Better health and ageing for all Australians

Aboriginal and Torres Strait Islander Health Performance Framework - 2010

2.01 Access to functional housing with utilities

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Why is it important?:

Research on housing and health shows a relationship between inadequate housing and related infrastructure, and poor health outcomes (Atkinson et al. 2007). For Aboriginal and Torres Strait Islander peoples, lack of access to clean water, adequate sanitation and reliable electricity services is associated with higher rates of infectious diseases (ABS & AIHW 2008).

The right to water ‘entitles everyone to sufficient, safe, acceptable, physically accessible and affordable water for personal and domestic uses. An adequate amount of safe water is necessary to prevent death from dehydration, to reduce the risk of water-related disease and to provide for consumption, cooking, personal and domestic hygienic requirements’ (WHO 2010). Internationally, poor water supply, sanitation and personal and domestic hygiene were estimated to account for 7 per cent of the total burden of disease measured in the Global Burden of Disease Study (Vos et al. 2007). These determinants of health outcomes were second only to malnutrition as a major risk factor category. An adequate and reliable supply of water is required for washing people, food, kitchen utensils, and clothes.

A functional sewerage system prevents sewerage from contaminating drinking water, and reduces the risks of infectious diseases. Waste water in the living environment can be a source of infection for diseases such as diarrhoea and hepatitis (WHO 2010).

A power supply such as electricity/gas contributes to health through improved nutrition by ensuring food is safely stored through refrigeration, prepared and cooked appropriately. Avoiding less safe forms of fuel for cooking and heating may improve indoor air quality and decrease the risk of harm from fire.

Aboriginal and Torres Strait Islander peoples in remote and very remote areas are more likely to live in conditions considered to be unacceptable by general Australian standards. Problems can include overcrowding, poorly maintained buildings, high housing costs relative to income and a lack of basic environmental health in­frastructure, such as adequate sanitation, water supply and appropriate housing.

Findings:

In the 2006 Community Housing and Infrastructure Needs Survey (CHINS), 1,187 discrete Aboriginal and Torres Strait Islander communities were surveyed (ABS 2007b). These communities had a popula­tion of 92,960 people, representing 18% of the Indigenous population. Most of these communities were in remote areas. Just over half of these people (52%) relied on bore water as their main source of water supply. This proportion was down from 65% in 2001. Over the same period there was an increase in the proportion of the discrete communities’ population whose main source of drinking water was a connection to a town water supply, from 17% in 2001 to 30% in 2006. Very few communities (9 with a population of 20 people) reported they had no organised water supply.

More detailed analysis is available for 366 communities that were larger or were independently administered. Sixty-nine communities (19%), with a combined population of 21,291 usual residents, experienced 5 or more interruptions to water supply in the 12 months prior to survey. For 22% of the 366 communities surveyed, the duration of the longest water supply interruption was two days or more.

Of the 164 communities that were not connected to a town water supply and had their drinking water tested for levels of microbiological agents, drinking water failed water quality tests for 48 communities (24% of the reported usual population). Test results were not known for 16 communities (10%) that had their water tested. The proportion of communities whose water failed testing was lower than in 1999 (34%) and 2001 (33%).

There were 4,796 people in 45 discrete Indigenous communities, not connected to a town water supply, where drinking water was not sent away for testing in the 12 months prior to the 2006 survey.

Community generators supplied electricity for 377 Indigenous communities (32%). There was an increase since 2001 (from 21% to 23%) in the proportion of communities whose main source of electricity was the state grid or other transmitted supply. In 2006, 212 communities (18%) relied on solar or solar hybrid sources but this proportion was higher (24%) in smaller communities of fewer than 50 people. Thirty-two communities, all but one having a population of fewer than 50 persons, reported no organised electricity supply compared with 80 communities in 2001.

In 2006, interruptions to the electricity supply in the 12 months prior to the CHINS survey occurred in 246 communities (76% of the discrete Indigenous communities with a reported population of 50 or more). This was slightly lower than in 2001 and 1999 when interruptions were reported for 82% and 81% of these communities respectively. Approximately one-third (32%) of the larger communities experienced fewer than 5 electricity interruptions, while 12% had experienced 20 or more interruptions in the previous 12 months. In 2006, ap­proximately 26% of communities experienced interrup­tions to electricity supply lasting longer than 24 hours. This was higher than that reported in 2001 (13%) and 1999 (14%), with an increase evident across all remote­ness categories.

The number of discrete Indigenous communities connected to a town sewerage system increased from 89 in 2001 to 121 in 2006 (10% of communities). Septic tanks remained the most commonly used sewerage disposal system (694 or 58% of all communities). Approximately 22 discrete Indigenous communities did not have an organised sewerage system. A further 202 communities relied on pit toilets for their sewerage. The proportion of discrete Indigenous communities in very remote areas without an organised sewerage system dropped from 8% (86 communities) in 2001 to 2% (20 communities) in 2006.

In 2006, 142 discrete Indigenous communities (38%) reported sewerage system overflows or leakages in the previous 12 months. Of these 82 (22%) reported up to 4 overflows/leakages and 14 (4%) reported 20 or more overflows/leakages. These were most common in discrete Indigenous communities with septic tanks with leach drains as the main sewerage system. In 22% of communities the leakages or outflows had continued for longer than 48 hours.

In 2008, the National Aboriginal and Torres Strait Islander Social Survey found that approximately 99% of Indigenous households reported that they had working facilities for washing people, 94% reported working facilities for washing clothes/bedding (down from 98% in 2002), 94% reported working facilities for preparing food and 98% reported working sewerage systems. This varied considerably by remoteness with 21% of households in very remote communities reporting a lack of working facilities for the storage and preparation of food. This is important in considering intake of fresh fruit and vegetables (measure 2.23) by remoteness.

Implications:

Improved access to functional housing is associated with better health outcomes. An evaluation of the NSW Housing for Health Program found that ‘Those who received the Housing for Health intervention had a significantly reduced rate of hospital separations for infectious diseases—40% less than the hospital separation rate for the rest of the rural NSW Aboriginal population without the Housing for Health interventions’.

The National Partnership Agreement on Remote Indigenous Housing has been established as a ten-year funding strategy to address overcrowding, homelessness, poor housing condition and severe housing shortage in remote Indigenous communities. Over 10 years the agreement will deliver construction of up to 4,200 new houses to address overcrowding and homelessness and upgrades and repairs to around 4,800 existing houses through a program of major repairs and/or replacement. Funding is also provided for property and tenancy management arrangements, including a program of tenant support and ongoing repairs and maintenance.

Under the partnership, a municipal and essential services audit of 86 communities was completed in March 2010. The audit assessed levels of services and related infrastructure in remote Indigenous communities.

In addition, there are a number of complementary programs being delivered by the Commonwealth including:
  • The National Indigenous Infrastructure Guide, launched in February 2010, which consolidates codes and standards together with research for those involved in the design, installation, operation and maintenance of infrastructure in Indigenous communities. It covers water supply, storm water, waste­water, energy, waste management, telecommunications and transport, with an emphasis on community involvement.
  • The National Indigenous Housing Guide which assists in the design, construction and maintenance of housing for Aboriginal and Torres Strait Islander peoples, and focuses on Healthy Living Practices.
  • Fixing Houses for Better Health which provides funding for small-scale critical repairs and maintenance carried out in houses located predominantly in remote communities. Projects funded under the program survey and fix critical health hardware items such as hot water systems, taps, toilets, drains, showers and electrical fittings, and;
  • The Army Aboriginal Community Assistance Program, a grant program, designed to improve primary environmental health and living conditions in remote Indigenous communities. One project per year is undertaken targeting improvements in housing, essential services such as water, power and sewerage, other community infrastructure, health and municipal services, and education, training and employability initiatives.
There is a need to better coordinate all parties, including the range of government portfolios and jurisdictions with responsibility for health, housing, water and sewerage.

Table 38 – Main source of drinking water, discrete Indigenous communities, by state/territory, 2006

Communities
Communities
Population
NSW
Qld
WA
SA
NT
Australia
No.
%
No.
%
No.
%
No.
%
No.
%
No.
%
No.
%
Connected to town supply
51
89.5
11
8.9
43
15.9
19
20.9
84
13.1
209
17.6
28,084
30.2
Bore water
2
3.5
32
25.8
197
72.7
48
52.7
414
64.6
694
58.5
48,511
52.2
Rain water tank(s)
2
3.5
24
19.4
-
-
6
6.6
8
1.2
41
3.5
2,378
2.6
River/reservoir
2
3.5
24
19.4
5
1.8
3
3.3
22
3.4
57
4.8
11,667
12.6
Well or spring
-
-
21
16.9
2
0.7
1
1.1
15
2.3
39
3.3
887
1.0
Carted water
-
-
4
3.2
2
0.7
-
-
21
3.3
27
2.3
637
0.7
Other organised water supply
-
-
1
0.8
1
0.4
1
1.1
-
-
3
0.3
104
0.1
No organised water supply
-
-
-
-
1
0.4
1
1.1
7
1.1
9
0.8
20
0.02
Total
57
100
124
100
271
100
91
100
641
100
1,187
100
92,960
100
Source: ABS 2007b

Figure 67 – Proportion of discrete Indigenous communities, with reported usual population 50 or more, experiencing interruptions to electricity supply greater than 24 hours in the previous 12 months, by remoteness, 1999, 2001 & 2006


Figure 67 – Proportion of discrete Indigenous communities, with reported usual population 50 or more, experiencing interruptions to electricity supply greater than 24 hours in the previous 12 months, by remoteness, 1999, 2001 & 2006
Source: AIHW analysis of the 1999 and 2001 Community Housing and Infrastructure Needs Surveys; FaHCSIA and AIHW analysis of 2006 Community Housing and Infrastructure Needs Survey
Text description of figure 67 (TXT 1KB)

Figure 68 – Proportion of discrete Indigenous communities, with reported usual population 50 or more, experiencing 10 or more sewerage system overflows or leakages in previous 12 months, by remoteness, 1999, 2001 and 2006


Figure 68 – Proportion of discrete Indigenous communities, with reported usual population 50 or more, experiencing 10 or more sewerage system overflows or leakages in previous 12 months, by remoteness, 1999, 2001 and 2006
Source: AIHW analysis of the 1999 and 2001 Community Housing and Infrastructure Needs Surveys; FaHCSIA and AIHW analysis of 2006 Community Housing and Infrastructure Needs Survey
Text description of figure 68 (TXT 1KB)

Figure 69 – Proportion of Indigenous households reporting lack of working facilities for each of the first 4 Healthy Living Practices by remoteness, 2008


Figure 69 – Proportion of Indigenous households reporting lack of working facilities for each of the first 4 Healthy Living Practices by remoteness, 2008
Source: AIHW analysis of 2008 NATSISS
Text description of figure 69 (TXT 1KB)

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