Environmental health challenges in remote Aboriginal Australian communities: clean air, clean water and safe housing

Objective: A considerable health disparity exists between Aboriginal and non-Aboriginal Australians, including a higher incidence and severity of cardiovascular and respiratory diseases. The burden of these diseases appears to be greatest in communities located in the remote regions of Australia. Unique environmental challenges in these regions may be a contributing factor; however these are yet to be adequately investigated. We aimed to develop a case to improve our understanding of environmental risk factors in remote Aboriginal communities.

Methods: We comprehensively reviewed the literature regarding physical environmental challenges that are likely to be highly prevalent in remote Aboriginal communities, and have been linked with adverse health. We focused on exposure to inhaled geogenic (earth-derived) dust and biomass smoke, bacterial and heavy metal contamination of drinking water and overcrowding.

Results: These environmental factors are anecdotally high in remote Aboriginal communities and have been linked, mostly epidemiologically, to cardiovascular, respiratory and other infectious diseases. These challenges are an under-recognised problem and are likely to have a significant impact on Aboriginal community health; increased research focus in this area would be of great benefit.

Implications: It is crucial to identify and quantify these physical environmental factors, and to determine the mechanisms through which they impact on health, particularly as these factors are modifiable and may be suppressed using relatively simple, cost-effective changes in community infrastructure. Protection against these exposures is likely to reduce their cumulative negative effects on individuals across the life course and result in significantly improved health in remote Aboriginal Australian communities.