Ageing in place – what should we do?

A lot of work in environmental health is invariably about the bottom end of privately rented sector, where housing conditions are at their most acute. However there is little published about the environmental health role in owner occupied housing where residents ‘age in place’. This has become a more complex area as with our ageing population comes a concurrent rise in degenerative disease and a need for more specialist services to respond to the interrelated needs of housing, health and social care.

This week the Journal of Integrated Care published a piece by Jill Stewart and colleagues entitled Ageing at home? Meeting housing, health and social needs, (not open access) which consolidates a range of issues relevant to owner occupiers who age in place. It suggests how effective partnerships might respond to and meet the changing needs of housing, health and social care of our ageing population as most owners wish to stay in their own homes for as long as possible. We need however to think through new and innovative ways of developing and providing front-line services to enhance health and safety in the home alongside addressing quality of life and well-being, including tackling loneliness and isolation. There are examples of evidence-based good practice, but scope for service provision to be improved – what could or should we expect from housing, health and social care services as we ourselves age?

Jill

Guest blog from Russell Moffatt: Licencing at the London Borough of Newham

We are delighted to add this blog from Russell Moffatt, Environmental Health Practitioner, at Newham’s Private Sector Housing Team about their innovative approach to tackling the sector.

03067_PRPL_Successes of the Scheme_A4Booklet (2)

Newham’s private rented property licensing scheme may change the way the private rented sector is regulated and held accountable by local communities.

Over the last decade Newham’s private rented sector has doubled in size from 20,000 to more than 40,000 properties. Intense demand for cheap housing has resulted in some shocking housing conditions and some of the highest levels of overcrowding in the UK. Houses designed for a family of 5 are regularly found with 12 plus adults living in every available room, on occasions even in the kitchen. Families have been found sharing properties with people they do not know and living at the bottom of gardens in cheaply built sheds with no heating at all. These types of housing conditions put serious environmental pressures on individuals and families and are likely to result is poor health outcomes and diminished life chances.

Newham has licensed 95% of all the eligible private rented properties within 2 years of the scheme starting, along the way many criminal landlords have been prosecuted and property conditions improved.
Licensing has enabled Environmental Health Practitioners (EHPs) to identify and tackle the worst run properties and ensure tenants are afforded reasonable protection from exploitive and incompetent landlords. At the extreme end, 20 landlords who have been found ‘not fit and proper’ have been banned from renting property in Newham at all, sending a very strong message to the criminal landlord community.

Each property licence sets an occupation limit to help EHPs tackle and prevent overcrowding in the sector as well as to introduce minimum standards relating to the way properties and tenancies are managed.  Through issuing licenses not only does the housing authority know who is responsible for maintaining properties, tenants and the general public can also begin to hold landlords accountable, making it easier for them to report problems, such as disrepair and anti-social behaviour.

Public Health England – Evidence into Action – I am not convinced

Originally posted on Local Democracy and Health:

PHE Blog Illus

Reading the Public Heath England report ‘Evidence into Action” I sometimes get the feeling that Duncan Selbie is being held  in a room by the Governments Public Health Minister and a bunch of doctors from the Health Protection Agency.

Every so often he manages to get out a passing reference to inequality or the social determinants of health – but for most of the time all that escapes the room is talk of diseases, clinical interventions and changing the behaviour of the irresponsible public.

The values are right.

“Evidence into Action” starts by recognising the importance of a new approach:

  • that encourages everyone to gain more control of their health
  • where prevention and early intervention are the norm
  • where action on health inequalities is across all the wider determinants of health
  • where assets of individuals families and communities are built on to support improved health

Unfortunately aside from a passing reference to “Due…

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PHE and evidence into action

Public Health England have released From Evidence into Action: Opportunities to Protect and Improve the Nation’s Health (October 2014). It lists priorities for the next five years based on evidence of what is known to work to most effectively rank interventions and encourages others including health professions, national and local government, voluntary and community organisations to apply evidence to protect and improve health.

Jill

Ebola: the UK EHP response?

This brief blog was prompted by yesterday’s request from Graham Jukes, Chief Exec of the UK Chartered Institute of Environmental Health, for EHPs to participate in the response to the Ebola outbreak. See:

Detail on the UK response to the outbreak is being updated constantly, but the UK Government’s website contains some useful resources including Public Health England’s guide for humanitarian aid workers considering travelling to the Ebola affected countries of West Africa. See:

https://www.gov.uk/government/topical-events/ebola-government-response/about

The site also includes a link to the NGO Save the Children’s jobs page and the Ebola WASH (i.e. environmental health) related posts available:

http://www.savethechildren.net/jobs

The recent BBC article by Save the Children’s WASH advisor Mark Buttle provides a good summary of what this post would involve:

http://www.bbc.co.uk/news/uk-29457546

Lastly, I have very limited humanitarian aid experience (2 very traumatic weeks!!) but I’ve spent three years working in WASH and wider environmental health in three African countries and I would urge any potential UK EHP volunteers to think very, very carefully before putting their names forward.

I’m also a water & sanitation alumnus of WEDC, Loughborough University like Mark Buttle (http://wedc.lboro.ac.uk) and have completed three RedR EH humanitarian training courses (http://www.redr.org.uk/), but I can’t reinforce enough Graham Jukes’s comment that any UK EHP volunteer would need much training (and ideally lots of developing country EH experience) before embarking on this complex, important and potentially dangerous work. Mark Buttle’s article above summarises the roller coaster of humanitarian work in this outbreak very well, but I also recommend the 2006 book Emergency Sex (and other desperate measures) by Postlewait (et al) Ebury Press as compulsory reading for all those considering humanitarian work (please don’t be put off by the title)!

I hope these resources are of interest and my thoughts remain with all those affected by the outbreak.

With best wishes, Rob.

The Watling Estate, Burnt Oak: ‘Building the new England’

UK EHRNet:

This is a blog I am following through wordpress: entitled Municipal Dreams. It provides a fantastic history on some of our housing estates and is timely in light of the Lib Dems suggesting the building of 10 new towns to reduce the housing demand in the south east. Well worth a read

regards Alan

Originally posted on Municipal Dreams:

We looked last week at the building of  the Watling Estate and its early residents.  Watling was seen – for good or ill – as a symbol of the ‘new England’.  Middle-class observers – particularly the new breed of sociologists and planners – asked what type of community was it, was it a community at all? Perhaps what really concerned was that it should be the right sort of community.

Storksmead Road

Storksmead Road

As we saw last week, it certainly wasn’t that for many of the well-heeled residents of near-by Mill Hill and Edgware, shocked by this supposed incursion of uncouth slum-dwellers. A 1927 letter to the Hendon and Finchley Times reported flowers stolen from gardens, fruit trees stripped and language that apparently even shocked a local workman. (1)  Children attending the Watling Central School from outside Watling saw the Estate as ‘dirty’ and ‘rough’, according to Ruth Durant. (2)

Watling Central School: class divided its pupils more than gender in the interwar period Watling Central School:…

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Systematic Reviews and Environmental Health

Dear all

Yet another useful article from Environmental Health Perspectives, this time on the value of systematic reviews.  The authors make a really strong case for the use of such reviews in pulling together existing research,  evaluating it, rating the quality of the evidence provided and through this method being able to draw conclusions.  The article provides a narrative and protocol on how to undertake a systematic review which practitioners and researchers alike can utilise for future research

http://ehp.niehs.nih.gov/1307175/

regards Alan