1. Health and Wellbeing Board Stakeholder Network 21st January 2013 Impact of Housing on Health On behalf of the Health and Wellbeing Board

2. Housing conditions affect people’s health. Inadequate housing causes or contributes to many preventable diseases and injuries, including respiratory, nervous system and cardiovascular diseases and cancer. Poor design or construction of homes is the cause of most home accidents. In some European countries, they kill more people than do road accidents. Use of proper building materials and construction could prevent indoor pollutants or mould, causing asthma, allergies or respiratory diseases. About every tenth lung cancer case results from radon in the home. Appropriate design can prevent both exposure and the risk to health. Extract from World Health Organisation meeting of Health and Housing experts Oct 2010 On behalf of the Health and Wellbeing Board

3. Nottinghamshire Health and Well- Being Priorities Obesity (including physical activity and healthy eating) Mental Health and Emotional Wellbeing Older people (including falls and fuel poverty) Substance Misuse - especially alcohol Learning Disability and Autism Smoking Long-term conditions (including NHS health checks) Teenage conception and pregnancy Education / personal attainment and aspirations Environment, community engagement and community satisfaction Dementia Physical Disability Crime and safety On behalf of the Health and Wellbeing Board

4. Public Health Outcomes Framework The Public Health Outcomes Framework sets out the desired outcomes for public health and how these will be measured. The framework concentrates on two high-level outcomes to be achieved across the public health system. These are: –increased healthy life expectancy –reduced differences in life expectancy and healthy life expectancy between communities The outcomes reflect a focus not only on how long people live but on how well they live at all stages of life. The second outcome focuses attention on reducing health inequalities between people, communities and areas. Using a measure of both life expectancy and healthy life expectancy will enable the use of the most reliable information available to understand the nature of health inequalities both within areas and between areas. On behalf of the Health and Wellbeing Board

5. Public Health Outcomes framework Domain 1: Improving the wider determinants of health Objective: Improvements against wider factors that affect health and wellbeing, and health inequalities Domain 2: Health improvement Objective: People are helped to live healthy lifestyles, make healthy choices and reduce health inequalities On behalf of the Health and Wellbeing Board

6. Public Health Outcomes framework Domain 3: Health protection Objective: The population’s health is protected from major incidents and other threats, while reducing health inequalities Domain 4: Healthcare public health Objective: Reduced numbers of people living with preventable ill health and people dying prematurely, On behalf of the Health and Wellbeing Board

7. Links between Housing and Health The exact relationship between housing and health is complex and difficult to assess. Building Research Establishment (BRE) has calculated that poor housing cost the NHS £600 million per year In the private rented sector alone the BRE estimates the cost to the NHS of not improving the energy efficiency rating (SAP) of the two lowest categories (F and G) to the average to be at least £145 million per year. East Midlands estimate £12 million Quantifying the cost of poor housing BRE press 2010; Health costs of cold dwellings BRE 2011 On behalf of the Health and Wellbeing Board

8. Links between housing and Health Studies using population data suggest the strongest links are for: –Accidents – 45% of accidents occur in the home and accidents are in the top 10 causes of death for all ages –Cold – cold homes linked to cardiovascular, respiratory and rheumatoid diseases, as well as hypothermia and poorer mental health. It is estimated that there are up to 40,000 deaths per year can be attributed to the hazard of excess cold. Case studies have shown an increase in quality of life after improvements to homes. Good housing leads to good health BRE,CIEH London 2008 On behalf of the Health and Wellbeing Board

9. Housing need in Nottinghamshire Non-decent private sector homes – 81,700 (2007) Applicants on the housing register – 16,559 (excluding Bassetlaw and Newark and Sherwood) (January 2013) 2362 of which are requesting housing for medical reasons. 1450 living in overcrowded accommodation 412 homeless decisions (2012) 200 applicants waiting for housing adaptations On behalf of the Health and Wellbeing Board

10. Housing needs in Nottinghamshire Not all about bricks and mortar. Growth in need for supported housing from growing elderly population. –Loneliness and exclusion is a reality for millions of older people according to a report from Age UK which states that 11% of people aged 65 or over are often or always lonely and that neighbourhoods that exclude older people can exacerbate isolation and feelings of loneliness. Harrop A and Jopling K (2009), One Voice - Shaping our ageing society. Age UK. – Well designed housing options for older people will reduce the level of admissions into residential care for housing related reasons. It will also promote improved health, such as reducing falls and fractures, which in turn will lessen the demand for care services. »ADASS/Housing LIN (2011) Strategic Housing for Older People: Planning, designing and delivering housing that older people want Increase in number of vulnerable adults/disabled adults wanting independent living. On behalf of the Health and Wellbeing Board

11. Health & Wellbeing Strategy The Health & Wellbeing Board (HWB) has a duty to produce a Joint Strategic Needs Assessment (JSNA) and Health & Wellbeing Strategy from April 2013 HWB has agreed early priorities for 2012-13 to provide leadership & support CCG authorisation JSNA refresh completed May 2012 First version of Health & Wellbeing Strategy (HWS) presented to Board in May 2012 Strategy draws together current priorities from the individual organisations that make up the Health & Wellbeing Board membership Work programme is now in place to refine and further develop strategy and JSNA for 2013. On behalf of the Health and Wellbeing Board