Household infrastructure in Aboriginal communities and the implications for health improvement

Abstract

Objective To evaluate housing survey data, describe the state of household infrastructure in Aboriginal communities in the Northern Territory (NT), and to discuss implications for health improvement for people in these communities. Design Quantitative analysis of survey data and qualitative analysis of the survey process. Setting All NT houses funded for repairs and maintenance through the Indigenous Housing Authority of the Northern Territory (IHANT). Main outcome measure Status of infrastructure necessary for four key “healthy living practices” (washing people, washing clothes and bedding, waste removal, and food storage and preparation). Results 3906 houses (79% of all houses funded by IHANT) were surveyed. Infrastructure components most frequently identified as not functional or not present were those required for the storage and preparation of food (62% not functional). The facilities required for personal hygiene and safe removal of human waste were not functional in 45%–46% of houses. Conclusions These findings highlight the significance of absent or non‐functioning household infrastructure as a potential contributory factor in the poor nutritional status and high rates of respiratory, skin and gastrointestinal infections in Indigenous communities. The environmental health and housing survey in the NT is an important tool for monitoring progress on addressing a key underlying determinant of the health of Indigenous people, and potentially for facilitating research aimed at gaining an improved understanding of the relationship of the household environment to health in Indigenous communities.

Clinical Associations of Human T-Lymphotropic Virus Type 1 Infection in an Indigenous Australian Population

“…In a setting of overcrowded housing, inadequate health hardware and poor community hygiene [45], [46], HTLV-1 infection substantially increases respiratory and infection-related morbidity. Socially disadvantaged HTLV-1 carriers in our Indigenous Australian cohort experienced more BSI episodes and were more often admitted with respiratory conditions including LRTI and bronchiectasis, which was the major independent risk factor for death.…”

Non-communicable diseases, infection and survival in a retrospective cohort of Indigenous and non-Indigenous adults in central Australia

“…In some Indigenous Australian communities, the average number of people living per house is 1739 and non-functioning health hardware leads to environmental conditions that are detrimental to householders 21. Overcrowded housing40 and an inability to maintain adequate skin hygiene21 contribute to high rates of pyoderma. More than 40% of Indigenous patients in the present study were previously admitted with skin infections, which are the most common primary focus for S aureus bacteraemia in this population 41.…”

“…Similarly, the transmission of respiratory pathogens is promoted by household crowding43 and nearly 40% of Indigenous adults were admitted previously with pneumonia. Environmental contamination,24 inadequate sanitation and unhygienic food preparation areas21 contribute to infection with enteric pathogens and S stercoralis . The risks of complicated strongyloidiasis, crusted scabies44 and bronchiectasis13 are further increased by HTLV-1 infection; however, no attempt has been made to control transmission of this virus among Indigenous Australians.…”

“…Living conditions that increase the risk of pathogen exposure21 and high background rates of focal infections, which provide portals of entry for bacterial invasion, are likely to precede these life-threatening infections. BSI incidence rates therefore provide measurable endpoints to which environmental and host factors contribute.…”

Impact of housing improvement and the socio-physical environment on the mental health of children’s carers: a cohort study in Australian Aboriginal communities

“…Houses in remote communities range from modern design through to bricks and mortar, tin sheds and makeshift shelters. Houses are generally publicly owned and at the time of data collection (2003–2005) houses were frequently poorly maintained [22]. …”