Improving the state of health hardware in Australian Indigenous housing: building more houses is not the only answer

Background. This article outlines a program of applied research and development known as Housing for Health that, over the period 1999-2012, targeted health-related improvements in housing for Indigenous householders in communities across regional and remote Australia. In essence, the program focuses on measuring the functionality of key appliances and structures (we term this health hardware) against clear criteria and ensuring identified faults are fixed. Methods. Detailed survey and assessment of all aspects of housing was undertaken, particularly focusing on the function of health hardware. All results were entered into a database and analyzed. Results. The results demonstrate extremely poor initial performance of the health hardware. A key finding is that attention to maintenance of existing houses can be a cost-effective means of improving health outcomes and also suggests the need to superintend the health-conferring qualities of new infrastructure. We briefly outline the early foundations of the Housing for Health program, major findings from data gathered before and after improvements to household amenities, and our efforts to translate these findings into broader policy. Conclusions. These data demonstrate that simply injecting funds into housing construction is not sufficient for gaining maximum health benefit.