Solutions to Child Poverty: Housing (Paper 18) Philippa Howden-Chapman 19 September 2012

Housing and health Housing is an important driver of health People spend 75% of time indoors, young, old & sick 90% of time at home NZ houses old & cold have lowest energy use in OECD Only one room usually heated 70% children in poverty in rental houses Crowding in cold houses increases infectious disease in children

Specific Proposals: Housing Improve the quality and quantity of housing o Prioritise housing in the National Infrastructure Plan (Treasury + MBIE) o Recognise housing provides public & private goods

Establish a Warrant of Fitness for all rental accommodation & enforce them -- Private rental housing stock requirements extremely limited Boarding houses and camping grounds increasingly housing of last resort including children Insecurity of tenure -> residential mobility -> irregular primary care -> school attendance + +

Specific Proposals: Housing Enhance the supply of social housing, currently ~ 5% Register or license all social housing providers

Statistics New Zealand, Crowded Housing in New Zealand

Specific Proposals: Housing Re-focus the Accommodation Supplement and Income-Related Rent subsidies as part of wider package of income & housing support Target more housing support to smaller number of low-income families in greatest need large families families living in areas with high rents families with higher needs

Crowding linked to high levels of infectious diseases in children Rental houses smaller Children in poverty most likely to be living in private rental accommodation (50%) Families in poverty less likely to heat their houses Cold, damp houses enable viruses and bacteria to survive for longer

Baker, M., Telfar-Branard, L., Kvalsvig, A., Verrall, A., Zhang, J., Keall, M., Wilson, N., Wall, T. Howden-Chapman, P. Increasing incidence and inequalities in infectious diseases in a developed country.The Lancet, 2012,

Healthy Housing Programme: Improving social housing & linking with primary health services Cohort study links tenants to hospitalisations, After Healthy Housing Programme, acute and arranged hospitalisations fell (27%) year after Fall in hospitalisations more marked (61%) for most intensive intervention Baker et al reports available on

Specific Proposals: Housing Extend subsidies for insulation and heating

Evaluation of Warm Up NZ: Heat Smart Programme 100,000 houses in first 2 years of programme $320 million, not targeted to low income Quasi-experimental study, detailed anonymised matching of first 46,655 houses Small but significant drop in metered energy Significant health outcomes in pharmaceutical usage, length of hospitalisation, avoidable mortality for over 65s Benefit/cost ratio 3.9:1

Specific Proposals: Housing Enhance opportunities for home ownership for low-income families. Measures should specifically address barriers for Maori and Pacific households

Questions Which proposals will be effective in reducing child poverty? Which proposals are less likely to be effective? What are the most important proposals to reduce child poverty? What needs to be done first and why? What is missing from the package?