This study investigated the interconnections between housing, community infrastructure and quality of life for Indigenous people living with disability. It incorporated three case studies from Yalata and Point Pearce in South Australia and Greater Geelong in Victoria that revealed poor health and disability are major issues facing the Indigenous populations in these areas. The research highlights the need for specialist facilities for Indigenous people with disability designed and built in consultation with the local community and stakeholders, and that the NDIS understand and account for the challenges facing Indigenous people with disability.
To provide a backdrop for the study, the prevalence of disability at the three case study locations was investigated. This found that poor health and disability are major issues facing the Indigenous populations in these areas. Moreover, government data has not accurately captured the prevalence of impairment and disability in the Aboriginal population, nor the level of need for assistance. It also does not capture the complexity of disabling impairments or health conditions. Co-morbidities are common among the Indigenous populations studied. The study found that people were often hesitant to access disability services outside their family networks, as this tended to result in interference in their life and a loss of personal control.
There were contrasts observed in the living circumstances of Indigenous people with disability in the remote, rural and urban locations. In remote Yalata, housing was in high demand and difficult to access. It was often of substandard condition, overcrowded and 2 poorly maintained. In the urban setting (Geelong) we also found that people with disability had difficulty accessing housing, and when they did the housing was often substandard, inappropriate or unsuitable due to a lack of repairs and maintenance or suitable modifications. In Point Pearce, the rural setting, housing was much easier to access, and due to a renovation program coincidentally occurring during the research period, the housing was of reasonable quality.
The research highlights the interconnections between housing, community infrastructure and quality of life. We encountered people separated from their family and country as a result of their disability; people who lacked basic amenities such as a place to cook or sleep; people who were trapped in their houses because of the failure of an agency to complete simple house modifications or make residents aware of the range and types of modifications available and the process for accessing them; and people whose housing circumstances did not, and could not, meet their health or disability needs. Other people were homeless and cycled through a series of different (and often dangerous) living circumstances due to the nature of their disability, including psychosocial conditions. People with certain disabilities fared very poorly in all locations. In particular, people with cognitive and/or psychosocial disability had great difficulties accessing safe and appropriate housing, with impacts on the wellbeing at the individual, family and community levels (see Wright, Zeeman et al. 2016 and Zeeman, Whitty et al. 2016 for a useful recent general discussion around these issues).
At the remote location we found that Indigenous people with disability often had to move to access housing, health services or supported living arrangements. When people were required to move, they were greatly affected by their dislocation. Communities wanted to keep people with disability living within the community whenever they could. People with disability in Yalata saw family as responsible for their care. Remarkably, at the rural location, we found that some people with disability had moved back to the community to access housing and health services. The rural community had become a place of refuge. In the urban setting, there were indications that people had access to a full range of requisite services however discussions with study participants in Geelong found that some were faring very poorly in terms of accessing housing appropriate to their physical, social and cultural needs.
The rollout of the NDIS is a timely moment to examine the housing outcomes of Indigenous people with disability. Implementation of the scheme provides opportunity to illuminate the housing and living conditions of Indigenous people with disability, many of whom live in challenging circumstances. Given the importance of appropriate housing for the health outcomes and wellbeing of Indigenous people with disability, future NDIS rollouts should involve the assessment of the housing and living environments of eligible participants during the NDIS assessment and service delivery phases.
The challenges facing Indigenous people with disability in terms of housing and community infrastructure, particularly those elements that are design-related, will not lessen without these higher-level policy recommendations being formally adopted and enforced by the relevant stakeholders (including governments, government agencies, the housing industry and Indigenous communities) and through the appropriate frameworks and channels, including in legislation.