Abstract
BackgroundIn the ongoing debate on optimum methods for identification of Indigenous people within linked administrative data, few studies have examined the impacts of method on population counts and outcomes in family-based linkage studies of Aboriginal children.ObjectiveTo quantify differences between three algorithms in ascertaining Aboriginal and Torres Strait Islander children in linked administrative data.MethodsLinked administrative health data for children born in Western Australia (WA) from 2000-2013, were used to examine the cohorts identified by three methods: A) the Indigenous Status Flag (ISF, derived by the WA Data Linkage Branch using a multistage-median approach) for the children alone; B) the ISF of the children, their parents and grandparents; and C) Indigenous status of the child, mother or father on either of the child’s perinatal records (Midwives or birth registration), to determine differing characteristics of each cohort.ResultsMethod B established a larger cohort (33,489) than Method C (33,306) and Method A (27,279), with all methods identifying a core group of 26,790 children (80-98%). Compared with children identified by Method A, additional children identified by Methods B or C, were from less-disadvantaged and more urban areas, and had better perinatal outcomes (e.g. lower proportions of small-for-gestational age, 10% vs 16%). Differences in demographics and health outcomes between Methods C and B were minimal.ConclusionsDemographic and perinatal health characteristics differ by Aboriginal identification method. Using perinatal records or the ISF of parents and grandparents (in addition to the ISF of the child) appear to be more inclusive methods for identifying young Indigenous children in administrative datasets.KeywordsAboriginal health, identification, data linkage, Indigenous, child, methodology
Highlights
In the ongoing debate on optimum methods for identification of Indigenous people within linked administrative data, few studies have examined the impacts of method on population counts and outcomes in family-based linkage studies of Aboriginal children
Disparities in health outcomes between Aboriginal and non-Aboriginal Australians occur from birth, with higher rates of Aboriginal children born preterm and/or small for gestational age [9, 10], and higher rates of infant and child mortality [11,12,13]
Creation of the Indigenous status flag (ISF): The ISF for an individual, used here in Method A and Method B, was created by the Western Australian Data Linkage Branch (WA Data Linkage Branch (DLB)) using a multi-stage median algorithm applied to variables indicating Aboriginal and/or Torres Strait Islander status from Midwives’ Notification System (MNS), Birth Registration, Hospital Morbidity Data Collection (HMDC), Emergency Department Data Collection (EDDC), and Death Registration datasets
Summary
In the ongoing debate on optimum methods for identification of Indigenous people within linked administrative data, few studies have examined the impacts of method on population counts and outcomes in family-based linkage studies of Aboriginal children. Routinely-collected health and other administrative data are frequently used to report on the health of populations groups [1,2,3]. This type of data is used to identify and track disparities in health between groups [4], to guide policy formulation, program development, service delivery, and allow large-scale evaluation of programs and policies [2, 5]. Given that methods used to identify Aboriginality in data may have differing impacts on the reported outcomes depending on the type of data and on the age and region [4, 15], it is important to examine these potential impacts
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