Change in adult health following medical priority rehousing: a longitudinal study.

Abstract

Background: Over 90 per cent of local housing authorities in England allocate medical priority for rehousing (MPR) to applicants with medical or care needs but very few studies have been undertaken to investigate the health effects of this practice. This longitudinal study compares the change in health status of adult applicants for MPR who were rehoused with applicants who were not rehoused.

Methods: A total of 566 households applying for MPR were interviewed before any rehousing, and of these 253 households were re-interviewed between 9 and 12 months later. Data from initial and follow-up interviews were analysed for 227 adults, of whom 104 were rehoused. The rehoused and not rehoused groups were not significantly different in terms of health status, gender, education, income or housing conditions, but participants who were not rehoused were more likely to report mobility problems and to be aged over 50. Health data were collected by interview using the Short Form 36 (SF-36) questionnaire. Questions were also asked about housing conditions and the local neighbourhood, instrumental activities of daily living (IADL) and health-related behaviour.

Results: The health status of adult applicants for MPR was very poor. Those who were not rehoused experienced a slight improvement in five dimensions of the SF-36 whereas those who were rehoused experienced much larger improvements in six dimensions. For those who were rehoused, significant net improvements occurred in reports of tiredness, feeling depressed, sleeplessness, use of prescribed medication, use of medical services and problems with IADL. No changes occurred in reports of respiratory problems, longstanding illness or disability, use of antidepressants, sleeping pills or tranquillizers, smoking or social support.

Conclusions: MPR was associated with improvements in mental health status and mobility, and among respondents aged 50 years or under with a reduced use of prescribed medication and medical services. Whereas most applicants applied for MPR because of mobility problems, they were less likely than other applicants to be rehoused. The health improvements that appeared to occur should be qualified by the extent of unmet need for appropriately adapted housing and the high level of ill-health that persisted even among adults who were rehoused.