{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T03:01:01Z","timestamp":1784689261311,"version":"3.55.0"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Journal of Australia"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Household overcrowding is a major driver of acute rheumatic fever and rheumatic heart disease, along with other adverse social, cultural and health outcomes in remote Aboriginal communities. Overcrowding is compounded by poor thermal performance of current housing, energy insecurity and climate change. Despite strong evidence of the causes of rheumatic heart disease, upstream prevention through housing design remains underexplored. Wilya Janta, an Aboriginal\u2010led organisation in Tennant Creek, has developed the Explain Home design: a culturally responsive, climate\u2010adapted prototype designed to reduce overcrowding\u2010related harms. With an unprecedented $4 billion investment in remote housing, health professionals have a critical role in advocating for evidence\u2010informed, culturally safe housing as a form of preventive health intervention to improve equity and outcomes.<\/jats:p>","DOI":"10.5694\/mja2.70209","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T03:34:16Z","timestamp":1779939256000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Designing Housing to Reduce Overcrowding\u2010Related Harms: Rheumatic Heart Disease as the Canary in the Coal Mine"],"prefix":"10.5694","volume":"224","author":[{"given":"Simon","family":"Quilty","sequence":"first","affiliation":[{"name":"National Centre for Epidemiology and Population Health Australian National University  Canberra Australian Capital Territory Australia"},{"name":"Wilya Anyul Janta Aboriginal Corporation  Tennant Creek Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1319-257X","authenticated-orcid":false,"given":"Veronica","family":"Matthews","sequence":"additional","affiliation":[{"name":"The University Centre for Rural Health University of Sydney  Lismore New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angus","family":"Baumann","sequence":"additional","affiliation":[{"name":"Cardiology Alice Springs Hospital  Alice Springs Northwest Territories Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8688-506X","authenticated-orcid":false,"given":"James","family":"Marangou","sequence":"additional","affiliation":[{"name":"Global &amp; Tropical Health Division Menzies School of Health Research  Darwin Northwest Territories Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Remenyi","sequence":"additional","affiliation":[{"name":"Paediatric Cardiology Royal Darwin Hospital  Darwin Northwest Territories Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavin","family":"Wheaton","sequence":"additional","affiliation":[{"name":"Paediatric Cardiology Women's and Children's Hospital  North Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena Morton","family":"Nabanunga","sequence":"additional","affiliation":[{"name":"Wilya Janta  Tennant Creek Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norman Frank","family":"Jupurrurla","sequence":"additional","affiliation":[{"name":"Wilya Janta  Tennant Creek Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Robinson","sequence":"additional","affiliation":[{"name":"Architecture OFFICE.org.au  Collingwood Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Mintern","sequence":"additional","affiliation":[{"name":"Architecture OFFICE.org.au  Collingwood Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cary","family":"Duffield","sequence":"additional","affiliation":[{"name":"Troppo Architects  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9302-4543","authenticated-orcid":false,"given":"Joshua R.","family":"Francis","sequence":"additional","affiliation":[{"name":"Global &amp; Tropical Health Division Menzies School of Health Research  Darwin Northwest Territories Australia"},{"name":"Department of Paediatrics Royal Darwin Hospital  Tiwi Northwest Territories Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul C.","family":"Memmott","sequence":"additional","affiliation":[{"name":"Aboriginal Environments Research Centre, (AERC) University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"WHO Housing and Health Guidelines. Chapter\u00a03: Household Crowding","author":"World Health Organization","year":"2018"},{"key":"e_1_2_11_3_1","volume-title":"Australia's Children: Overcrowding","author":"Australian Government, Australian Institute of Health and Welfare","year":"2023"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2007.tb01052.x"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e3181fbd85b"},{"key":"e_1_2_11_6_1","volume-title":"Housing Circumstances of Indigenous Households: Tenure and Overcrowding","author":"Australian Government, Australian Institute of Health and Welfare","year":"2014"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.50853"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.13421"},{"key":"e_1_2_11_9_1","volume-title":"Australian Guideline for Prevention, Diagnosis and Management of Acute Rheumatic Fever and Rheumatic Heart Disease","author":"RHD Australia (National Heart Foundation of Australia and Menzies School of Health Research)","year":"2022"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0006577"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.50682"},{"key":"e_1_2_11_12_1","volume-title":"Landmark $4 Billion Investment for Remote Housing in the Northern Territory to Help Close the Gap. 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