Journal article
Infectious disease outcomes associated with inadequate housing and access to healthy living practices in Australia: a systematic review
BMJ public health, Vol.4(1), e003531
2026
PMID: 41789367
Abstract
Objectives
Inadequate housing and living conditions underpin significant health and wellbeing inequality in Australia, particularly for Indigenous people. This review aimed to define infectious disease (ID) outcomes used to measure the health impact of inadequate housing in Australia within a research context.
Design
A systematic review of published studies following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines.
Data sources
Four online databases were searched in May 2024 with no date restrictions using terms relating to housing, ID and Australia. Results were screened in Covidence.
Eligibility criteria
Studies were included if they measured both housing exposures and ID outcome variables among any population group in Australia. Both quantitative and qualitative designs were considered.
Data extraction and synthesis
Data were extracted from 81 studies. Exposures and outcomes were classified according to the Healthy Living Practices (HLPs) and the International Classification of Primary Care (ICPC-2) body system classes, respectively. Acute infections and chronic post-infectious sequelae were considered ID outcomes. Descriptive statistics were calculated and ID-HLP associations were synthesised and narratively described. Methodological quality was assessed from both biomedical and Indigenous perspectives using relevant appraisal tools.
Results
Most studies (79%) were published within the past 25 years and more than half (60%) involved remote-living Indigenous children and families. A total of 176 measured ID outcomes and 571 ID-HLP associations were tested. Exposures were frequently related to the negative effects of crowding (HLP5), unsafe wastewater treatment/drinking water (HLP3) and reduced capacity for washing people (HLP1). Skin, respiratory and digestive system infections were the most common ID outcomes, followed by eye and ear infections and post-infectious cardiovascular sequelae. Studies relied on intensive data collection methods and bespoke definitions.
Conclusions
Substantial research has described ID outcomes associated with inadequate housing in Australia. However, high-quality evidence is lacking, and methodological heterogeneity between studies limits the synthesis and actionability of this work. We recommend prospective classification of housing exposures according to the HLPs and encourage the exploration of routinely collected primary care data. Agreed measurement approaches and data collection tools that are consistent with Indigenous Data Sovereignty principles would add value.
Details
- Title
- Infectious disease outcomes associated with inadequate housing and access to healthy living practices in Australia: a systematic review
- Authors/Creators
- Kate Summer - The Kids Research Institute AustraliaKeerthi Anpalagan - The Kids Research Institute AustraliaIngrid Stacey - The University of Western AustraliaSamantha Stiles - Princess Margaret Hospital for ChildrenRachel Burgess - The Kids Research Institute AustraliaVicki Wade - Victor Chang Cardiac Research InstituteAsha C. Bowen - Menzies School of Health ResearchJudith Katzenellenbogen - Princess Margaret Hospital for ChildrenRosemary Wyber - Australian National University
- Publication Details
- BMJ public health, Vol.4(1), e003531
- Publisher
- BMJ Publishing Group
- Identifiers
- 991005884939407891
- Copyright
- © Author(s) (or their employer(s)) 2026.
- Murdoch Affiliation
- Ngangk Yira Institute for Change
- Language
- English
- Resource Type
- Journal article
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