Complexity to inform issues of methodology, taxation and politics in a context of crisis

In the early1980s together with Sheila Harrison and Jane Keithley, my Durham colleagues and  both former nurses, I got an ESRC grant to look into the relationship between housing conditions and health (SSRC ‘Health and Housing Conditions in Public Sector Housing Estates’ (with Keithley and Harrison 1980-3) (note still then the Social SCIENCE Research Council before the mad monk Keith Josephs insisted on dropping the science and the servile powers than be in UK academia let him). What prompted this was an observation in the Black Report https://en.wikipedia.org/wiki/Black_Report  that the health of residents on social housing – still at that time predominately council housing – was worse than that of residents in privately rented accommodation. It was no surprise that it was also worse then for residents in owner occupied housing – a matter essentially of social class – but social housing had been created in large part to address issues of the problems of health in privately rented slums, although extensive slum clearance had largely eliminated slums as such.

I was very well aware from my times in North Shields CDP and in Belfast that social housing was not a uniform stock set but was highly differentiated. In older stock this was a matter of the purpose for which it had been built. If built for “General Needs” as under the 1919 and 1924 Housing Acts and the very large amount built post second world war, first under Nye Bevan and Labour, and then under Macmillan and the Tories (although with a reduction in quality) it was good and desired by residents. If it had been been built under schemes designed to replace cleared slums as in the 1930s and later then it was not. The good housing was mostly in the form of semi-detached houses on well laid out estates. Most of the slum clearance replacement was in the form of flats and from the 1960s in the form of non-traditional dwellings much of it in high rise form. I had worked when an undergraduate at Newcastle as an interviewer on Betty Gittus’ study of Flats, Families and the Under-Fives, the title of a resulting book 1976) and from Belfast experience and having taken a look at the horrific non-traditional housing in Killingworth New Town, was well aware of the issues surrounding high rise as it then was. A particularly grim example was in Gateshead in the form of blocks of flats in St Cuthbert’s Village where a lot of the youngsters in the Woodcraft Folk Group (I still have the shirt) which my daughter attended and where I was a helper actually lived. Bizarrely these flats appeared in Get Carter as the locale of the luxury apartment of the gangster’s moll who was drowned in the boot of her car when it was shoved of a cross Tyne ferry.  They were built on a difficult sloping site and in order to meet construction cost limits had had electric central heating installed in the ceilings in defiance of the laws of physics – heat rises by convection. They were plagued with black mould and residents were advised that the way to deal with this was to turn the heating full on and open all the windows!

I had access through the cooperation of Gateshead housing department to lettings data for all their estates and in particular data on estates where people wanted to live – listed as first choices on applications for housing or wanted to transfer from existing council housing into, and did not – did not list or wanted to transfer out from. This corresponded exactly to the character of the differentiation in social housing which I have outlined above.  The actual research is fully described in Byne, Harrison. Keighley and McCarthy Housing and Health (1986) –   Pete McCarthy was the excellent statistician we hired as an RA and who did a lot of the actual survey management. It was an enjoyable and interesting experience. We had a really good team of interviewers – both students and others, all paid – who were a source of ethnographic information and did quite a lot of interviewing ourselves – always a good practice. I well remember being puzzled by finding that the relationship between residents’ assessment of their housing quality and their health was always positively correlated except for people over the age of 65. When I mentioned this in a team meeting an interviewer said, absolutely accurately, that is because the sheltered housing is always good and the residents are old people who get it because they have poor health.  They love it but their health, although it may improve, remains poor. I have used this in encyclopaedia definitions of statistical interaction – age changed the sign of the correlation between health and housing condition because a different causal mechanism was in play.

What I want to focus on here is a chapter Jane Keighley and I wrote in Unhealthy Housing (Eds Burridge and Ormandy 1993). The chapter title was “Housing and the Health of the Community”. The editors’ summary of our chapter hit the nail on the head. They said we: ‘challenge the merit of a research enterprise which seeks to attribute individual ill health to ‘bad housing’ because of its emphasis on individual pathology. Their perspective sites housing conditions as an environmental concern, differentially experienced within communities, classes and other social fractions fixed in space. They present a compelling and authoritative argument for the monitoring of community health, collectively based and spatially ordered.’ (1993 xviii). When I read over the chapter in order to inform this blog it struck me of how the argument in it whilst explicitly realist, which we counterposed to the explicit positivism of so much scientistic epidemiology, was also implicitly complex. It argued for complex and multiple causation set within historical and temporal context. Bradbury had done just the same in his Causal Factors in Tuberculosis (1933) which has informed all my thinking about causality ever since the local studies librarian in Gateshead – a lovely man and well informed historian – handed me a copy when I mentioned what we doing when booking a room to hold interviewer meetings.  We also referred back to the evidence provided by Tynemouth County Borough’s Medical Officer of Health (MOH) to support the slum clearances of the bankside slums in North Shields in the1930s which drew and relative TB rates to sustain the programme. We were, implicitly, understanding housing as set within an interwoven complex set of urban systems in historical context. See my interlude blog on that. See also my response to the grand  inquisitors of the Church of Critical Realism on this precise topic of endemic tuberculosis in industrial cities.

This is how research and thinking about what we find and how to understand it actually works in the real, messy, exciting and delightful work of actually doing it in empirical contexts. I am pleased to say that our work contributed to the demolition of St Cuthbert’s Village and the rehousing of households in decent homes. The high rise block remains but like other high rise blocks in Gateshead it is now a decent place to live because of resident caretakers – crucial – adequate maintenance particularly of lifts, and a location in a spectacular viewpoint of the banks of the Tyne. High rise when well managed and properly insulated can provide a good home for single people and couples, especially for older people.

I cannot leave this piece without giving an account of a meeting between St Cuthberts’ residents and the then leader of Gateshead Council, Bill Collins, not actually a stupid man and with some real virtues as a politician. When challenged on why the heating had been put in the ceilings because everybody knows heat rises, Bill said: ‘No, it doesn’t.  It falls just like it falls down from the Sun to the Earth’.  He looked at me for support (I was then a Gateshead Councillor) but with my A level in Physics he did not get it. I had actually briefed the resident to say heat rises.