Community-level built environmental factors related to chronic and infectious diseases: strengthening evidence base for remote Indigenous communities

High prevalence of preventable chronic and infectious diseases in the Indigenous population is a major public health concern. Existing research has rarely examined the role of built environmental factors in relation to remote Indigenous health. This study engaged stakeholders to examine their perceptions of built environmental factors in relation to the development of chronic and infectious diseases in remote Northern Territory communities. 

Built environmental indicators (n=1,120) were consolidated from publicly available community and regional planning documents. Representatives from the Indigenous and non-Indigenous public and environmental health workforce were engaged to further consolidate, sort and rate a final set of indicators (n=84) based on their experiences working in remote communities. The indicators and perceived importance ratings were displayed using concept maps, outlining 9 built environmental domains. 

‘Facilities for health/safety’ and ‘essential services’ were the highest ranked domains in mean importance ratings for both chronic and infectious disease. Within these domains, adequate housing, housing infrastructure maintenance, water supply, storm water and drainage system, access to health services, reliable sewerage system and power infrastructure were identified as the most important contributors to the development of these diseases. These results can inform public health planning efforts to improve living conditions in remote Indigenous communities.