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. Housing quality improves health.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.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.

Universal Design drives Housing Quality

Big houses are still being built without accessibility in mind. Universal design for housing quality.Although there have been fundamental changes in the building code and regulations in Norway, it seems that none of this has guaranteed improvements in quality on the usability of homes. Perhaps there are some lessons for Australia when it comes to implementing the new building code for housing in 2022. 

In a research study, the authors conclude that architects, more than any other group in the construction industry are trained to break conventional frameworks. How the regulations are applied by users is the key to success – this is where the education of architects and building designers comes in.

Architects are often willing to innovate, the authors claim. “One chief intention of the building code is to promote universal design in the built environment. It seems that the appending regulations may not follow up the intention as it could be expected. Amendments are probably needed and should be based on a broader view on the design process.”

The title of the article is, Universal Design as a Booster for Housing Quality and Architectural Practice. It seems we could learn from this experience – regulations are one thing, but applying them appropriately and for maximum effect is another. The abstract gives a good overview of the project. 

Preferences of older people in residential design

Aerial view of high rise buildings in Hong KongGuy Luscombe did a great report on his findings from a study tour of residential settings for older people. He found aspects such as natural light were of important to residents. A similar study was undertaken in Hong Kong looking at age, gender, marital status, etc., to see the preferences of older people in residential design

The importance of living in a space you like has ongoing health benefits (or detriments if not). This is a thorough study using qualitative techniques which looks at residents preferences. Differences emerged about windows, but there seemed to be some general agreement about bedroom size. The title of the paper is, Comparison of facilities management in private domestic buildings among different elderly groups in Hong Kong.  Here is the last part of the abstract:

“The result shows that satisfaction with natural daylight was significantly different among elderly people of different genders, while the one-way between-groups ANOVA indicates that satisfaction with the size of bedrooms, turning spaces at doors, temperature in bathrooms and/or toilets, colour, accessibility and ease of closing or opening the doors were significantly different among elderly people belonging to different age groups and of different marital status and education level.

Designers and private developers are therefore recommended to increase the sizes of bedrooms, install windows on opposite sides of walls in the flats and ensure there is an adequate light reflection ratio for wall and floor colours, in order to accommodate elderly people’s special characteristics.”  

The Home is for Every Body

Front cover of the thesis showing four pictures of homes and apartments along with the title of the thesis
The Home is for Every Body?

Rachelle Newman‘s Masters thesis provides some valuable insights into some of the issues in creating accessible homes. Although it was written in 2010, the content is still relevant as little, if any, change has occurred in the house-building industry.

The thesis is well researched, well written and well presented. It discusses the role of Livable Housing Australia, Landcom Guidelines, national standards, state planning instruments, and legislative frameworks. The section covering the relationship between the adaptable housing model and the universal design model is very useful for anyone confused by it. Tables and photographs add to the explanations throughout. The title of the thesis is: The home is for every body? An investigation of the statutory and strategic planning implications of inclusive housing design.

Abstract excerpt: Through qualitative research and a critical review of legislative and policy frameworks, this thesis explores the employment of two types of inclusive design – adaptable and universal – in Australia wide and NSW contexts. The research reveals how a lack of coordination at the national level has resulted in a divergence of approaches and interpretation between states. … This thesis offers an understanding of the planning implications of inclusive housing design so that better policy and legislation may be developed.

Editor’s note: We may get progress in 2018. The Australian Building Codes Board has been charged with the task of overseeing a Regulatory Impact Assessment of accessible housing. See previous post about this.

Sustainable Apartments – Nightingale Housing

An artist's impression of the Nightingale housing development for sustainable apartments.The Nightingale Housing project in Melbourne has captured the imagination since its inception in 2014. Founder, Jeremy Mcleoad, suggests an architecture of reduction, which provides moderation of these housing models. Using architecture as a catalyst to engage and generate interaction, Nightingale housing supports communication and community with sustainable apartments.

Jeremy also explains how they side-stepped the property developer control of design and put it back in the hands of architects. Through a triple bottom line approach – financial return, sustainable and liveable, Jeremy’s vision provides a universal design approach to the housing product.

Watch Jeremy’s TEDxStKilda talk below:

“As a not-for-profit, we build apartments ‘at cost’, without adding meaty profit margins. Reducing the long-term cost of ownership is also a key consideration in every Nightingale building. Rooftop solar, an embedded GreenPower network, no gas connection, and a shared, super-fast commercial internet connection mean lower ongoing costs.”

Urban density: not the answer to everything

Picure of very high rise buildings on the waterfront at Dubai UAEPoliticians and planners make frequent calls for older Australians to give up their three bedroom homes to make way for “working families”. The expect them to move into apartments. But is urban density the answer? Regardless of the ageist inference that older people are “hogging all the houses”, with the political focus on working families, little room is left to discuss the housing needs of older cohorts. 

Research by Bruce Judd on downsizing found the majority of older people want to stay put, not move into apartments. But there still remains the question, will these homes support them in their latter years?  Within the older cohorts the number of people with dementia is expected to rise significantly, but not much thought has been given to their housing needs.

An article, Housing and age friendly communities policies for future direction – A stepped approach puts the spotlight on this issue. Participants in the study were representatives from peak housing organisations, including strata managers, and advocacy organisations to assess how well their membership were prepared for this group. 

The article comes from the International Research Forum on Multi-owned Properties Deakin University, Melbourne 9-10th February 2017.

The picture was taken in Dubai, UAE. 

Older home-owners need their space

Dwelling Land and Neighbourhood use older homeownersThis is a major work by Bruce Judd, Diana Olsberg, Joanne Quinn and Oya Demirbilek (2010). It challenges the often held assumption that older people are “taking up space” in big houses that they no longer need – assumptions that their homes are “underoccupied”.

This qualitative research shows a very different picture. When people retire, they typically spend more time at home (about 85% of their time), so it makes sense to have “spare” space for home activities, including accommodating family members who live away and come to visit. So downsizing isn’t the answer for everyone.

Download the full report, Dwelling, land and neighbourhood use by older home owners, or the slideshow presentation from a NSW AHURI seminar.  

Housing aspirations of older Australians

An armchair is by a big window in a high rise building. Through the window you can see the tops of other buildings in the distance.Three bedrooms and urban living are what most older people want. These are two of the key findings in a new Australian report from AHURI. Age specific housing is not a preference. So researchers suggest more innovation to attract the older cohort so they can age in place after all.

There was no mention of universally designed homes so that age-specific housing doesn’t become the only option. There was only a brief mention of homes being adaptable. 

The title of the research paper is, Older Australians and the housing aspirations gap. There are three separate documents: an Executive Summary and a Policy Evidence Summary. The full report is also available from the AHURI website.


Building a new home – a wheelchair user’s perpective

Steve’s Story.

A two storey home. Steve's story of building a new home - a wheelchair user's perspective.This is the fourth and last in the series of stories about wheelchair users building a new home. Steve is married with two children and tells his story about building a two storey project home. Similarly to George, he had to make compromises when the builder failed to deliver on promises. However, when allowed to speak directly with tradespeople, some of the problems were easily solved.

Download the synopsis of Steve’s Story

Mike’s Story

living room udI interviewed four wheelchair users who had recently built a home as part of my PhD research project. I was interested in the process and the interaction with house-building professionals. In coming newsletters I will feature the other three interviews. Mike tells how he engaged an architect because he had little confidence in a project home builder understanding what he wanted. However, this did not result in plain sailing.

Download Mike’s story

George’s Story

modern-patioGeorge who comes from a family of builders. He relates his experiences with a project home builder and how he had to overcome resistance to incorporating basic access features.

Download a synopsis of George’s story

Tomas and Lisa’s Story.

Modern shower recess with easy access. Wheelchair user's perspective. Tomas tells his story about designing a home for two wheelchair users and their children. Unlike Mike, Tomas and Lisa had an easier time. Tomas also provides some comparisons with Europe.

Download the synopsis of Tomas’ Story

A builder’s perspective

Twostoreyframeand housesThis is Sam’s story. As part of my PhD research project I interviewed a family member who built a home for a relative who uses a wheelchair. It transpired he was also a builder. The interview shows that being a builder with a family member with a disability does not always make for a better understanding of when and where regulations apply. It also shows how misunderstood the whole area of accessibility, public domain standards and housing design can get mixed up. 

Download Sam’s story

I interviewed four wheelchair users who had recently built a home as part of my PhD research project. I was interested in the process and the interaction with house-building professionals.

Jane Bringolf, Website Editor

Making universal design a reality – confronting affordability

Head and shoulders pic of Kay Saville-Smith. Making Universal Design a reality: confronting affordability.
Kay Saville-Smith

Edited transcript from live captioning of Kay Saville-Smith’s keynote presentation at the Australian Universal Design Conference 2014. Titled: Making universal design a reality – confronting affordability.

Synopsis: The Christchurch earthquakes which flattened much of the city provided an opportunity to start from scratch and implement some of the good design ideas, including universal design, that have been around for some time.  However, this UD-logo-200x200has not happened and there are many reasons for this, not least of which is the stance of the insurance industry.

The issue of affordability is a complex one. It is a market driven issue where the actual cost of the building is not the main issue. Universal design and affordability can co-exist. However, there are many attitudinal barriers and well-worn arguments touted in the industry that say it cannot be done.

Kay Saville-Smith Keynote Presentation transcipt in PDF or Transcript in Word

Kay Saville-Smith Keynote Slideshow PDF 3MB   


Barriers to Universal Design in Australian Housing

A single storey home has few barriers to universal design in housing.From the Editor: I prepared a 2000 word version of my PhD thesis for easier reading. The title is Barriers to Universal Design in Australian Housing. I wanted to find out what the barriers are and if we could do something about it. 

The simple answer is that the industry runs on regulations which holds the house building system together. So nothing will change without regulation. Outdated ideas about market segmentation, general resistance to change, and risk avoidance are key issues. Cost was cited most often as a barrier, but without any evidence of the costs.  

A line of complex manufacturing machinery used to show the complex process and number of stakeholders involved in mass market housing.


The graphic shows that the house building industry is a system with several stakeholders. This system relies on everyone doing the same thing in the same way. The best way to achieve this is through regulation.


Read the conference paper to find out more about the complexities of the house building industry and why there is resistance to change from both builders and purchasers. You can also download the accompanying slide show from the 2011 FICCDAT conference.

The full thesis is available from the Western Sydney University archives. I did my best to make it as readable as possible within the constraints of academic writing.

(FICCDAT is, Festival of International Conferences on Caring, Disability, Aging and Technology.)

Hope I die before I get old

I presented this paper and presentation at the 2011 State of Australian Cities Conference (SOAC). It raises the issues of housing an ageing population in a context of industry believing retirement villages and aged care are the places to put older people. However, the majority of people will age in their current home – a home that is not suitably designed for this purpose. Around 200,000 new homes are built each year – each one a lost opportunity. 

SOAC slide cover

Download the paper  Hope I die before I get old article PDF

Download the slideshow Hope I die before I get old Slideshow PDF

Jane Bringolf

The cost of NOT including accessibility in new homes

House half built showing timber frameworkWhen talking about the costs of including basic access features in new homes, we should also discuss the cost of NOT including those features.

Download an academic article from the Journal of the American Planning Association, by Smith, Rayer and Smith (2008) that spells out the economic argument using economic methodologies. The key point is that conservatively, a new home built today with a minimum of four different households over its lifetime is 65% likely to have an occupant with a permanent disability. If we include visitors the likelihood rises to 91%. It is often forgotten that people with disability live in families – not alone. This is an open access article.

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