Environmental Health

Environmental health refers to the physical, chemical, and biological factors, which affect the health and wellbeing of people within their surroundings, primarily within their homes and communities [42032]. Aboriginal and Torres Strait Islander people are disproportionately affected by the diseases associated with environmental health, due to factors such as the remoteness of some communities, lack of adequate housing and home health hardware, lack of access to tradespeople and repairs, and the cost of infrastructure maintenance [42074].

Key factors in the physical environment which impact on the health and wellbeing of Aboriginal and Torres Strait Islander people and communities include:

• access to clean water for sanitation and hygiene hardware (WASH) [47331] such as plumbing, taps and showers in healthy bathrooms and laundries [42753]
• adequate housing, including repairs and maintenance, and the number of people staying in one house
• healthy living practices including safely handling food in clean kitchens, and having adequate facilities for washing and doing laundry
• reliable power supply to operate refrigerators, washing machines and air conditioners
• waste management, including rubbish collection and disposal, and wastewater and sewage disposal
• animal and pest management
• weed management and dust control.

Poor environmental health conditions, that can be exacerbated by crowded housing, contributes significantly to the excess burden of infectious disease and chronic illness including trachoma and rheumatic heart disease (RHD), both of which disproportionately affect Aboriginal and Torres Strait Islander people living in remote communities [44607] [46304]. Examples of other health problems associated with the environment include respiratory, cardiovascular and renal diseases, cancers, skin infections, gastrointestinal illness and vector-borne diseases (illness caused by germs spread to people through the bites of organisms like mosquitoes or ticks). Using data from 2018, one study in the Kimberley region of Western Australia found that a quarter of the budget spend on hospitalisations for Aboriginal people, and over a third of the budget spend for Aboriginal children aged up to 14 years, was due to environmental determinants, revealing the heavy burden that environmental health has on primary health care [43290].

The provision of adequate infrastructure to minimise environmental health risk factors is the responsibility of individuals, communities, and government and non-government agencies [45397]. Many Aboriginal and Torres Strait Islander communities employ an Indigenous Environmental Health Practitioner who plays a vital role in preventing disease through minimising environmental health risks and promoting awareness on healthy living practices [20152].

Aboriginal and Torres Strait Islander people have a holistic conception of health that incorporates their connection to the land, sea, culture, spirituality, family and community [45397]. The interconnectedness of these dimensions, means that environmental health in the context of Aboriginal and Torres Strait Islander culture and values, can also include caring for Country initiatives by Indigenous ranger groups. As Aboriginal and Torres Strait Islander people have such a strong connection to their Country, they are especially vulnerable to the impacts of climate change [46348]. Incorporating Indigenous knowledges into adaptive strategies, can help to reduce the effects of climate change on health and wellbeing.

Indigenous knowledges and participation can also help with other environmental health related activities, such as emergency management, to limit the impact on human health posed by natural disasters such as cyclones, bushfires and floods, and public health issues such as the ongoing COVID-19 pandemic.