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There is a long-established, recognised relationship between poor housing and poor health. This report presents the findings from a joint BRE Trust-DCLG project to update and improve estimates of the cost to the NHS of living in poor housing. It builds on data originally published in The real cost of poor housing in 2010, which have been revised to reflect new knowledge and information that has since become available. It is estimated (using revised NHS information) that leaving vulnerable people living in the poorest 15% of England's housing is costing the NHS some £1.4 billion per annum in first-year treatment costs. This report is aimed at surveyors, housing policy analysts and policy makers, town planners, housing managers in the public and private sector, landlords, property owners, health professionals and managers.