Housing is central to wellbeing.
106.In this chapter, we will examine how pre-existing housing inequalities amplified the impact of coronavirus for BAME communities. We have considered housing throughout the sub-inquiry because where and how people live directly relates to their risk of contracting and transmitting the disease. Poor housing conditions can make an individual susceptible to contracting the virus and living in overcrowded housing or houses with multiple generations can mean they transmit the virus to their household members. We have primarily focused on the health impacts of overcrowding and housing conditions. We have set out recommendations on how to address some of the pre-existing housing inequalities to mitigate the impacts of the pandemic on BAME people.
107.There are two standards that assess whether a home is statutorily overcrowded: the bedroom standard, which is more frequently used, and the space standard. The room standard looks at the number and sex of people who have to sleep in the same room, by this standard a home is overcrowded if two or more people of opposite sexes (over ten years of age and not a couple) have to share a room. A room is defined as any space including living room or a study except for a bathroom and kitchen. The space standard can be measured in two ways: (i) considering the number of people and the number of rooms, or (ii) how many people can be accommodated by the square metres of the rooms. For a household to be considered as statutorily overcrowded, it has to meet at least one of these two standards.
108.BAME households are more likely to live in overcrowded accommodation. Dr Haque told us “approximately one in three Bangladeshi families live in overcrowded housing. That is around 33% compared to 2% of white British households and approximately 15% of black African households”. This is supported by the Equality and Human Rights Commission’s (ECHR) report, Is Britain Fairer, which found that, in England, ethnic minorities are more likely to live in overcrowded accommodation compared with White people. Moreover, the Government Ethnicity Facts and Figures website sets out that in the three years to March 2019, an average of around 787,000 (3%) of the estimated 23 million households in England were overcrowded. Of these overcrowded homes around 2% were of White British households. Comparatively, 24% of Bangladeshi households were overcrowded; 18% of Pakistani households were overcrowded; 16% of Black African were overcrowded, and 15% Arab households were overcrowded.
109.In the context of the coronavirus pandemic, we heard that work was ongoing to consider how the virus operates within households. However, it was clear that overcrowding made self-isolation much more difficult and increased opportunities for within-household transmission for some ethnic groups. This is because if someone in the household tests positive for the virus, then it is harder to socially distance and isolate due to limited space, for example, in shared bathrooms and kitchens where the virus can spread to other members of the household. The All-Party Parliamentary Group (APPG) for Africa and The Royal African Society, in collaboration with AFFORD-UK, informed us that:
BAME families are often living in cramped conditions without access to private outside space. This means the risk of exposure and spread within family units is higher.
Dr Nagpaul said that “coming out of [the pandemic] there has to be a Government policy to reduce overcrowding as a principle, because it has negative health impacts on people, in terms of wellbeing or otherwise, even without a Covid crisis”.
110.There is an important distinction to be made between overcrowded housing and households where several generations choose to live together. The Runnymede Trust found that Bangladeshi, Indian and Chinese households are particularly likely to have older people over 65 living with children under the age of 16. Cym D’Souza informed us that the issue of overcrowded accommodation arose when people choose to live together but the housing stock is not suitable or affordable to accommodate them. Dr Haque told us that:
there will always be multigenerational homes where people decide to live with multiple generations—maybe their mothers as well as their grandparents—but they do not ever choose to live in overcrowded housing.
Research from the Resolution Foundation notes that overcrowding is much higher among renters and in the social rented sector than in owner occupied accommodation, and that, in the social rented sector, rates of overcrowding have doubled over the past two decades.
111.Benefits of multigenerational living include allowing cohabitants to share costs, reducing isolation among older people, and allowing older family members to help with childcare. During the pandemic, however, multigenerational homes were problematic. The Independent Sage, an independent group of scientists that advise the UK Government and public, has stated that:
Overcrowded households among BME populations are also much more likely to be multigenerational, making social distancing, self-isolation and shielding much more difficult, and increasing opportunities for within-household coronavirus transmission.
Given that BAME groups are more likely to be renters or to live in social housing, overcrowding affects them disproportionately. The APPG for Africa and The Royal African Society and AFFORD-UK informed us that, “[i]t is common amongst many BAME communities for the older generations to co-habit with the younger members of the family. Consequently, is more likely that BAME households would have clinically vulnerable people co-habiting with keyworkers with increased exposure risk”.
112.We were informed that there was limited clarity in the Government’s coronavirus messaging about overcrowded or multi-generational accommodation, especially with regards to self-isolating and reducing the risk of household transmission. Dr Nagpaul explained that:
We need to look at the messaging given. The messaging included that, if a person in the household was infected, they should use a separate bathroom; that sort of luxury would not be even remotely possible in an overcrowded house. There were no practical suggestions of how to deal with that.
Dr Nagpaul explained, “you need practical interventions that need to be culturally sensitive as well as a determined policy after today that we have to reduce overcrowding as a social principle”. Similarly, Dr Haque said:
What do people do to isolate? There is no guidance whatsoever. That is the first short-term important consequence of overcrowded housing. It can be relieved by the Government but there has been absolutely nothing. There is no alternative if you are in overcrowded housing to do anything, whether it is guidance or to go elsewhere, so that is an important thing.
113.We asked the Parliamentary Under-Secretary for Health, Jo Churchill MP, to clarify the advice that was being communicated on the use of bathrooms for those living in overcrowded accommodation, and the cascade route for that advice. She said, “the PHE advice was around particular interventions, making sure that the person who was symptomatic went last and that then the bathroom was thoroughly cleaned, so that the minimum spread of the virus happened”. The Minister was unable to provide information on the cascade route of the guidance. The Department committed to provide the information and we received this on 26 November. The information points to guidance for landlords and tenants and this guidance only advises on what to do for the clinically extremely vulnerable living in overcrowded accommodation.
114.On the guidance for those living in overcrowded accommodation during the pandemic more generally, Minister for Housing, Chris Pincher MP, explained that:
We have continually updated our guidance. I think on 1 June we updated it, reminding people that they can, if they need to, refer to their local authority, if they are in overcrowded shared accommodation, to seek alternative housing solutions if that is necessary and possible. All local authorities need to provide a reasonable preference to certain groups, and that includes for issues like overcrowding and insanitary or unsuitable accommodation. We have been careful to maintain our advice through the epidemic to make sure that people in overcrowded accommodation, whoever they may be, have the right advice available to them.
The guidance that the Minister was referring to is the COVID-19 and renting: guidance for landlords, tenants and local authorities. This guidance outlined:
For the purpose of this guidance, accommodation is overcrowded if it is so dangerous that there is a risk to the health of the residents.
It may be harder for residents of overcrowded properties to take appropriate precautions to protect themselves in the same way as residents of other properties. At this time, the government is encouraging landlords and other tenants to work together wherever feasible in order to help to support these residents and carefully follow the relevant guidance on social distancing.
Local authorities may also be able to use their enforcement powers to require their landlord to remedy a serious overcrowding hazard.
The guidance does not explain how to reduce the risk of transmitting coronavirus in shared spaces, such as kitchens and bathrooms, if someone in the household is diagnosed with coronavirus. The guidance does not explain how to self-isolate in an overcrowded home.
115.The guidance that the Government has produced for those in overcrowded housing is substandard. There was no clear guidance in one place from the Government on how to overcome the practical challenges of living in overcrowded, and in some cases multigenerational, accommodation. This continues to be the case nine months after the country first entered lockdown. We recommend that the Government should, within the next four weeks, publish clear, culturally competent guidance with practical recommendations on how to self-isolate for people living in overcrowded, and/or multi-generational, accommodation. The Government should liaise with BAME groups on how to cascade this guidance. We further recommend that the Government by the end of summer 2021 produce a strategy to reduce overcrowding due to its poor health impacts.
116.Where housing is located influences the risk of contracting the virus; for example, living in an urban area increased an individual’s risk. Infection rates have been the highest in urban areas; by the end of March, London accounted for close to a third of all confirmed cases in England. Birmingham was also a particular ‘hotspot’ for transmission. Since the end of the first lockdown, cities in the North of England have often had the highest infection rates. The Institute for Fiscal Studies in its report, The geography of the COVID-19 crisis in England, published in June 2020, found that the contagion and death rates for all people were the highest in urban areas. This was judged to be because the connectivity, population size and the use of public transport in urban areas made people in these parts of the country particularly vulnerable to the spread of the virus.
117.BAME people tend to live in cities and urban areas; this puts them at greater risk of contracting the virus. BAME communities are also more likely to live in Britain’s larger cities, such as London, Birmingham and Manchester. The Government Ethnicity Facts and Figures website outlined that the BAME groups most likely to live in urban areas were Pakistani (99.1%), Bangladeshi (98.7%), and Black African (98.2%). Usually, this is within tightly connected and densely populated inner-urban wards, such as Newham (London), Sparkbrook (Birmingham) and Moss Side (Manchester). ONS analysis found that between 1 March and 17 April all London boroughs had the highest age-standardised death rates compared to other regions. Newham has had the highest age-standardised rate with 144.3 deaths per 100,000 population followed by Brent with a rate of 141.5 deaths per 100,000 population and Hackney with a rate of 127.4 deaths per 100,000 population. Newham has the most diverse population profile of any local authority in the country. Some 78% of residents are from ethnic minority communities.
118.A significant issue that has been raised with us regarding housing is the condition of accommodation. Tower Hamlets Councillor, Rabina Khan, informed us that:
Tower Hamlets has one of the highest levels of social housing, and multi-generational and ethnic occupancy in the country. It also has a high level of deprivation, with many families in fuel poverty, which also has an impact on health. The poor quality of many of these homes–and the failure of housing associations to fix the problems–has led to an increase in respiratory illnesses as a result of damp and mould.
119.In 2011, of the 2.2 million ethnic minority households around 15% (around 344,000) were in fuel poverty. A ‘fuel poor’ household was defined as one needing to spend in excess of 10% of its income on all fuel used to achieve a satisfactory standard of warmth. Moreover, in 2020, the Government published data that showed Bangladeshi and Black African households were more likely to have damp problems than White British households. Data from the Government also showed that the most common reason for Bangladeshi households to be given priority for social housing was living in unsanitary, unsatisfactory or overcrowded conditions. Living in unsanitary housing conditions poses significant challenges to following Government guidance on preventing household transmission.
120.The Race Equality Foundation in its report (published in January 2014), The Housing Conditions of Minority Ethnic Households in England, noted that there are differences in housing conditions for BAME people living in public housing and BAME people living in privately rented housing. BAME people in privately rented housing have poorer housing conditions. This is because there are fewer regulations in private housing to maintain housing conditions.
121.If there is damp, limited insulation or a home is unsanitary then the risk of contracting and transmitting infections is much higher. The PHE review, Beyond the Data: Understanding the Impact of COVID-19 on BAME Communities, found that “poor housing increasing the risk of cardiovascular disease, respiratory disease, depression and anxiety, as well as lack of sleep and restricted physical activity. All of these were mentioned as risk factors for worse outcomes with covid-19 once infected”.
122.Poor housing conditions have adverse impacts on health; living in poor quality housing is an aggravating factor in experiencing coronavirus severely. Pre-existing housing inequalities may have exacerbated the impact of coronavirus on BAME people. We welcome the Social Housing White Paper 2020 that the Government published in November 2020. We recommend that the Government publish and implement a strategy to improve housing conditions in social housing and privately rented accommodation by the end of Summer 2021.
249 [Professor Lucinda Platt]
250 Shelter England, , 13 December 2019
252 EHRC, , 25 October 2018, page 60
253 Ethnicity Facts and Figures, , 9 September 2020
256 [Professor Lucinda Platt]
257 Online Wiley Library, , 3 June 2020, page 17
258 [Dr Chaand Nagpaul]
259 , page 2
261 The Health Foundation, , February 2020, page 113
262 The Runnymede Trust, , November 2012, page 27
265 The Resolution Foundation, , July 2020, page 18
266 Independent Sage, , 6 July 2020
267 , page 2
272 , Deputy Director, Children, Families and Communities, dated 26 November 2020
274 GOV.UK, , 28 March 2020
275 Online Wiley Library, , 3 June 2020, page 7
277 The Guardian, , 15 May 2020
278 Institute for Fiscal Studies, , 15 June 2020, page 4
279 Online Wiley Library, , 3 June 2020, page 7
280 GOV.UK, , 1 August 2018
281 The Conversation, , 15 April 2020
282 Office for National Statistics, , 1 May 2020
283 The Guardian, , 1 May 2020
284 , written evidence to Coronavirus (Covid-19) and the impact on people with protected characteristics inquiry
285 The Race Equality Foundation, , January 2014, page 24
286 Ethnicity Facts and Figures, , April 2020 [accessed 29 June 2020]
287 Ethnicity Facts and Figures, , April 2019
288 The Race Equality Foundation, , January 2014, page 24
289 GOV.UK, , 16 June