Oral Presentation National Aboriginal and Torres Strait Islander Environmental Health Conference

Developing a primary care-based index for monitoring housing-associated infectious diseases in Australia (142839)

Rosemary Wyber 1 2 , Kate Summer 1 , Ingrid Stacey 3 4 , Rachel Burgess 1 , Samantha Stiles 3 , Carl Francia 5 , Kezia Bates 1 , Asha Bowen 1 , Judy Katzenellenbogen 3
  1. The Kids Research Institute Australia, Perth , WA, Australia
  2. Yardhura Walani, Australian National University, Acton, ACT, Australia
  3. Cardiovascular Epidemiology Research Centre, University of Western Australia, Perth, WA, Australia
  4. Cardiology Population Health Laboratory, Victor Chang Cardiac Research Institute, Sydney, NSW, Australia
  5. Poche Centre for Indigenous Health, University of Queensland, Brisbane, QLD, Australia

Background: Adequate housing is foundational for enabling Healthy Living Practices (HLPs), such as washing clothes and skin, managing wastewater, and preparing food safely. The quality and quantity of housing for Aboriginal and Torres Strait Islander families is often inadequate, especially in remote communities. It is well-known that housing inequity and reduced access to HLPs are associated with poor health and wellbeing outcomes. However, there is a lack of consensus on the health outcomes most strongly associated with housing. This makes it hard to understand and demonstrate the impacts of inadequate housing or the impact of housing and environmental health improvement initiatives.

We have been working to explore how clinics and communities could use routinely collected primary care data to help tell the story about housing and health.

Governance: Our team comprises Indigenous and non-Indigenous researchers and clinicians. This project was developed in response to priorities established by leading Aboriginal and Torres Strait Islander organisations, including Closing the Gap Priority Reforms. It forms part of a larger NHMRC-funded program of work focused on environmental health (STARFISH), the hallmark of which is leadership by an Indigenous Governance Council (IGC). Ongoing review and input from the STARFISH IGC continue to guide the direction of this project. Development of a housing-associated infectious disease index requires research but ultimately should exist outside of the research context: our vision is for a tool that is held by community-controlled health services and operationalises Indigenous Data Sovereignty Principles.

Research: This presentation outlines the work we have been doing to explore the possibilities for a housing-associated infectious disease index including:

  • The rationale and potential use cases for a housing-associated infectious disease index [1].
  • Systematic review of infectious disease outcomes associated with different HLPs, demonstrating the current variation in approaches to measurement [2].
  • Key knowledge holder interviews with 20 stakeholders to understand priorities and potential approaches (AIATSIS REC-0489).
  • Exploring partnerships with community-controlled health service to inform co-creation of a useful tool.
  • Exploring other agreed lists of conditions and approaches for composite measurement in Australia and internationally.

Results and next steps: The concept of a housing-associated infectious disease index is broadly supported, but there are a range of technical considerations. Refining a core list of housing-associated infectious disease outcomes could support environmental health monitoring and evaluation activities for services. The index may enable community-controlled health services to identify and communicate priorities and successes, while reducing the burden of research. Further validation work and development for scale up is needed.

  1. Wyber R, Summer K, Stacey I, Stiles S, Katzenellenbogen J, Bowen A, & Burgess R. (2025). The need for community-controlled tools to monitor health impacts of housing and living conditions in Australia. Frontiers in Public Health, 13, https://doi.org/10.3389/fpubh.2025.1509550
  2. Summer K, Anpalagan K, Stacey I, Stiles S, Burgess R, Wade V, Bowen A, Katzenellenbogen J, & Wyber R. (2026). Infectious disease outcomes associated with inadequate housing and access to healthy living practices in Australia: a systematic review. BMJ Public Health, 4: e003531.