Solutions to Child Poverty:Housing (Paper 18)

Philippa Howden-Chapman19 September 2012

Housing and health• Housing is an important driver of health• People spend 75% of time indoors, young, old &

sick 90% of time at home• NZ houses old & cold have lowest energy use in

OECD• Only one room usually heated• 70% children in poverty in rental houses• Crowding in cold houses increases infectious

disease in children

Specific Proposals:Housing

• Improve the quality and quantity of housing

oPrioritise housing in the National Infrastructure Plan (Treasury + MBIE)

oRecognise housing provides public & private goods

Establish a Warrant of Fitness for all rental accommodation & enforce them

-- Private rental housing stock requirements extremely limited

Boarding houses and camping grounds increasingly housing of last resort including children

Insecurity of tenure -> residential mobility -> irregular primary care -> school attendance

++

Specific Proposals:Housing

• Enhance the supply of social housing, currently ~ 5%• Register or license all social housing providers

Statistics New Zealand, Crowded Housing in New Zealand 1986-2006

Statistics New Zealand, Crowded Housing in New Zealand 1986-2006

Specific Proposals:Housing

• Re-focus the Accommodation Supplement and Income-Related Rent subsidies as part of wider package of income & housing support

• Target more housing support to smaller number of low-income families in greatest need• large families• families living in areas with high rents• families with higher needs

Crowding linked to high levels of infectious diseases in children

• Rental houses smaller• Children in poverty most likely to be living

in private rental accommodation (50%)• Families in poverty less likely to heat their

houses• Cold, damp houses enable viruses and

bacteria to survive for longer

Baker, M., Telfar-Branard, L., Kvalsvig, A., Verrall, A., Zhang, J., Keall, M., Wilson, N., Wall, T. Howden-Chapman, P. Increasing incidence and inequalities in infectious diseases in a developed country.The Lancet, 2012,

Healthy Housing Programme:Improving social housing & linking

with primary health services• Cohort study links tenants to

hospitalisations, 2004-2008• After Healthy Housing Programme, acute

and arranged hospitalisations fell (27%) year after

• Fall in hospitalisations more marked (61%) for most intensive intervention

Baker et al reports available on www.healthyhousing.org.nz

Specific Proposals:Housing

• Extend subsidies for insulation and heating

Evaluation of Warm Up NZ: Heat Smart Programme

• 100,000 houses in first 2 years of programme• $320 million, not targeted to low income• Quasi-experimental study, detailed

anonymised matching of first 46,655 houses• Small but significant drop in metered energy• Significant health outcomes in pharmaceutical

usage, length of hospitalisation, avoidable mortality for over 65s

• Benefit/cost ratio 3.9:1http://www.motu.org.nz/news-media/detail/reports_on_warm_up_new_zealand_heat_smart_now_available.

Specific Proposals:Housing

• Enhance opportunities for home ownership for low-income families.

• Measures should specifically address barriers for Maori and Pacific households

Questions

• Which proposals will be effective in reducing child poverty?

• Which proposals are less likely to be effective? • What are the most important proposals to

reduce child poverty? • What needs to be done first and why? • What is missing from the package?