WHO Housing, Health & Accessibility

Multi coloured graphic depicting the key elements in the guidelines "How housing can improve health and well-being".The WHO latest guidelines on housing and health have five key areas and accessibility is one of them. The “strong recommendation” is, “Based on current and projected national prevalence of populations with functional impairments and taking into account trends of ageing, an adequate proportion of the housing stock should be accessible to people with functional impairments.” In the remarks it argues that living in an accessible home improves both independence and health outcomes. Although the guidelines argue for a proportion of housing stock it has put the issue on the agenda. It shows it is as important as all other factors. However, the notion of proportion can lead some agencies to think that means specialised and segregated housing. It is worth noting that the lead author of this section is an Australian, Prof Peter Phibbs. The other key areas are crowding, indoor cold, indoor heat, and home safety. For more detail there is an additional document showing method and results of the systematic review that underpinned this section of the Guidelines – Web Annex F. and includes interventions such as home modifications and assistive technology. 

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Longevity, housing, carrots and sticks

A view of a narrow street with two storey buildings on either side and shops with high rise buildings in the background. With 28% of the population over 65 years, suitable housing is a critical policy area for Japan. In his latest article, Satoshi Kose argues for ageing in place and compares Japan with UK and US housing policy from an ageing perspective. Voluntary guidelines for new housing has not worked and Kose says in his conclusion that viewing housing construction as a booster for economic growth where quality of design is out of question means that “Japan must pay the cost of that ignorance as the country grows older and older.” Australia should heed this warning. The title of the article is, “Housing Design for the Ageing: Struggle Toward Supporting Age-in-Place Instead of Special Housing for Seniors”. The article discusses the attempts made in Japan, UK and US to introduce universal design features but with little success. He concludes we need both carrot and stick approach – regulations and incentives. The housing industry is complex in all three cases and this is why we need both carrot and stick (for our housing donkey?)

Satoshi Kose has been writing and researching housing design over many years. He is Emeritus Professor at Shizuoka University of Art and Culture. This paper was presented at the UDHEIT2018 Conference

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Sea Change or Urban Uplift?

long view of a Perth city mall with shops and cafes under awnings and trees for shade. Tall buildings are in the backgroundA thoughtful article from an architectural group about ageing in the urban context. While some retirees will seek a sea change to resort-style living, others want to stay connected to their families and established neighbourhoods. The article critiques the age-restricted model and proposes alternatives, one of which is flexibility of design across the housing market so that people can receive care at home when it is needed. This fits with the principles of universal design as outlined in the Livable Housing Design Guidelines at Gold level. Other key points are inter-generational interaction, connectivity, inclusion, and proximity to conveniences. A good article on Aged Care Insite from an architect’s perspective. 

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Teaching and learning UD in real time

Student's model of the housing site showing topography and buildingsCork County Council in Ireland has provided an excellent opportunity for second year architecture students to get some hands on practice and expand their design thinking. In Kevin Busby and Jim Harrison’s paper, Universal Design in Architectural Education – Community Liaison on ‘Live Projects‘, they report on imaginative examples of student responses to the challenges of integrating age-friendly features in housing. They also report on the learning gained from observing students and finding out the main design difficulties they found in the process. Illustrations demonstrate some of the ideas. Good to see students operating in the real world and making a difference.

The article is from the proceedings of the UDHEIT 2018 conference held in Dublin, Ireland, an open access publication.

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Home Coming? Yes it’s possible

A graphic in shades of green showing various types of dwellingsA timely article from Penny Galbraith given the Australian Building Codes Board’s call for responses to their Options Paper on Accessible Housing. Essential reading for anyone proposing to submit a response (closing date is 30 November). The title of Penny’s paper presented at the recent UD Conference in Ireland is, Home Coming? A Story of Reassurance, Opportunity and Hope for Universally Designed Housing in Australia.  You can also see Penny’s analysis of the Options Paper. It is on the open learning platform for convenient access. There is a short summary to get you going and an alternative question response sheet that you can submit. This is a very important time for this issue. There may not be a second chance.

Paper Abstract: This paper shows the complexity of housing and how it is the linch-pin for achieving economic, social and human rights imperatives. In Australia there are no minimum housing standards; the effect is now critical. In October 2017, a regulatory impact assessment was instructed, to consider Livable Housing Australia’s Silver and Gold standards, for inclusion in the National Construction Code. A substantial research project provided a knowledge and evidence base of the policy perspective; an expanded statistical context; and detailed analyses of Silver, Gold and Platinum design levels. The policy perspective included greater economic focus. The effect on productivity, directly attributable to housing, is significant. 34 specific policy ‘problems’ were identified that could be solved or mitigated if acceptable standards of housing were introduced. It is reassuring that universal design has permeated all levels of government policy. The statistical context explored demographics, households, dwelling types; tenure; occupants; disability and carers. Detailed analyses challenged many common assumptions and re-framed accessible housing into a mainstream problem. 73% of all dwellings are separate houses and the average home has 3.1 bedrooms. There are tremendous opportunities for universally design-led mainstream solutions. The compliance gap analyses show which design features might cost more; have potential to be designed out; or be cost neutral. Many design features are cost neutral and arguably should be included within mandated standards. As there is a minimal gap between universal design standards and current housing, there is hope that all Australians will, one day, live in a universally designed home.

The article is from the proceedings of the UDHEIT 2018 conference held in Dublin, Ireland, an open access publication.

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Flexible housing offsets risk

Picture of a tall long skinny house with white lattice covering. It fits into a driveway.The current standard design ideas for homes goes back more than a century. It’s time for a rethink on home design to suit the way we live our lives now is the claim in an article by Kirsty Voltz in The Conversation. Home designs are not keeping up with societal changes that include affordability, size of homes, accessibility across the lifespan, and designing so that as lives change, the interior of the home can adapt to suit. The risks are in not recognising the need to change and adapt to current circumstances, lifestyles, societal changes and personal aspirations. The article contains links to other references and concludes, “Existing housing stock is designed around the numbers of bedrooms and bathrooms that appeal to the market and so fails to be responsive to what people need from housing in the 21st century.” This includes the need for an update to the National Construction Code for creating homes that provide at least a basic level of accessibility for all. The picture is of the 3 bedroom home that Kirsty Voltz designed to fit in the space of an obsolete driveway.

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Designs for Quality of Life

Dr Phillippa Carnemolla is in the news for her work on home modifications and how it can improve the quality of life for older people and people with disability. In the UNSW Newsroom article, she says, “I want it to be much easier for people to have houses that they can live their entire lives in with autonomy and mobility and freedom.”  As an industrial designer, she has a passion for design and human rights.

Phillippa’s PhD study showed that “improving people’s home environments not only impacted the amount of care received in the home – it almost halved the amount of care – but it changed relationships.” She goes on to say, “Inclusive design is design that enables people to have that quality of life that we’re talking about – so to participate, to be as independent as possible, to be autonomous and to live in the world without having to ask permission.  It’s about how we include people in the research and design process so that they’re a participant in that decision making and that what we get in the end works for as many people as possible.”

Kitchen Drawers with easy grip handlesRead the full article by going to the UNSW Newsroom website. You can also read one of Phillippa’s conference papers.  She is currently working on a project providing supported accommodation for people at the highest level of need; people who require assistance to be available 24-hours a day.

Dr Carnemolla is a Director of Centre for Universal Design Australia.  

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UD Conference Housing Presentations

Three presentations focused on universally designed and accessible housing and discuss the need for regulation in the building code. 

Title slide of the presentation.Margaret Ward tells the story from the perspective of Australian Network for Universal Housing Design (ANUHD) and their advocacy and lobbying for regulation. Universal design in all new housing: Keeping COAG to account (PDF 13MB).  Transcript of the presentation in Word. 

Title slide of the presentation.Courtney Wright reports on a survey about accessible housing and attitudes to regulation, costs and benefits to Australian society. Building all new homes to an agreed universal design standard: Understanding the perceived costs and benefits to Australian society. (PDF 500kb).  Transcript of the presentation in Word.

Title slide of the presentation.Penny Galbraith gives a policy perspective and links it to Population, Participation and Productivity. She provides some interesting facts and figures including how costs can be designed out. Home Coming? A story of reassurance, opportunity and hope. (PDF 1MB).  Transcript of the presentation in Word.

All presentations were converted to PDF before being provided to CUDA. If you are unable to access the content of the documents please email udaustralia@gmail.com.

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Relationship between housing and health

A yellow brick house with yellow steps to the front door set back under a red brick archway.By undertaking a systematic review of the literature, Janet Ige and colleagues in UK found there is a strong association between housing and health. However, it is not clear that there is a causal link and their article argues that more research needs to be done. The team found more than 7,000 studies on the topic, with 39 matching their criteria for analysis. Findings showed that housing refurbishment and modifications, provision of adequate heating, improvements to ventilation and water supply were associated with improved respiratory outcomes, quality of life and mental health. The title of the article is, The relationship between buildings and health: a systematic review, and this can be downloaded from the Journal of Public Health, or you can download the PDF directly. 

Abstract: Background – The built environment exerts one of the strongest directly measurable effects on physical and mental health, yet the evidence base underpinning the design of healthy urban planning is not fully developed.  

Method: This study provides a systematic review of quantitative studies assessing the impact of buildings on health. In total, 7127 studies were identified from a structured search of eight databases combined with manual searching for grey literature. Only quantitative studies conducted between January 2000 and November 2016 were eligible for inclusion. Studies were assessed using the quality assessment tool for quantitative studies.

Results: In total, 39 studies were included in this review. Findings showed consistently that housing refurbishment and modifications, provision of adequate heating, improvements to ventilation and water supply were associated with improved respiratory outcomes, quality of life and mental health. Prioritization of housing for vulnerable groups led to improved wellbeing. However, the quality of the underpinning evidence and lack of methodological rigour in most of the studies makes it difficult to draw causal links.

Conclusion: This review identified evidence to demonstrate the strong association between certain features of housing and wellbeing such as adequate heating and ventilation. Our findings highlight the need for strengthening of the evidence base in order for meaningful conclusions to be drawn.  

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Home adaptations: Costs? or Savings?

A man kneels on the floor, he is laying floor tiles.Lesley Curtis and Jennifer Beecham argue that the expertise of occupational therapists can help save money in health budgets as well as improve the lives of people needing assistance at home. Their article is about home modifications and identifying the hidden savings in providing home adaptations. They explain their methods and argue that significant savings can be made if you tally all aspects into the calculations. The article is available from Sage Publications. You will need institutional access for a free read. The title is, A survey of local authorities and Home Improvement Agencies: Identifying the hidden costs of providing a home adaptations service.

Abstract: The Royal College of Occupational Therapists has launched a campaign to demonstrate that occupational therapists improve lives and save money for health and social care services. Occupational therapists play a major part in supporting older and disabled people to remain in their own homes through the provision of home adaptations. Among other benefits, studies have shown that home adaptations can reduce falls in the home and could therefore help reduce hospital admissions. However, to evidence savings, information on the full costs of supplying and fitting home adaptations are needed.

Method: Local authorities and Home Improvement Agencies were surveyed in 2014–2015 to obtain the information required to estimate these costs. Time inputs for staff involved in their provision have been collected and staff costs and total costs calculated for 18 commonly fitted adaptations. The process of obtaining publicly funded home adaptations is also discussed.

Findings: For major adaptations, the total mean cost was £16,647, ranging from £2474 to £36,681. Staffing costs absorbed up to 24% of the total mean cost. The total mean cost for minor adaptations was £451, with average staffing costs forming 76%.

Conclusion: Staff costs are an important consideration when estimating the costs of providing home adaptations.

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