Summary

What we know

  • Housing is a key social determinant of health.
  • The relationship between housing outcomes and health outcomes is bi-directional: housing affects health outcomes, and health affects housing outcomes.
  • There are clear links between the quality and location of housing and health outcomes.
  • The impacts of housing on health vary between geographic and climatic locations and contexts.
  • There is a wide range of housing interventions that positively impact Indigenous health. One way of categorising these is: infrastructure improvements; addressing behavioural factors; and adjustments to policy environments.

What works

  • Addressing infrastructure, health promotion and the policy environment simultaneously.
  • Effective policy environments that administer and enforce appropriate housing standards and design guidelines, while allowing sufficient flexibility to tailor designs and materials to local conditions.
  • Indigenous environmental health workers are vital for ongoing housing maintenance and the promotion of healthy living practices.
  • High-quality, well-maintained health hardware such as taps, toilets, showers and sinks, coupled with attention to safety of a house, can make a major positive impact on Indigenous health for any age group.
  • Improving indoor temperature regulation, as well as preventing damp, mould and fungi, reduces respiratory and skin diseases.
  • Involving communities in the design, construction and maintenance of housing empowers them and builds capacity for improved housing-related health outcomes.

What doesn’t work

  • Imposing housing and health promotion programs or housing design that is inappropriate for the physical, climatic and social context.
  • Using low-quality materials and construction to generate initial cost savings increases the costs of maintenance and housing replacement in the longer term.

What we don’t know

  • Although some very clear associations between housing and health are evident, it is very difficult to demonstrate a causal relationship between the two.

The Closing the Gap Clearinghouse has published a resource sheet on housing construction and maintenance (Pholeros & Phibbs 2012). This resource sheet is intended to complement it by examining how the quality of housing impacts health outcomes, and by taking a broader view of housing including its location and social environment. It is recommended that the two resource sheets be read alongside one another.