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Investing in social housing is fundamental to improving Londoners’ health

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Public health consultant, Emma De Zoete, writes about why good quality, affordable and safe social housing is paramount to good health in London
I am frequently asked what I do. My answer is that if we think about what makes us healthy it is largely about the building blocks of life – a stable job, good pay and work, quality housing and education. Access to these is not spread evenly across the capital – people living in one part of London will live shorter and less healthy lives compared to others, but this is not inevitable. My job is to help the Mayor maximise the opportunities to create health, and address health inequalities (the uneven spread) in his work on housing and vulnerable adults.
At the start of the pandemic I spent all my time working with the rough sleeping team to protect the homeless population from COVID. That work led to the GLA opening up hotels, and the ‘everyone in’ initiative to accommodate people in self-contained accommodation in the first wave of the pandemic followed shortly after. I continue to work closely with that team, on protecting and improving the health of rough sleepers and ultimately ending rough sleeping.
As the GLA group public health unit launches, and following the recent Institute for Health Equity (IHE) evidence review on housing and health in London and the tragic death of Awaab Ishak, I’m struck by the need to repeat what early public health pioneers knew well. A good quality, secure and affordable home is the foundation that everybody needs to lead a healthy life.
We all experienced first-hand through the pandemic how our homes shaped our health. Our ability to isolate in a separate room, to work and study, and our mental and physical health was shaped in large part by our homes. The reality is that housing in London is poorer quality, and less affordable when compared with the rest of the country, and this has powerful consequences for our health.  
A lack of affordable housing in London means that people are pushed into high-cost rentals in the private rented sector and this is driving poverty. More than half of homes in London are rented, either socially or privately, and private rents for new tenancies are rising faster in London in 2022 than anywhere else in England. Housing Benefit and Universal Credit caseloads are considerably higher than at the start of 2020 among privately renting households and, in a recent survey, a fifth of all renters in London said they were either behind with their rent payments or expected to fall behind soon.
The impact on children is particularly concerning, and although immediate we have to ask ourselves if we are storing up the next generation of health inequalities. After housing costs are considered, London has the highest rates of poverty in England, and children in the capital are significantly more likely to grow up in after-housing cost poverty than the average for England, with 38% of children in London in poverty in 2019/20. Over 75,000 children live in households in temporary accommodation arranged by local authorities in London, and almost two-thirds (63%) of these families in England are based in the capital.
As London enters a period of the highest inflation in a generation there is a real risk of widening housing-related health inequalities: this includes a particular risk of growing rates of fuel poverty, higher costs of maintenance and repairs, and greater insecurity of tenure leading to rising homelessness, especially for people living in the private rental sector.
As food and energy bills rise, some people will be unable to heat their homes, increasing exposure to damp and mould. Cold homes adversely affect child development, can cause and worsen respiratory conditions, cardiovascular diseases, poor mental health, dementia and hypothermia. It is estimated that 1 in 5 excess winter deaths is due to cold homes.
The impact will be felt in A&E departments across London, and a recent analysis found that the per annum cost to the NHS of poor housing in London is £114m.
The effects of these issues are not equally felt across the city. People from minority ethnic backgrounds experience worse housing conditions and greater housing insecurity and need than White Londoners. Black, Asian and minority ethnicity households in London’s private rented sector are significantly more likely to be in poverty after-housing-costs than White households. Londoners of Asian ethnicity are more likely to live in homes that fail to meet the Decent Homes Standard, while Black Londoners are more likely than people of other ethnicities to have damp problems in their homes. In 2017/18 more than two in three (68%) of statutory homeless households in London were from Black, Asian, mixed or ‘other’ ethnic groups.
These stark inequalities in access to quality, affordable and secure housing are unjust but critically avoidable. The IHE review highlights that there is already a wealth of evidence-based housing interventions across London, that can have clear and tangible benefits to health. These range from affordable housing, selective licensing and enforcement, to supported accommodation, debt advice, and multi-agency working to prevent homelessness. The new Integrated Care Systems (ICSs) which bring together health and local authorities in five areas across London offer a significant opportunity to work more closely on this.
Supporting the GLA in delivering on these, and demonstrating the health impact, will form my work programme in the new GLA Group public health unit. After all, a good quality, secure and affordable home is the foundation that everybody needs to lead a healthy life.   
Emma De Zoete, Public health consultant

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Graduate Organist vacancy in London and Home Counties – Church Times

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Graduate Organist vacancy in London and Home Counties  Church Times

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The dwindling case for living in London

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The recent debate around ‘levelling up’ may be missing something. I would argue that there is another way to consider geographical inequality – and, by this alternative measure, a levelling has been under way for more than 20 years.

I’ve spent three decades working in advertising, so it’s unsurprising that I tend to view economic life through the lens of consumption. By contrast, mainstream economists tend to view disparities through the medium of earnings or wealth. To me, measures of wealth should include not only the quantity of money you have but the breadth of worthwhile options available in choosing how to spend it.

Let’s put it another way. If you live in a boring village, and suddenly a great pub or café opens on the high street, then by my measure you have become richer; by the economist’s measure you have not.

Things that would once have been available in London decades before the provinces now appear everywhereat once 

There was undoubtedly a time when you were richer in London in two ways. You had more money, but you also had a far more exciting range of ways to spend it. Now not so much.

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London is a great city but, in terms of consumption quality, it has not improved markedly in the past 20 years. Over the same period, many smaller cities and even towns have advanced rapidly, significantly narrowing the gap. The kind of things that would once have been available in the capital decades before making it to the provinces – like sushi – now appear everywhere at once. Consider Turkish barbers, who seem to have taken over the country in only five years. (I can remember a time when it was enough just to get a haircut without having burning methylated spirits flicked in my ears. Back then I just didn’t know any better.)

This levelling is especially true of anything in the digital world: Amazon gadgets, Netflix films, Asos fashions and PlayStation games hit Aberystwyth the same day they hit Islington. But it also applies to the physical environment, as anyone over 50 can attest. I went to Manchester and Sheffield for the first time in 1989. Compared with London, they were then, let’s be honest, utterly rubbish. Now, when I visit those same cities, I experience mild ‘northern envy’. There are interesting places open everywhere. Northerners have better cars, because they have more money left over after paying for housing. And they are much better-looking, because they can nip home to get changed before going out.

Relatively speaking, London has improved far less dramatically than these provincial cities have. (New York, many aficionados argue, has got worse.) OK, the Tube is better than it used to be. Uber is a handy addition. But some things are awful – the last pleasure of driving in London ended when they put speed cameras on the Westway. Accommodation costs for the young wipe out any salary gains.

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By my measure, high property prices won’t just hit Londoners once – they’ll hit them twice. Not only do high rents wipe out what you earn, they also put at risk London’s once unassailable advantage as a great place to spend what money you have left. Creative businesses of any kind require space at a price which allows them to take risks. For a time, London found this space by moving its heartland from west to east. But suppose the people supporting what Douglas McWilliams calls ‘the flat white economy’ flee altogether? In my own experience, Kent suddenly seems weirdly full of fascinating restaurants founded by London exiles. If more of these people leave, the case for staying weakens further.

Londoners always say things like ‘Yes but there’s the theatre’. Let’s face it though – even Shakespeare left London for Stratford in his mid-forties. As he no doubt found, the theatre is all very well, but it’s nothing like being able to park outside your house.

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Gentrification is not a sin

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Gentrification is not a sin – UnHerd

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