Housing As a Social Determinant of Health: Its Impact on Health Inequalities Across Europe

Housing has long been considered a key determinant of health, however research has tended to focus on the physical qualities of housing, such as the presence of damp or overcrowding.  Yet the role of housing in people’s lives is such that this approach does not adequately demonstrate the full importance of housing to health and the role it plays in health inequalities. This presentation brings together a portfolio of research investigating the broader influences, such as affordability and stability, of housing on health.  Results of secondary analysis of large-scale data, including the EU Statistics on Income and Living Conditions survey, are presented.  Results of multilevel modelling and fixed-effects regression analysis show that falling into housing arrears has a significant detrimental impact on health equivalent to that caused by job loss.  However, this impact varies across tenures, levels of wealth, gender, as well as across countries.  Generally it is renters rather than owners, the less wealthy and women that are affected most severely, but this varies across countries.  Indeed in some countries no negative impact on health is found for those that fall into housing arrears, suggesting some countries are better able to protect the health of those in housing difficulty than others.  The causes of these variations and consequences for health inequalities are discussed with particular reference to the development of scales of housing precariousness and precarity.  These scales have been developed using cross-national secondary data from a range of sources and are used to investigate the stability and security of housing across countries, their association with different approaches to housing policy, and which policies are most successful at mitigating health inequalities.