Health inequalities: Cold or damp homes

How do cold or damp conditions affect health?

Housing quality has a significant and material impact on health and wellbeing.

Condensation and damp in homes can lead to mould growth, and inhaling mould spores can cause allergic type reactions, the development or worsening of asthma, respiratory infections, coughs, wheezing and shortness of breath.

Living in a cold home can worsen asthma and other respiratory illnesses and increase the risk of heart disease and cardiac events. It can also worsen musculoskeletal conditions such as arthritis.

Cold or damp conditions can have a significant impact on mental health, with depression and anxiety more common among people living in these conditions.

Each year, the NHS spends an estimated £1.4 billion annually on treating illnesses associated with living in cold or damp housing. When wider societal costs are considered, such as healthcare, that figure rises to £15.4 billion.

How many households are affected by damp, mould and excess cold?

According to the English Housing Survey, around 904,000 homes in England had damp problems in 2021. Of these, around 11% in the private rented sector had damp problems compared with 4% in the social-rented sector and 2% of owner-occupied homes.

In 2019, an estimated 653,000 households in England lived with a ‘category 1 hazard’ of excess cold – i.e. a home with poor energy efficiency that could lead to cold conditions posing a serious risk to health and safety.

Some households are likely to be disproportionately affected by cold and damp. Households with children are more likely than others to have damp in their home, while households with over-60s are most likely to live with an excess cold hazard.

Are cold or damp homes an inequalities issue?

Certain groups of people, such as children and young people, the elderly or people with pre-existing illness, are at a greater risk of ill health associated with cold or damp homes.

Some groups of people are more likely to live in these conditions, including households with an older person living in them, households with a lone parent, households with children, low income households and households with people from minority ethnic backgrounds.

Why is there increasing concern about cold or damp homes?

With growing pressure on household finances because of increasing energy costs and wider concerns about the cost of living, there are concerns households are choosing between “heating or eating” over the winter months.

In 2022, the media reported widely on poor conditions caused by damp and mould in social and private rented housing. This was preceded by reporting on the case of two-year old Awaab Ishak who died in 2020 due to prolonged exposure to mould in his home.

Cold or damp housing creates an additional burden on the NHS which is already struggling to keep up with demand.

Government action to address damp and mould in rented housing

Across the UK private and social rented sectors, landlords have statutory duties to maintain their rented properties. Where landlords breach these duties, tenants can seek redress. For example, enforcement action can take place through the courts, through engaging with local authority environmental health officers (who also have enforcement powers), and through social landlords’ complaints procedures.

There are barriers to tenants exercising their rights in relation to housing conditions. In the private rented sector in England they can face ‘retaliatory eviction.’ Tenants may not be aware of their rights and there is evidence of inconsistent enforcement activity by local authorities.

Following the coroner’s report on the death of Awaab Ishak, the Secretary of State at the Department for Levelling Up, Housing and Communities, Michael Gove, wrote to all council leaders and social housing providers in England setting out expectations in relation to damp and mould. It’s expected that the Social Housing Regulation Bill, currently before Parliament, will strengthen tenants’ rights to hold their landlords to account for poor housing conditions.

The Regulator of Social Housing in England also wrote to housing providers seeking assurances on action to address damp and mould risks. Similar assurances have been sought by ministers and regulators in the devolved administrations.

There are also proposals to extend the Decent Homes Standard in England to apply to private landlords and to make breaches a criminal offence. Scotland is considering a new housing standard to apply to all homes.