Housing conditions associated with recurrent gastrointestinal infection in urban Aboriginal children in NSW, Australia: findings from SEARCH

Abstract

Housing problems were independently associated with recurrent gastrointestinal infection in a dose-dependent manner. Implications for public health: The role of housing as a potential determinant of health in urban Aboriginal children merits further attention in research and policy settings.

The Relationship between Infectious Diseases and Housing Maintenance in Indigenous Australian Households

“…The resulting 16 publications analysed for this study varied significantly in design, and included five cohort studies [32,33,34,35,36], three cross-sectional studies [16,37,38], three qualitative descriptive studies [39,40,41], two case studies [42,43], government-commissioned research summary and cohort study [44,45], and one modelling study [46]. Geographically, 10 studies (62.5%) focused on rural communities [33,35,37,39,40,41,42,43,46].…”

“…Geographically, 10 studies (62.5%) focused on rural communities [33,35,37,39,40,41,42,43,46]. The Northern Territory was the most studied region ( n = 6) [16,34,39,41,43,46], followed by Western Australia ( n = 4) [32,33,35,37], New South Wales ( n = 2) [36,44], Multi-state ( n = 2) [37,45], Queensland ( n = 1) [38], and South Australia ( n = 1) [42]. These are described in Table 1.…”

“…Residential environmental factors found to be positively associated with infectious diseases in Indigenous Australian populations are summarised in Table 2. Ear-related illnesses were the most common condition assessed in the included studies [16,32,33,34,37,38,45,47], followed by skin-related illnesses [16,34,35,37,45,47] and gastrointestinal illnesses [34,35,36,37,47].…”

“…The link between crowding variables and gastrointestinal infection varied across studies; one study found crowding to be strongly associated with gastrointestinal infection (Crude Odds Ratio (cOR) 3.51; p = 0.004) [37], while another found no statistically significant association (although a link between carer reports of feeling crowded were found to be associated with gastrointestinal infection, Adjusted Prevalence Ratio (aPR) 1.63; p = 0.05) [36]. Counterintuitively, having six or more people sleeping in a home was protective against recurrent gastrointestinal infection (aPR 0.56, p = 0.05) [36]. Major structural problems (aPR 2.42; p = 0.05), major plumbing problems (aPR 1.95; p = 0.05), and damp or mildew (aPR 1.82; p = 0.05) showed positive associations with gastrointestinal infection [36].…”

“…Counterintuitively, having six or more people sleeping in a home was protective against recurrent gastrointestinal infection (aPR 0.56, p = 0.05) [36]. Major structural problems (aPR 2.42; p = 0.05), major plumbing problems (aPR 1.95; p = 0.05), and damp or mildew (aPR 1.82; p = 0.05) showed positive associations with gastrointestinal infection [36]. Infectious skin disease was found to be associated with crowding (cOR 2.71 (reported crowding as environmental risk factor), p = 0.007 [37]; cOR 2.92 (3–5 adults per room vs. <3 adults per room), p = 0.05 [16]; cOR 3.96 (7–8 adults per room vs. <3 adults per room), p = 0.05 [16]; (Adjusted Odds Ratio) aOR 1.81 (reduction of 2 or more persons per bedroom), p = 0.28 [34]).…”