At the Charted Institute of Housing (CIH) we have long argued that social housing providers are valuable partners for health and social care, working to improve the health and wellbeing of people and communities. For public health, the presence of social landlords in places where health inequalities are often most stark, makes them great partners to get key messages into communities that public health might otherwise deem ‘seldom heard’.
The latest report from ASH and the Housing LIN - Smoking and social housing: supporting residents, addressing inequalities - provides more examples of the benefits that can be delivered for individuals and communities, when housing and health connect to provide services that support people in their ambitions to improve their own health and wellbeing.
The physical conditions of housing and neighbourhoods for health inequalities is well known and has been shown up clearly with the difference in people’s experience through the pandemic. The role of social housing to provide decent and affordable homes can make a significant difference. However, the impact of social landlords goes wider than that, in its involvement in local neighbourhoods, often amongst some of the most deprived, making a vital contribution to wellbeing through many of the additional services they run directly or support, such as schemes for education, training and employment, as well as health and wellbeing.
As the report from ASH and the Housing LIN highlights, smoking is a huge factor in wider health inequalities; differences in smoking rates for people in the people in the least and most deprived areas are estimated to account for at least half of the 7-10 years life expectancy gap. It therefore seems an obvious target to include in the activities of social landlords to support wellbeing. However, it is not always included or seen as something for them to engage with. Some of that might be because of a lack of awareness by landlords about how much of a significant factor smoking can still be for their tenants and residents – the report draws out evidence that around 1 in 3 people in social housing smoke, underlining how important helping them to quit is, for their own benefit and to achieve the ambition to make England smoke free by 2030.
It might also be because social landlords are wary of appearing judgemental about something perhaps still seen as a choice or lifestyle issue. However, public health approaches shifted from that many years ago, aware of how difficult smoking can be to overcome, especially in environments where more people do smoke. Given that the evidence in the report indicates that the majority of social tenants who smoke want to stop – with 1 in 7 indicating they ‘want and plan to stop within 3 months’ - landlords could usefully help by finding out what local support services already exist and as a minimum signposting to these in their health and wellbeing services, without any additional costs being incurred. Finding out what training is available from public health partners on how to approach conversations about smoking cessation appropriately would also equip staff to provide support more effectively.
There are also great examples of how public health and housing associations are working more closely and proactively, through ‘swap to stop’ initiatives for example, which help people to quit by supplying e-cigarettes, although one pilot example, in spite of showing really successful results, still ended when pilot funding ceased – a common challenge that such services face unless long term funding can be found. So, the recommendations that the government should invest in these partnerships and that public health authorities should build work with social landlords into their strategic plans are really important to ensure a long-term partnership approach, and lead to other useful initiatives to tackle health inequalities. The report highlights one such strategic partnership between Flagship Homes and public health, a potential template for more integration to focus on population health and places within Integrated Care Systems.
This is both a positive report and a rallying cry to social landlords to maximise the health benefits for their residents by integrating some level of smoking cessation support into their existing health and wellbeing work. It stretches beyond physical health into help for tenants struggling with the cost-of-living crisis, making a sound business case as well. It is worth a read, but even more, it is worth using it to inspire action for the benefit of social tenants.
You can find out more about the joint ASH and Housing LIN report, ‘Smoking and social housing: supporting residents, addressing inequalities’ here. You can also sign up to the HAPPI Hour session which will feature this project on Tuesday, 28 June 2022 at 4pm.
And, if you found this blog of interest, do also have a look at the dedicated Health and Housing - Health Intel webpages curated by the Housing LIN, and supported by IBI Group.