People in the UK are now spending fewer years in good health than they did a decade ago, according to a new analysis by the Health Foundation. The UK now sits near the bottom of a 21-country comparison, ahead only of the US.

A drop in healthy life expectancy is explained through many causes: obesity, alcohol, drugs, suicide, chronic disease, poverty and widening inequality. But one of the most powerful causes sits atop them all: housing. Where and how people live is one of the main factors explaining how health risks are created and distributed across society.

The UK Housing Review is an annual independent review of housing policy and evidence, written by housing experts and published by the Chartered Institute of Housing. Its latest edition, which we contributed to, identifies several interrelated ways that housing affects health.

A key one is affordability – housing costs shape where people can live, whether they can heat their homes, whether they can afford food and transport, whether they can move for work, whether they can leave unsafe or unsuitable housing and whether they live with chronic financial stress.

In the UK, housing costs are high by historical standards and poor housing remains widespread. The review notes that private rents are now at their highest recorded share of earnings, while millions of homes in England still contain serious health and safety hazards.

When housing is unaffordable, people are forced to make tradeoffs. For example, trading affordability for damp or overcrowded homes. They cut back on heating, food, medication, transport and social participation. They move further from public services, work and........

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