The quality of housing and the internal housing environment are determinants of health and wellbeing.

A lack of access to affordable (both to buy and to occupy) and high quality housing can have an adverse impact on people?s health and wellbeing.

  • Fuel poverty: as the climate changes and we experience more temperature extremes (both hot and cold) heating and cooling of homes is necessary (The Marmot Review, 2011), yet as energy prices increase it is more important than ever that our homes are as efficient as possible, not only to reduce cost but also to reduce energy expenditure that results in increased greenhouse gas emissions.
  • Health inequalities and vulnerability: one of the determinants of vulnerability is quality of housing stock (Joseph Rowntree Foundation, 2011). By introducing energy efficient measures (e.g. prevention of drafts, damp and overheating) this cause of inequalities can be lessened. The Marmot Review (2011) reports that approximately 33% of the poorest fifth of households are in fuel poverty, compared to less than 1% of the richest fifth of houses.
  • Climate change mitigation: changes to housing design in terms of energy efficiency can help to reduce carbon dioxide emissions that contribute to climate change (Kent County Council JSNA, 2013).

“To support the move to a low carbon future, local planning authorities should actively support energy efficiency improvements to existing buildings.”

NPPF, 2012

The Housing Standards Review was part of the Government’s attempts to remove bureaucracy and barriers that hinder the delivery of the number of houses that England requires to meet housing needs. Outcomes of this review include a ‘winding down’ of the Code for Sustainable Homes and limits on what energy and sustainability standards local authorities can set in their Local Plans. Energy efficiency is largely to become a responsibility of Building Control rather than planning, with energy standards in Building Regulations tightening towards a ‘zero carbon’ standard for new homes from 2016. New homes will need to be increasingly energy efficient, but local flexibility to specify particular sustainability standards through planning will be curtailed.

“The UK performs the worst for fuel poverty in Western Europe with over half of single pensioners and two thirds of workless households classified as fuel poor”

Kent JSNA 2013

Nevertheless there is scope to explore options for facilitating the retrofitting of insulation measures to existing housing and to encourage uptake of renewable energy generation. This is a critical area given that the vast majority of homes in Kent and Medway will, for many years, be those that have been built to lower energy efficiency standards in previous decades. Addressing the quality of housing across the social gradient, focusing proportionately on those in most need, has the potential to have an important impact on health inequalities (Marmot review, 2011).

Kent and Medway are already taking action on energy efficiency, as set out in the Kent Environment Strategy Implementation Plan and demonstrated by the Warm Homes Scheme, which is a partnership project between Kent County Council and the district councils that supports residents in Kent and Medway to save energy in their homes. Kent County Council’s Joint Strategic Needs Assessment (JSNA, 2013) provides an overview of housing and fuel poverty. It states that the UK performs the worst for fuel poverty in Western Europe with over half of single pensioners and two thirds of workless households classified as fuel poor. By making homes more fuel efficient, the extent of fuel poverty could be alleviated for the most vulnerable.

  • A Healthy Sustainable Communities Spatial Planning Self Appraisal Checklist for London – This guide, based on the WHO publication Healthy Urban Planning, is a tool for assessing the impact on public health of planning policies and planning proposals. See the Housing Quality, Climate Change and Resource Minimisation sections.
  • Fuel Poverty & Health Toolkit – This is a guide for public health professionals, health and wellbeing boards and local authorities in England. The guide, provided on UK Health Forum?s Healthy Places website, is intended to be a tool for directors of public health and their teams, health and wellbeing boards, and colleagues across local authorities who want to start, extend or improve their work on fuel poverty.
  • Excess winter deaths and illnesses: guideline consultation – NICE is developing a public health guideline on ‘Excess winter deaths and illnesses: identifying and supporting vulnerable children and older people’. This guideline makes recommendations on how to reduce the risk of death and ill health associated with living in a cold home. The aim is to help meet a range of public health and other goals. These include: Reducing preventable, excess winter death rates; improving health and wellbeing among vulnerable groups; reducing pressure on health and social care services; reducing ‘fuel poverty’ and the risk of fuel debt or being disconnected from gas and electricity supplies.
  • Health contacts
  • Planning contacts
  • The Marmot Review: Implications for Spatial Planning (2011) – contains a section on implementing the review’s recommendations, which contains information on improving the energy efficiency of housing across the social gradient and fully integrating the planning, transport, housing, environmental and health systems to address the social determinants of health in each locality.
  • Energy Saving Trust – provides a range of technical guidance on energy issues
  • The Zero Carbon Hub – provides a range of resources on ‘zero carbon’ definition, policy and practice.
  • Good Homes Alliance – a group committed to promoting sustainable development in housing in the United Kingdom; the website provides useful resources and case studies.
  • English Heritage – provide guidance on climate change and the historic environment.
  • The Health Impacts of Cold Homes and Fuel Poverty – this report, commissioned by Friends of the Earth and written by the Marmot Review team, which reviews the existing evidence of the direct and indirect health impacts suffered by those living in fuel poverty and cold housing. It makes the case for aligning the environmental and health benefits of reducing fuel poverty and improving the thermal efficiency of the existing housing stock.
  • The National Institute for Health and Care Excellence (NICE) (Gray et al, 2010) suggests that the benefits of undertaking high-quality, comprehensive spatial planning significantly outweigh the costs. NICE modelled whether high-standard spatial planning for areas including retrofitting local homes with insulation was worthwhile in terms of outcomes. They found outcomes significantly outweighed costs, by 50:1 for insulating local homes.
  • Local Government Association Warm and Healthy Homes : How Councils are helping Householders Improve the Energy Efficiency of Their Homes – This publication forms the Local Government Association’s response to the Hills Review, and also provides a platform to showcase the excellent work that councils lead on to curb and reduce the incidence of fuel poverty.
  • London Borough of Barking and Dagenham : Smart Metering in Colne and Mersea – This case study, produced by the London Climate Change Partnership, details the process and benefits of installing smart meters and other energy efficiency measures during the refurbishment of two blocks of flats in London.
  • Islington Council’s Environmental Design SPD and Companion Guide: The Environmental Design Supplementary Planning Document (SPD) provides guidance on how new development in Islington should be designed and built so that the positive effects on people?s quality of life (including through tackling fuel poverty) and the local environment are maximised and negative environmental impacts are minimised or avoided. The SPD contains detailed guidance on key sustainable design topics including minimising energy use and carbon emissions, sustainable building standards and operational sustainability. A Companion Guide to the SPD provides broader guidance on these sustainable design topics, including useful principles, examples and sources of further information.
  • Stockport Metropolitan Borough Council has a Supplementary Planning Document (SPD) on sustainable design and construction. Health is explicitly included within sustainability to take advantage of the current momentum behind low-carbon design and development.