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4704.0 - The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples, 2008  
Previous ISSUE Released at 11:30 AM (CANBERRA TIME) 29/04/2008   
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Contents >> Housing Circumstances >> HOUSING AND HEALTH

HOUSING AND HEALTH

Housing is a key social determinant of health and is often considered to be a proxy indicator of socioeconomic status as well as of health and wellbeing (Shaw 2004). In Britain, housing tenure has been found to be related to health outcomes such as self-assessed health, hospital admissions and mortality; with home owners having better outcomes than renters.

Housing can impact on health in both direct and indirect ways (Shaw 2004). Overcrowding, poor dwelling conditions and inadequate basic utilities such as facilities for washing clothes, sewerage systems or safe drinking water, can directly impact on both physical and mental health. Indirect effects include the area or neighbourhood in which housing is located, proximity to services and facilities, and the broader community functioning (Shaw 2004; Bailie 2007).

Health problems related to inadequate housing and infrastructure in remote areas of Australia include infectious diseases such as skin infections and infestations, respiratory infections, eye and ear infections, diarrhoeal diseases and rheumatic fever (Menzies School of Health Research 2000). These diseases have the greatest impact on Indigenous children and are directly related to factors such as inadequate water supplies, sanitation and overcrowding (Bailie 2007).

Information on the status of housing and infrastructure in discrete Indigenous communities (including access to essential services) is presented later in this chapter. Data are from the 2006 Community Housing and Infrastructure Needs Survey (CHINS).


Overcrowding

Overcrowding can put stress on bathroom, kitchen and laundry facilities as well as on sewerage systems such as septic tanks. It can lead to the spread of infectious diseases such as meningococcal, tuberculosis, rheumatic fever, respiratory diseases and skin infections (Howden-Chapman & Wilson 2000). It has also been associated with poorer self-reported physical and mental health and higher rates of smoking and hazardous drinking (Waters 2001; Shaw 2004).
4.10 WAACHS - POOR QUALITY HOUSING

The 2001-02 Western Australian Aboriginal Child Health Survey (WAACHS) collected a range of data about the housing characteristics of families with Aboriginal children and examined their relationship to life stresses, family functioning and community characteristics (Silburn et al 2006). Using criteria based on number of bedrooms and number of people in the household, the WAACHS researchers classified 15% of dwellings with Aboriginal children as overcrowded. This result is similar to that for WA using the Canadian National Occupancy Standard and 2006 Census data (see table 4.12).

In the 2001-02 WAACHS, overcrowding was independently associated with poor housing quality, higher levels of life stresses, overuse of alcohol (causing problems in the household) and a higher number of neighbourhood problems. An earlier report from the survey, however, found that overcrowding had some positive effects. Children living in households with a high household occupancy level were half as likely to be at risk of clinically significant emotional or behavioural difficulties as children living in homes with a low household occupancy level. Source:Zubrick et al 2005.

Data on overcrowding at the national level come from ABS surveys and the Census. Various measures can be used to define and measure the extent of overcrowding. The Canadian National Occupancy Standard for housing appropriateness is an internationally accepted measure of housing utilisation. Households that require one additional bedroom to meet the standard are considered to experience 'a moderate degree of overcrowding', whereas households requiring two or more bedrooms are said to experience a 'high degree of overcrowding'. The Canadian model is sensitive to both household size and composition and uses the following criteria to assess bedroom requirements:

  • there should be no more than two people per bedroom;
  • a household of one unattached individual may reasonably occupy a bed-sit (i.e. have no bedroom);
  • couples and parents should have a separate bedroom;
  • children less than five years of age, of different sexes, may reasonably share a bedroom;
  • children five years of age or over, of the opposite sex, should not share a bedroom;
  • children less than 18 years of age and of the same sex may reasonably share a bedroom; and
  • single household members aged 18 years or over should have a separate bedroom.

In the 2006 Census, information on the number of bedrooms (in dwellings) was obtained for 151,900 Indigenous households (91% of all Indigenous households). Some 376,600 Indigenous people were living in these dwellings. The following overcrowding rates are based on these dwellings (and their Indigenous residents), i.e. those for whom housing utilisation could be determined.

Using the Canadian housing utilisation measure, there were around 20,700 overcrowded Indigenous households (14%) and 102,400 Indigenous people (27%) living in overcrowded conditions in 2006. There has been some improvement in rates of overcrowding, with the proportion of Indigenous households that were overcrowded decreasing from 16% in 2001 to 14% in 2006 (table 4.11).

Overcrowding rates varied according to tenure, with the highest rates of overcrowding found in Indigenous households renting Indigenous/mainstream community housing (40% of Indigenous households and 64% of Indigenous people). In contrast, home owners (with or without a mortgage) had the lowest rates of overcrowding (7% of Indigenous households and 11% of Indigenous people).

4.11 OVERCROWDED INDIGENOUS HOUSEHOLDS AND PERSONS LIVING IN OVERCROWDED CONDITIONS(a)(b), by tenure type - 2001 and 2006

Households 2001
Households 2006
Persons 2006
no.
%
no.
%
no.
%

Home owner/purchaser
3 310
7.7
3 687
6.9
12 528
11.4
Private and other renter
6 077
13.5
5 570
11.6
19 167
18.6
Renter state/territory housing authority
4 546
16.3
4 970
15.9
24 371
28.1
Renter Indigenous/mainstream community housing
6 572
42.9
5 567
39.9
43 853
63.6
Total
21 258
15.7
20 734
13.6
102 364
27.2

(a) Excludes dwellings for which the number of bedrooms was not stated.
(b) Excludes visitors.
Source: 2001 and 2006 Censuses of Population and Housing


State or territory

Overcrowding rates also varied by jurisdiction, reflecting the type of housing options available to Indigenous people in different parts of Australia. In 2006, Queensland had the largest number of overcrowded Indigenous households (6,200) followed by New South Wales (5,200). The highest rates of overcrowding among Indigenous households were in the Northern Territory (38%) followed by Western Australia (16%). Rates of overcrowding were especially high in the Indigenous/mainstream community housing sector in the Northern Territory, where 61% of households were overcrowded.

4.12 OVERCROWDED INDIGENOUS HOUSEHOLDS(a), by tenure type and state/territory - 2006

NSW
Vic.
Qld
WA
SA
Tas.
ACT
NT
Australia

Number of crowded households

Home owner/purchaser
1 301
318
1 081
366
194
187
22
218
3 687
Private and other renter(b)
1 977
423
2 088
413
210
177
21
258
5 570
Renter state/territory housing authority
1 309
323
1 511
894
390
133
44
366
4 970
Renter Indigenous/mainstream community housing
475
50
1 253
811
223
6
3
2 743
5 567
Other
135
40
246
109
31
22
3
163
752
Total(c)
5 246
1 170
6 232
2 615
1 064
530
93
3 775
20 734

Overcrowded households as a proportion of all Indigenous households

Home owner/purchaser
6.7
6.0
7.9
7.2
6.1
4.8
3.1
11.6
6.9
Private and other renter(b)
11.3
10.1
13.0
9.8
9.3
9.2
4.5
17.5
11.6
Renter state/territory housing authority
11.5
12.3
21.5
20.5
14.5
10.7
9.6
24.9
15.9
Renter Indigenous/mainstream community housing
18.0
15.6
33.0
41.7
36.9
8.7
8.8
60.8
39.9
Other
11.2
11.4
13.5
19.4
14.6
11.4
13.0
39.9
18.1
Total(c)
10.0
9.0
14.8
16.0
11.8
7.2
5.5
38.5
13.6

(a) Excludes dwellings for which the number of bedrooms was not stated.
(b) Includes landlord type not stated.
(c) Includes tenure type not stated.
Source: ABS 2006 Census of Population and Housing



Housing quality

The most recent national survey to include measures of housing quality was the 2002 National Aboriginal and Torres Strait Islander Social Survey (NATSISS). According to the survey, around one-third (35%) of Indigenous households were living in dwellings that had structural problems (e.g. rising damp, major cracks in floors or walls, major electrical/plumbing problems and roof defects). Just over half (55%) of Indigenous households renting mainstream or community housing reported that their dwellings had structural problems, while the corresponding proportions for renters of state/territory housing, private and other renters, and home owners were 42%, 33% and 22% respectively (ABS & AIHW 2005). In 2006, the ABS Community Housing and Infrastructure Needs Survey (CHINS) also collected information about the state of repair of houses in discrete Indigenous communities, and their connection to essential services. Selected data from the survey are presented in tables 4.13 and 4.14.

The WAACHS developed a measure of housing quality based on the healthy living practices outlined in the National Framework for Indigenous Housing. The survey classified 16% of dwellings with Aboriginal children as being of 'poor housing quality'. Dwellings with poor housing quality were more likely to be rented, and to be located in areas of extreme isolation and areas of relative socioeconomic disadvantage. Households living in poor quality dwellings had poorer economic wellbeing, lower levels of family functioning, experienced more life stresses and were more likely to overuse alcohol (Silburn et al 2006).

Discrete Indigenous communities

The 2006 CHINS provides more detailed information on the housing quality of dwellings in discrete Indigenous communities (ABS 2007). Discrete Indigenous communities are those inhabited predominantly by Aboriginal and Torres Strait Islander people, with housing or infrastructure that is managed on a community basis. These communities have an estimated population of 92,960 people and are primarily located in remote and very remote areas of Australia (ABS 2007d).

Dwelling condition

The CHINS data on dwelling condition were collected for permanent dwellings and categorised according to the cost of repairs required to the dwelling. No data were collected on the 1,596 temporary or improvised dwellings in these communities which are likely to have been in the poorest condition. Some 4,039 Indigenous people (4% of the usual resident population) were living in temporary or improvised dwellings in 2006.

In discrete Indigenous communities across Australia, there were around 6,674 dwellings (31%) that required major repair or replacement (table 4.13). Dwellings in remote and very remote areas tended to be in the poorest condition, with 9% requiring replacement compared with 4% of dwellings in non-remote areas.

4.13 CONDITION OF PERMANENT DWELLINGS IN DISCRETE INDIGENOUS COMMUNITIES, by remoteness - 2006

Dwelling condition
Non-remote
Remote
Very remote
Total

Number

Minor or no repair
5 015
1 560
8 605
15 180
Major repair
1 718
634
2 759
5 111
Replacement
273
247
1 043
1 563
Total
7 006
2 441
12 407
21 854

Percent

Minor or no repair
71.6
63.9
69.4
69.5
Major repair
24.5
26.0
22.2
23.4
Replacement
3.9
10.1
8.4
7.2
Total
100.0
100.0
100.0
100.0

Source: ABS 2006 CHINS


Connection to services

The 2006 CHINS collected data on main source of water, sewerage and electricity at the community level for all discrete Indigenous communities. While the data show services available to communities and the number of permanent dwellings located in these communities, some of these dwellings may not have had access to a service that was available at the community level. In addition there are improvised dwellings in these communities for which data were not collected.

The main source of drinking water for the majority of permanent dwellings (8,078 or 53%) was bore water. There were another 4,685 dwellings (30%) in communities connected to a town supply and 1,682 (11%) in communities where the main source of water was a river or reservoir. In addition there were 201 permanent dwellings in communities where the main source of water was a well or spring and 10 permanent dwellings in communities that had no organised water supply (table 4.14).

In relation to sewerage, 5,725 permanent dwellings (33%) were in communities with some type of septic system. The next most common type of sewerage system was a town system (5,229 or 30% of dwellings) followed by community water-borne systems (5,162 or 30% of dwellings). There were also 51 permanent dwellings in communities with no organised sewerage supply (table 4.14).

The main type of electricity supply for the majority of permanent dwellings (9,161 or 53%) was community generators. There were also 6,323 dwellings (37%) in communities connected to the state grid and 447 (3%) in communities with domestic generators as their main source of electricity. In addition, there were 85 permanent dwellings in communities with no organised electricity supply (table 4.14).

4.14 TYPES OF CONNECTION TO WATER, SEWERAGE AND ELECTRICITY IN DISCRETE INDIGENOUS COMMUNITIES - 2006

All communities
Number of permanent dwellings(a)
Proportion of dwellings
no.
no.
%

Main source of drinking water
Connected to town supply
209
4 685
27.3
Bore water
694
8 078
47.0
Rain water tank
41
525
3.1
River or reservoir
57
1 682
9.8
Well or spring
39
201
1.2
Carted water
27
105
0.6
Other organised supply
3
33
0.2
No organised supply
9
10
0.1
Type of sewerage system(b)
Connected to town system
121
5 229
30.4
Community water-borne system
108
5 162
30.1
Septic tanks with common effluent disposal
101
2 194
12.8
Septic tank with leach drain
593
3 531
20.6
Pit toilets
202
587
3.4
Pan toilets
1
3
-
Other organised sewerage system
9
6
-
No organised sewerage system
25
51
0.3
Main type of electricity supply
State grid transmitted supply
274
6 323
36.8
Community generators
377
9 161
53.3
Domestic generators
178
447
2.6
Solar
105
304
1.8
Solar hybrid
107
395
2.3
Other organised electricity supply
8
214
1.2
No organised electricity supply
32
85
0.5
Total
1 187
17 177
. .

. . not applicable
- nil or rounded to zero (including null cells)
(a) Data are collected at the community level and some permanent dwellings may not be connected to the type of service reported at the community level.
(b) More than one type of sewerage system could be specified.
Source: ABS 2006 CHINS


Between the 2001 and 2006 CHINS' there was a decrease in the number and proportion of permanent dwellings not connected to an organised sewerage system (table 4.15). Over this period, the number of dwellings in communities not connected to an organised sewerage system fell from 153 to 51. There was also a small decrease in the number of dwellings in communities not connected to an organised water supply (from 13 to 10) and a small increase in the number of permanent dwellings in communities not connected to an organised supply of electricity (from 80 to 85).

4.15 PERMANENT DWELLINGS IN DISCRETE INDIGENOUS COMMUNITIES, not connected to an organised supply of water, sewerage and/or electricity - 2001 and 2006

2001
2006
Number of dwellings in communities with no organised supply
Total number of permanent dwellings
Number of dwellings in communities with no organised supply
Total number of permanent dwellings

Water
13
16 966
10
17 177
Sewerage
153
16 966
51
17 177
Electricity
80
16 966
85
17 177

Source: ABS 2001 and 2006 CHINS






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