Aboriginal and Torres Strait Islander Health Performance Framework (HPF) 2012
Why is it important?:Factors related to housing, such as overcrowding in housing, housing tenure type and homelessness, have potential impacts on health. The effects of overcrowding occur in combination with other environmental health factors such as poor water quality and sanitation, which are associated with increased risk of infectious diseases such as meningitis, acute rheumatic fever, tuberculosis, and skin and respiratory infections (AIHW 2005b). Overcrowding may increase psychological stress and adversely affect educational opportunities for students (see measure 2.05). However, the presence of more people in a household may decrease social isolation, which could have a positive impact on health (Booth et al. 2005b).
Housing tenure is associated with health outcomes including mortality and morbidity; people who own their own home typically experience better health than those who rent. Housing tenure is also associated with socioeconomic status, with different levels of health hazards in the dwelling itself (e.g., overcrowding, structural problems) and the immediate environment (e.g., amenities, problems with crime) (AHURI 2010).
Aboriginal and Torres Strait Islander peoples perceive, define and experience homelessness in distinct ways. A 1998 study found five types of Indigenous homelessness: spiritual homelessness (including being separated from traditional lands—see measure 2.14), overcrowding, relocation and transient homelessness, escape from an unsafe or unstable home, and lack of access to any stable shelter. Ill-health was identified in this study as both a cause and consequence of homelessness (Keys Young 1998). 'Healthy homes' is one of seven strategic platforms identified by COAG as a 'building block' that needs to be in place in order to comprehensively address the current state of Indigenous disadvantage. A healthy home is a fundamental pre-condition of a healthy population.
Findings:In 2008, 25% of all Aboriginal and Torres Strait Islander persons aged 15 years and over were living in overcrowded households (households requiring one or more additional bedrooms according to the Canadian National Occupancy Standard). In comparison, 4% of other Australians aged 15 years and over were living in overcrowded households in 2007–08. Half (49%) of Indigenous Australians aged 15 years and over in remote areas lived in overcrowded households, compared to 17% in other parts of Australia. There has been no major change since 2002 (26%).
Household overcrowding varies by socioeconomic status. In 2008, Indigenous Australians aged 15 years and over were more likely to be living in overcrowded households if their household income was in the lowest income quintile rather than the highest income quintile (30% compared with 8%); if the highest year of school they completed was Year 9 or below rather than Year 12 (29% compared with 19%); and if they were unemployed or not in the labour force than if they were employed (27% and 31% compared with 20%). Overcrowding also varies by housing tenure type. In 2006, approximately 40% of Indigenous households in cooperative/community/church group housing were overcrowded, 16% of state/territory housing authority households, 11% of private and other renter households and 7% of home owners or purchaser households were overcrowded.
In 2008, 29% of Indigenous adults lived in households that were owned or being purchased (here referred to as home owners), 29% lived in private rentals, 23% lived in a property rented from a state housing authority and 16% were renting from an Indigenous Housing Organisation or other community housing provider. In comparison, 65% of non-Indigenous adults were home owners, and 29% were renters. Rates of Indigenous home ownership and private rental increased between 1994 and 2008. Housing tenure patterns are influenced by a range of factors including socioeconomic status and Indigenous land arrangements in some remote areas (where there are communal tenancy arrangements). In 2008, home ownership was higher in non-remote areas (36%) than remote areas (16%). In remote areas the largest category of housing was rentals through Indigenous Housing Organisations and other community housing providers (33%), whereas in non-remote areas this only represented 5% of Indigenous households. Private rentals were more common in non-remote areas (34%) compared with remote areas (20%). Home ownership was highest in Tasmania (50%), followed by the ACT (48%), and lowest in the NT (21%).Top of page
In 2006, Aboriginal and Torres Strait Islander peoples accounted for around 9% of the homeless population (9,526 out of 104,676 homeless people). This definition of homelessness included people without conventional accommodation, people moving frequently between various forms of temporary shelter and people living in single rooms in private boarding houses, without their own bathroom, kitchen, or security of tenure (ABS 2008a). However, these definitions may not reflect how homelessness is perceived by Aboriginal and Torres Strait Islander peoples. In 2008–09, almost one-fifth of specialist homelessness service clients were Aboriginal and/or Torres Strait Islander. While domestic/family violence was the most frequently recorded main reason for both Indigenous and non-Indigenous clients seeking specialist homelessness services, overcrowding issues were more frequently recorded for Indigenous clients than for non-Indigenous clients (AIHW 2011i).
Implications:There is a complex relationship between housing and health. Living with extended family groupings may be culturally desirable for some Aboriginal and Torres Strait Islander peoples (Long et al. 2007) and this requires innovation in the provision of appropriate housing (AIHW 2005b). Housing tenure is influenced by socioeconomic status, such as income (see measure 2.08) and employment (see measure 2.07), and communal tenancy arrangements in some remote communities. Similarly, the distinctive causes and contexts of Aboriginal and Torres Strait Islander peoples experiencing homelessness must be understood when responding to this issue (Keys Young 1998).
The Australian Government provides direct support to Aboriginal and Torres Strait Islander peoples to purchase their own homes through financial literacy support and assisted loans by Indigenous Business Australia. The Indigenous Home Ownership Program provides support for purchasing an established home, purchasing land and constructing a new home, making essential improvements to an existing home, or to move into home ownership on Indigenous land. The National Partnership Agreement on Remote Indigenous Housing supports the supply of safe and adequate housing in remote communities, including facilitating the building of up to 4,200 new houses and the refurbishment of up to 4,800 existing houses in remote Indigenous communities over ten years. The reform includes standardised tenancy arrangements for all remote Indigenous housing that include rent collection, asset protection, repairs, ongoing maintenance and governance arrangements consistent with public housing standards. The initiative includes progressive resolution of land tenure on remote community-titled land in order to secure investment and home ownership possibilities.
Under the National Partnership Agreement on Homelessness (NPAH), governments have committed $1.1 billion over five years to create new and expanded support services for those experiencing or at risk of homelessness in Australia. Reducing Aboriginal and Torres Strait Islander homelessness is a key priority under the NPAH. The NPAH includes a commitment to a 7% reduction in homelessness and a decrease of Indigenous homelessness by one-third. Of the 180 new and expanded initiatives introduced under the NPAH, 24 Indigenous-specific initiatives are being implemented. These initiatives are working to directly address the high rates of Aboriginal and Torres Strait Islander homelessness across Australia and provided over 10,800 assistances in 2010–11. Also under the NPAH, governments are implementing a policy of 'no exits into homelessness' from statutory, custodial care and hospital, mental health and drug and alcohol services for those at risk of homelessness. Under this strategy, young people leaving child protection and juvenile justice systems, including Indigenous youth, will be prioritised.Top of page
Figure 80—Proportion of people 15 years and over living in overcrowded households, by Indigenous status, Indigenous Australians (2002, 2008), non-Indigenous Australians (2001, 2006)
Source: ABS and AIHW analysis of 2002 and 2008 NATSISS and the 2001 and 2006 CensusTop of pageTop of page
Figure 81—Proportion of persons 15 years and over living in overcrowded households, based on the Canadian National Occupancy Standard, by Indigenous status and remoteness, 2008
Source: ABS and AIHW analysis of 2008 NATSISS, non-Indigenous data from Survey of Income and Housing 2007–08Top of page
Figure 82—Tenure type by remoteness, proportion of Indigenous persons 18 years and over and households, 2008
Source: AIHW analyses of 2008 NATSISSTop of page
Figure 83—Tenure type, Indigenous persons 18 years and over, 1994, 2002 and 2008
Source: ABS and AIHW analysis of 1994 NATSIS, 2002 & 2008 NATSISSTop of page