This document discusses how housing design can contribute to building healthy places and communities. It provides examples of retrofitting existing homes in New Zealand to improve insulation, which led to reductions in reported health issues. A second case study examines a purpose-built housing development in the Netherlands called Hogeweyk that is designed specifically for people with dementia. Hogeweyk incorporates design elements like outdoor greenspaces and opportunities for social interaction to stimulate residents and slow cognitive decline. The document concludes that links between housing and health have long been known, and both retrofitting existing homes and new developments present opportunities to positively impact public health through improved design.

1. HOW CAN
HOUSING CONTRIBUTE TO BUILDING HEALTHY PLACES?
DR TIM TOWNSHEND
SCHOOL OF ARCHITECTURE PLANNING AND LANDSCAPE

2. PURPOSE OF THIS PRESENTATION
 Quick overview of issues
 Look at a couple of examples of improving health through retrofitting in
housing
 More ambitious example of trying to help dementia suffers through a
carefully designed new housing environment
 Conclusions

3. SLUMS TO BYE-LAW HOUSING

4. Wate
r
Warmth
Safety
Space
Sanitation
Noise
Privacy
Walkability
Air Quality
Flood Risk
Traffic
Access to Employment
ServicesPlay space
Greenness
Perceived Status
Affordability
Social Capital
Contemporary links between housing and health
Accessibility
Light
Outdoor space

5. CASE STUDY 1: HOUSING AND HEALTH NEW ZEALND
 Effects of retrofitting insulation to 1350 low income homes (4407 participants) – where at least
one person had chronic respiratory problems
 Retrofitting was associated with small increase in winter bedroom temp (+0.5C) & decrease in
humidity (-2.3%)
 Reduction in self-reports of
 ‘fair’ and ‘poor’ health
 wheezing
 children taking a day off school
 adults taking a day off work
 Home Injury Prevention Intervention (HIPI) study reduced home fall injury rates by 26% though
low-cost intervention
From special issue of Urban Design and Planning (2015) – vol. 168 (4

6. HOUSING OLDER PEOPLE AND HEALTH/WELL-BEING
 In UK ageing housing stock (as well as population!) – one of
the oldest in Europe
 1 million people over age of 75 live in poor housing conditions
but spend 80% of their time at home (Dept. of Health , 2013)
 We have a huge shortage of suitable housing for older people
(DEMOS, 2013)

7. DESIGN ESSENTIALS FOR OLDER PERSONS’ HOUSING
(SOURCED FROM EVIDENCE-BASED GUIDELINES)
 Flexible & Adaptable ‘homes for life’
 Comfortable
 ‘Care-ready’ – future proofed for current (and future)
technologies e.g. telecare can be installed
 Adequate space allowing free movement & space
for guests (at least 2 bedrooms)
 Kitchen can accommodate a dishwasher and
washing machine
 Easy reach ample storage
 Accessible – e.g. downstairs toilet
 Safe and secure
 Good insulation and thermal efficiency – cost
effective heating
 Means of shading/keeping cool
 Good natural and artificial light
 Good ventilation
 Private outdoor space
 Views and greenery
 Sensory needs (e.g. for those with impairment)
 Proactive consultation
 Adapted from Rachel Dutton (Accord Group -
housing and social care organisation) (2015)

8. CASE STUDY: DEMENTIA FRIENDLY HOUSING DEVELOPMENT
 By age 80, 1 in 5 have some form of
dementia
 Currently 850,000 living with dementia in UK
– over 2million by 2051 (more than
population of Liverpool, Birmingham and
Manchester) (Alzheimer’s Soc. 2014)
 Some design issues well-known – e.g.
access to greenspace/multisensory
environments hugely beneficial/avoidance
of dead-ends/certain flooring etc.
 Even best designed housing tends to ‘shut
people off’
Source: Pollock and Marshall, 2012, p.219

9. HOGEWEYK, NETHERLANDS: DEMENTIA FRIENDLY VILLAGE

15. KEY POINTS
 Stimulation is positive for dementia sufferers
 Outdoor activity/interaction with greenspaces etc. positive for dementia sufferers
 Really key difference with Hogeweyk and similar Dutch developments is the emphasis on
greater support of physical activity and encounter with others
 Encounter to improve the quality of life of those with dementia, slow down symptoms
 Encounter to break down the stigma of dementia
 i.e. this doesn’t just benefit those suffering with dementia, but everyone
 N.B. Hogeweyk is currently undergoing post occupancy evidence gathering

16. CONCLUSIONS
 Housing is the basic building block of our towns and cities
 The links between housing and health have been known for a very long time and through our
increasingly sophisticated understanding of health and well-being are continually developing
 There are many ways in which we can build healthier housing and thereby healthier town and
cities – we know much of this already
 Still room for the basics to improve existing stock – e.g. improving insulation etc. can be v cost
effective
 However - potentially we may even be able to mitigate (at least to an extend) some of our
most challenging health problems, such as dementia, through more creative thinking and
better design – here commitment to resourcing is clearly much more significant – but the
benefits are potentially huge

17. THANKYOU
Tim.Townshend@ncl.ac.uk