“You can't heal yourself in that setting and you wouldn't expect other people in this country to”: Yarning about housing and environmental health in remote Aboriginal communities of Western Australia

Abstract

Remote Aboriginal communities in Australia are located on traditional lands holding deep cultural significance and meaning for residents. However, systemic inequity rooted in colonisation has driven persistent housing and health disparities, with inadequate environmental health conditions within homes and communities a prominent example. Embedded within the SToP (See, Treat, Prevent) Skin Sores and Scabies Trial, which aimed to reduce skin infections in children aged 5–9 years by 50 % across nine Kimberley communities, this qualitative sub-study sought to understand access to and perceptions of environmental health initiatives by yarning with those living and working in remote Aboriginal communities. Between 2019 and 2022, 208 people participated in individual or group yarning activities. Using a political economy of health lens, analysis of 137 yarning sessions revealed barriers to health, including infrequent services, inadequate housing, and entrenched challenges to achieving household maintenance. These obstacles stem from governance, procurement and logistics arrangements; a direct result of colonisation and land appropriation rather than individual behaviour. Addressing these barriers requires equitable standards in service provision, as well as clear decision rights over land and housing assets, procurement options enabling timely repairs, resourced local maintenance with guaranteed response times and sustained funding. Equity and reconciliation will only be achieved once structural barriers are removed.