Despite unprecedented investment in remote housing, many Aboriginal families continue to live in homes that are overcrowded, hot and poorly suited to culture and family. This presentation explores the relationship between housing design and health outcomes, including RHD, infectious disease, heat stress and wellbeing, drawing on the work of Wilya Janta in Tennant Creek. Dr Quilty will discuss how Aboriginal-led design can improve housing performance, strengthen community participation and deliver better value from public investment and present emerging evidence, practical examples and lessons for policymakers, health services and communities seeking to address social determinants of health through housing.