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Title: Housing and health : a geography of welfare restructuring
Author: Easterlow, Donna
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1998
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Current health policy in England emphasises the environmental determinants of health and well-being and the care of chronically sick and vulnerable people in and by the community. A recent resurgence of research interest into the complex links between housing and health provides evidence of the detrimental effect of poor housing design, condition and location on occupants' physical health and mental well-being as well as on their access to care and social support. A new, less documented, line of research argues that the observed relationship between housing and health might also reflect the effect of health status on opportunities in the housing system. In this light it is argued here that the success of national health policy depends both on the availability of 'healthy' homes and on the effective use of housing provision to meet health and care needs. Historically, the only part of the housing system that has actively attempted to operationalise the concept of housing for health has been the social - largely council - rented sector. For the past 25 years this has been achieved through the mechanism of medical priority for rehousing (MPR) - the process of assigning priority in the housing queues on the grounds of medical need. There is evidence, however, that just as health gain has become a legitimate objective for housing policy and practice, the system of medical priority rehousing is under increasing pressure in many areas of the country. The most important challenge comes from the privatisation of the social housing system and its changed character, size and quality, as well as its spatial unevenness. In order to explore the current capacity and future potential of a restructured social housing system to secure health gains through housing interventions, this study includes the ESRC-funded secondary analysis of data collected in the early 1990s as part of a national study into social housing provision for people with health and mobility needs in England. My analysis highlights geographical differences in the operation of medical rehousing and documents the inequitable outcomes that occur both within and between local areas as housing managers implement a range of different rationing methods in the attempt to regulate demand for rehousing. Complementing a large existing literature on the problems of access to council housing for the most marginalised groups in society, I explore the difficulties experienced by those with health needs - a relatively privileged group among the benefit-dependent poor - in mobilising the system of medical priority rehousing and of securing a suitable home through the process of matching applicants to stock. While on the one hand the study shows that medical priority rehousing can secure favourable housing (and health) outcomes for some of those with health needs, an important point to emerge is that the system is increasingly failing to cater for the majority of those in medical need, albeit more so in some areas than others, in most parts of the country. This raises important questions - that are also briefly explored - about how those with health problems fare in the market sector of the housing system. I conclude that, in order to harness housing policy and practice to health aims more effectively, a more tenure-neutral healthy housing policy is required. Thus my recommendations include a number of administrative changes to the operation of medical priority rehousing as well as an increased social investment in all housing sectors.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available