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Evaluation of an Australian indigenous housing programme: community level impact on crowding, infrastructure function and hygiene
  1. Ross S Bailie1,
  2. Elizabeth L McDonald1,
  3. Matthew Stevens1,
  4. Steven Guthridge2,
  5. David R Brewster3
  1. 1Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, Northern Territory, Australia
  2. 2Health Gains Planning Division, Northern Territory Government Department of Health and Families, Darwin, Northern Territory, Australia
  3. 3James Cook University, School of Medicine, Cairns, Queensland, Australia
  1. Correspondence to Ross S Bailie, Post Office Box 41096, Casuarina, North Territory 0811, Australia; ross.bailie{at}


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, χ2=3.9, p=0.047); and (3) no clear overall improvement in hygiene (Kruskal–Wallis test, χ2=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.

  • Housing
  • Indigenous health
  • crowding
  • hygiene
  • child
  • housing infrastructure
  • health policy
  • ecological approach
  • aboriginal populations
  • environmental health
  • policy development
  • public health FQ

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  • Funding National Health and Medical Research Council, Canberra, Australia. Cooperative Research Centre for Aboriginal Health, Darwin, Australia.

  • Competing interests None.

  • Ethics approval Ethics approval for the study was obtained from the Human Research Ethics Committees in the Top End and Central Australia of the Northern Territory. Informed written consent was obtained from everyone who participated in the study.

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