Scope of this review and nature of evidence base
This review primarily explores the links between housing quality and health outcomes, the mechanisms by which housing influences health outcomes, and a range of practices that can improve the condition of Indigenous housing. Due to the limited size of this paper, it was not possible to conduct an extensive review of the effects of other housing issues such as housing affordability and security of tenure on health. Nonetheless, these are important issues and some limited reference has been made where relevant.
Issues relating to home ownership and its impacts upon health have been excluded, as this is a large, complex and contentious area which cannot be adequately covered in a paper of this size. Over recent years, a number of programs have attempted to increase home ownership rates among Indigenous Australians, with some improvements. The 2011 Census indicates:
• 59% of Aboriginal and Torres Strait Islander households were renting, down from 60% in the 2006 Census
• 25% of Aboriginal and Torres Strait Islander households owned their home with a mortgage, up from 23% in 2006.
Despite these modest improvements, there remains a range of barriers to effective Indigenous home ownership programs. Due to the large range of challenges, and its complex relation to health outcomes, it will not be discussed further in the current paper.
This resource sheet draws on evidence from over 60 studies, including 7 epidemiological surveys, 3 cohort studies, 4 program evaluations, 18 systematic literature reviews and a range of qualitative case studies and program descriptions. Of these 60 studies, 43 were Australian and 40 were Indigenous-specific.
About 40 per cent focused on remote settlements, with additional studies exploring the links between Indigenous housing and health outcomes in urban areas. Therefore this study will focus primarily on remote regions, with urban-specific housing issues raised wherever appropriate.