Whilst there is a long-established tradition of research which demonstrates the health consequences of housing disadvantage, the global Covid-19 pandemic provides a new impetus for housing and health researchers to offer clarity of thought in presenting models which might support policy interventions. This coincides with an uncharacteristic period of critical reflection about the nature of causation within the field, such that recent papers (Baker et al., 2017; Garnham et al., 2021; Rolfe et al., 2020) have suggested new models to account for the ways in which housing functions as a social determinant of health or how it is implicated in accounting for Covid-19 excess mortality (Gurney, 2021).   This paper makes some critical remarks and reflections about two ways in which causation has recently been expressed; first, as the outcome of the accumulative inter-relationships between various bundles of housing attributes as an “insult to health” (Baker et al., 2017) and second, as a series of (often hidden) causal mechanisms which may or may not be triggered by the interplay of underlying structural properties and surface level contexts (Rolfe et al., 2020).  This discussion about causation is then further developed by considering alternative accounts in which housing might be metaphorically understood as a valve which controls, regulates or (re)directs accumulations of social harms or as a part of a circuit in which negative health outcomes can be attenuated, amplified or stored up as a result of policy flows. Mindful of ubiquitous “The Science” narratives of the Covid-19 pandemic, the paper concludes with some general remarks about epistemology, metaphor and methods for housing and health research and makes suggestions for further discussions on how causation might be theorised, expressed and communicated.


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Gurney, C. 2021, 'Insult, Trigger or Valve? Critical Reflections on Metaphors and Causation in the Residential Contexts of Health', European Network for Housing Researchers International Conference (ENHR 2021). http://eprints.gla.ac.uk/257079/

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Last updated: 16 June 2022
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