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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Ageing better at home

Bathroom in an old house has been stripped and bare walls and old tiles remainBecause the majority of our homes are designed as if we are never going to grow old, most of us will need to modify our home as we age. That’s if you want to stay put, which is what most older people say is their preference. An easy to read and nicely presented report from Centre for Ageing Better in the UK gives an excellent overview of how home modification improves quality of life, mental health and overall independence. All good reasons for universally designing our homes from the start for the whole of our lives so modifications aren’t needed or are at least easier to do. Dwellings might be a “product” to property developers but for the rest of us a “home” is the pivot point for living our lives.

A great quote from a study participant to reflect upon, “You don’t get taught, at any point in your life, how to become an older person. It just sort of happens, you know…”. So waiting for consumers to ask for universal design isn’t going to work.

For a more academic take on a related issue of housing quality and health see a longitudinal study from UK.  

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UD for a social and sustainable life

A long ladder is resting against the gutter of a two storey houseThe word “sustainability” mostly conjures up notions of clean and green, but social sustainability – an aspect just as important – has been left out of mainstream discussions. This point is made in Universal Design as a Significant Component for Sustainable Life and Social Development. The authors argue that both home and neighbourhood need to be considered for a socially sustainable environment. An evolving criteria for social sustainability is access to facilities and amenities that are vital for people to run errands and do all the everyday things. Going to the shops, a medical appointment, or the cinema should be available to all no matter their age or circumstances. There are useful explanatory graphs in this in-depth paper that emphasises well-being, safety and accessibility. The authors sum up in the conclusion, “The social aspect of sustainability should be emphasized in the mainstream discussion on sustainability because it influences human behaviour and quality of life in many ways”. They also point out that it is environmentally unsustainable to build homes that need major modifications, “which causes pollution, hazardous construction equipment and material and inappropriate methods of wastage removal”. The article can also be found in Asian Journal of Environment-Behaviour Studies.

Abstract: Universally designed environment provides comfort, adaptability and flexibility that can help to reduce human life cycle impact and encourage residents’ participation in the community. With that, the purpose of this conceptual study is to explore the concept of Universal Design (UD) as a significant aspect of social sustainability, based on professional practitioners’ and scholarly views. UD implementation in built environment may cater the needs of diverse users over the changing abilities throughout lifespan. This study concludes that UD has evolved as a significant component for sustainable life and social development within the individual’s own dwelling and the community as well.

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Housing quality improves health

A man in a bright yellow T shirt is painting and archway in a wall inside a home. The wall is grey and there are tools on the floor.Ever wondered what the long term effects of a home modification are? A longitudinal study from the UK shows that household improvements in social housing can reduce risk of hospital stays, particularly in older people. While the study picks up major improvements in chest and heart health, it also found that falls and burns were reduced too. Over the ten years of the study, they found that homes that were modified and upgraded correlated with reduced hospital events. That means savings in the health budget or beds freed up for other patients. Obviously it is better for occupants too. It is not clear how poor the condition of the housing was prior to the upgrade or modification relative to Australian housing. This is an academic paper outlining the methods and comparing to other studies, but the discussion and conclusions give you the take-home message – health and  the quality and design of housing quality are related and should be integrated in policy-making and planning. 

One key finding was: “Using up to a decade of household improvements linked to individual level data, we found that social housing quality improvements were associated with substantial reductions in emergency hospital admissions for cardiovascular conditions, respiratory conditions, and fall and burn injuries.”

The title of the study is, “Emergency hospital admissions associated with a non-randomised housing intervention meeting national housing quality standards: a longitudinal data linkage study”. Sarah Rodgers et al. Journal of Epidemiology and Community Health.

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Survey on accessible housing

Front cover of the reportIf you want to know what people think about accessible housing, the findings from a recent survey will give you a good idea. With the prospect of a Regulatory Impact Assessment of accessible housing on the horizon this is a timely report. There are four narratives that frame the report: the housing industry view; the government view; prospective buyers’ view; and the perspective of people who need mainstream accessible housing. The survey was initiated by Australian Network on Universal Housing Design and the data were collated, analysed and discussed by Courtney Wright and Jacinta Colley from Griffith University. It is a lengthy but detailed report. Essential reading for anyone interested in this topic and/or who wants to know the history behind the universal design in housing campaign that goes back nearly 20 years. Dr Courtney Wright will be presenting the findings at the 3rd Australian Universal Design Conference in Brisbane 4-5 September.

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Is there a market for accessible homes?

Front cover of Habinteg report showing coins and Monopoly housesA UK blog site has an article that discusses the market appeal of Lifetime Homes in the UK context. Dominic Aitken cites some interesting research and reports by the London School of Economics, Ipsos MORI, and Habinteg Housing and Papworth Trust. UK homes are traditionally two storey with the bathroom and toilet upstairs. They are generally smaller than Australian homes too, which makes it more difficult in terms of circulation spaces. It was thought that Part M of the building code would create greater accessibility in homes, but it hasn’t helped much at all. The best part is that it requires a downstairs toilet, which is handy for everyone. Aitken explains his own research project on this topic looking at homebuyers and estate agents. The blog site has attracted several good comments and are worth reading too. By the way, it seems stair lifts are not that popular with purchasers. 

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