Hope for Healthier Homes

Safe and healthy housing is a basic right. Research by the team led by Professor David Ormandy has shown that the health and safety of residents (their ‘health outcomes’) should be at the centre of housing policy.

Working with the Department of the Environment, the UK Building Research Establishment and the London School of Hygiene and Tropical Medicine, our research has led to a system that changed housing laws to prioritise the health and safety of occupants. International interest in this work is now informing housing improvement across the globe.

The challenge

Poor housing conditions cause illnesses and injuries that cost the NHS millions of pounds each year, but it is difficult for health authorities to monitor the state of patients' housing. With the youngest, oldest and most vulnerable citizens suffering the most from the effects of bad housing, the legal system needed to recognise its role in keeping residents safe and healthy but the absence of a reliable metric to measure the health risks posed by dwellings in an unsatisfactory condition needed to be addressed.

Our approach

Professor Ormandy and his team identified 29 potential hazards posed by poor housing, grouping them under four headings (to show that all aspects of health and safety were considered:

• Physical requirements

• Psychological requirements

• Protection from infection

• Protection from injury.

A new metric was devised to assess the hazards, the Housing Health and Safety Rating System (HHSRS). By using this tool, authorities can accurately assess the risks to public health posed by the state of any housing unit.

Our impact

Thanks to Professor Ormandy’s team, housing laws and priorities in England and Wales and has had an influence in other countries, putting a greater focus on public health. The HHSRS has become the key indicator for the Government’s Decent Homes Standard, which all social housing should meet. The Housing Act 2004 now requires English and Welsh local authorities to enforce remedies to unsatisfactory housing, as assessed by the HHSRS. Enforcement using the HHSRS saves the NHS hundreds of millions of pounds annually, and prevents thousands of occupiers from becoming ill or suffering injury. In Liverpool alone, 6,000 HHSRS inspections led to the removal of over 4,410 serious hazards, encouraging over £5.45m in investment by private landlords and benefitting 47,248 occupants.

Professor Ormandy’s work is also making a difference outside of the UK. Working through the World Health Organisation, his input has helped shape housing assessment and improvement in various countries. For example, the HHSRS informed work in New Zealand where they have developed a Healthy Housing Index and a Warrant of Fitness. Through these, rental homes are required to be properly heated, insulated, drained and ventilated, protecting tenants from draughts and damp.

The US Department of Housing and Urban Development (HUD) adopted the HHSRS as the Healthy Homes Rating System (HHRS). This was used to inform decisions on who to qualify for federal housing grants, whether cities, states or NGOs, and imposed it as a condition of grant-aid to those agencies. Professor Ormandy has also worked with EDF, the second largest energy company in the world. His research has shown that the outlay needed to upgrade energy inefficient homes is less than the potential savings for the French healthcare system.

Access the HHSRS

Discover more of Professor Ormandy's research projects