Biomarker May Link Stress to Housing Type and Tenure

Theresa Bebbington

January 15, 2019

There have already been well-established links between inadequate housing conditions such as damp and cold indoor temperatures and their impact on health. Previous research has often concentrated on the 'hard' physical characteristics of housing such as poor sanitation, overcrowding, disrepair, inadequate ventilation and lighting, and fire risk.

Researchers are now also looking at how potential 'soft' social and psychological factors such as housing affordability and tenure differences can affect health. Studies have indicated, for example, that health impacts can differ between private renters in the UK – who have short tenancies and little security – and UK home owners or private renters in other countries such as Germany, where tenancies are indefinite and robustly regulated. The type of housing can also play a role: one study in Scotland found that people who moved from a flat to a house reported better mental wellbeing and quality of life.

According to the charity Shelter, 4.7 million households in England (20% of households) now rent privately, a 74% rise in the last 10 years. The charity also reported that private rents in England increased 60% faster than average wages between 2011 and 2017.

Adding a Biomarker to Research Methods

Until now, much of existing evidence has often relied on self-reported health measures. However, new research, led by Dr Amy Clair of the Economic and Social Research Council (ESRC) Research Centre on Micro-Social Change, University of Essex, has included biomarker data alongside data taken from the UK Household Longitudinal Study (UKHLS). The observational research is being published online in the Journal of Epidemiology & Community Health.

The UKHLS is an annual survey of about 40,000 households in the UK that includes information on housing details, demographic characteristics and health behaviours. It looks at factors such as if participants owned their homes outright, had a mortgage, or rented through social housing or privately. It also includes the dwelling type such as detached, semi-detached, terraced, or flat, as well as factors such as payment burden and arrears, whether there was adequate heating or overcrowding, and if the participants wanted to move.

Blood samples were collected from more than 13,000 survey participants about 5 months after the main survey interview between 2010 and 2012. These were used to analyse levels of C-reactive protein (CRP), a chemical in the body associated with stress and inflammation. The final analysis excluded participants who had CRP levels above 10mg/L, suggesting recent infection, in order to focus primarily on indirect pathways relating to chronic processes, such as stress. Those under 21 years old and a few over 95 years old were also removed from the study, so the final sample size was 9593.

The researchers controlled for variables such as age and gender, since CRP levels are higher in women than men and increase with age. They also took into account the region in which participants lived and their ethnicity, level of education, employment status, smoking status, and body mass index, and excluded participants taking statins or anti-inflammatory medication as these can influence CRP levels.

Housing Variables Affect Health 

The findings showed that certain housing types and tenure were associated with raised CRP levels:

  • Renters in the private sector had significantly higher CRP levels than homeowners with a mortgage

  • People living in semidetached and terraced houses and flats had higher CRP levels than those living in detached properties

Unexpectedly, the study found that people with a high housing payment burden – those spending more than one-third of household income on housing costs – who also had an income was below 60% of the median - had lower CRP levels. The researchers have suggested that this might be because higher proportional expenditure on housing secures better quality accommodation, so the health benefits of living in better housing might outweigh any financial strain.

The researchers comment in a news release: "The significant findings for housing type and tenure point to an influence of autonomy and control. Where control is low [the sense of] security is reduced, which may affect health through chronic stress responses."

In their conclusions they argue for "greater consideration of the negative effects of the current private rented sector in the UK, characterised by greater insecurity, higher cost and lower quality than is typically found in other tenures". They suggest the use of biomarker data in their analysis complements self-reported measures of health and provides additional evidence of an important link between housing and health. They say their results "support arguments that health outcomes should be a consideration of housing policies".

JECH.  2019;0:1–7. doi:10.1136/jech-2018-211431. Abstract.


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