BME National Conference 2016 Health and Housing for BME people Dr Ann Marie Connolly Deputy Director, Health and Wellbeing

Reported limiting long term Illness (men) Satisfaction with life: Black 6.7/10 Bangladeshi 7/10 Mixed/Multiple 7.1/10 White 7.4/10 England and Wales 2011 census - Becares et al 2013

Ethnic inequalities in mental health Proportion of adults with generalised anxiety disorder in past week, by sex and ethnic group, England, 2014 Proportion of adults with a depressive episode in past week, by sex and ethnic group, England, 2014 Men – seeing % of anxiety and depression in Asian men with lowest rates in the white other category, with low proportions of depression in Black men For women we see specifically higher % of depression in Black and British women Overall we see higher rates of psychotic disorder in black men and to a lesser extent in asian men when compared with White british but not amongst women of thos ethnic communities Source: Age-standardised percentages from the Adult Psychiatric Morbidity Survey, 2014

Adult smoking prevalence by ethnic group, England, 2015 When we consider un/healthy behaviours we see that many ethnic minority groups have much lower rates of smoing than the Engalnd average which of course is protective of health Source: Annual Population Survey reported in Public Health Outcomes Framework

Housing Impacts on Mental Health and Physical Health Unhealthy or Unsafe Housing Noise, temperature, damp , air quality, light, ventilation, radon, sanitation Stairs, windows, hazards to mobility, intruders, fire, CO Unsuitable Housing Disability or age Families and children Overcrowding Insecure Housing Temporary Accommodation Gypsies and travellers Insecure social networks Moving on to say something about housing and health We know what look like good housing and we know what impacts adversely on health outcome Biggest challenges are cold, damp as well as overcrowding and increasing numbers of people in insecure housing Developing care and support options in the community AMC 7th October 2016

Percentage of individuals in relative low income by ethnic group (below 60% of the median), Before housing costs After housing costs White 14% 19% Mixed/ Multiple ethnic groups 34% Asian / Asian British: Indian Pakistani Bangladeshi Chinese Any other Asian background 27% 17% 40% 35% 31% 21% 37% 24% 46% 51% 49% 38% Black/ African/ Caribbean/ Black British 25% 41% Other Ethnic Group All groups 15% We see that a greater % of people from different ethnic minority communities are on low income and that that housing costs push hese groups into evne greater set of needs A third (33%) of ethnic minority households lived in privately rented accommodation in 2013/14 compared with 18% of households in the white population . Private renting was highest among Other White (51%) and Arab (49%) populations and lowest among Black Caribbean and White British populations (both 15%). Increase in private renting between 1991 and 2011 with proportionately larger increases among Indian, Pakistani and Black Caribbean populations over the two decades. Employment is highest among the White population and lowest in the combined Pakistani/ Bangladeshi group where a high proportion of people (mainly women) are not in the active labour market. The unemployment rate is normally calculated as a percentage of people in the labour force and figures by broad ethnic group for 2014 are shown below. The average across Britain was 6.2% but the rate was nearly three times higher in the Black population than in the White group. White 5.5% Black 15.4% Mixed 13.2% Indian 6.1% Pakistani/Bangladeshi 14.7% Chinese 7.2% Other Asian 6.6% Other 11.1% Department for Work and Pensions ‘Labour Market Status by ethnic group: annual data to 2014’ DWP 2015. 2013/14, UK (3-year average) Developing care and support options in the community AMC 7th October 2016

% of households overcrowded by ethnic group 16% of people aged 16 and over in England and Wales lived alone, with the proportion rising with age. But lower at 3.7%, 4.2% and 6.3% in the Bangladeshi, Pakistani, and Indian populations respectively 22.7% in the Black Caribbean population and 23.7% in the Irish population. The 2011 census showed that the proportion of people in socio-economic groups 1 and 2 (professional and managerial) varied greatly across ethnic groups: White 35% Indian 43% Pakistani 28% Bangladeshi 25% Black African 39% Black Caribbean 33% Summary data in Sunak R and Rajeswaran S ‘A Portrait of Modern Britain’ Policy Exchange 2014 (Appendix 3 Figure 14). Data exclude never worked, long term unemployed and full-time students. ONS 2014. England and Wales Census 2011 - ONS 2014.

Sustainability and Transformation Plans New STP plans in pipeline Variable level of development PHE produced guidance on prevention for local areas But housing does not yet feature a key part of the plans Housing Associations have significant opportunities and offers Developing care and support options in the community AMC 7th October 2016

Current policy and Finance environment What are the respective roles of Housing for better and more integrated pathways with health and social care Are we maximising the opportunities of the BCF and DFG with housing partners for better prevention and impact What does MECC mean to you

Our Vision: Home and health in all policies People leaving a health, care or other institutional setting move on to a healthy home environment People who become ill, face crisis or other life change manage their health & wellbeing at home People with long term conditions are able to manage their health at home Everyone’s home promotes good health & prevents ill-health Healthy homes and neighbourhoods Populations End of life support at home Hospital discharge Step down housing Specialist & supported housing Telehealth/telecare/alarms Home improvement & adaptation Making every contact count Home related info, advice, support Homeless prevention & response Housing interventions Health and wellbeing in the community Developing care and support options in the community AMC 7th October 2016

Thank you annmarie. connolly@phe. gov. uk @connolamc healthypeople Thank you annmarie.connolly@phe.gov.uk @connolamc healthypeople.healthyplaces@phe.gov.uk