Habitatge, Urbanisme i Règim Interior Urbanisme i Obres

It is in the area of preventable isolation, disability and disadvantage that the greatest gains are to be made in terms of better housing and better health.

Demographic projections can only give us the bones of what our future society will look like. Emerging evidence suggests that as we live longer, we also spend longer in ill-health;32_{but we cannot be sure what differences medical advances could make in}

the longer term, nor what impact our current lifestyles will have on our future health.

Gypsy and Traveller households

Not all older people live in conventional bricks and mortar housing, and this can present particular challenges to health and well-being. Around one in four Gypsy and Traveller households living in caravans currently have no authorised place to stop, often resulting in repeated evictions and difficulty accessing health and other services. Older Gypsies and Travellers may move into conventional housing as a result of ill health – but this can present its own difficulties with isolation from friends and families, and difficulty maintaining a tenancy.

Shelter has recently published good practice guidance on housed Gypsies and Travellers.31

29 _{compared with only a third of younger older people.}

30 _{2006 to 2026 projections; Communities and Local Government (forthcoming).} 31 _{Shelter (2008); for more information on Gypsies and Travellers, see}

www.communities.gov.uk/housing/housingmanagementcare/gypsiesandtravellers/

32 _{The expected number of years spent in poor health in Great Britain rose from 6.4 to 8.8 for men between 1981 and 2002, and}

Chapter 2 Context and Evidence – Housing an Ageing Population | 35

What we do know is that, as we grow older, we spend more time in our homes, and they become more important to us and more likely to enhance or undermine our health and well-being. The over 65s spend over 80 per cent of their time in their homes, and this figure rises to 90 per cent for over 85 year olds.33

Older people tend to be the most satisfied with their accommodation,34_{but for some}

poorer social groups this perception is likely to be because they have lower

expectations. In fact, many older people live in the worst housing conditions or lack suitable accommodation. A third of older people (2.1 million households) live in non- decent or hazardous housing, with the worst conditions in the private rented sector. Whist recent figures show a modest improvement in conditions for older people,35

there is still a long way to go.

The number of disabled older people is projected to double from approximately 2.3 million in 2002 to approximately 4.6 million in 2041.37_{Based on current}

prevalence rates, the number of older people with dementia could rise from 684,000 to 1.7 million by 2051, an increase of 154 per cent (see Fig.2.938_{). Gypsies and}

Travellers have a life expectancy of between 10 and 12 years less than the settled population, and may require support earlier in life than would be usual amongst the general population.

If we do nothing to change the current housing situation, occupied places in care homes and hospitals would need to rise by 151 per cent, from around 450,000 to around 1,130,000 by 2051, and some estimates project long-term care expenditure as rising by around 325 per cent in real terms between 2002 and 2041.39

Older people are twice as likely to be unable to afford fuel in winter, and

thermally inefficient housing has been linked to the increase in deaths during the colder months.36_{Older people are also at highest risk of dying in a dwelling fire.}

Poor housing conditions can exacerbate existing medical conditions. 40 per cent of those aged 80 and over report a long-term illness or disability and there are currently 1.5 million people with a medical condition or disability requiring specially adapted accommodation.

33 _{Adams and White (2006).} 34 _{EHCS (2005).}

35 _{EHCS (2004): 30.3 per cent of those aged 60+, and 33.3 per cent of those aged 75+ lived in non-decent homes; these figures}

fell to 28 per cent and 30.8 per cent respectively in 2005 – CLG statistics.

36 _{JRF (2001); ONS (October 2006) In winter 2005/06 there were 20,200 more deaths among those aged 75+ compared to levels}

in the non-winter period, compared with only 5,500 more deaths among those under 75. Respiratory and circulatory diseases are responsible for most of these excess winter deaths. See also Curwen (1997).

37 _{Wittenberg et al(2006).} 38 _{PSSRU (2007).}

In England, just over three quarters of a million people aged 20 or older are estimated to have a learning disability, but only a minority of older people with a learning

disability may currently be known to services. It has been estimated that in 2001, only 15 per cent of those aged 60 or older with a learning disability were known to services compared to 23 per cent of those aged 20-64.40

The growth in the numbers of older people with learning disabilities is set to increase significantly, with estimates ranging from a 37 per cent increase to 59 per cent in the numbers of people aged 60 and over with learning disabilities between 2001 and 2021. This has significant implications for the providers of both specialised housing and for support services for older people in mainstream housing.