In Australia, Acute Rheumatic Fever (ARF) and Rheumatic Heart Disease (RHD) occur almost exclusively among Aboriginal and Torres Strait Islander peoples particularly those living across northern and central Australia . ARF and RHD is a preventable condition when the appropriate measures are taken. Managing the home environment by assessment and maintenance of health hardware together with health promotion and disease prevention in a culturally safe way is critical. This presentation will demonstrate how an Aboriginal environmental health service works in this nexus to improve living conditions and reduce rates of this preventable disease.