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Clinical Effectiveness Group

Half of families with children in North East London are living in overcrowded households

Data scientists at CEG used novel methods to estimate inequalities in household overcrowding in North East London. In some areas of the region, over 70% of families have less than 16.6m2 per person, which is little more than a parking space. 

Published:

The CEG analysis, published in the International Journal of Population Data Science, found that household overcrowding affects almost half (46%) of families with children in North East London. In some neighbourhoods in Tower Hamlets, Newham, Havering, and Barking & Dagenham, 70-79% of households with children are living with fewer than 16.6m2 per person. 

The research team analysed information from the Energy Performance Certificate (EPC) register, which provides the floorspace of each property, and linked this with de-identified data from GP health records, which indicates how many people are registered as living at the address. The researchers linked the datasets using encrypted Unique Property Reference Numbers (UPRNs), which keeps actual addresses and patient identities hidden.

Inequities in overcrowding

Homes were over five times more likely to be overcrowded, and had an average of 22 square metres per person less, if the household included children. This was more marked if the property was privately rented rather than owner occupied, and if the oldest household member was from a South Asian or Black ethnic group rather than from a White ethnic group.

Household overcrowding is an important wider determinant of health

Living in close proximity to others with limited space increases the transmission of infections and the risk of condensation, damp and mould. It also restricts residents’ privacy, and space for children to play or do their homework. Research has shown that children living in overcrowded households are more likely to suffer behavioural problems and have poorer educational attainment. 

How is overcrowding measured? 

Most analyses of household overcrowding use the ‘bedroom standard’, which calculates the number of bedrooms required depending on the ages and relationships of the occupants. These estimates are usually based on data from surveys, including the Census. Using the ‘bedroom standard’ recognises issues of privacy, but it does not consider the overall space within a property, which has more influence over work and play and the risk of condensation.

The CEG research demonstrates the viability of a ‘space standard’, calculated using a novel method that links health and property data while keeping identifiable information hidden from researchers.

The de-identified data linkage method also enables future research into the impacts of household overcrowding on people’s health.

Marta Wilk, lead author and health data scientist, said: 

“Using de-identified demographic and health data of people sharing households, linked to information about the physical characteristics of the places where they live, enables much needed future research to address gaps in our understanding of the health outcomes of overcrowding and poor housing conditions.”

Using UPRNs for population health research

In this study, researchers used encrypted Unique Property Reference Numbers (UPRNs) as the link between information on health and properties. UPRNs are identifiers for every addressable location in Great Britain and they are already applied to many public datasets, including the EPC register. 

Researchers used the ASSIGN algorithm, which generates encrypted versions of UPRNs from the patient addresses in GP health records. Patients with the same encrypted UPRN at a point in time were assumed to live together and were grouped to create anonymous ‘households’. Researchers then linked these household units to information about the corresponding property using encrypted UPRNs in the EPC register. This method of encryption keeps patient identities and addresses hidden while enabling valuable research into household health and overcrowding.

Carol Dezateux, co-author and Professor of Epidemiology, said:

“Our research has highlighted the inequalities in access to space experienced by households with children. Understanding how this impacts on the health, education and social activities of children will help inform policies to mitigate the effects of overcrowding.” 

This work was funded by Barts Charity (MGU0419 and MGU0504). It was also supported by ADR UK (Administrative Data Research UK), an Economic and Social Research Council investment, part of UK Research and Innovation (Grant number: ES/X00046X/1).

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