Framework for Research on Aboriginal Health and the Physical Environment

The Cooperative Research Centre for Aboriginal Health (CRCAH) has identified environmental health and health-related infrastructure as priority areas for research. The aim of this project is to provide a framework that will assist in the development of a focused and strategic research program in the area of Aboriginal health and the physical environment. The research framework was developed through a survey of CRCAH partner organisations and other stakeholders involved in research or service delivery in the area of Aboriginal health. The aim of the survey was to identify current and future research interests and elicit views on how research into the physical environment and Aboriginal health could make a meaningful contribution to policy, planning and the delivery of services. A review of the published and unpublished literature on the physical environment and Aboriginal health looked at research that has been conducted to date and pointed to gaps in activity and knowledge. The survey findings were categorised into three broad areas of research, and respondents ranked these categories closely. The categories were: A) research that enhances our understanding of Aboriginal people’s perceptions and behaviour in relation to the physical environment; B) research aimed at understanding the determinants, outcomes and relationships between environmental factors and health outcomes; and C) research that enhances the development and assesses the impact of programs and interventions. Category A research was given the highest priority by CRCAH industry partners. In contrast to this, respondents from research organisations nominated Category B as the top priority. The current research activities reported in the survey showed that most of the research related to the physical environment is being conducted in the area of housing. There are also projects underway in the areas of hygiene, water supply, migration and the environment in a broader sense. The majority of these research projects were consistent with the research priorities identified in the survey and the review of the literature. The review summarised research in each area of the physical environment and highlighted recommendations for research identified in the literature. It encompassed: environmental health, the urban environment, housing, maintenance, crowding, hygiene, water supply, waste disposal and drainage, swimming pools, dog health, roads and transport, energy, communication, climate and temperature, dust, pests and feral animals, land management, food supply, environmental health workforce, and trauma. The survey and review found that research priorities should be in the urban environment, housing and areas directly related to housing, and water supply and sanitation. Many of the interventions reported in the literature are not based on either good evidence or good knowledge of Aboriginal people’s perceptions and needs. This points to the importance of setting research priorities based on existing Category B evidence, and further investigating Aboriginal people’s perceptions and needs in order to develop health strategies and actions based on Category A research. The proposed research framework is based on the three categories of research in each identified area of the physical environment. Because of the complex nature and the multiple factors that influence each component, it may be useful to take an ecological approach to research in Aboriginal health and the physical environment. The ecological approach is guided by appropriate causal concepts based on universal laws (Category B), with the realisation that health and disease are mediated by specific social behaviours at the individual, population and global level (Category A). The best hopes for making an impact through interventions (Category C) in any of the areas identified in the framework rests upon a coherent strategy that is based on sound research in both Categories A and B. The importance of a more holistic approach to research is evident in the high priority placed on all three categories in the survey and on the expressed need to take a multi-disciplinary approach to research. The research framework is intended as a guide to setting research priorities for the CRCAH in the area of Aboriginal health and the physical environment.