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The impact of housing improvement and socio-environmental factors on common childhood illnesses: a cohort study in Indigenous Australian communities
  1. Ross S Bailie,
  2. Matthew Stevens,
  3. Elizabeth L McDonald
  1. Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, Northern Territory, Australia
  1. Correspondence to Professor Ross S Bailie, Post Office Box 41096, Casuarina, Darwin, Northern Territory 0811, Australia; ross.bailie{at}


Background Improvements in health are an important expected outcome of many housing infrastructure programs. The authors aimed to determine if improvement in the notoriously poor housing infrastructure in Australian Indigenous communities results in reduction in common childhood illness and to identify important mediating factors in this relationship.

Methods The authors conducted a prospective cohort study of 418 children aged 7 years or younger in 10 Australian Indigenous communities, which benefited most substantially from government-funded housing programs over 2004–2005. Data on functional and hygienic state of houses, reports of common childhood illness and on socio-economic conditions were collected through inspection of household infrastructure and interviews with children's carers and householders.

Results After adjustment for a range of potential confounding variables, the analysis showed no consistent reduction in carers' reporting of common childhood illnesses in association with improvements in household infrastructure, either for specific illnesses or for these illnesses in general. While there was strong association between improvement in household infrastructure and improvement of hygienic condition of the house, there were only marginal improvements in crowding.

Conclusions High levels of household crowding and poor social, economic and environmental conditions in many Australian Indigenous communities appear to place major constraints on the potential for building programs to impact on the occurrence of common childhood illness. These findings reinforce the need for building programs to be supported by a range of social, behavioural and community-wide environmental interventions in order for the potential health gains of improved housing to be more fully realised.

  • Housing
  • Indigenous health
  • crowding
  • hygiene
  • child
  • housing infrastructure
  • health policy
  • Aboriginal populations
  • child health
  • housing and health
  • policy development

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  • Funding National Health and Medical Research Council (NHMRC) Project grant number 236205. The Co-operative Research Centre for Aboriginal Health (CRCAH). RSB's work in this area is supported by a National Health and Medical Research Centre Senior Research Fellowship number 283303. ELM is supported by a National Health and Medical Research Centre—Aboriginal and Torres Strait Islander Training Fellowship.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the Human Research Ethics Committees in the Top End and Central regions of the Northern Territory, Australia.

  • Provenance and peer review Not commissioned; externally peer reviewed.