Health Column: Health Begins at Home: Why Housing Is One of Our Most Powerful Tools for Better Health

When we talk about health, we often think first about hospitals, GPs or lifestyle choices. But as Director of Public Health, I know that some of the biggest influences on our health start much closer to home, quite literally.

The quality, safety and security of the place we live shapes our physical health, our mental wellbeing and our life chances from childhood through to older age. Warm, safe and stable homes are not a “nice to have”; they are one of the most powerful building blocks of health we have.

That’s why housing sits at the heart of our public health approach in Wigan Borough.

Housing Is a National Health Issue – and a Local One

Nationally, we are facing well‑documented challenges: an ageing housing stock, rising fuel costs, growing numbers of families in temporary accommodation, and stark inequalities in who lives in poor‑quality or overcrowded homes. Reviews such as the Marmot reports have repeatedly shown that poor housing conditions, particularly cold, damp and insecure homes, directly contribute to worse health outcomes and widen health inequalities.

Recent policy developments, including Awaab’s Law and updates to the Decent Homes Standard, rightly recognise that unsafe housing is not just a housing failure, but a public health one. These changes signal a growing national understanding that prevention matters, that intervening earlier, improving standards and protecting residents’ rights can prevent illness, injury and avoidable pressure on the NHS.

But policy alone doesn’t change lives. What matters is how these principles are applied on the ground, in real places, with real people.

Why This Matters

In Wigan Borough, we see first‑hand how housing conditions affect health every day. Cold homes increase the risk of respiratory and cardiovascular disease. Damp and mould can worsen asthma, particularly for children. Unsafe layouts or poor maintenance increase the risk of falls for older people, often leading to life‑changing injuries.

We also know that these challenges are not evenly distributed. Families on low incomes, people living in the private rented sector, older residents and those with long‑term health conditions are more likely to be affected. That’s not just a health issue; it’s an issue of fairness.

Through our Progress with Unity missions, we’ve been clear that improving health means tackling the underlying causes of inequality, not just responding to the consequences. Housing is one of those causes, and one of our biggest opportunities to make a lasting difference.

A Place‑Based, Prevention‑First Approach

Our latest update on Housing and Health, shared with councillors this month, sets out how we are taking a place‑based, prevention‑focused approach to this challenge.

This includes practical action: surveying housing stock to identify and address the most serious hazards; supporting residents to improve energy efficiency and reduce fuel poverty; adapting homes so people can live independently for longer; and working with partners to reduce reliance on unsuitable temporary accommodation, especially for families with children.

But it also means working differently. Housing, public health, adult social care, children’s services and community organisations all have a role to play. When we join up our efforts, we can spot risks earlier, respond more effectively and design solutions around people’s real lives, not service boundaries.

This approach reflects national thinking about prevention, but it’s rooted in Wigan Borough’s strengths: strong partnerships, community insight and a shared commitment to doing what works.

Listening to Lived Experience

Evidence is essential, but so is lived experience. National research increasingly shows that poor housing affects mental wellbeing, feelings of control and stress levels; impacts that aren’t always visible in statistics alone.

In Wigan Borough, we are committed to listening to residents’ experiences and involving them in shaping solutions. Understanding what it’s like to live in cold, overcrowded or unstable housing helps us design better, more humane responses and reminds us that behind every data point is a person, a family, a story.

Showcasing What’s Possible

There is no single fix to the housing and health challenge, either locally or nationally. But there is growing momentum around the idea that health doesn’t start in clinics, it starts in communities, neighbourhoods and homes.

Wigan Borough’s approach shows what’s possible when we treat housing as a foundation for health, not a separate policy area. By aligning national policy ambition with local action, and by keeping prevention and fairness at the centre, we can improve lives now and reduce pressures on health and care services in the future.

Healthy homes won’t solve every health challenge we face, but without them, many challenges become much harder to tackle. If we are serious about improving health, reducing inequalities and giving every child and adult the chance to thrive, then housing must remain at the heart of the conversation.

And in Wigan Borough, that’s exactly where it will stay.

By Rachael Musgrave, Director of Public Health, Wigan Council