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

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.

Automated summary

High prevalence of chronic and infectious diseases in Indigenous populations is a major public health concern globally, with limited research focusing on the role of built environments in remote Australian Indigenous communities. Stakeholders were engaged in a study to understand the influence of built environmental factors on diseases in remote Northern Territory communities, resulting in a concept map with nine built environmental domains. Essential services and facilities for health and safety were identified as the highest ranked domains, with key contributors being adequate housing infrastructure, water supply, drainage system, sewerage and power infrastructure, and access to health services. The findings highlight actionable community environment features to help reduce disease prevalence through public health and social policy interventions.