Abstract
BackgroundAboriginal and Torres Strait Islander peoples are under-reported in administrative health datasets in NSW, Australia. Correct reporting of Aboriginal and Torres Strait Islander peoples is essential to measure the effectiveness of policies and programmes aimed at reducing the health disadvantage experienced by Aboriginal and Torres Strait Islander peoples. This study investigates the potential of record linkage to enhance reporting of deaths among Aboriginal and Torres Strait Islander peoples in NSW, Australia.MethodsAustralian Bureau of Statistics death registration data for 2007 were linked with four population health datasets relating to hospitalisations, emergency department attendances and births. Reporting of deaths was enhanced from linked records using two methods, and effects on patterns of demographic characteristics and mortality indicators were examined.ResultsReporting of deaths increased by 34.5% using an algorithm based on a weight of evidence of a person being Aboriginal or Torres Strait Islander, and by 56.6% using an approach based on 'at least one report' of a person being Aboriginal or Torres Strait Islander. The increase was relatively greater in older persons and those living in less geographically remote areas. Enhancement resulted in a reduction in the urban-remote differential in median age at death and increases in standardised mortality ratios particularly for chronic conditions.ConclusionsRecord linkage creates a statistical construct that helps to correct under-reporting of deaths and potential bias in mortality statistics for Aboriginal and Torres Strait Islander peoples.
Highlights
Aboriginal and Torres Strait Islander peoples are under-reported in administrative health datasets in New South Wales (NSW), Australia
Enhancement resulted in 780 reported deaths using the algorithm and 908 reported deaths using ‘at least one linked record’ where the person was reported as Aboriginal or Torres Strait Islander (Table 1)
Perinatal Data Collection and Registry of Births, Deaths and Marriages birth registration data. aFor 3 or more linked units of information 2 are required to report an individual as Aboriginal or Torres Strait Islander, otherwise 1 is sufficient. bCancer cause of death codes ICD-10: C00-C97. cCardiovascular diseases cause of death codes ICD-10: I00-I99. dExternal causes of death codes ICD-10: V01-Y98 eAccessibility/Remoteness Index of Australia—ARIA Plus 12. fTotal includes records with missing information ARIA+ or cause of death
Summary
Aboriginal and Torres Strait Islander peoples are under-reported in administrative health datasets in NSW, Australia. Correct reporting of Aboriginal and Torres Strait Islander peoples is essential to measure the effectiveness of policies and programmes aimed at reducing the health disadvantage experienced by Aboriginal and Torres Strait Islander peoples. Improving the health of Aboriginal and Torres Strait Islander peoples is a priority under the Australian Government’s National Partnership Agreement on Closing the Gap on Indigenous Health Outcomes [1] This Agreement aims to reduce the disadvantage experienced by Aboriginal and Torres Strait Islander peoples with respect to life expectancy, child mortality, access to early childhood education, educational achievement and employment outcomes. Correct reporting of Aboriginal and Torres Strait Islander peoples in health and healthrelated data collections is essential to measure the effectiveness of policies and programmes aimed at reducing. Using a record linkage method (linking Census to death registrations data), the ABS estimated that the rate of reporting of deaths among Aboriginal and Torres Strait Islander peoples was 76% in 2006–07 [3]. Information on Aboriginal and Torres Strait Islander peoples is drawn from all linked records and used to ‘enhance’ information on the ABS death data
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