Aboriginal peoples' lived experience of household overcrowding in the Kimberley and implications for research reciprocity in COVID-19 recovery.

Objective: Household overcrowding was identified early in the COVID-19 pandemic as a risk factor increasing transmission and worsening outcomes. Nirrumbuk Environmental Health and Services designed this project to deepen understanding of Aboriginal peoples' experiences of overcrowding in social housing.

Methods: Our household survey explored overcrowding, capacity to respond to COVID-19 directives and the Canadian National Overcrowding Standard (CNOS).

Results: For 219 participating Aboriginal households, usual number of residents per household ranged from 1 to 14, increasing with short- and long-term visitors. 17.8% had occupants who themselves were on waiting lists for their own home. Nearly one-third of houses had three generations under one roof. 53.4% indicated isolation of COVID-19 cases as 'extremely' difficult. 33.8% indicated their community could not manage COVID-19 at scale. Overcrowding was defined by interpersonal dynamics or consequences such as plumbing blockages or conflict rather than the number or people or ratio of people to bedrooms. 64.8% welcomed CNOS to determine acceptable and healthy occupancy levels. Participants encouraged research about environmental health in Aboriginal hands.

Conclusions: Cultural obligations, poverty and social housing waitlist management impose extreme demand on remote housing. CNOS relevance was endorsed but tempered by lived experience.

Implications For Public Health: Aboriginal-led research is directly accountable to communities through reciprocity and kinship. Nirrumbuk has already modified service planning.