Aspect 2 - Housing

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Overview

A large amount of time is spent daily in the home.  Housing is a basic human right and the quality, accessibility and affordability of houses can determine the health and wellbeing of residents. Living in good quality, accessible, adaptable and affordable housing is associated with numerous positive health outcomes for the general population and particularly those from vulnerable groups.

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Determinant 2a - Quality housing

Requirements

Quality housing is a key requirement and a critical determinant of health, influencing physical and mental wellbeing. Poor housing conditions, such as damp, cold, mould, and inadequate ventilation, are strongly linked to a range of health problems. Conversely, tenure-neutral good quality housing can promote health and improve overall wellbeing. Housing which is energy efficient and well-ventilated improves indoor air quality and lowers energy costs which can improve mental health.

Issues, Impacts and Links to Health and Wellbeing Effects 

Below is an outline as to the importance of the determinant, its connection to health and wellbeing outcomes, and how it affects different population groups, particularly the most vulnerable. (East Sussex DPH Report, 2020), (TCPA, 2025)

General

  • Environmental factors: High-quality housing reduces exposure to harmful environmental factors such as cold, heat damp, mould, overcrowding, and poor ventilation, which can exacerbate cardiovascular conditions and are linked to chronic respiratory illnesses and increased risk of infections.
  • Safe and stable: A safe and stable home environment supports mental wellbeing, reduces stress, and encourages healthy behaviours, contributing to both physical and psychological health.
  • Wider community: Good housing also facilitates access to key health promoting opportunities like employment, social networks, essential services, and green spaces.

Vulnerable groups

  • Older people: People who are 65 years and overspend on average 80% of their time at home, this means their living environment has a greater impact on their health and wellbeing. They are particularly vulnerable to poor housing conditions, with hazards such as stairs, loose fittings, and the absence of grab rails increasing the risk of falls and fractures. Fuel poverty and inadequately heated homes can result in cold living conditions, contributing to excess winter deaths. Damp and mould further exacerbate poor health, especially among frailer older adults and those with respiratory conditions. (ESCC, 2024)
  • Children: Children are especially vulnerable to the negative effects of substandard housing on both physical and mental health. Poor conditions, such as overcrowding, damp, cold, infestations can seriously impact their development and wellbeing. There is strong evidence linking cold, damp, and mouldy homes with an increased risk of respiratory problems. Poor housing can also limit educational achievement, social development, and overall life opportunities, reinforcing cycles of inequality and disadvantage. (Shelter, 2006) 
  • Long-term respiratory conditions: People suffering from long-term respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD) are at risk from poor housing conditions such as damp and mould caused by poor ventilation.  This can increase the risk of life-threatening flare ups, infections and reduced lung functions.

 

Specific measures (UK Government, 2025)

  • Energy efficiency: Energy efficiency measures, including necessary ventilation, helps maintain healthy indoor environments by stabilising air temperatures, humidity, noise, and air quality, while reducing energy costs that can alleviate financial stress and improve mental health.
  • Outdoor space: Access to private or shared outdoor spaces is important for mental health and wellbeing, offering opportunities for relaxation and social connection.
  • Tenure-neutral: Tenure neutral design promotes equity and social interaction by creating housing that benefits all residents regardless of ownership status, positively impacting on health and wellbeing. (National Design Guide, 2021)
  • Sustainable design and construction: Using sustainable design and construction methods contributes to climate change mitigation and adaptation and supports long term health benefits by creating environmentally responsible and resilient homes.

The opportunities - what the planning system can do

Positive actions, principles and measures that should be considered and where feasible implemented to address adverse effects and enhance health and wellbeing benefits.

  • Warm (regulated temperatures) and well-ventilated: Provide homes which have comfortable temperatures, good airflow and ventilation.
  • Safe and secure: Provide homes which design out crime and are secure. Also safe in relation to fire risk.
  • Tenure neutral design: Design neighbourhoods where it is difficult to distinguish between rented, owned, or social housing, promoting social equity, inclusion and cohesion.
  • Adequate internal spaces: Provide Homes which have sufficient spaces to move freely, study, and play, supporting physical and mental wellbeing for all ages and abilities. As a minimum comply with the Nationally described space standard
  • Outdoor spaces: Provide private or semi-private (shared) outdoor spaces with either private or community gardens or balconies and terraces for homes above ground floors.
  • Natural light and good outlooks: Design homes to ensure ample daylight and pleasant views, which contribute positively to mood and health.
  • Energy efficiency: Build homes to high energy-efficiency standards, including low-carbon heating, to reduce costs, improve comfort, and lower environmental impact.
  • Sustainable design and construction: Incorporate features like solar gain to support climate change mitigation and adaptation and create resilient living environments.

Local data and evidence

Data available on Healthy Places Data Profile: East Sussex Healthy Places Data Profile

  • Housing: Percentage of dwellings by type, Homeless households, percentage of households by accommodation type, percentage of households by tenure
  • Loneliness:  Percentage of adults who feel lonely always, often or some of the time
  • Fuel Poverty: Percentage of households in fuel poverty 

Evidence: County-wide plans, strategies and reports.

National planning policy context

The National Planning Policy Framework (December 2024) includes the following paragraphs:  

  • Paragraph 167 - Local planning authorities should also give significant weight to the need to support energy efficiency and low carbon heating improvements to existing buildings, both domestic and non-domestic (including through installation of heat pumps and solar panels where these do not already benefit from permitted development rights).
  • The National Planning Policy Guidance, 2029:
  • Paragraph 3 on What is a healthy place? includes – ‘It is a place which is inclusive and promotes social interaction. The National Design Guide sets out further detail on promoting social interaction through inclusive design including guidance on tenure neutral design and spaces that can be shared by all residents.’

Other key guidance and standards

Guidance highlights that well-designed healthy homes are functional, accessible and sustainable, providing internal and external spaces that are designed to support long term physical and mental wellbeing and enable people to live active and fulfilling live.

Examples, best practice and or case studies

Stowe Place, Newhaven

  • A development of 21 affordable council homes on the site of a former police station. High quality housing through strong design, sustainability approach and energy-efficient building including solar panels, heat pumps and low-energy systems.
  • Status: Completed
  • Website: Stowe Place - MCA Consulting Engineers

Links with other determinants

There are overlaps and synergies between ‘Aspects’ and ‘Determinants’. This section provides a list of determinants which are interconnected and cross cutting with this determinant. 

  • 1c. Inclusive design – Quality housing supports and enables everyone to thrive including older people and the young who are particularly vulnerable to poor housing conditions. 
  • 1d. Safety and Security – Quality housing includes measures to design out crime contributing to a safe and secure neighbourhood.
  • 1e. Social Cohesion and Interaction – Tenure neutral housing design supports social cohesion and interaction.
  • 2b. Accessible and Adaptable Homes – Quality housing supports homes to be accessible by creating living conditions such as warm and well-ventilated to allow the most vulnerable to stay in their homes.
  • 4a. Environmental Hazards - Quality housing reduces exposure to harmful environmental hazards particularly air and noise pollution.
  • 4d. Climate Change Adaptation – Energy efficient housing and using sustainable design and construction methods creates climate resilient homes.
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Determinant 2b - Accessible and Adaptable Homes

Requirements

Housing is required to be accessible and adaptable to enable everyone to enjoy and live independently in their own homes. Adaptable homes are required to make them physically accessible for disabled people and those with mobility issues. They are designed to accommodate people’s lifelong needs, creating homes that can grow and adapt to individual’s and families’ diverse needs over time. Accessible homes also require housing to be affordable for low-income households and individuals.

Issues, Impacts and Links to Health and Wellbeing Effects

Below is an outline as to the importance of the determinant, its connection to health and wellbeing outcomes, and how it affects different population groups, particularly the most vulnerable. (East Sussex DPH Report, 2020), (TCPA, 2025), (East Sussex Housing Partnership, 2025)

  • Independent living: Fully accessible and adaptable housing ensures that individuals of all abilities, particularly older adults and those with disabilities, can live in their own homes. Such housing accommodates changing health or mobility needs, reducing reliance on institutional care. It supports greater independence, autonomy, and overall wellbeing.
  • At home care: Homes designed to accommodate changing physical needs allows care to be provided in the community more easily. At home care promotes comfort, dignity and continuity in people’s lives which positively affects mental and emotional wellbeing. (HAPPI)
  • Risk of injury: Properly designed accessible homes reduce the risk of accidents such as falls, especially for older adults. Preventing injuries reduces hospital admissions and long-term health complications. Unsuitable housing can delay discharge from hospital with both mental health impacts and costs to the NHS.
  • Mental Health: Being able to remain in a familiar environment, despite changing physical needs, helps reduce anxiety, stress, and depression. People who stay in their home feel more secure, stable and empowered. It allows for continued engagement with local communities, maintaining social networks and familiar routines. This familiarity provides a sense of comfort, security, and stability, which are vital for emotional wellbeing.
  • Disabled children: Inappropriate housing can severely limit disabled children’s development, physically, emotional, socially and in building essential life skills. This can have a profound impact not only on the child’s wellbeing but also on the mental health of the entire family, including parents and siblings. To support a disabled child’s growth and daily needs, housing must be adaptable and offer sufficient space for safe access to bedrooms, hygiene facilities, and ease of movement in and out of the home.
  • High housing costs: A lack of affordable housing is a significant health concern. High housing costs can force people to choose between housing and other essentials such as food, heating and healthcare, leading to poorer health outcomes. Difficulties accessing affordable, suitable housing are issues for older people, affecting mental health and increasing the risk of living in inappropriate or unsafe conditions. Young people and students also face challenges in finding affordable homes, which can influence their ability to remain in the county and take up employment opportunities.
  • Poverty and homelessness: In severe cases, unaffordable housing can result in homelessness and push individuals and families into poverty, all of which have serious negative impacts on physical and mental health. Homelessness, being without a home or a place to call home, has a significant impact on health and wellbeing.
  • Equity: Affordable housing is essential for reducing health inequalities and ensuring everyone has the opportunity to live a healthy life.

The opportunities - what the planning system can do

Positive actions, principles and measures that should be considered and where feasible implemented to address adverse effects and enhance health and wellbeing benefits.

  • Range of housing: Provide a diverse range of housing tenures to meet local needs and ensure there is access to a variety of affordable housing options within the local area. This should include housing that is affordable for families, young and older people and opportunities for intergenerational living.
  • Accessible and adaptable housing: Provide fully accessible and adaptable homes that cater for all abilities, and which allow residents to stay in their home as their needs change over time. Provide housing suitable for older people and for those with disabilities including children and their families.
  • Standards: Ensure homes comply with M4 (2) and M4 (3) standards to support independent living for older adults and people with disabilities.
  • Storage spaces: Provide storage spaces for mobility scooters and other mobility aids.
  • Community led schemes: Encourage and support opportunities and delivery of community led housing. Particularly those delivering affordable housing and housing for specific groups.
  • Self-build housing: Support opportunities for communities to deliver self-build plots.

Local data and evidence

Data available on Healthy Places Data Profile: East Sussex Healthy Places Data Profile

  • Age: Population by broad age group
  • Housing: Percentage of dwellings by type, Homeless households, percentage of households by accommodation type, percentage of households by tenure.
  • Loneliness:  Percentage of adults who feel lonely always, often or some of the time

Evidence: County-wide plans, strategies and reports.

National planning policy context

The National Planning Policy Framework (December 2024) includes the following paragraphs:  

  • Paragraph 63 – Within this context of establishing need, the size, type and tenure of housing needed for different groups in the community should be assessed and reflected in planning policies. These groups should include (but are not limited to) those who require affordable housing (including Social Rent); families with children; looked after children; older people (including those who require retirement housing, housing with-care and care homes); students; people with disabilities; service families; travellers; people who rent their homes and people wishing to commission or build their own homes.’
  • Paragraph 135 – Planning policies and decisions should ensure that developments:
  • f) create places that are safe, inclusive and accessible and which promote health and well-being, with a high standard of amenity for existing and future users (Footnote 51);
  • Footnote 51: Planning policies for housing should make use of the Government’s optional technical standards for accessible and adaptable housing, where this would address an identified need for such properties. Policies may also make use of the nationally described space standard, where the need for an internal space standard can be justified.

Other key guidance and standards

Guidance stresses the need for a mix of housing types and tenures that suit the needs of the local community. Housing must meet residents’ diverse and lifelong needs and provide genuinely affordable homes, recognising that affordability is a fundamental component of health and wellbeing.

Examples, best practice and or case studies

Coronation Place, Uckfield

  • A scheme of 20 affordable homes providing a mix of social rent and shared ownership housing. Two of the houses are fully wheelchair adapted properties. The remainder are built to accessible and adaptable standards to ensure future mobility needs can be accommodated.
  • Status: Completed.
  • Website: Coronation Place - Wealden District Council

Orchard Close, Icklesham

Links with other determinants

There are overlaps and synergies between ‘Aspects’ and ‘Determinants’. This section provides a list of determinants which are interconnected and cross cutting with this determinant. 

  • 1c. Inclusive Design – Fully accessible and adaptable housing supports inclusive design ensuring homes can be used by a wide range of people, regardless of age, mobility, or disability, throughout their lifetime.  
  • 1e. Social Cohesion and Interaction – Accessible and adaptable housing provides a stable home base while enabling people to remain in their homes, engage with their local community, and maintain social networks.
  • 2a. Quality Housing – Accessible and adaptable housing complements and supports the delivery of quality housing.
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