Evaluation of an Australian indigenous housing programme: community level impact on crowding, infrastructure function and hygiene. Issue 5 (12th May 2010)

• Record Type: Journal Article
• Authors: Bailie, Ross S; McDonald, Elizabeth L; Stevens, Matthew; Guthridge, Steven; Brewster, David R
• Is Part Of: Journal of epidemiology and community health. Volume 65:Issue 5(2011)
• Page Start: 432
• Page End: 437
• Publication Date: 2010-05-12
• Subjects: Housing -- Indigenous health -- crowding -- hygiene -- child -- housing infrastructure -- health policy -- ecological approach -- aboriginal populations -- environmental health -- policy development -- public health FQ; Public health -- Periodicals; Epidemiology -- Periodicals; 614.4
• DOI: 10.1136/jech.2009.091637
• Languages: English
• ISSNs: 0143-005X

Abstract

Abstract : Background and Aim: Housing programmes in indigenous Australian communities have focused largely on achieving good standards of infrastructure function. The impact of this approach was assessed on three potentially important housing-related influences on child health at the community level: (1) crowding, (2) the functional state of the house infrastructure and (3) the hygienic condition of the houses. Methods: A before-and-after study, including house infrastructure surveys and structured interviews with the main householder, was conducted in all homes of young children in 10 remote Australian indigenous communities. Results: Compared with baseline, follow-up surveys showed (1) a small non-significant decrease in the mean number of people per bedroom in the house on the night before the survey (3.4, 95% CI 3.1 to 3.6 at baseline vs 3.2, 95% CI 2.9 to 3.4 at follow-up; natural logarithm transformed t test, t=1.3, p=0.102); (2) a marginally significant overall improvement in infrastructure function scores (Kruskal–Wallis test, χ 2 =3.9, p=0.047); and (3) no clear overall improvement in hygiene (Kruskal–Wallis test, χ 2 =0.3, p=0.605). Conclusion: Housing programmes of this scale that focus on the provision of infrastructure alone appear unlikely to lead to more hygienic general living environments, at least in this study context. A broader ecological approach to housing programmes delivered in these communities is needed if potential health benefits are to be maximised. This ecological approach would require a balanced programme of improving access to health hardware, hygiene promotion and creating a broader enabling environment in communities.