Identifying Environmental Determinants Relevant to Health and Wellbeing in Remote Australian Indigenous Communities: A Scoping Review of Grey Literature

Abstract

The high prevalence of preventable infectious and chronic diseases in Australian Indigenous populations is a major public health concern. Existing research has rarely examined the role of built and socio-political environmental factors relating to remote Indigenous health and wellbeing. This research identified built and socio-political environmental indicators from publicly available grey literature documents locally-relevant to remote Indigenous communities in the Northern Territory (NT), Australia. Existing planning documents with evidence of community input were used to reduce the response burden on Indigenous communities. A scoping review of community-focused planning documents resulted in the identification of 1120 built and 2215 socio-political environmental indicators. Indicators were systematically classified using an Indigenous indicator classification system (IICS). Applying the IICS yielded indicators prominently featuring the “community infrastructure” domain within the built environment, and the “community capacity” domain within the socio-political environment. This research demonstrates the utility of utilizing existing planning documents and a culturally appropriate systematic classification system to consolidate environmental determinants that influence health and disease occurrence. The findings also support understanding of which features of community-level built and socio-political environments amenable to public health and social policy actions might be targeted to help reduce the prevalence of infectious and chronic diseases in Indigenous communities.

Prioritizing Built Environmental Factors to Tackle Chronic and Infectious Diseases in Remote Northern Territory (NT) Communities of Australia: A Concept Mapping Study

“…These standards capture features of environments such as housing, public sanitation facilities, water supply, power supply, sewerage systems, rubbish collection and disposal, repair and maintenance of environmental health infrastructure. Systematically selected built environmental indicators generated in the scoping review [ 43 ], followed by this concept mapping study, may support the environmental and public health sectors to identify priority indicators that can be actioned in the shorter term (e.g., within the next 2–3 years) and the longer term (within 5–10 years). The most important built environmental indicators identified in this research may provide an evidence base for the NT Department of Health to influence the broader government system through networking, communicating, and negotiating (on behalf of the community) with regional councils and other sections in the government system to address local-level environmental health issues.…”

“…The brainstorming component of the concept mapping study identified locally relevant built environmental indicators from a scoping review of community and strategic planning documents [ 43 ] with evidence of Indigenous input [ 75 ]. In our discussions, stakeholders identified several policy and strategic planning documents developed through community consultation.…”

“…These documents included community-level environmental factors relevant to the development of chronic disease and more broadly to community health and wellbeing. Therefore, to capture community perspectives in existing documents, and to avoid burdening communities with additional consultation to brainstorm ‘de novo’ built environmental indicators, a scoping review of such under-utilized publicly available documents [ 43 ] was undertaken to identify and consolidate indicators for this GCM study.…”

“…The brainstorming activity in this GCM study was informed by a preceding scoping review of community-level strategic planning documents [ 43 ]. A group of experienced Indigenous (A.CH., and A.B.)…”

“…with expertise in community engagement and Indigenous culture, spatial epidemiology, health promotion, and prevention of chronic disease and infectious disease guided the identification of documents, and extraction and synthesis of built environmental indicators as part of the scoping review. An established Indigenous Indicator Classification System (IICS) [ 44 , 45 ] was integrated in the scoping review [ 43 ] to guide the classification, measurement and validation of existing built environmental indicators from Indigenous community members’ perspectives. The IICS was adapted from the “German System of Social Indicators” through a collaboration of Indigenous and non-Indigenous researchers, and community stakeholders from Canada, Australia and New Zealand [ 44 , 45 ].…”