Being forced to move home – or the threat of it – is an increasing problem in the UK. Wages are stagnating, and rents are at their highest in relation to income for a decade. It’s not just renters who are affected, either. High interest rates are driving up mortgage costs, housing benefits are frozen, and the cost-of-living crisis is not over.
Looking at the bigger picture – and government decisions, in particular – we can see that local authority spending on housing services has fallen by 40% since the start of austerity, the social housing sector is half its 1980 size, and England’s private rental sector has doubled since 2000. Figures from the Ministry of Justice and from UK Finance show housing payment arrears, evictions and repossessions all increasing.
Using the data
We would expect this to cause renters, in particular, stress, but in fact there is only limited evidence on the impact of all this on people’s health, so my co-authors (Alexandros Alexiou, Ang Li, and David Taylor-Robinson) and I used Understanding Society covering 2009-19 to look at mental health scores, and sleep disturbance due to worry, in relation to problems with the cost of housing.
We chose this period because it includes the introduction and impact of austerity, but leaves out the COVID-19 pandemic, when furlough, mortgage protection and an eviction moratorium protected owners and renters (although all have since been withdrawn). We also decided to look at people aged 25-64 only – leaving out young adults, who are often still living with their parents.
We linked the survey data to data on local authority services and ONS regional figures on public sector employment. These last two sources allowed us to classify people as living in areas where cuts to local public services were either above or below the median change for England.
We used people’s answers in Understanding Society to:
- whether they had fallen behind on rent or mortgage payments in the last 12 months
- whether they had moved due to eviction or repossession in the last 12 months
- the 12-item general health questionnaire (GHQ-12) which screens for mental health problems
- the question “Have you recently lost much sleep over worry?” (the possible answers being ‘not at all’, ‘no more than usual’, ‘rather more than usual’, and ‘much more than usual’).
To eliminate other factors that might affect the results, we used methods designed to take into account where appropriate factors such as gender, ethnicity, educational attainment, age, income, and employment.
To make sure that any results we saw could reasonably point to a causal relationship, we also analysed whether there was any association between housing insecurity and an outcome we would not expect to be related to housing insecurity – in this case a new diagnosis of cancer in the same year. If our hypotheses were correct, we would expect to see links between housing insecurity and sleep and mental health, but not between housing insecurity and cancer.
What we found
There is strong evidence that experiencing housing payment problems has a detrimental effect on mental health and sleep. With all other factors equal, the likelihood of developing a common mental health disorder is 2.4 percentage points higher for people who fell behind on housing payments in the past year than those who were able to keep up with their payments. The risk of sleep disturbance due to worry was 2 percentage points higher.
As we expected, we found no link between problems with housing payments and a cancer diagnosis, which supports the idea that we are seeing a causal relationship with mental health and sleep. This would mean that housing payment problems are responsible for 1.3% and 1.1% of the burden of poor mental health and sleep disturbance, respectively, in the UK working-age population.
There were larger effects, though, for people who are more likely to suffer housing and financial insecurity: renters, younger people, people with fewer educational qualifications, and families with children. The risk difference for a common mental health disorder increased to as much a 5.5% among private renters, and 4.6% for 25-34-year-olds, while social housing residents and people without a university degree stand out as being particularly susceptible to sleep disturbance due to worry after falling into housing payment arrears.
Social housing tenants are more protected from eviction, but we found they are still at elevated risk of sleep disturbance and developing poor mental health if they fall behind with their rent. This may be a sign that it isn’t just the threat of eviction which is a problem – the other trade-offs to avoid rent arrears, such as going without meals or heating will have an effect, too.
As well as mental health and sleep, we also looked at high blood pressure diagnoses, but did not find a link between housing payment arrears and developing hypertension, at least not in the short term.
Further findings – austerity
Given the cuts to government spending in the period we studied, we expected to find that any health effects of housing insecurity would be stronger in areas more severely affected by austerity. Mental health effects of housing payment problems were, indeed, concentrated among people living in areas where expenditure on housing support services was cut most. However, effects were felt across England regardless of the relative loss of public sector jobs in the wider region.
Implications for policy
During the period we looked at, 20% of individuals reported falling behind with their housing payments at least once, and our results strongly suggest that housing insecurity has affected the health of many people in the UK. The current cost-of-living crisis means more people will be affected by these problems – but the United Nations enshrines adequate housing as a basic human right, specifying that housing “is not adequate if its cost threatens or compromises the occupants’ enjoyment of other human rights”, including health.
We know that around 20% of households in England and Wales currently live in the private rental sector, and that people with mortgages are facing interest rate rises. The health effects of housing insecurity, then, pose a growing challenge – one which requires policy action. In the short term, we need to see more support for households at risk of falling into arrears – especially in areas where housing services have been diminished – as well as investment in mental health services. Tackling the root of the problem will require significant investment in social and affordable housing, too.
Authors
Kate Mason
Kate Mason is a McKenzie Postdoctoral Research Fellow in the Centre for Health Policy at The University of Melbourne and Honorary Associate at the University of Liverpool
