one or more Category 1 hazards in 2009. The most common types of Category 1 hazards were related to falls affecting  about 1 in 8 (12%) of dwellings, followed by excess cold (8%).

In 2009, 20% of UK households lived in homes with substantial disrepair. Privately rented households were much more likely to live in such homes (32% compared to 17% for owner occupiers and 19% for social renters).  The likelihood of private renters living in dwellings in substantial disrepair increased markedly the longer they had been resident in their current home, from 27% for those resident for less than one year to 54% of those resident for 20 years or more.

Around 8% of dwellings had damp problems in 2009. This problem is less common in owner occupied stock (6%) but higher for private rented dwellings and local authority dwellings (15% and 12% respectively).

Less than half of households (44%) lived in homes with fully modern electrical wiring in 2009.

Terraced houses, converted flats and dwellings built before 1919 are far more likely to have any Category 1 hazards relating to falls than other dwellings.

While 8% of households live in dwellings with damp problems this was notably higher for households containing five or more people (11%).

Welfare reform
A study for Shelter, carried out by the Cambridge Centre for Housing and Planning Research (2010), estimates that private sector tenants who claim Local Housing Allowance (LHA) will lose an average of £12 per week and that between 136,000 and 269,000 households will be unable to afford their rent, with about half of these likely to be evicted or move on voluntarily.

Housing Benefit claimants, including those renting from councils and housing associations, and private rented sector tenants who receive traditional Housing Benefit rather than LHA, will be hit by increases in non-dependant deductions from April 2012.

Working-age families deemed to be living in ‘under-occupied’ social rented housing will have their Housing Benefit cut, while there will also be a cap on the benefits that may be claimed by any individual working-age household.

According to the National Housing Federation (news article 9th November 2011) the Housing Benefit changes alone will leave 642,160 households worse off by an average of £39 per month.

Fuel poverty
It is estimated that 3.5 million households in England were living in fuel poverty in 2010, with a projected rise to 3.9 million in 2012 (DECC, 2012a).

Living in cold homes has effects on both physical and mental health. But the most serious is its contribution to Britain’s unusually high rates of ‘excess winter deaths’.  Many of these excess winter deaths could be prevented through warmer housing (Institute of Health Equity, 2011).


Last updated: 05/04/13

4. What is the level of need in the population?

The Tees Valley Strategic Housing Market Assessment (SHMA) (2009) assists with the identification of affordable housing requirements within each borough in Tees Valley. The SHMA examines housing requirements within seven sub-areas of Redcar & Cleveland to assist with planning. A detailed breakdown of gross and net affordable requirements by sub-area, property size and designation shows the following annual requirements for Redcar and Cleveland:

  • There is a requirement to develop 53 net additional affordable dwellings per annum.  However, the number of homes required will be much higher as the unmet demands for affordable housing are in different areas and for different sizes than where there are projected surpluses.
  • When the figures for gross requirements are examined, it can be seen that there are significant affordable needs in most sub-areas of the borough, equating to a total of 231 new homes per annum.  (‘Net’ is the simple difference between the existing number of affordable homes and the number required per annum. ‘Gross’ takes into account the fact that any projected surpluses of existing affordable housing tend to be for different areas/property sizes from the projected unmet needs.)
  • Additionally, in April 2011 there were 2,260 applicants on the borough’s Choice Based Lettings register. The total number of affordable housing lettings during 2010/11 was 1,195.

House prices in Redcar & Cleveland remain lower than other parts of the UK. According to Land Registry data for the last quarter of 2010, the median house price in Redcar & Cleveland was £116,500, compared with £122,000 for the North East and well below the England median of £182,000

Housing for older people
In Redcar & Cleveland:

  • There is an ageing population
  • There is increasing desire from older people to live independently
  • There is a high cost of residential care
  • An estimated 400 units of housing with care and support required (there are currently 113 units)
  • The provision of general housing and specialist accommodation for older people is unbalanced.
  • Limited funding is available through agencies such as the Homes and Communities Agency (HCA).
  • Capital funding needs to be identified for the development of housing with care and support.


Fuel poverty
It is estimated that 12,400 households (20.9%) in Redcar & Cleveland are in fuel poverty (England, 16.4%).  This varies from 4.8% to 29.7% in lower super output areas within Redcar & Cleveland (DECC, 2012b).  In Redcar & Cleveland from 2006 to 2009, on average there were an extra 61 deaths each year in winter months compared to other times of the year (WMPHO, 2012).


Last updated: 05/04/13

5. What services are currently provided?

Registered providers (RPs) of social housing own and manage 12,152 affordable homes (19.9% of all housing) in Redcar & Cleveland.

During 2010/11, there were 1,195 lettings made by RPs in the borough. The majority of these lettings are made to households assessed as having a ‘reasonable preference’ (those defined by law as requiring prioritisation within housing allocations policies) for affordable housing, such as homeless households or those with severe medical conditions.

Housing for older people
Redcar & Cleveland Borough Council has a policy to maintain independent living and to personalise services, supporting vulnerable people to remain in their homes. This includes a programme of adapting RP homes and making available Disabled Facilities Grants to householders. However, demand is already outstripping supply and the council and registered providers are working together to develop more innovative approaches to this challenge.  The aim is to offer as much choice as possible enabling older people to remain safely in their homes or the home of their choice for as long as possible.  It is recognised that there is a need to rebalance the general needs and specialist accommodation system for older people.  This includes consideration of how to shift the balance away from residential and nursing home care towards sheltered and housing with care and support.


Last updated: 05/04/13

6. What is the projected level of need?

Redcar & Cleveland has an ageing population.  The table below shows that an increasing proportion of the population will be aged over 65 years, with reduced proportions of younger adults living in Redcar & Cleveland compared to 2011. This has implications for the housing infrastructure of the borough, as the existing housing stock is designed predominantly for traditional family housing.

Projection of older age groups, Redcar & Cleveland, 2011 to 2026


Aged over 65 (%)

Aged over 75 (%)

Aged over 85 (%)













Source: Tees Valley Unlimited


Addressing the housing and care needs of older person households over the next 15 years will be a very significant challenge. By 2026, those aged over 65 years will comprise over 30% of the population of Redcar & Cleveland. The number of residents aged over 75 years will increase by 60% over this period, and those aged over 85 years by 76%.  In addition, over 13,500 people aged 65+ are likely to require some form of support and care.

By 2030, 5,040 more people aged over 65 years will not be able to manage at least one self-care activity and therefore may require some form of housing with care and support. By 2030, an additional 1,300 residents are forecast to suffer from dementia (Source: Tees Valley Economic and Regeneration Investment Plan).


Last updated: 05/04/13

7. What needs might be unmet?

When the figures for gross requirements are examined, there are significant affordable home needs in most areas of Redcar & Cleveland, equating to a requirement of total of 231 new homes per annum.  This is more than double the current rate of development (in the last three years, around 100 new affordable homes per annum have been developed).  There is an unmet need for about 130 affordable home each year.  In five years, this would create a shortfall of 650 affordable homes.

Single people, aged under 25 are the largest client group approaching the council for advice and assistance in finding a home. However, they are significantly under-represented in terms of affordable housing tenancies. There is a significant mismatch between supply and demand, which is further exacerbated by reductions in single persons’ accommodation through regeneration schemes.  There is an unmet need for affordable housing for single people aged under 25.

The proposals to limit Housing Benefit for working-age households living in under-occupied social rented housing and to raise the threshold for the shared room rate of Local Housing Allowance from claimants aged up to 25 years to those aged up to 35 years, have the potential to severely limit the already pressurised supply of accommodation for this group.

Redcar & Cleveland Council aims to offer as much choice as possible for older people, enabling them to remain safely in their homes or the home of their choice for as long as possible.  There is a need to rebalance the ‘general needs’ and ‘specialist’ accommodation for older people.

The council owns land throughout Redcar & Cleveland which could be disposed of to facilitate new housing development. In terms of marketing some of these sites, it may be necessary to consider prioritising the delivery of affordable housing above the requirement for significant capital receipts.  There is an unmet need for land for affordable housing development, which the council is in a position to solve.

Although private lending has become much more restricted, registered providers are still generally able to successfully obtain private funding for new housing developments. There may be opportunities for the inclusion of affordable housing and housing with care and support within some private housing developments, using the council’s planning powers.


Last updated: 05/04/13

8. What evidence is there for effective intervention?

9. What do people say?

The Tees Valley SHMA used primary data collected from residents of Redcar & Cleveland via a postal survey of 13,000 households, supplemented with 454 face-to-face interviews with resident households. The total number of respondents for the survey was 2,905.

Housing for older people
The ‘Real Voices and Real Choices’ consultation found that up to four-fifths of older people would prefer to stay in their own home for as long as possible.

As part of the consultation for the Ageing Well Strategy, a significant number of older people stated that their preference is for bungalow accommodation.


Last updated: 05/04/13

10. What additional needs assessment is required?

A new ‘Affordable Rent’ product has been developed nationally, increasing rents for new homes from their traditional social rent levels up to a maximum of 80% of the market rent. Affordable Rent will be the primary housing product supported by Homes and Communities Agency (HCA) funding.

Redcar & Cleveland Council has concerns about the ability of the Affordable Rent model to bridge the gap between development costs and significantly reduced grant funding in Redcar & Cleveland. The Council will need to work with registered providers (RPs) to develop appropriate offers to the HCA to secure required levels of new affordable homes. The Affordable Rent model needs to be fully assessed for its applicability in Redcar & Cleveland.

Redcar & Cleveland Council needs to work in partnership with RPs, the HCA, private landlords and other developers to maximise the accommodation options for single people. The Council also needs to continue to lobby to mitigate the potential impact of proposed welfare reforms on our existing residents.


Last updated: 05/04/13

Key Contact

Name: Erika Grunert

Job title: Housing Manager

e-mail:  erika.grunert@redcar-cleveland.gov.uk

Phone number: 01642 774774



Local strategies and plans




Redcar & Cleveland Borough Council (2012). Redcar & Cleveland Housing Strategy 2012-2017.

Redcar & Cleveland Borough Council (2009). Redcar & Cleveland Youth Homelessness Strategy 2009-2013.

Redcar & Cleveland Borough Council Planning Strategy

Tees Valley Unlimited (2012). Tees Valley 2012 Strategic Housing Market Assessment.

University of Salford (2009). Tees Valley Gypsy and Traveller Accommodation Needs Assessment.


National strategies and plans

Department for Communities and Local Government (DCLG, 2011). Planning Policy Statement 3.

Department for Communities and Local Government (DCLG, 2010). Local decisions: a fairer future for social housing.

Department for Communities and Local Government (DCLG, 2009) The English Housing Condition Survey – Housing Stock Report 2009

Department for Communities and Local Government (DCLG, 2008) Lifetime Homes, Lifetime Neighbourhoods – A National Strategy for Housing in an Ageing Society

Department of Energy and Climate Change (2008). The UK Fuel Poverty Strategy: 6th annual progress report.

Department of Health (2011). Cold weather plan for England.

HM Government (2011). Localism Act 2011.

HM Government (2008). The Housing and Regeneration Act 2008

HM Government (2004). The Housing Act 2004

HM Government (2002). Homelessness Act 2002


Other references with dates

Cambridge Centre for Housing and Planning Research for Shelter, (2010) Housing benefit changes and their effects on the private rented sector.

Care Services Improvement Partnership (CSIP, 2008a). The Extra Care Housing Toolkit.

Care Services Improvement Partnership (CSIP, 2008b) Commissioning housing support for health and wellbeing.

Chartered Institute of Environmental Health (2008) Good housing leads to good health.

County Durham and Tees Valley Public Health Network (2006). Cold kills.

Crisis (2011). The Hidden Truth About Homelessness.

Department of Energy and Climate Change (DECC, 2012a). Annual report on fuel poverty statistics 2012.

Department of Energy and Climate Change (DECC, 2012b). Fuel poverty sub-regional statistics 2010.

Department of Health (2010). Healthcare for Single Homeless People.

Food Standards Agency (2007). Homelessness and food poverty.

Housing Learning and Improvement Network (2011). Living Well and Home Inquiry.

Institute for Fiscal Studies (2011). Children and working age poverty from 2010-2020.

Institute for Health Equity (2011). The Health Impacts of Cold Homes and Fuel Poverty.

Joseph Rowntree Trust (2011) Tackling homelessness and exclusion: understanding complex lives.

National Centre for Social Research (2008). The Dynamics of Bad Housing: the impact of bad housing on the living standard of children.

National Housing Federation (2011). News article (login required)

Northern Housing Consortium (2011). A foot in the door: a guide to engaging housing and health.

Office for National Statistics (ONS, 2011). Measuring unmet needs for social care amongst older people. (in Population Trends, No. 145)

Shelter (2011). Improving outcomes for children and young people in housing need: A benchmarking guide for joint working between services.

Shelter (2006a). Chance of a Lifetime.

Shelter (2006b). Against the odds.

West Midlands Public Health Observatory (WMPHO, 2011). Excess Winter Deaths in England Atlas.

World Health Organisation Health Evidence Network (2004). What are the main risk factors for falls amongst older people and what are the most effective interventions to prevent these falls?