There are well documented problems with the quality and availability of data about Aboriginal and Torres Strait Islander health issues. These limitations include the quality of data on all key health measures including mortality and morbidity, uncertainty about the size and composition of the Aboriginal and Torres Strait Islander population and a paucity of available data on other health-related issues such as access to health services.
The following information has been provided by the jurisdictions to provide information on action being undertaken in relation to data development.
Australian GovernmentThe Australian Government is committed to improving the availability of good quality Aboriginal and Torres Strait Islander health data. Through the National Advisory Group on Aboriginal and Torres Strait Islander Health Information Development (NAGATSIHID), the Australian Government is actively engaged with key stakeholders, state and territory Governments, the ABS and the AIHW to improve the availability of quality Aboriginal and Torres Strait Islander health data. Further, the Health Performance Framework has established priorities for data development linked to policy objectives.
In July 2009, COAG committed to a range of activities to improve the quality of Aboriginal and Torres Strait Islander data, including a Australian Government commitment of $46.4 million over four years to June 2013 under the NIRA (COAG 2008b). This work covers the key datasets required for NIRA Indigenous reporting, e.g., mortality, morbidity, perinatal data and population estimates. Jurisdictions have committed to undertaking the work outlined under Schedule F to the NIRA, in liaison with the AIHW and the ABS.
Data development projects already completed include:
- ABS improvements to Census Indigenous enumeration procedures and expansion of the Census Post Enumeration Survey.
- The report on Best Practice Guidelines for the Collection of Indigenous Status in Health Data Collections was published by the AIHW on 8 April 2010.
- The AIHW's National Indigenous Data Improvement Support Centre (NIDISC) has been established to support jurisdictions and service providers to implement the guidelines.
- The ABS has developed an ongoing six-yearly Indigenous health survey program (with additional funding from the Department of Health and Ageing). They have also funded an ongoing six-yearly Indigenous social survey program.
- Since the previous report, the AIHW has finalised reports on the assessment of the quality of Indigenous identification in labour force data collections, the National Cancer Registry, and the National Diabetes Register.
- AIHW has redeveloped a web portal on Indigenous identification in the community services, which provides information and resources related to improving Indigenous identification in health, community services and housing data sets.
- ABS and AIHW work in partnership with jurisdictions to 'lead analysis of the level of Indigenous identification in key datasets, including a baseline report and ongoing five-yearly studies to monitor identification over time'. States and territories have agreed to adopt the standard ABS Indigenous status question and recording categories on data collection and information systems for key data sets.
- States and territories have agreed to improve Aboriginal and Torres Strait Islander data collection procedures in key data collections including implementation of the Best Practice Guidelines.Top of page
- The AIHW is responsible for undertaking periodic evaluations of the implementation of the Guidelines from December 2012. In Phase 1 of the Guidelines evaluation and support project in 2011–12, the AIHW has focused on providing national support to assist in the implementation process, providing support in selected sectors and the collection of baseline information for the evaluation.
- States and territories have agreed to develop and implement a program to raise the Aboriginal and Torres Strait Islander community's awareness about the importance of identifying as Indigenous.
- ABS will link 2011 Census records with death registration records to assess the level of Indigenous identification.
- The National Best Practice Guidelines for Data Linkage Activities Relating to Aboriginal and Torres Strait Islander People were published jointly by the AIHW and ABS in July 2012 (AIHW & ABS 2012).
- Nationally consistent data items on smoking during pregnancy were included in the Perinatal NMDS from 1 July 2010.
- A data item for the Indigenous status of the baby was added to the Perinatal NMDS from 1 July 2012.
- A data item on gestational age at first antenatal visit was added to the Perinatal NMDS from 1 July 2010 and a data item on number of antenatal visits will be included in the Perinatal NMDS from 1 July 2013.
- Work is still underway to progress data elements related to alcohol use in pregnancy.
- A draft of the Business Case for the inclusion of Indigenous status on pathology request forms has been completed by the AIHW. As part of this work, the AIHW has investigated the capture of Indigenous status in relevant e-health initiatives, in particular the Personally Controlled Electronic Health Record (PCEHR) and the separate E-pathology program.Top of page
The nKPI data collection will be implemented in three stages, with rollout in 2012 and 2013. Commonwealth-funded Aboriginal primary health care services that participate in the Healthy for Life program began reporting on the first eleven nKPIs in July 2012. The Healthy for Life program essential indicators have been replaced by the new nKPIs. All OATSIH-funded services will report on the first 19 indicators in December 2012. From 2013–14, it is anticipated that all Commonwealth and state/territory funded services will report on the full set of 24 indicators.
The ABS continues to work on the Indigenous Administrative Data Project. This project aims to improve the level and quality of Indigenous identification in key administrative data sets held and managed by Australian governments. In this capacity, and complementing the COAG-funded activities the ABS has been conducting various engagement and education activities; liaising with government departments about best practice in Indigenous data collection, and conducting data linkage programs to assess and improve Indigenous identification status.
The ABS continues to utilise an Indigenous Community Engagement Strategy to improve the collection and dissemination of statistics, in partnership with Aboriginal and Torres Strait Islander communities. Through the use of Indigenous Engagement Managers in ABS offices across Australia, the ABS is building relationships with communities to improve the quality and relevance of Aboriginal and Torres Strait Islander statistics.
More information on ABS key directions in Aboriginal and Torres Strait Islander statistics can be obtained from ABS cat. no. 4700.0 ABS 2007.
The AIHW, along with the Australian Institute of Family Studies, manages the Closing the Gap Clearinghouse, which collates online source research and evaluation evidence on what works to overcome Aboriginal and Torres Strait Islander disadvantage. The Clearinghouse synthesises evidence for policy makers and service providers and presents it in an easy to read format. Issues papers and resource sheets identify the key issues on the topic, critically examine the evidence on the effectiveness of relevant programs and initiatives, and summarise the findings about what works and what does not work.
AIHW has redeveloped a web portal on Indigenous identification in the community services which provides information and resources related to improving Indigenous identification in health, community services and housing data sets.
A Voluntary Indigenous Identifier was introduced into the Medicare database from November 2002. By May 2012, 339,310 people had identified as Aboriginal, Torres Strait Islander, or both.Top of page
The AIHW is undertaking a project to develop an Enhanced Mortality Database to improve information on Indigenous status on the registered deaths data set by linking it to several additional data sources that contain information on Aboriginal and Torres Strait Islander deaths and Indigenous identification. The enhanced data are expected to enable more accurate estimates of Aboriginal and Torres Strait Islander mortality, including life expectancy, to be made. A report on the results of the first phase of the project which linked death registration data to hospital data, perinatal data and residential aged care data for the period 2001 to 2006 was published by the AIHW in July 2012—An enhanced mortality database for estimating Indigenous life expectancy: a feasibility study.
A project was undertaken by the AIHW in collaboration with the Centre for Health Research in Criminal Justice (CHRCJ), located within NSW Justice Health, as well as other stakeholders, to develop a national prisoner health data set to enable the monitoring of the health of prisoners. The project has involved an audit of current data collection on prisoner health in prisons; the development of a range of policy-relevant draft indicators for prisoners mapped to the National Health Performance Framework; and the development of detailed specifications for the data supporting these measures. Further AHMAC funding was provided to support the work program for 2008–09, including a national data collection. In 2010, the AIHW released The health of Australia's prisoners 2009 report. This report represents a major milestone on the road to a national data collection, including valuable data on the health of Aboriginal and Torres Strait Islander prisoners. In 2011, the AIHW released a second report on prisoner's health; The health of Australia's prisoners 2010.Top of page