What is home?

PUBLIC

HEALTH

The Journal of The Society of Medical Officers of Health Vol. 84 :.-=::-i:'~-':'.

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November . . . . . .

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1969 -""

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No. 1 r=

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W h a l is I l o m e ?

ir was .()NI.Y I.() bc expected that the booklet " W h o are tile llomeless?", i~ublishcd by Shelter (National Campaign for the i j o m e l e s s ) a t tile beginning of September should produce a considcrablc public reaction, l:or some years lhcre has been much argument aboul the number of homeless families in the c~,ui,t~y, with estimates ranging from a few thousand Io a few million. Clearly, the variations have been partly due to ill-informed guessing and, also, to tim use of diit~rent deiinitions. The "'official" ligure, given early this year by the Minister of State for Health and Social Security took the word "homeless" as referring It) famiiies living in temporary accommodation and included 3594 Ii~milics comprising 18,689 individuals. ()bviously this was the only authoritative ligure lhal could be given. Even using the word in its most literal sense this was an unde:'-estimatc in lhat it did not include people of no fi×cd abode who might be "sleeping rough" or alternating between using common lodging }muses and "squatting" in derelict premises, but Mr [i,.'nnals couh! plead in extenuation that the counting of these last was an impossibility. Shelter leaps off to the other extreme. Taking as its basis the concept of a Imme as a place where a family can lead a decent life in accordance with twentieth century ideas, it regards as homeless any family which is inadequately housed, whether the inadequacy lies in the size or in the nature of its dwelling place. Manifestly, any exact count is impossible. The detinition of "slums, near .slums or grossly overcrowded conditions" is aIliacted by the absence of absolute standards. Some families can thrive in conditions which are far from perfect; others can be grossly disturbed by minor del~cts in their houses. There may, in ~his sense of the lerm be anywhere between one million and three million tiu nilics witllout "homes". Whatever the number may be it is too many and an essential part of seeing housing problems in perspective is the recognition that these families have a just claim on public resources. Nevertheless, we find it hard to accept the implications in this reporl that "the authorities" are trying to minimize the total problem of housing.

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I'lilll I ( I I I . A I / l i l

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,~t'ic'ilc'c I)Ct'illlhC il %V:l), I~;i;,Ctt illl I;IW Illilit'l'i;ll w i l h Illllt'h I1)t)I'l~ hllllllill :ll)]=lt';ll ihlili tlllilll~ w:lll:-i ~lild roflili!~ ll~l~tlll~t;li'llc llllil ~hc'llc~'~ +lt.vil cl]t~clivt:llc.',~ hi llic t~i~,,t h:i;~ hcll~Cd I<> dive:r| :lllL'iili~Hi I'l~ill lll¢ nioi'C C~niliilOli lllii ICn,u'c'hil.'lil:ir ii~l~CCt.~ ill* lhc .hiilljc'cl. 'l'hc i~riil¢iplll it oilY oI" Ihc .~ilu:i!i~)li, h~twc.vcr, lic~ hi tile' t]iml lh:il lhe il!~pc~li-. iliicc i~i" ilii~ it'l)~rl nllll~,~! c'~,inchlc'<, with lhc" coillilllt illl~ cllc'cl ~1" Ihc I I~;u~ill!.t :\¢I, ll)(l! ), ()Vcl" I%~1 Yt~,il:~ ~t!.,~i Ihc Mini.,,Iry ~d' II~ni:~ilit.'. ~ii]tl I,~lcal (ioV¢l-ltillC~ill l~ltl>ii'xi~.~'ll ii ;'¢l~Orl hy :~ ,,ul>-.corlnniilvc o1 llic ('c'lllral I I~)u,,dlit~ /\ctvis~ny ('Oltllitillmc" (,"()ill' ()hlcu Itonlc's i \ (':ill I\)1 A-'lib)it") whh;h, in l]ll)lt~ illl>dUl;.ite ICl'lil~ ill;ill tllo.m: li>ic-tl ll), ,ghc:llcr, hilt Clllilc. C~l~licilly, :,tin i,lil ,1 vt'Fy hJllliJ:ir' t::lht'; illttc't~t| its tisl of llll~',ili.~t':imlory c-liVilOilillt;illlil t':iclllH;~ WC'lit I)cT~>ll(t ~hc'l.lc'l".~ Sll{t!tt'.~tittll,~, "t'llc'r~" t'~lli I)C' Ill)ttilt~h!il>ii ill' lhc: ~ltlliil)rilic',$ i}'.liliiilil: I the" ~i(l,_'l l~i'ol~lc'il~s iiiltl it i,~ ~'ic':ii" lh;tl lilt liC~w /\c:i i~i :l .nc'.i'itlU.', iillt:llil)l [i! lhc iilil>Jt:liiC'N~ lnlioil o f Ihc l>i'Ol~>.~:il,s in " ( ) i i r ()ldci t lti-ilit,:,,," I I~,w t]|Y Ihis c'all i~c: l~lkc, li :i.~ ;i s;ili~l'llC-I~_lr)., ~illclllpl ill i'Hc',~ciil circliliihl~llic:t:.~ i,~ '..I ill~lllcr l\~i" :lrl.-tilll¢llt, ('omil/ciilill~:, .ll lhc lillic wht;ii lh;il rt'F~orl ;ll~l)C:itxsd vYc liOlcd, i?lfl'r ciil :llilholiliu'~ OF " l h c llL'CL'.<,hill'y l'l~)',~,'c.'l'X to ht'.C.III'C llr~l~c'r lllllilil¢li,'iilCt" Of all tiou+scs" :l mint~rily i'c.'mo.|lliliClltl',lliOll i~rcfcrrcd lll:lI inll)r()vc:iiiclll .~l!oLlid roillliiil \'oliiill~ir)' aiid bc cil¢~tlir:l}:etl by t.,rc~;ilt.r l]n~lnt;iiil ilicu'.l~livc:>, 1~ iandlord.~, While I>arl VI o t ihc t\ct .glrcil<.~'thell<~ lilt; powu:r~ tit" loc:ll aul!l(H*ilit;~ iO L'.[iI'I'V Ol.lt illlprovolllu'l/l W~)l'kS l)%' ;llkt'ol.~lllt'ill Or ill {tt;l':-itlll, il WOl.lid [it-lpc~ir ttuit the millOl'ilv Yicw h:ls been a¢ccplcd in rcl.,,ard t()"'st~indai'd anlcltilic,:C' in lt~ai, tll~Clci' Parl i l i a l a n d l o r d w i l o providc.s ll~,csc llia y iiliv¢ ;i loll;tilt:)' lrali:~fcrrcd frolll " c o n l r o l l c d ' " to "ro!,'tlln!c'd" .sl~lltl$. i t o ~ c:ll~cciive this ~sxiblc t,~ fake inlo accotlllL " b a d internal ;ll'ran~,,cmcnt" hi dctcrllliilill{~ w h c t h c r il i~ou.<~c is unlit for occ[ll)ation. "|'hough t h e / ~ c l illigh[ ll~t\:o dollt: illorc', ,~o t'~.ir ;.is "lii[iiilt~liilill~ l i l t nl(~ck ~.tl" hOLlSc:,s" i$ COIICCI+IIC{| it is cvidcnm~ thnl tl10 powcr.~ th:ll bc arc liyiti{~, i(~ ttllll prolnisc into t')CI't])I'!rll;IIICc. "l~hc |';IC{ I'~[1*)~lilt% that 8()Illc hotlSCS wJ~ich arc ,~tilt oc~ctlpicd {li'c~ illcapabic oF being It~adc Ill and thai s()lTiC lu;uscs arc ~.~vercrowdcd, so thal oven il" lhc I:lOpulatioil wcrc iil~i l~,,i-owiii 7 there w~ti.lld bc :l .~ub~l;tnlial llc¢ci for new dwcllin[zs l o b c btiilt. "lh¢ i~c¢(l is l~rc,'ilc;r thilll sortie of the oflicJlil stati.~tics would imply, bt~C,'lUSC', as M . O . s t t, Itavc long bccn poinlin}, (>tit, Ihc stlli]tl:.tl'd.~; which (]OlCl'lllill0 Milttitl)r)' ovcrcn,~wding ~t1o t~y ilo iYic:[ll~.~ ,>:iti.~,factory. T h e y wcrc aCCCl)t:ll~lc 30 yt;.ar,g ;.it;o o n l y I)c'c'at.l.~c~ ilicy were ;i Illst altClllpl 1o produce ~l dclh~ition :tiid it cl)tllcl U¢ hoped their tile)' we'.re ~l lirsl

WIIAT IS iIOMI:?

3

slop ()l', lhc road I() s~mlcthing holler. "|'~) cnI~l'cc Ihc prcsclll lilw olI (~vcrcr()w(linl, al lhc prcscnl lime would merely rc.~ull il~ Ihc familics invnlvcd being I\~rccd inl() lemporary accomrnodati~m or inl~ h(msc~, which arc e~.',cnlially tlldil. Tilt: (rely praclical value ~fl" existing ,'.;l;ind;ird.,.;i.'.,l|Inl lhcy oilL~r ~mc u:.;cful c.vilcric,n in dclcrmi.nirIy, prioi'ilics i,i IIic aII.~)c,ali,~m¢.ffbnc;.t! ~lulhorily Ii,~.'~t.lsc.,.; .:ind llal~. TIiill enforcement (d" lhc l~rc.',cn!luw i:-,l~!,m:mly imp~,ssihlc d,ocs n,:~l,h0wcvcr, mean lhaI iIi.,;rcas~mablc to hc c~,,niI",laccl~iIah;c "o!" llotJ:;c<< 'Fhc l(Ul-l'OOtll Ill:lllhi~)il occupied by :l i n m i l y ~d" Ihrcc ~u t<~u;-is :t rarily. l h c ma.io,ity oF lhix undcr-tJSC i:. I,~ bc f~tmd where ;l couple livc oil in lhcir thrcc-hcdrtmn) h~m.~c :lflcr Ihcir chil,drcn ha.re m;~r,'icd :..m,,.l:-:elup ll'mir c,v,m l~i~ciilic,;arv...llllcrc .arc lflcnly of vali,:Irc,:iv.mx wily they v,.',.u~hlsuIIL'r iI'iIu:yv,:crcc~.mil',elh.:di..n,:move; p,,:rs,u:isi,:m, v,,I'~icll'..rillI'u..'. rcip..f<:,rccdhiy (he div~bili,ics, wh£ch ,,rillc,~m~c I,~>illcrn a~, IIicy }...,.row~:,hlcr, is IIm ni~.'.,Ithat can I;c tl~'Ic-it"~m,.: is It) acl llumancly. Ic,r rill tI'~c.-;crc;;x,;m:-;,Sheller i~ ri!.'..hlin cmph:.i,,izin!,,lhal the Imilding ,nf ,lh~+'c lt(+il:;c~+ is ul'trcl~! ail(I Ill;ll while lhc ct~nccpl ,d- ;I "prt)pcl+ly-~;'a:l'ting "'dclm~cracy" is I;iud;ihlc Ihc lillinl-, ~t' the llc.cd will I~avc l~, Ix: maillly ihc ta.,,l( o1" lilt: ~'puhlic ,~cclt~i"'. W c ;ire n<~t in II-ic Ic;l~l surpri.<;c~l lhill lhcrc .<;h~tild bc ptitflic C(lllCCiul ;il)oUl l i l t l'tci lhnl ti!i'~c',t." ¢~tlicc: i;h~cks ~d;iil(I ciilply, wailing l"~r lcilanl.,; wll<)t:;iil s;llisl~ lhc develop, or<,' Iirlal~ci;ll c.xi)cctalit~li>,. I.)~ubllcx.,, tJiC.l-C is !-tlilch viitrio in seeking 1(~ cnc'otiri',l:',.c !he l~tiri,>l Ira(.Ic I~y pr:n, idint~ i~l(~io Iill(.l t)cllcr .-and II101"C UXl~Cnsi,,c -tlolc:i acc~mlin~)diilh);l, llui if Ihcrc is indc-ctl iI tack of builciing l'c.c;()llrCCs, wllich i~ lhc ]cs~;cl evil it) inip(x.,c hiilllt" tii~,COIllI'~lli ~.lli t,Ilicc workers by day ~tlt(t :iOlllC: i:lccmvcnicm:c t)ti lotlri.<,ls by ititthl, c)r io leave fTinlitie.~ living t~y day anti liighl ill stlli;tlor'? 'i'o say lhal tho Coli~ili'y clillll()l ;itl'oi'tl adctlU;llc hol.i.<,int.,, for its pcol:Ic lk t.o disguise Ihc~lrulli. "lllc p()hilioii is ralhcr lhal at prcsclt{ lhc c(Ul~llry i:~ lit.ft. .~,lil]]clcllliy concc:rllcd to wish It.; ;ittTird il. ()twhms, ly lhc ,~ltllion o|" Ihc hm.t.sinj..,. l)lohlcl~i is gOilllJ i.<) rcquirc .~otlld sacrifice on ";()lllt*(lllC'£ p<'lrl. {Vhclhcr or nt~t il illvt)lvcs diversion tit" huitdit;t.,., lC~Oill'Ct, h fr(>lll ollc iypc ~|" tlcvc:It~pnlctll I<~ rthcl, ii will CCllaiiilv rcqtlirc the cxpclldilljrc of more lll()liCy, illld llllJch ti(" ihis will have io coil-1o fronl one or liilo!her par! (~t' Ihc public ptir~c. Shc:tlcr lllay have pitinl
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PUBI_]C tlEALTt! VOL. 8,1 NO. I

to statutory nuisances. But certainly damage to emotional health may result not only from the presence of material defects but from other shortcomings which cannot be dealt with as nuisances and one cannot ignore the possibility of psye,!m-somatic illness. In any cvenl, a sick person is less concerned about a diagnosis than about his daily pains, his breathlessness and his tiredness: if his housing conditions make these more burdensome it is irrelevant that they are not greatly exacerbming tlie basic disease process. We have previously emphasized that the M.O.t,'. has an essential role, complementary to that of lhe public health inspector and ihe engineer or surveyor, in guiding and advising on the totality of health in relation to both individual and collective problems of housing. This new report, in spite of the points which we have criticised, rnav help the M.O.H. by emphasizing from outside much o[" what he has been trying to express from the inside.

News Item

Second International Ah- Pollution Cottfi'rem'd" THF~ SECOND International Air Pollution Conference will be held 6 to |l December 1970, at the Sheraton Park Hotel, Washing!on, D.C., U.S.A. Details are available from: Professor Arthur. C. Stern Department of Environmental Sciences and Engineering School of Public Health Universily of North Carolina P.O.Box.630 Chapel Hill. N,C.27514, U.S.A.

Tal~leu'are for Disal)led Persons A NEW RAY~E of tableware and cutlery, specially designed for use by disabled persons, has been introduced by Melaware Lld., 6 Commerce Road. Brentford, Middlesex. Sponsored by the British Rheumatism and Arthritis Association, the new Melaware Manoy range has been designed for people who suffer From rheumatism, arthritis and abnormalities of co-ordination. The range in heat-resistant melamine, includes two oval dishes, or bowls, scooped and contoured, with a variation in depth from left to right; an easy-to-handle beaker with a flat base and cut-out stem, and a three-piece cutlery set in chromium-plate with black moulded handles comprising an angled left-hand spoon, a similar right-hand spoon and an angled knife. The complete set of two dishes, beaker and cutlery will be sold a~ 49s. 6d,