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A potential homebuyer looks at the Customer Service Centre of Housing Authority in Lok Fu. Hong Kong was ranked the world’s least affordable housing market for the 10th straight year in 2019. Photo: Winson Wong

Why unaffordable housing affects physical, mental health of Hongkongers

  • High prices make it harder for people to afford necessities such as food and medical care, and this has an indirect effect on health
  • Study is the first to look at relationship between housing affordability and health in Hong Kong, the world’s costliest housing market

Unaffordable housing has negative effects on the physical and mental health of Hongkongers, a large-scale study by local researchers has found.

High housing prices also make it harder for people to afford necessities such as food, clothing and medical care, and this has an indirect effect on health, according to the team from Chinese University.

Housing market slump sends more borrowers into negative equity

It is the first study on the relationship between housing affordability and health in Hong Kong, which was ranked the world’s least affordable housing market for the 10th straight year in 2019. It would take 20.8 years, on average, to save enough money to buy a home in the city, according to the latest Demographia International Housing Affordability Survey.

“Income affects wealth, but there are other factors that affect well-being. Deprivation is more multidimensional ... and health is not just one-dimensional too. People who have permanent illnesses are more likely to be affected by deprivation, for example,” said Wong Hung, associate professor of social work at CUHK.

In conducting studies on inequalities in health, deprivation as a form of social inequality is a more important factor than just wealth, according to the researchers.

The CUHK team used the residual income approach, which measures the amount of income left after housing payments, as a predictor of housing affordability.

They adopted a list of 21 items as a Deprivation Index to assess the affordability of products and services considered to be necessities by a majority of adults in Hong Kong.

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How public and private sectors can tackle Hong Kong's housing crunch

How public and private sectors can tackle Hong Kong's housing crunch

Respondents’ health-related quality of life was assessed using a 12-item short-form health survey from which a component summary score for physical and mental health was derived.

The researchers surveyed 1,978 Hong Kong adults between June 2014 and August 2015 and found that the proportion of deprived respondents (37.7 per cent) in the poorest housing affordability quartile was about 10 times as high as those (3.6 per cent) in the greatest housing affordability quartile.

Those with high housing burdens tend to be older, unmarried, less educated, less physically active, smokers and tenants, especially of public housing. They also tended to have worse physical and mental health.

“Deprived individuals should also be targeted for intervention programmes and policies to tackle health disparity as deprivation of necessities helps exacerbate the problems of unaffordable housing costs,” said Roger Chung Yat-nork, assistant professor of public health and primary care at CUHK.

But housing affordability still independently poses a threat to both physical and mental health, and the association with mental health was particularly strong, according to the study.

It found that 84.2 per cent of poorer mental health can be attributed to housing unaffordability alone, while 65.7 per cent of worse physical health can be explained by high housing costs.

Chronic stress due to high housing prices can lead to worse physical health through an allostatic load, or “the wear and tear on the body”, according to Samuel Wong Yeung-shan, professor of medicine at CUHK.

To improve the health of the Hong Kong population, the problem of housing affordability should be targeted, the researchers said.

Wong said the government should continue to work with the Hong Kong Council of Social Service and other NGOs to build more shared housing projects in the short term. The existing plan, called the Community Housing Movement, rents flats to households waiting for public housing and living in poor conditions at only a quarter of their monthly family income.

“With this scheme, poorer households pay less rent [for the shared flats] than they would for a subdivided flat, giving them more money to spend,” he said. “This approach can help release their deprivation and improve their health outcomes.”

In the long term, Wong believes the government needs to increase and speed up the supply of public housing and add more options near the city centre.

“Citizens don’t want to move to a place that lacks job opportunities or require them to completely get acclimated to the new environment. These are reasons why people don’t want to be allocated public housing that is far away, [and] which will create more problems in the future,” he said.

The study was published in the Journal of Epidemiology and Community Health last November. A press conference discussing the results was delayed until Tuesday because of coronavirus social-distancing measures.

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