No abstract

Background In England, nearly one child in ten lives in overcrowded housing. Crowding is likely to worsen with increasing population size, urbanisation, and the ongoing concerns about housing shortages. Children with behavioural difficulties are at increased risk of mental and physical health problems and poorer employment prospects. Objective To test the association between the level of crowding in the home and behavioural problems in children, and to explore what factors might explain the relationship. Methods Mothers of 2576 children from the Southampton Women's Survey population‐based mother‐offspring cohort were interviewed. Crowding was measured at age 2 years by people per room (PPR) and behavioural problems assessed at age 3 years with the Strengths and Difficulties Questionnaire (SDQ). Both were analysed as continuous measures, and multivariable linear regression models were fitted, adjusting for confounding factors: gender, age, single‐parent family, maternal education, receipt of benefits, and social class. Potential mediators were assessed with formal mediation analysis. Results The characteristics of the sample were broadly representative of the population in England. Median (IQR) SDQ score was 9 (6‐12) and PPR was 0.75 (0.6‐1). In households that were more crowded, children tended to have more behavioural problems (by 0.20 SDQ points (95% CI 0.08, 0.32) per additional 0.2 PPR, adjusting for confounding factors). This relationship was partially mediated by greater maternal stress, less sleep, and strained parent‐child interactions. Conclusions Living in a more crowded home was associated with a greater risk of behavioural problems, independent of confounding factors. The findings suggest that improved housing might reduce childhood behavioural problems and that families living in crowded circumstances might benefit from greater support.

Permitted Development Rights are a regulatory mechanism in the English planning system where the use of a building can be changed bypassing the standard planning process. Other countries have similar arrangements. In England, no assessment of the health impacts has been completed. This systematic review provides the first overview of the health and wellbeing impacts of housing created through Permitted Development Rights. 1,999 literature items were identified from a structured search of 14 databases and manual searching for grey literature. Literature published between January 2013 and July 2020, in England, were eligible. Eight academic and 13 grey literature items were included. The review identifies both a greater number of literature and greater number of ways permitted development conversions have negative compared to positive health impacts, and may contribute towards widening health inequalities. There is a lack of research directly with the occupants of housing created through Permitted Development Rights. These findings provide an indication of the impacts of deregulating a planning system without explicitly considering health and wellbeing. They warrant further assessment of how to enable the change of a buildings use to take place whilst also ensuring the homes created are supportive of good health.