Evaluation of an Australian indigenous housing programme: community level impact on crowding, infrastructure function and hygiene
Evaluation of an Australian indigenous housing programme: community level impact on crowding, infrastructure function and hygiene
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DOI：
10.1136/jech.2009.091637
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发表时间：
2011-05-01
影响因子：
6.3
通讯作者：
Brewster, David R.
中科院分区：
文献类型：
--
作者：
Bailie, Ross S.;McDonald, Elizabeth L.;Brewster, David R.
澳大利亚土著社区的住房方案主要侧重于实现基础设施功能的良好标准。在社区一级评估了这一方法对儿童健康的三个潜在重要住房影响：（1）拥挤程度;（2）房屋基础设施的功能状态;（3）房屋的卫生状况。方法采用前后对照研究，包括房屋基础设施调查和对主要户主的结构化访谈，结果与基线相比，随访调查显示：（1）调查前一晚，每个卧室的平均人数略有下降，但不显著（基线时为3.4，95% CI 3.1 - 3.6，随访时为3.2，95% CI 2.9 - 3.4;自然对数转换t检验，t=1.3，p=0.102）;（2）基础设施功能评分总体改善略显着（Kruskal-Wallis检验，卡方（2）-3.9，p-0.047）;及（3）整体生情况未有明显改善（Kruskal-Wallis检验，卡方（2）=0.3，p=0.605）结论这种规模的住房方案只注重提供基础设施，似乎不太可能带来更卫生的一般生活环境，至少在本研究中。如果要最大限度地发挥潜在的健康效益，就需要对这些社区的住房方案采取更广泛的生态办法。这一生态方法需要一个平衡的方案，改善获得保健硬件的机会，促进卫生，并在社区创造更广泛的有利环境。
Background and Aim Housing programmes in indigenous Australian communities have focused largely on achieving good standards of infrastructure function. The impact of this approach was assessed on three potentially important housing-related influences on child health at the community level: (1) crowding, (2) the functional state of the house infrastructure and (3) the hygienic condition of the houses.Methods A before-and-after study, including house infrastructure surveys and structured interviews with the main householder, was conducted in all homes of young children in 10 remote Australian indigenous communities.Results Compared with baseline, follow-up surveys showed (1) a small non-significant decrease in the mean number of people per bedroom in the house on the night before the survey (3.4, 95% CI 3.1 to 3.6 at baseline vs 3.2, 95% CI 2.9 to 3.4 at follow-up; natural logarithm transformed t test, t=1.3, p=0.102); (2) a marginally significant overall improvement in infrastructure function scores (Kruskal-Wallis test, chi(2)-3.9, p-0.047); and (3) no clear overall improvement in hygiene (Kruskal-Wallis test, chi(2)=0.3, p=0.605).Conclusion Housing programmes of this scale that focus on the provision of infrastructure alone appear unlikely to lead to more hygienic general living environments, at least in this study context. A broader ecological approach to housing programmes delivered in these communities is needed if potential health benefits are to be maximised. This ecological approach would require a balanced programme of improving access to health hardware, hygiene promotion and creating a broader enabling environment in communities.