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Issue 3, January 1999, pp.6-7.

Housing tenure, ethnicity and inequalities: towards a contextualised approach
Katherine Charsley, Helen Lambert and George Davey Smith

Introduction
This article reconsiders one aspect of the well-established association between housing and health. It draws on findings from a project in the ESRC Health Variations Programme to show how a range of context-specific characteristics can substantially influence what housing tenure means to residents. An introduction to the research project in the next section is followed by background information on the use of housing tenure as a measure of socio-economic position in the study of health inequalities. We then show how three interacting dimensions - changing local and national housing policies, area of residence and ethnicity of the household - influence the meaning of housing tenure. We discuss the implications of these findings for the use of tenure as a proxy for socio-economic position in explanations of health inequalities.

Research background
The article draws on data collected in the first phase of the project, 'Comparative methods for studying socio-economic position and health in different ethnic groups' which aims to examine the extent to which the meaning of different indicators of socio-economic position (SEP) vary within and across ethnic groups in the UK. There are well-established ethnic differentials in health status, but how far these may be accounted for by variations in SEP is not clear. Controlling for SEP is not straightforward, since conventional indicators of SEP, such as occupation or housing tenure, may be differently prioritised by, or accessible to, members of different minority ethnic populations. Our research aims to explore this question. The first phase of the research, being carried out in Bristol and Leeds, entails ethnographic fieldwork and in-depth interviews among White, Afro-Caribbean and South Asian communities in the two cities. The second phase of the research will use these qualitative data to develop and pilot a survey instrument for measuring socio-economic position in relation to health comparatively across these broad ethnic groupings.

Housing tenure and health inequalities
Housing tenure and car ownership have proved more discriminatory as indicators of mortality differentials associated with socio-economic position than occupation based social class.(1) Housing 'classes' were proposed as an alternative to occupational classes as an index of socio-economic position as far back as 1967,(2) and have shown an enduring correlation with health. As Sally Macintyre noted in the first issue of this newsletter (Health Variations Programme Newsletter, Issue 1, pp.6-7), death rates for those living in local authority housing were over 30% higher than for owner occupiers in the 1980s.(3) Our qualitative research in Bristol and Leeds, however, points to the need to contextualise housing tenure within an understanding of the political, local and individual processes which give it meaning as an indicator of socio-economic position, particularly with regard to low and mid-income households.

Policy context and tenure patterns
Local and national policies influence the meaning of housing tenure and, consequently, the characteristics of residential areas. There are signs of increasing differentiation within the class of 'owner occupiers', partly due to government policies concerning house purchase. Home-owning has often been treated as an indicator of socio-economic well-being4 but, in the 1980s, discounted sales of council houses and the deregulation of the credit market created a dramatic rise in low-income home-ownership. The subsequent recession produced increased numbers of households with mortgage arrears and record numbers of repossessions, a situation which has prompted some observers to suggest that for many households, owner occupation during the 1990s became a 'new route to poverty.'(5)

These policies have also produced increasing differentiation in the meanings of tenancy. For some, social housing combines security of tenure and regular maintenance with an ability to move, which, albeit often a lengthy process, is not contingent on the housing market. Rent arrears can restrict the possibility of obtaining a transfer, but arrears may also provide a form of interest free credit for low-income households unable to access other sources of credit. However, while some tenants benefit from these advantages, others report problems such as damp, overcrowding, and poorly maintained high rise flats which are particularly vulnerable to vandalism and burglary.

'Right to buy' council policies have led to a 'residualisation' of social housing: to a reduction in stock with a higher proportion of the most undesirable housing remaining. This situation influences area characteristics, since those residential areas in which large numbers of council houses remain (such as the media-notorious 'sink estates' in most major cities - some of which are included in our study) become increasingly undesirable, and few council tenants who are able to wait for alternatives accept re-housing in such areas. Under local authority policy however, priority cases have limited ability to refuse housing, with the result that in many stigmatised areas, tenants who move out or who are evicted are replaced by equally vulnerable people in the form of those who are desperate to be housed and cannot choose to wait for something better. Thus, a single mother in inner city Bristol explained:

I hate this place so damn much it's unbelievable. . . Well I kind of like chose to live here because I found out that I was five months pregnant. . . When you're that far gone you just need somewhere basically. ..[they say] 'You haven't got enough points to go to another area. We've got one vacancy in [neighbouring street], . . . If I ain't taking drugs here I'm surely going to be taking drugs there serious just to cope with the road itself.

Ethnicity and the meaning of tenure
Ethnic minorities in Bristol and Leeds show some distinct patterns of housing tenure, such as high owner occupation amongst South Asians and high social housing - in inner-city areas rather than suburban estates - amongst Black Caribbeans. However, a recent survey of ethnic minorities in Bristol showed no difference by housing tenure of the numbers reporting their health as 'excellent/good'.(6) These observations suggest that, for ethnic minorities, housing tenure is not a simple reflection of socio-economic position.

Tenure patterns among ethnic minorities are often treated as a consequence of preference, but our interviews with Black Caribbeans suggest that low levels of owner occupation reflect a lack of financial resources and difficulties in securing loans rather than a lack of interest in becoming a home-owner. This may be exacerbated by differences in Caribbean and White British household formation - one Bristol woman said her mother had always regretted not owning, but had found it impossible to get a mortgage as a single woman with children. Similarly, whilst our research concords with other studies suggesting that many South Asians place a high value on owning, external factors are also influential, including lack of information on social housing, racism in the private rented sector, and the fact that only short-term mortgages were available to many South Asians on arrival. Interviews with some first generation migrants suggest that these factors have conspired to produce a pattern of South Asian owner-occupation concentrated at the cheaper end of the market, with many reporting high levels of disrepair coupled with limited ability to rectify problems.(8) Hence, in Leeds, a South Asian family reported increasing difficulties paying bills as they struggled to slowly repair extensive damage caused by a roofing problem.

In regard to location preferences, the received wisdom that minorities prefer to 'stick together' makes assumptions about cultural and class homogeneity within ethnic groups, and ignores the tensions between the advantages and disadvantages of living in a 'Black' area. Whilst many people from ethnic minority backgrounds report gaining strength in identity as well as material benefits from living near kin, community members or services, others find family obligations or the scrutiny of 'the community' oppressive. Thus, a Pakistani-born woman explained her rationale for moving:

When I first bought the house [people said] there's no Asians up there, why are you going to K-, I thought that's the whole point, I don't know anybody.

Environmental and housing stock problems also often exist in 'Black' areas, as a young Black Caribbean man in Bristol who wanted to move to the inner city after feeling out of place in a wealthier 'White' area, was keenly aware:

This area, it's got a lot of advantages, the only thing is about the areas where black people live in Bristol is that it's all dead close to the motorway and it's all dead polluted. . . It's a great place to live in terms of people. As far as the housing is concerned, it's difficult to have a private garden, a lot of people are living in places that are too small for themselves, there's too much traffic around here, it's not a good place to bring kids up in terms of health. So there's all those disadvantages and if you want to change all that you need to move to an area where there's no black people. It's a catch 22 in Bristol.

A contextualised approach
A contextualised approach to housing tenure demands that researchers take note of the dynamic processes through which housing policy and the socio-cultural environment construct patterns of tenure, and so alter their meanings as indicators of socio-economic position. Such an approach is particularly important in the field of health research related to inequalities, as it is likely that many of the processes thus highlighted, such as the experience of repossession or residence in a high crime area, may also have direct impact on physical and mental health through increased levels of stress.

Katharine Charsley and George Davey Smith are at the Department of Social Medicine, University of Bristol; Helen Lambert is in the Department of Public Health and Policy at the London School of Hygiene and Tropical Medicine. Together with Waqar Ahmad and Steve Fenton they are members of the project team that is examining 'Comparative methods for studying socio-economic position and health in different ethnic communities.' Kathy Powell (now based at Manchester University) worked on the project until September 1998.

References:
1. Goldblatt. P. (1990) 'Social Class Mortality Differences' in N. M. Mascie-Taylor The Biology of Social Class, Oxford : Oxford University Press.
2. Rex, I. and Moore, R. (1967) Race, Community and Conflict, London : Oxford University Press for the Institute of Race Relations.
3. Macintyre, S. (1998) 'Area inequalities in health.' Health Variations newsletter Issue 1 pp.6-7. See also articles by R. Mitchell et al., A. Gatrell, and M. Shaw et al in Issue 2 of Health Variations..
4. See Kendig, H. L. (1984) 'Housing careers, life-cycle and residential mobility: implications for the housing market' Urban Studies 21: pp.271-83, for an outline of the ideal housing career in the 1980s.
5. Nettleton, S. (1998) 'Losing homes through mortgage possession: a 'new' public health issue' Critical Public Health 8, 1: pp.47-58.
6. Fenton, S. and Hine, C. (1994) 'Health, economic status and ethnic origin: self-assessed health in Black and minority ethnic groups' Paper presented to Association for Public Health, Birmingham.
7. Lambert, C. and Razzaque, K. (1997) Asian Housing Needs in Bristol, Bristol : University of the West of England.
8. Law, I., Davies, I., Phillips, D. and Harrison, M. (1996) Equity and Difference: Racial and Ethnic Inequalities in Housing Needs and Housing Investment in Leeds, Leeds : University of Leeds.