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  1. Queen Mary University of London
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  6. Housing Distress in the Health System

Housing Distress in the Health System

Project team

Dr Elizabeth Storer – Lecturer in Health Geography (SSE)
Dr Anna Moore – Lecturer in Medical Education (IHSE)

Project description

Whilst Tower Hamlets registers among the highest rates of housing inequality in Britain, we lack granular evidence as to the precise impact on tenant’s health.

This project uses ethnographic methods to follow how housing distress – particularly related to damp and mould and breathlessness - is communicated and acted upon by clinicians in Tower Hamlets.  Through an interdisciplinary partnership between a health geographer and clinician-researcher, this project aims to contribute to understandings of:

a) how ethnographic methods can help us to understand the interface and interstice between tenant’s housing related distress and the health system

b) how the structural determinants of health can be more clearly represented within NHS data practices

How did the team come together?

Between 2021-2025, Liz was involved in collaborative research exploring housing distress in Birmingham. This research has been published here, and here, and contributed to this QMUL policy brief.  This research team – based at CAMHRA, SOAS and QMUL, continue to explore tensions between housing distress and the forms of evidence through which marginalised tenants seek redress and health.

Anna is a clinician working at the Tower Hamlets Breathlessness Service, which takes an integrative and holistic approach to managing respiratory distress. Over the last decade, Anna has encountered an increasing number of patients who attributed symptoms to their housing conditions. Anna is also interested in housing as part of medical training and in her role as Clinical Lecturer at QMUL offers elective courses on housing and health.

This project emerged at the intersection of their research and practice and seeks to harness ethnography to better elucidate frictions between care-seekers and NHS systems which tend towards medicalised, rather than structural, explanations for the cause of illness.

How did you decide on this question/topic?

The research coalesces around the question of how complex patient biographies – and interactions between clinicians seeking to deliver good care within austerity health systems – might serve as data.

Anna’s students have conducted research in Tower Hamlets which suggests significant underreporting of housing issues in relation to respiratory and other forms of illness. Given this dissonance between what’s been reported in data via GP codes and what Anna and colleagues have seen in practice – how can we produce data that actually reflects the scale of the problem?

This research is intended to serve as a pilot to explore how engaged-research can inform the student medical curriculum, and more generally can inform the contemporary emphasis on prevention and ‘joined-up data systems’ in the NHS 10-Year Plan.

What activities will you undertake as part of this project?

There are two strands to the project. The first will be 2 weeks of ethnographic research in the Tower Hamlet’s breathlessness clinic at the end of 2026. This aims to understand the presentations of distress at the point of care, and to understand how patient complaints are translated into NHS data.

Secondly a series of workshops will translate this research into resources for the medical curriculum. These workshops will involve medical students and partner organisation MedAct.

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