The Bob and June Prickett Churchill Fellowship to examine healthy housing initiatives in the primary prevention of Acute Rheumatic Fever

Acute Rheumatic Fever (ARF) is a preventable infectious disease that has been eradicated in Australia’s general population. However, the Northern Territory has one of the highest rates of this infectious disease in the world and these rates are continuing to increase for Aboriginal and Torres Strait Islander people. Environmental factors, such as overcrowding and other housing related living conditions, are associated with the exposure and transmission of Group A Streptococcal infection that causes ARF. Aboriginal and Torres Strait Islander people living in Central and Northern Australia are at increased risk of this disease, with 5-14 year old children being at a much higher risk of having a first episode.

Maida’s journey took her to Auckland, on Aotearoa’s (NZ) North Island to investigate the Healthy Homes Initiative, one of several strategies to reduce the rates of ARF among Māori and Pacific Islander communities by addressing the quality of housing and household crowding.

Conclusions:

• Australia needs a coordinated government response to address key housing and environmental health issues specifically affecting Aboriginal and Torres Strait Islander communities with high rates of ARF.
• Encouraging innovation in this area can assist in the development of practical housing and environmental health related interventions that are ‘low cost, high impact, fit-for-purpose and locally relevant’.
• Key stakeholders need to work with families and communities to identify priorities for addressing these issues
• Human-centred co-design provides an opportunity for those most affected by health and social policy to actively engage in the policy development.
• Government investment into such programs will see a return on that investment and savings to the public health care system.
• Increasing the current level of affordable housing supply is challenging but necessary to address household crowding in communities. Refurbishing current housing stock to cater for larger families may be a short to medium term alternative.

Healthy Housing initiatives in Aotearoa are providing cost savings to the health care system in reduced hospital admissions, GP visits and prescriptions being dispensed. To improve the supply of housing interventions and the programs, the initiative used innovation, exploring “what can be done right now to improve the health of our homes”? This resulted in practical interventions that were readily available and affordable, making them accessible for families. Innovation and human-centred co-design have been used to ensure that Maori and Pasifika have ‘buy in’ for housing solutions and policy design that will directly affect communities for the long term.

Maida was a 2021 Policy Impact Program participant and featured in the Policy Futures publication with his article Healthy Housing Programs. Watch his presentation below. You can also watch all PIP presentations here.