Assessing the impact of funding cuts to local housing services on drug and alcohol related mortality: a longitudinal study using area-level data in England

Abstract Since 2010 there have been large reductions in funding for local government services in England. This has led to reduced income to fund services, such as housing services, that potentially promote health. Housing services expenditure includes spending on housing advice services, homelessness relief and provision of temporary accommodation. During the same period there has been an increase in homelessness and drug related mortality. We carried out an ecological study by linking data on housing services expenditure to deaths from drug and alcohol abuse by local authority in England between 2013 and 2018, to assess whether those areas that experienced a greater decline in spending, also experienced more adverse trends in mortality rates. Our results demonstrate that spending cuts were associated with increased mortality rates due to drug misuse, however, we found no strong evidence of an association with alcohol-specific mortality. This study suggests that reduced fiscal support alongside the introduction of policies that changed how funds are distributed between areas may in part explain the recent adverse trends in drug-related mortality. Since housing expenditure decreased more in the most deprived areas of England compared to less deprived areas, such spending cuts may have contributed to the widening of health inequalities. KEYWORDS Housing services; spending; drug; alcohol; mortality