Private business representing Local government clients
Name of your organisation (if applicable)
Organisation
ID Consulting Pty Ltd
What is your submission about?
Please provide a brief summary of your submission
Topic name
The suggestion to include a question or questions on long-term health conditions experienced by the population in the Census.
Choose your area of interest
Please select one item
(Required)
Population
Sex and gender
Households and families
Aboriginal and Torres Strait Islander peoples
Income and work
Unpaid work and care
Education and training
Disability and carers
Housing
Location
Transport
Cultural diversity
Religion
Ticked
Other topic
If Other topic please specify
Health
Assessment Criteria 1
1.
This topic is of current national importance.
National Importance
One of the most common questions asked of .id during our presentations on our community profile tools to Local Government is whether there is any information available on health topics. Generally this isn’t presented in the profile, as the Census has nothing on health beyond the “Need for assistance” question, addressed under our disability submission.
We recognise that collecting health information via the Census is difficult, but there is clearly substantial demand for this from Local Government. The National Health Survey has a lot of information on health conditions, and would likely remain the primary source for detailed information, due to the availability of an interviewer-based survey. The fact that is survey is collected every 3 years shows that the topic is of national significance and is likely to remain so.
National debates on health focus on two areas – provision of health services such as hospitals and aged care, and the prevalence of preventable lifestyle diseases and other long-term conditions. The provision of services are addressed to a large extent by current Census data, as they are mainly population/demographic based. Long term health conditions seems to be the most likely area in which the Census could have an impact. The complexity of health issues not withstanding, we believe that the Census could collect information on a limited range of conditions which are widely discussed in the community and could be the focus for national debate.
This could include, but not be limited to:
• Diabetes (Type 1 and 2)
• Obesity
• High blood pressure
• Obesity
• Mental Health – depression etc.
• Allergies
• Skin cancer
• Osteoporosis
• Asthma
• Other allergies
Assessment Criteria 2
2.
There is a need for data from a Census of the whole population.
For whole population
This information is already available in quite a lot of detail at the national and state level. The deficiency is local level information, specific to those areas of health that local authorities (local government and community organisations) can have an impact on, through management and education programs. For this purpose, small area data and data cross-tabulated by demographic sub-groups is of critical importance, hence the need to use the Census as a vehicle.
Assessment Criteria 3
3.
The topic can be accurately collected in a form which the household completes themselves.
Easy to answer
This is the primary difficulty with collecting health data in the Census. Health topics and definitions are inherently complex, and there may be a level of uncertainty and subjectivity to how a person answers – particularly for things like obesity and mental health.
For this reason, we think that the Census data on health, if included, should be limited to a few key diagnosed conditions which should be relatively unambiguous to respondents. This should be able to produce meaningful information at the local level. This should also be limited to “suffering from now” rather than questions about past – as this will then give a snapshot at a point in time on the total prevalence and be easier to answer. The National Health Survey could continue to be the vehicle for more detailed information on past and present conditions, but the Census data could then more readily be used to model this to small area levels.
Assessment Criteria 4
4.
The topic would be acceptable to Census respondents.
Acceptable
A question on health conditions may be considered intrusive to some. In the debates around privacy for the 2016 Census, these mostly centred on name and address collection and identification of individuals.
Health data is protected by strong privacy provisions and most people would consider it confidential, so there may be some issues if respondents didn’t consider their details to be kept confidential by the ABS. There is also the issue of multiple people using the same form, and perhaps not wanting to share this information with other householders. There are provisions for this in the online form and via personal forms in group households and NPDs which can alleviate this issue with other Census questions, but we need to acknowledge that health is probably a bit more sensitive again. Limiting to a set of pre-defined conditions with no “Other” option might assist with this, or (an alternative view) could in fact make this worth - making particular groups of people feel like they’re being targeted.
Assessment Criteria 5
5.
The topic can be collected efficiently.
Collected efficiently
For the broader health topic there would be substantial expense associated with coding and classifying (though it’s noted that the infrastructure for the NHS already covers a lot of this). But limiting to a few long-term conditions of national importance would limit this.
Assessment Criteria 6
6.
There is likely to be a continuing need for data on this topic in the following Census.
Continuing need
The main value of this data would actually in be having a time series – the purpose of looking at health data is to attempt to influence outcomes in the community, and what needs to be monitored is whether it’s getting better or worse. So if health information is to be collected at all, it must be in time series, hence a continuing need. The National Health Survey is run every three years on a regular cycle to enable this analysis.
Assessment Criteria 7
7.
There are no other alternative data sources or solutions that could meet the topic need.
No alternatives
The National Health Survey and Survey of Disability, Ageing and Carers are clearly two alternative sources from the ABS at a national level, and provide a greater level of detail than the Census is ever likely to be able to, in terms of conditions, type and severity, frequency etc. They lack information at the local level which is why the Census would be a good adjunct to this – combining Census data on these conditions with detailed survey data might also be useful.
Some states have comprehensive health surveys (Eg. Victoria) which can produce some information at a local level – but this is patchy at a national level.
Other sources would be admin-by-product data such as Medicare treatment records. This suffers from two problems – privacy issues are likely to make it very difficult to collect, and it will only capture those who seek medical treatment (having said that, the question as proposed may not capture people who haven’t been medically diagnosed anyway).
Any further comments?
If you would like to tell us anything else about your submission, please comment below.
Further comments
Thanks for the opportunity to submit on health. It's one of the most commonly requested topics to include in the Census from our client base, but we recognise it's not an easy topic to collect on a self-responded form. Hopefully this submission is useful in addressing some of these issues. While it's not a comprehensive framework for including health data in the Census it can be a starting point for discussion.