Key Facts about Housing conditions in Hackney and the City

  • Well over 90% of council properties in Hackney now meet the Decent Homes Standard and most housing associations are above 99%, but many properties in the private rented sector are in poor condition.
  • Reported problems with the home cited in Hackney are mainly associated with cold, mould and damp. More issues are reported for social rented homes than privately rented accommodation (though this may not reflect the true picture), with owner-occupied homes having the least problems.
  • Overcrowding is a major concern in both Hackney and the City.

The Housing Health and Safety Rating System (HHSRS) provides an assessment of the level of health-related hazards within a property.  The key (‘category 1’) hazards used to assess properties under HHSRS are listed in Table 1, grouped into four categories – physiological requirements, psychological requirements, protection against infection and protection against accidents.  These hazards give an idea of the range of health risks associated with the housing conditions in which people live.

Table 1: Housing Health and Safety Rating System (HHSRS) category 1 hazards

Physiological requirements Protection against infection
Damp and mould growth etc Domestic hygiene, pests and refuse
Excessive cold Food safety
Excessive heat Personal hygiene, sanitation and drainage
Asbestos etc Water supply
Biocides Protection against accidents
Carbon monoxide and fuel combustion productions Falls associated with baths etc
Lead Falling on level surfaces
Radiation Falling on stairs etc
Un-combusted fuel gas Falling between levels
Volatile organic compounds Electrical hazards
Psychological requirements Flames, hot surfaces etc
Crowding and space Collision and entrapment
Entry by intruders Explosions
Lighting Position and operability of amenities etc
Noise Structural collapse and falling elements

Source: Housing Health and Safety Rating System enforcement guidance – housing inspections and assessment of hazards

Poor housing conditions can affect health in a variety of ways.  Outcomes of poor housing conditions – such as overcrowding, damp, indoor air pollutants and cold – have been shown to be associated with illnesses such as eczema, hypothermia and heart disease. 1 They are also linked to increased incidence of infections, respiratory disease and asthma.  However, it can be difficult to separate out the impact of specific housing-related hazards from other confounding factors (such as socioeconomic status or age), which in themselves may give rise to poor health outcomes and are also linked to housing circumstances.

A study carried out by Shelter in 2006 outlined the significant health consequences associated with poor housing conditions specifically for children, including: 2

  • mental health problems (such as anxiety and depression)
  • risk of contracting meningitis
  • respiratory problems
  • long-term ill health and disability
  • slow physical growth and delayed cognitive development.

The physical health impacts most commonly experienced by those living in cold homes are circulatory diseases and respiratory illnesses, and these are also the main causes of excess winter deaths (although it is important to remember that the health problems associated with cold homes are experienced during ‘normal’ winter temperatures, not just during extremely cold weather). 3 4 One of the causes of excess winter deaths is fuel poverty (see Box 1), which has been shown to be as important a driver of health for young people as it is for frail elderly people (see Box 3).

Box 3: Health harms of fuel poverty for children

The Chief Medical Officer’s 2013 report highlighted the health harms of fuel poverty for families, noting the following issues: 5

  • more than one in four adolescents living in cold homes are at risk of mental health problems, and are less likely to have a good diet
  • infants living in fuel poverty show poorer weight gain
  • affected children and young people are at greater risk of hospital admission and accidents in the home
  • impacts on the ‘wider determinants’ of health include poorer educational attainment, emotional wellbeing and resilience.

Poor housing conditions can increase the risk of depression, stress and anxiety.  For example, there is strong and growing evidence on the mental health and wellbeing impacts of fuel poverty and cold homes, and the significant benefits to mental wellbeing from tackling fuel poverty across the entire age range. 6

Overcrowding also has significant health implications for residents. Living in an overcrowded home disrupts sleep patterns and affects family relationships, child development and mental wellbeing, as well as creating noise nuisance and (perceptions of) anti-social behavior, especially where people live in close proximity to their neighbours. 7 8


  1. Chartered Institute of Environmental Health, “‘References’,” [Online]. Available: [Accessed October 2016].
  2. L. Harker, “Chance of a lifetime: The impact of housing on children’s lives,” Shelter, 2006.
  3. UK Health Forum, “‘Fuel Poverty: how to improve health and wellbeing through action on affordable warmth’,” April 2014.
  4. National Institute for Health and Care Excellence, “‘Excess winter deaths and morbidity and the health risks associated with cold homes: NICE guidelines’,” March 2015.
  5. Department of Health, “‘Annual Report of the Chief Medical Officer 2012, Our Children Deserve Better: Prevention Pays’,” October 2013.
  6. The Marmot Review, “The Health Impacts of Cold Homes and Fuel Poverty,” 2011.
  7. Shelter, “‘Full house? How overcrowded housing affects families’,” 2005.
  8. W. Wilson and C. Fears, “Overcrowded housing (England),” House of Commons Library, 14 November 2016.