Housing and health in old age: a research agenda

Housing is a key element in maintaining well-being and independence in old age. However, the elderly live in worse housing conditions than younger people in terms of unsuitable housing, accommodation which is draughty, cold and lacking in basic amenities and in properties in a poor state of repair. Given the generally accepted policy objective to keep old people in their own homes in the community for as long as possible and desirable, it is essential that housing policies are coordinated with health and social policies to ensure that the domenstic environment is as clean, comfortable, sage and warm as possible. Investment in satisfactory housing accommodation forms an important element of any preventative health strategy for the elderly. The purpose of this paper is to propose through a carefully thoughtout research agenda a broad examination of the links between housing and health in old age. The research agenda is designed to cover existing gaps in the information presently available to housing, health and social services about the effects of improved housing provision on health and health care provision. The agenda consists of a major follow-up study and a set of smaller-scale proposals. There is a marked lack of information about the way in which elderly people make choices about their housing accommodation and the ways in which they can be guided to make them. A follow-up study of a cohort of elderly people would aim to identify the full range and mix of housing needs in old age and the nature of their interaction with health, status, services and costs. It would also evaluate different approaches to meeting these needs. The smaller-scale projects would be concerned inter alia with examining the role of housing in maintaining the independence of the elderly (for example in preventing admission to residential care or facilitating early discharge from hospital) and/or with evaluating specific initiatives in the development of housing services for elderly people. If this research agenda were accepted the results would go a long way to helping policy makers decide about the most efficient use of resources available for helping the elderly to stay in their own homes and to ensure that these policies are effectively put into practice through joint planning and collaberation between agencies.