At the 2024 National Aboriginal and Torres Strait Islander Environmental Health Conference, Pilbara presenters posed a simple question: What if Environmental Health intervention began during pregnancy, rather than waiting for disease to occur? The concept emerged from regional Environmental Health referral and Healthy Home Assessment data, which highlighted the ongoing impact of housing and environmental conditions on preventable illness across Pilbara communities. While Clinical Environmental Health referrals traditionally occur following diagnosis of environmentally attributable disease, conference delegates were challenged to consider whether pregnancy could become a trigger for proactive Environmental Health action. Two years later, that concept has become reality.
The Pilbara Aboriginal Health Alliance, in partnership with Pilbara Aboriginal Community Controlled Health Services, Aboriginal Environmental Health Practitioners and the Department of Housing, implemented the Maternal Environmental Health Referral Pilot Program. The initiative embeds Aboriginal Environmental Health into routine maternal and infant care during the first 1,000 days of life, recognising that healthy pregnancies begin with healthy homes. Maternal and child health clinical teams work alongside Aboriginal Environmental Health Practitioners and Department of Housing to undertake culturally safe Healthy Home Assessments and provide strengths-based support to families. Importantly, the pilot has strengthened what partners have termed the "golden triangle" of Health, Housing and Environmental Health". Issues identified through home visits are no longer managed in isolation instead providers work together to coordinate responses to pest activity, non-functional health hardware and other environmental determinants affecting maternal and infant wellbeing.
The pilot has demonstrated that pregnancy provides a unique and culturally appropriate opportunity to engage families before preventable illness develops and challenges traditional Environmental Health referral models that rely on illness as the entry point for intervention.
The model also demonstrates the value of formal partnerships between Health, Environmental Health and Housing systems, creating a coordinated response that addresses the environmental determinants of health alongside clinical care.
This presentation returns to NATSIEH with the next chapter of a story first shared in 2024.
By bringing together Housing, Health and Environmental Health to support mums and bubs, the initiative is creating healthier homes, healthier families and healthier futures across the Pilbara.