Supporting communities with healthy homes: small changes make significant impact

The home where you live can have a significant impact on your health, from the bricks-and-mortar conditions of your house to your psychological connection to place and the services you access. Advice and guidance can help those most in need to access healthier home environments.

There is growing evidence that poor-quality homes are a major factor affecting people’s health. Living in an unsuitable house can impact physical health by worsening conditions like Chronic Obstructive Pulmonary Disease (COPD) or asthma, and mental health through financial stresses and worries about issues such as fuel poverty.

These problems are also more likely to be experienced by people already living in deprivation or difficult circumstances. Yet, we have strong psychological connections to our homes regardless of their health impacts – homes are often an expression of our identity and the places we make memories or build connections. As such, we tend not to make housing choices (if we have them) based on the ability of the environment to support our health needs.

Researchers from Fuse, the Centre for Translational Research in Public Health, worked with South Tyneside Council, the NHS North East and North Cumbria Integrated Care Board and AskFuse - the responsive research and evaluation service run by Fuse - to evaluate their healthy homes services (provided by First Contact Clinical). This service targeted the most deprived wards in the area with an advice and guidance service based around the health of their home, regardless of tenure (whether they owned or rented it). This included a home visit by a staff member trained in motivational interviewing - a person-centred counselling style to help people make changes in their lives - to assess the health of their home, and signposting to relevant resources.

The mixed methods evaluation used service data to identify trends and potential cost savings, and carried out qualitative interviews with 14 households who had been in receipt of the service. This included people from a range of age groups, backgrounds and tenures.

Key findings

• Vulnerable households experienced a range of factors influencing their health, including a combination of low household income, pre-existing health conditions and having older household members.
• Service users were often living in poor-quality housing, with 48% worried about fuel poverty, 31% being assessed as at risk due to a housing issue and 43% experiencing signs of excessive condensation.
• The most common hazards were excess cold, dampness and falls risks.
• These hazards had clear impacts on physical health (inability to negotiate stairs safely, exacerbation of COPD/asthma) and mental health (social isolation, worry about bills). These issues had a reciprocal relationship, with worry about the state of the home and the impact this was having on participants’ lives.
• These problems were exacerbated by factors like age (older participants not wanting to be seen to ask for help) and tenure (homeowners presumed there was no help available and they would need to fix problems themselves).
• Service impacts were massive: they addressed problems with even small changes having significant impacts (a new lightbulb alleviating worry about energy bills). Participants also felt valued by having a home visit from someone approachable and “nice”. Without this, they would allow issues to reach crisis point before accessing services.

Policy relevance and implications

• Services should ensure they consider housing more in their delivery. No matter what services have provided, returning people to environments which are unhealthy and exacerbating health concerns is likely to reduce impacts and benefits as time progresses.
• We need more conversations about healthy homes. People do not think about their homes as health environments, and are more likely to live somewhere for financial, aesthetic or convenience reasons. Raising awareness of potential health impacts alongside this will enable a more preventative approach to healthy housing.
• Contextual factors are important when expecting people to access housing services. Tenure and age in this study acted as indicators of people not approaching services, and required a proactive approach to address their problems.
• It is important to be nice. The approachable and “nice” delivery used by Healthy Homes was a positive outcome in itself. People felt valued and heard, making them more likely to follow advice, opt into services they need and address issues that arise in the future.

Further information

Dr Philip Hodgson - Cluster co-lead, Northumbria University
Email: philip2.hodgson@northumbria.ac.uk

Resources

Fuse blog: Going beyond bricks and mortar to 'Up' awareness of healthy homes

Last modified: Tue, 16 Sep 2025 13:43:07 BST