Bailie R.S.McDonald E.L.Stevens M.Guthridge S.Brewster D.R.2024-11-192024-11-1920112011-08-30Journal of Epidemiology and Community Health. Vol.65(5), 2011, pp. 432-437.https://dx.doi.org/10.1136/jech.2009.091637https://lowitja.intersearch.com.au/handle/1/590Background 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. Method(s): 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. Result(s): 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 (KruskaleWallis test, chi2=3.9, p=0.047); and (3) no clear overall improvement in hygiene (KruskaleWallis test, chi2=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.ArticleSocial determinants of health(Bailie, McDonald, Stevens) Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin Universit, Darwin, NT, Australia(Guthridge) Health Gains Planning Division, Northern Territory Government, Department of Health and Families, Darwin, NT, Australia(Brewster) James Cook University, School of Medicine, Cairns, QLD, Australia20466712 [https://www.ncbi.nlm.nih.gov/pubmed/?term=20466712]