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

Abstract

High prevalence of chronic and infectious diseases in Indigenous populations is a major public health concern both in global and Australian contexts. Limited research has examined the role of built environments in relation to Indigenous health in remote Australia. This study engaged stakeholders to understand their perceptions of the influence of built environmental factors on chronic and infectious diseases in remote Northern Territory (NT) communities. A preliminary set of 1120 built environmental indicators were systematically identified and classified using an Indigenous Indicator Classification System. The public and environmental health workforce was engaged to consolidate the classified indicators (n = 84), and then sort and rate the consolidated indicators based on their experience with living and working in remote NT communities. Sorting of the indicators resulted in a concept map with nine built environmental domains. Essential services and Facilities for health/safety were the highest ranked domains for both chronic and infectious diseases. Within these domains, adequate housing infrastructure, water supply, drainage system, reliable sewerage and power infrastructure, and access to health services were identified as the most important contributors to the development of these diseases. The findings highlight the features of community environments amenable to public health and social policy actions that could be targeted to help reduce prevalence of chronic and infectious diseases.

Association of Built Environmental Features with Rates of Infectious Diseases in Remote Indigenous Communities in the Northern Territory, Australia

“…Any new COVID-19 outbreak is likely to interact with existing disease burdens to accelerate disproportionate increases in all-cause morbidity and mortality in remote Indigenous communities. Our findings further demonstrate the relevance of remote Indigenous community environmental features systematically identified and prioritised in our earlier scoping review [ 53 ] and concept mapping [ 54 ] studies. Such enquiry can support the environmental and public health sectors to select actionable priority BE indicators potentially preventing future infectious diseases outbreaks.…”

Built Environment Features and Cardiometabolic Mortality and Morbidity in Remote Indigenous Communities in the Northern Territory, Australia

“…Limitations in data availability and quality are consistent with the call from Indigenous Australian leaders who have highlighted a strong need for community-level data to facilitate local decision making that affects local services [ 59 ]. Our research demonstrates that the compiling of such community-level built environmental data is not only possible but essential for evaluating relationships with the prevalence of diseases [ 40 , 60 , 61 ]. Providing such data for analysis is important to enable decision-makers to make better-informed, evidence-based decisions to guide health and social actions to benefit remote Indigenous communities in Australia [ 62 ].…”