Living conditions and health promotion strategies

Abstract

The paper assesses the empirical evidence con cerning the interface between living conditions and health status provided by a number of case studies of urban regeneration in London, and Brighton and Hove. These studies were carried out in the theoretical framework provided by the Cost-effec tiveness in Housing Investment programme that has been seeking since 1993 to identify and mea sure additional 'exported' costs to services such as health, education and policing which derive from poor living conditions. A chronological study of the 'health gain' asso ciated with the Central Stepney Single Regeneration Budget improvement to two run-down estates indi cates that a seven-fold health improvement in the rate of 'illness days' experienced has taken place over a four-year period (1996-2000). This 7:1 dif ferential was identical to that found in the synoptic comparison of illness days, and some health and policing costs, between the Stepney area and an area of improved housing in Paddington carried out in 1996. The paper presents an exploratory attempt to list and categorise in various ways the exported costs associated with poor living conditions and offers some preliminary assessment of their mea surability. Finally, a number of health promoting strategies that should be borne in mind when carrying out urban renewal programmes are discussed. It is argued that the provsion of satisfactory housing is a necessary, but not sufficient, condition to pro mote good health. Attention must also be paid to community development, especially of 'organic' activities, the quality of services especially in rela tion to benefits, access to healthy food, crime reduction and, critically, the promotion of jobs and the reduction of poverty.