The pressure on our health and hospital system in South Australia just seems to just keep rising, and it’s not hard to think that it’s going to get worse before it gets better.

After we reach 80 per cent vaccination rates, the easing of border and other restrictions will inevitably increase it further. So what is to be done? Keep pumping more and more resources into addressing each crisis as they arise or start to think a bit more laterally?

One low-cost way we could do this is to improve rental rights. The imbalance of power between tenants and landlords is impacting the health of South Australian’s who rent and is one of the many contributors to the rising pressure on our already stretched health system.

While the link between renting and our health system might seem like a long bow, there is an established pathway connecting housing tenure to health outcomes.

The World Health Organization has demonstrated that access to stable, secure and affordable housing is an essential requirement for health and wellbeing of individuals and communities. Housing is considered an essential requirement for good health – one of the social determinants of health.

If we want to relieve the pressure on our struggling health system, we need a greater focus on these social determinants and to recognise that housing is health care. One only needs to look at the ambulances regularly banked up out the front of South Australia’s hospitals to see a sign of the pressure our health system is under.

The longer a person lives in insecurity and uncertainty, the more their health is impacted.

What we know about the SA health system is that when you can get in, it delivers great results. The problem is, as Health Justice Australia has found, that the majority – up to 75 per cent – of the factors that affect people’s health cannot be addressed by the health system.

Housing has a huge impact on our health and wellbeing, but access to housing is getting harder.

In the past the great Australian dream of home-ownership was an expectation, a rite of passage, where nearly all Australians expected to purchase their own home at some point in their life. For many people, renting was, therefore, seen as just a stepping-stone on the way to purchasing a house. If this dream of home-ownership for everyone was ever a reality, it certainly is no more.

Today nearly a third of Australians rent their homes and the majority will have no option but to rent for their entire life. Renting is obviously a good alternative for many, but for those without other options, renting comes with increased stress and anxiety associated with having to renew the lease or needing to frequently move. Anyone who’s done it recently will know that moving is bloody stressful and often expensive.

Renters also tend to live in places that are lower quality; consequently, far too many renters live in homes that make them sick, often because they are too hot in summer and too cold in winter. This is not just about comfort: a home that is too cold, for example, can contribute to a range of health conditions including asthma or even stroke.

Currently, the rental market is under significant pressure, with limited properties available and increasing rents. These pressures favour the landlord and place increased stress and instability on those renting.

The length of time living in insecure housing also matters – the longer a person lives in insecurity and uncertainty, the more their health is impacted. We know that uncertainty is associated with a range of negative health outcomes, including short and long-term illness, alcohol misuse, deliberate self-harm and suicidal ideation. Insecurity and uncertainty can be just as bad for your health and wellbeing as homes that are too cold or hot.

At a time when SA’s house prices are continuing to hit record levels, there are fewer homes for sale and outside investors are driving up prices further, improving renters’ rights is not just the right thing to do in terms of housing policy, but it’s also the right thing to do in terms of health policy.

So what would a rebalancing of the rights of landlords and tenants rights look like? Organisations like Shelter SA and Better Renting have set out a range of measures to improve the situation.

They have called for:

• An end to no-cause evictions. Such practices enable landlords to terminate a tenancy without specifying any grounds, undermining the idea of having a legal agreement in the first place as well as creating uncertainty for tenants.
• Making renting more pet friendly. For people living on low incomes and trying to find affordable rental properties, owning a pet can be just another barrier to the private rental market. Too often people are forced to choose between a home or their pet, with some ‘choosing’ to either sleep rough rather than give up or euthanise their pet.
• More tenancy advice resources. There needs to be more resources for tenant education, information, advice, and advocacy. We think that SA should establish a Commissioner for Residential Tenancies as the Victorian Government has done to help make renting fairer and healthier.

Making renting fairer is not just good for renters and it’s not just good for relieving pressure on a struggling health system, it’s good for our overall economy too. Good health boosts productivity and improves workplace participation.

A healthier South Australia will mean a stronger economy as well as a more equitable society that leads to better health for all.

David Pearson is the CEO of the Australian Alliance to End Homelessness and Carmel Williams is the Director of the Australian Centre for Health in All Policies Research Translation.