In this post, Leanna Fairfax, a PGR Researcher in the School of Sociology and Social Policy at the University of Leeds, explores how COVID-19 urges the importance of interdisciplinary research on housing to help tackle health inequalities.
As we come out of, hopefully, our final lockdown, it remains stark how the pandemic has brought houses, homes, and local neighbourhoods to the forefront of media and policy discussion around public health, wellbeing, and deprivation. During the first lockdown, I found myself taking a deep interest in local history as I found it fascinating how different eras, sociological concepts and political ideologies influenced the houses and areas that we see around today. Inspired by my current home in east Leeds, one that was built in the 1930s and which benefits from good ventilation and large open spaces public and private, I know that this home may never have existed had it not been for the Public Health Act 1896 and the extensive research conducted by many sociological researchers at the time. Back then, inequalities began to be recognised as a contributing factor in health, and housing was understood as a significant factor in helping to tackle the spread of disease. COVID-19 has drawn people back to similar discussions revealing the prominence of housing and space once again.
I have the experience of living in several different properties, often in difficult personal circumstances, and found it hard to not reflect upon and envisage what lockdown would have felt like in these other locations. One thing that was apparent to me was that I believe lockdown would have been extremely hard to adhere to not just because the housing was inadequate but because in some of the properties, I had no access to a garden or outdoor space. The lack of security not just through tenure but domestic violence also contributed to the disconnection between home and house. Thus, I would often feel a sense of urgency to get outdoors at every opportunity as I felt unsettled. Yet COVID-19 restrictions relied on the concept of home as a place of safety and belongingness. This is a common conception as people can and do take home for granted, with not much thought on the sociological conception of what home means. Home can be a place of harm and insecurity, whether that be through domestic violence, inadequate housing, or insecure tenure (Gurney, 2021., Shaw, 2004).
An area not often discussed in relation to health nor widely researched is what Dunn (2004) explains as the less palpable areas of housing; there is a body of research that connect issues such as dampness to cardiovascular and respiratory diseases (Shaw, 2004., & Heart, 2020). However, less palpable issues are incredibly complex as housing under this view encompasses a more holistic sociological conception, one where home provides the space for a variety of needs to be met such as belonging and psychological comfort. Thus, these are harder to determine due to the multiple variables associated with poor housing such as race, poverty, working conditions and addiction (DiGuiseppi, et al, 2000). Although, it could be argued that some of the less palpable issues Dunn (2002) refers to are more commonly overlooked, COVID-19 has not only brought housing back to the forefront but drawn attention to some aspects of housing that may have been otherwise considered unpalpable.
Dunn (Ibid) refers to this as the ‘meaningfulness’ of a home where home is not borne out of a structure, home is constructed through a variety of relations to housing, such as housing affordability, security of tenure, deprivation of where housing is located, outdoor spaces and the availability to access services. In other words, the ontological security of home is paramount as health can benefit from the continuity of security which adequate affordable housing and space can provide (Giddens, 2013). The lack of this can have a considerable impact on one’s health. Dunn (2002) research evidenced this, as he found that those who attributed their home to negative connotations, such as a dislike of being at home, were found to feel more stress and more likely to have mental health issues. While outdoor space including private gardens interrelates with Dunn’s findings, research shows that having access to private outdoor space and at the very least access to adequate shared outdoor space improves mental health, binds communities, and reduces socioeconomic-related inequality in health for the disadvantaged (Public Health, 2020). A recent government report (2020) found that if everyone had access to adequate outdoor space this could save the NHS over £2billion a year. Yet outdoor space for some is scarce if we zoom in to a local level within Leeds. Over 10% in Harehills live in overcrowded conditions, less than 80% have access to a private garden and of those who do the size is on average 27.3m2, whereas the England average is 324.5m2 (City Monitor, 2021). Combined with this is the lack of public green space, with only 76.6m2 available compared to the English average of 348.9m2 (Ibid).
However, these findings are not new. In the late 19th century, research looked at areas that may be interrelated with health, one approach involved turning to the role housing played within health inequalities (Philliskirk, 2016). An area of common appearance was that of outdoor space, Fosters (1897) qualitative research within Leeds focused on space in general and the new style housing of the time ‘back-to-back’ houses. His findings argued for the need for allocated outdoor spaces for the densely built-up areas and for new homes to be built with consideration of access to sunlight, and communal greenery as back-to-backs failed to provide this (Foster, 1897). These findings were pivotal at the time and alongside notable people helped challenge these issues, eventually leading to changes at the central government level (Philliskirk, 2016). Many of the homes built through these changes still stand today, many of us whom will have resided in them during this pandemic and unknowingly benefited from historical sociological approaches to housing reform; me being one of them.
Reading this research, I felt a sense of gratitude to a person whom I had never met, his work innovative for its time, encompassing a home that is more than just a structure where one resides but a home that will enable a person to live with a combination of needs met. The historical work also demonstrates how the unpalpable which Dunn refers to is not so invisible. It appears that centuries of research has been consigned to history, whether that was through complacency or due to the advancements in medicine or just an oversight, but COVID-19 has certainly once again brought home that this research is central to discussion again. A pandemic that is likely not vacating anytime soon, and even if it does we cannot say we are immune from another viral attack, thus it is imperative to construct policy and build housing that meets the needs of all. To do this, further research is needed in this area to help establish workable recommendations, thus urging the importance of inter-disciplinary research between housing and health whilst not forgetting history as it is an important tool in guiding future research and policy recommendations.
City Monitor. (2021). Covid-19 is highlighting cities’ unequal access to green space. Available: https://citymonitor.ai/community/covid-19-is-highlighting-cities-unequal-access-to-green-space
DiGuiseppi, C., Edwards, P., Godward C., & Wade, A. (2002).
Dunn J. 2002. Housing and inequalities in health: a study of socioeconomic dimensions of housing and self-reported health from a survey of Vancouver residents. J. Epidemiol. Community Health. 56. Pp 671–81. Available: https://jech.bmj.com/content/56/9/671.short
Foster, B, D. (1897). Leeds Slumdom. Available: https://library.lse.ac.uk/collections/pamphlets/document_service/HD7/00000402/doc.pdf
Giddens, A. (2013). Sociology. Polity Press. UK.
Gurney, C. (2021). Dangerous liaisons?: Applying the social harm perspective to the social inequality, housing and health trifecta during the Covid-19 pandemic. Unpublished.
Heart. (2020). Unhealthy housing can lead to an unhealthy heart. Available: https://www.heart.org/en/news/2020/07/15/unhealthy-housing-can-lead-to-an-unhealthy-heart#:~:text=Studies%20have%20found%20that%20adults,in%20both%20children%20and%20adults.
Injury Prevention. British Medical journal. 6. Pp 250-254. Available: https://pubmed.ncbi.nlm.nih.gov/11144621/
Philliskirk, B. (2016). Bogged down in housing”: Politics and Planning in Residential Leeds, 1954-1979. University of Leeds. Available: https://etheses.whiterose.ac.uk/17765/1/Philliskirk_B_History_2016_PhD.pdf
Public Health Act. C.19. Available from: https://api.parliament.uk/historic-hansard/acts/public-health-act-1896
Public Health. (2020). Improving access to greenspace A new review for 2020. Available: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/904439/Improving_access_to_greenspace_2020_review.pdf
Shaw, M. (2004). Housing and public health. Urban residential fire and flame injuries: a population-based study. Annual Review of Public Health. 25. (1). Pp 397- 418.