Housing: the hidden health intervention

Australia’s long run of “home ownership for all” appears to have ended. Smashed avocado aside, young people are now much less likely than their parents to ever own their own home. Almost one-third of the nation rents, mainly from private landlords.

Governments have gradually shifted the focus of welfare away from public housing and towards subsidising housing in the private rental market. At last count, around 1.3 million households were receiving government rental assistance – that’s around one in five Australian households receiving on average A$128 per fortnight.

As the private rental sector expands and the cost of housing rises, it is important to acknowledge that the effects of unaffordable housing cascade into other areas of life, in particular, mental health.

Our research has found unaffordable housing has a negative effect on mental health. And it’s worse for private renters than those with a mortgage. When lower-income private renters’ housing becomes unaffordable, their mental health worsens. This doesn’t seem to happen for people on similar incomes paying a mortgage.

It’s different in the UK. Our cross-national comparison conducted before austerity measures were taken in the UK suggested more generous benefits and conditions may have protected their lower-income private renters from the mental health effects experienced by their counterparts in Australia.

While this work highlights the potential protective effect of affordable housing, recent changes in the UK as a result of austerity measures may have taken the Brits backwards.

A ‘natural experiment’

A recently published analysis tracked the effect of a national reduction to government-provided rent assistance in the UK.

In April 2011, austerity measures in the UK resulted in a reduction of the rental housing assistance payment. This meant that incomes for rent assistance recipients fell, on average, by approximately £1,220 (A$2,000) per year. Some people experienced much smaller declines, but many witnessed much larger reductions in their housing benefit.

Although not without methodological challenges, the research found reduced government support to meet housing costs has a negative impact on people’s mental health. The policy caused a measureable population-wide increase in depressive symptoms, with around 26,000 people experiencing symptoms for the first time.

Lessons for Australia

Affordable housing is an effective health intervention. Australia has some of the world’s least affordable housing, and while we debate the solutions to this (such as removing negative gearing), government assistance to meet housing costs protects many people from poor mental health, and possibly, depression.

As World Medical Association president Professor Michael Marmot argues, housing is a form of preventative health care. The one in five Australian households relying on government assistance to pay their rent are currently receiving this form of preventative health care.

Households that receive private rent assistance gain more than just shelter. Rent assistance may allow people to live nearer to good schools, buy healthier food for their kids, and provide some residential stability. It also protects their mental health.

Cuts to private rent assistance may do the opposite: pushing people away from good schools, leaving them without adequate food, and exposing them to housing insecurity. As the UK work shows, even slight changes to policy can have major (and often unintended) effects, particularly for mental health. The most economically vulnerable are likely to be disproportionately affected.

As we enter an era of substantial reassessment of the structure of welfare in Australia, this UK research highlights the importance of harnessing natural experiments to systematically test the outcomes of broad policy change, and develop evidence on which to build better health into the future.

While Australia’s cohort of private renters grows and housing affordability stress escalates, we need to ensure that health, well-being and productivity are supported. We need to address the structural factors that contribute to our housing affordability crisis. We also need to support people who are disadvantaged by it. We shouldn’t underestimate the importance of getting housing right.