Bricks and mortar
This section begins with the shortest chapter in the book, written with Mary Shaw, and published when we both worked in the School of Geographical Sciences at the University of Bristol. The Lancet would not normally publish a paper authored by a couple of non-clinicians, but the subject – mass visible homelessness – had become of such concern that early figures on the relative death rates of different types of homeless people were of great interest then. However, the response was mostly to remove the worst of street homelessness by forcing people away from the areas in which they were begging and sleeping. Death rates among the homeless who have a roof over their head, but with no real home, may be five times lower than among those on the streets, but remain five times higher than among the population who are better housed.1 Widespread street homelessness had hardly existed during my childhood, which had ended in 1986. A dozen years earlier and we are adding up early deaths which result from destitution. Just another dozen years later and I was writing about the lack of housing for the population at large (Chapter 34). It is as if there had been a coup. A population which had been relatively well housed at the start of the 1980s experienced growing rates of homelessness in the 1990s and then more widespread housing shortages.
The magazine which traditionally championed issues of homeless was called Roof. It ceased publication during 2010, an early victim of people cutting back on their subscriptions and on donations to Shelter, the charity that published it. A year before it folded the second chapter in this section was published, detailing how there is clearly enough housing for all in Britain, but also how it has become so badly shared out. In very recent years even mildly affluent homeowners have lost out to wealthier bankers.
Next the focus turns to New Zealand where the best data on housing, smoking and health are collected. This allows us to assess how the workings of a very private housing market underlie the determinants of growing geographical inequalities in health. The paper was published in 2010 in The Annals of the Association of American Geographers because Americans live with the most geographically polarised of health outcomes in the rich world. The findings are just as relevant to the UK where the increasingly unfair way in which our national housing stock is shared out is closely related to how inequalities in health between areas have risen.
This section ends with two more recent studies of growing geographical polarisation in poverty and wealth as it is being visualised both in Britain and worldwide. ‘Because enough is never enough’ was published in The Journal of Applied Spatial Policy as an example of just how much detail we now know of the geographies of who has most and who has least, where they live, and how these two residential patterns are interrelated. This is followed by a short extract from a much longer paper also published in 2010, in The Geographical Journal, on how these housing patterns in turn are connected to how we categorise people according to their area of residence, on how those places then separate groups, including separation by race, mortality and politics, and even by patterns of when we give birth, influenced too by hopes and fears over housing.