Healthy Living and Housing

I had the pleasure of chairing a webinar for The Institution of Engineering and Technology (IET) on Healthy Living and Housing. This was the first of a six part series looking at the interplay between our lived environments and our health.

You can access the session by clicking the link here, and registering. The next session is on 16 September and examines health and home in the context of care homes and community care.

Speakers for this session included

1. Julie Godefroy, Chartered Institution of Building Services Engineers
2. Dr Richard Miller, Connected Places Catapult
3. Annalise Johns, Connected Places Catapult
4. Dr Helen Crampin, InnovateUK

Clip from The IET’s EngShorts series covering many of the points raised in this discussion.

What we know and don’t know about the impact of the built environment

Julie provided an overview of the role of CIBSE and their recent guidance, Health and wellbeing in building services. The focus of the guidance is on the effects of the built environment on health, comfort and cognitive performance. And it is underpinned by principles of public health, with clear attention paid to health inequalities. The focus on health inequalities is essential given that in the UK, those in the most deprived areas live 9 years less than those in the least deprived areas.

Important factors in healthy built environments include natural light, having multiple aspect, and access to green space. And the impact of their lack for many in the UK and globally has been highlighted in the current pandemic.

CIBSE’s ambition was to have scientific evidence for what good quality indoor conditions are and to be able to set clear metrics. The review included evidence from WHO, Public Health England, and other bodies and research. However, what they found was the evidence itself is not always comprehensive – for example, what ‘good’ looks like is often based on requirements of healthy white males. When they departed from this to, for example, look at the needs of older populations, it can be more difficult to set metrics and clear guidance on the basis of the existing evidence.

Another challenge was it’s rarely the case in looking at indoor environments that it’s appropriate to look at one factor in isolation – noise, heat, indoor chemicals and so on. What’s needed is an approach that can take into account multiple effects and how they interact with each other. Another important consideration is the extent to which people have control over their own environments such as lighting and temperature control.

The case for retrofit for housing and healthy living

Richard made the case for retrofit, a critical issue in meeting our future housing needs. At is stands, existing housing stock will fail to meet these needs. This is the case whether it’s climate change, addressing fuel poverty, or meeting the needs of the ageing population.

What would housing that meets are future needs look like? Some of these factors include making homes low carbon, they need to be comfortable and attractive for quality of life and to support health and wellbeing, they must protect us, and they must be adaptable to changes in uses. And they must be resilient, particularly to environmental change.

At present, the most significant challenge is that of low carbon homes. In 2019, the UK committed to net zero carbon emissions by 2050. Our homes account for about 30% of the total UK energy budget, and 20% of the UK’s carbon emissions. Of that, 75% of our energy expenditure is for space and hot water heating.

Eighty percent of the homes we’ll be using in 2050 have already been built, and a lot of this housing stock is not in particularly good shape. Given the age of much of the UK’s housing stock, 70% of them have been built without the requirement for effective insulation.

Poor housing performance has significant health implications. The ‘Beast from the East’ in early 2018 was estimated to have killed over 200 people across the UK; and in 2018, heatwaves cost an additional 1,500 lives in France due to heat stress alone.

The key question is if we know all of this, why aren’t homes being retrofitted on a large scale? There are a few issues here including clarity on the benefits, including the health benefits, for individuals and families; lack of government push; lack of a supply chain that can deliver volume at speed; and, the lack of interest from the finance sector.

Making the case for homes to protect human health

Annalise discussed the impacts on homes on health and highlighted current trends in housing. What is clear is that the role of the home is not just to protect us from the outdoors, but has an important role in itself in protecting us from air pollution, unhealthy volumes of noise, cold and heat. These factors can each have detrimental impacts on our health.

The experience of lockdown across the UK has highlighted many of these vulnerabilities, and who they are having the most impact on. For instance, we know that COVID-19 has a disproportionate impact on those living in the most deprived neighbourhoods.

And our lived environment, particularly rapid urbanisation, has had significant impacts on our health. While we’ve seen a dramatic decrease in infectious diseases, notwithstanding the current pandemic, we have seen an acceleration on non-communicable diseases as a result of our modern lifestyles.

So what are some of the potential solutions? For instance, in some social housing projects, there is an increasing use of sensors to identify building and home performance. This could be useful for identifying issues such as levels of pollution, external noise, and improved indoor thermal regulation. And in terms of needs to make homes fit for the future, these include: making homes carbon neutral; fit for the circular economy; having better performance and energy performance; improved performance measurements; and include elements of biophilia.

And the role of greening our homes, our buildings, can be significant. Positive impacts can include providing a buffer between the outside and inside of our homes which can improve building performance, reduce the impact of environment change through improved water management, reduce carbon emissions, and add to a sense of health and wellbeing.

Healthy Ageing – The role of InnovateUK

The role of InnovateUK is, as a funding body, to work with people, companies, and other partners, to identify innovations that can scale and grow the UK economy, build connectivity across sectors, and address key challenges.

Helen discussed the work of InnovateUK with respect to healthy ageing. The work supports the government’s ambition to add an extra five years of healthy living in the UK. As part of this, it is clear that healthy ageing is more than preventing ill-health and disease. Wellbeing, the environments people are in, and reducing social isolation all play a part.

In response to COVID-19, the Healthy Ageing challenge is shifting focus a little onto looking to address some of the short term and longer term implications for older populations, specifically those in low income areas. And it has moved towards the top of the agenda. In response to some of the challenges posed by COVID-19, InnovateUK, alongside other government funding bodies have responded quickly with various grants being made available.

With respect to healthy ageing, there are a myriad of factors that come into play: from housing and the environment, to using people centred design approaches to building products and service, to understanding that regional differences in where and how people live require different types of responses. An important component is also looking at the trends behind building healthy and active spaces.

This is where organisations such as ExtraCare come in. ExtraCare have started building multi-generational villages that bring together people from different ages and ethnicities in one place. They provide the opportunity for people to stay at home for longer and have care at home, and also provide end of life care. They also use remote monitoring and telehealth solutions.

Helen leads on the Investment Partnerships Programme and is currently working as part of this programme with Barclays, Northstar and Legal & General to deliver healthy ageing via providing funding for business. InnovateUK are looking for additional impact investors in the programme. And there will be further funding opportunities over the coming months.

Key discussion points on healthy living and housing

How do we make our homes more resilient to climate change? What does industry need to do and what does it need to consider for instance with respect to design solutions?

• To include household users to determine requirements rather than focusing on building services and operations that fail to include them.
• Develop whole house plans so that changes aren’t one-off and will meet longer term needs including climate change.
• Consider the role of greenery which can reduce the impact of the heat island effect and have other benefits.

On the government’s Green Home funding announcements, how do we ensure we get this right?

• Ensure that insulation is fit for purpose i.e. different areas have different requirements.
• £2bn of funding is nowhere near the scale to change but it a step in the right direction.
• Use the funds to instead develop a ‘whole house’ plan which requires thinking about other impacts and what’s needed in the longer term. Any funds remaining could then be used to take initial steps.

How do we get the financing right?

• There is a real challenge is making this affordable both in terms of retrofit and new housing.
• Make a clear business case for long term investment which provides financial returns.
• Doing this at scale could have a major impact and provide opportunities for reinvestment.
• There’s a need for packaging projects in a way that can be scaled. This would be more attractive to investors that small investments such as retrofit of 50 or so properties at a time.
• Build on the growing trend for investments that reflect environmental, social and governance factors (ESG).

As part of The IET’s series on Responding to COVID-19: Healthy Living and the home

1. Healthy living and housing
2. Community care and care homes
3. Monitoring vulnerable patients and remote diagnostics
4. Reducing social isolation and loneliness
5. Smart home tech to support people’s needs
6. The future of Intelligent homes to support health