Indigenous Life Expectancy Using Multiple Australian Data Sources_PVERConf_May2011

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May 2011 Personal Validation Conference and Entity Resolution. Presenters: Richard Madden, Lisa Jackson Pulver

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  • Way back, before the current political climate, Australia was populated with peoples who had survived millennia upon a Land that sustained sophisticated peoples numbering 750 thousand to some 1.5 million or so peoples. There was no part of Australia where people did not live or know. This contradicts the wisdom of the new-comers who sent word of a great uninhabited Land, with a stone age resident incapable of understanding the ways of the times. They did nothing to describe fully the help that, originally the people of the Eora, gave to those disembarking the vessels sick and hungry, and ill equipped to deal with the Land before them. The people getting off the boats were quite unwell. They were sicker than those they left behind, and elicited a great deal of sympathy from the locals. And the healing treatments the newcomers received resulted in re-establishing wellness. And this is rarely acknowledged in history. And there are good reasons why people got well. I ’ ll speak of this later.
  • Indigenous Life Expectancy Using Multiple Australian Data Sources_PVERConf_May2011

    1. 1. Indigenous life expectancy using multiple Australian data sources Professors Richard Madden and Lisa Jackson Pulver , reporting the work of Richard Madden, Lisa Jackson Pulver, Ian Ring and Leonie Tickle
    2. 3. <ul><ul><ul><li>Source: Centre for Aboriginal Economic Policy Research, 2007 </li></ul></ul></ul>
    3. 4. Source: Census of Population and Housing: Population Growth and Distribution, 2001
    4. 5. Australia’s Indigenous Peoples <ul><li>2.5% of Australia ’s 21.9 million people identify as Aboriginal and/or Torres Strait Islander </li></ul><ul><li>Over 40% of these individuals are noted in the Medicare database as Indigenous </li></ul><ul><li>Majority live in Urban areas – 25% remote </li></ul><ul><li>A gradient of socioeconomic disadvantage with remoteness </li></ul><ul><li>Are over-represented on indicators of poor health and socioeconomic disadvantage </li></ul>
    5. 6. Who is an Indigenous Australian? <ul><li>“ An Aboriginal or Torres Strait Islander is a person of Aboriginal or Torres Strait Islander descent who identifies as an Aboriginal or Torres Strait Islander and is accepted as such by the community in which he (she) lives ” . </li></ul><ul><li>Statistical definition </li></ul><ul><li>Indigenous Status is a measure of whether a person identifies as being of Aboriginal or Torres Strait Islander origin. This is in accord with the first two of three components of the Commonwealth definition. </li></ul>
    6. 7. Health data and some issues <ul><li>Under-identification in many administrative data sets is a primary problem, due to: </li></ul><ul><ul><li>Historical & social factors </li></ul></ul><ul><ul><li>Different definitions over time & between data sets </li></ul></ul><ul><ul><li>Question not always asked (nor consistently) </li></ul></ul><ul><li>Extent of under-identification is not known and varies across data sets, state/territory, & time </li></ul><ul><ul><li>Death registrations, Birth registrations, National Perinatal Data collection, hospitalisations etc </li></ul></ul>
    7. 8. Australian population 2006
    8. 9. Non-Indigenous deaths 2005
    9. 10. Indigenous Population 2006
    10. 11. Indigenous Deaths 2006
    11. 12. Systematic under estimation <ul><li>Year Plausible scenario Official view </li></ul><ul><li>1788 750-800,000 300,000-1,000,000 </li></ul><ul><li>1891 200,000 200,000 </li></ul><ul><li>1901 150,000 150,000 </li></ul><ul><li>1911 130,000 100,000 </li></ul><ul><li>1921 120,000 80,000 </li></ul><ul><li>1933 117,000 70-80,000 </li></ul><ul><li>1947 132,000 78,817 </li></ul><ul><li>1954 151,000 70,678 </li></ul><ul><li>1961 178,000 84,270 </li></ul><ul><li>1966 199,000 85,610 </li></ul><ul><li>1976 255,000 160,915 </li></ul><ul><li>1986 325,117 250,738 </li></ul><ul><li>1996 414,390 414,390 </li></ul><ul><li>2006 517,043 517,043 </li></ul><ul><li>Source: Madden and Jackson Pulver 2010 </li></ul>
    12. 13. Development of Life Expectancy estimates <ul><li>In 1994, ‘ experimental ’ Indigenous population estimates introduced by Australian Bureau of Statistics (ABS) </li></ul><ul><li>First indigenous life expectancy estimate in 1998, based on 1991 census: </li></ul><ul><ul><li>Indirect method </li></ul></ul><ul><ul><li>Comparing 1991 and 1986 censuses </li></ul></ul><ul><li>Repeated for 1996 and 2001 census </li></ul>
    13. 14. New ABS direct method in 2009 <ul><li>For 2006 census, ABS used a direct demographic method </li></ul><ul><li>Mortality rates estimated from </li></ul><ul><ul><li>Indigenous deaths (numerator) </li></ul></ul><ul><ul><li>Indigenous population (denominator) </li></ul></ul><ul><li>Deaths from 7 August 2006 – 30 June 2007 were linked to census records </li></ul><ul><ul><li>92.8% Non-Indigenous records (106,945) linked </li></ul></ul><ul><ul><li>73.7% Indigenous records (1,327) linked </li></ul></ul><ul><ul><li>Source: ABS 2009a </li></ul></ul>
    14. 15. Consistency: the over-riding principle <ul><li>ABS Key Principle </li></ul><ul><li>‘ By aligning the deaths data to the population estimates derived from the 2006 Census and Post Enumeration Survey, the methodology assures consistency between the numerator (that is, estimates of deaths) and the denominator (estimates of population at risk)’ </li></ul><ul><li>In consultation, most outside the ABS argued for a second principle - both numerator and denominator need to be estimated accurately. </li></ul><ul><li>These two principles may be incompatible. </li></ul>
    15. 16. Life expectancy estimates at age 0 <ul><li>Male Female </li></ul><ul><li>Indigenous All Gap Indigenous All Gap </li></ul><ul><li>1991-1996 56.9 75.2 18.3 61.7 81.1 19.4 </li></ul><ul><li>1996-2001 59.4 76.6 17.2 64.8 82.0 17.2 </li></ul><ul><li>___________________________________________________________________ </li></ul><ul><li>2005-2007 67.2 78.7 11.5 72.9 82.6 9.7 </li></ul><ul><li>ABS warning: </li></ul><ul><li>Due to the significant changes in methodology, ABS strongly advises that comparisons </li></ul><ul><li>between the estimates presented here and previously published estimates should not be made. Differences should not be interpreted as measuring changes in Indigenous life expectancy over time. </li></ul><ul><li>Source: ABS 2009a (and earlier similar publications ) </li></ul>
    16. 17. Replacement not Ever Indigenous <ul><li>What ABS did: </li></ul><ul><li>In linked death records , ABS replaced Indigenous identification in death records by Indigenous identification in census records </li></ul><ul><li>Did not use ‘Ever Indigenous’ approach: if Indigenous in either collection, then Indigenous </li></ul>
    17. 18. NSW results <ul><ul><ul><ul><ul><li>DEATH REGISTRATION classification </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>CENSUS Indigenous Non-Indigenous Not stated TOTAL classification No. No. No. No. </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Indigenous 273 131 12 416 </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Non-Indigenous 87 34,460 196 34,743 </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Not stated 12 1,881 12 1,905 </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>TOTAL 372 36,472 220 37,064 </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>‘ Ever Indigenous deaths ’ : 515 (all deaths shown in green ) </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Source: ABS 2009a </li></ul></ul></ul></ul></ul>
    18. 19. Adjustment Factors by State <ul><li>Indigenous deaths 9 August 2006 - 30 June 2007 </li></ul><ul><li>Registered Estimated Increase Coverage Deaths Deaths % </li></ul><ul><li>NSW 372 427 14.8 87 </li></ul><ul><li>Qld 351 372 6.0 94 </li></ul><ul><li>WA 254 228 - 10.2 111 </li></ul><ul><li>NT 204 188 - 7.8 109 </li></ul><ul><li>Australia 1,327 1,441 8.6 92 </li></ul><ul><li>Source: ABS 2009a </li></ul>
    19. 20. 2005-2007 gaps by State/Territory <ul><li>Male Female Coverage </li></ul><ul><li>NSW 8.8 7.5 87 </li></ul><ul><li>Qld 10.4 8.9 94 </li></ul><ul><li>WA 14.0 12.5 111 </li></ul><ul><li>NT 14.4 11.9 109 </li></ul><ul><li>Australia 11.5 9.7 92 </li></ul><ul><li>Source: ABS 2009a </li></ul><ul><li>Note : T he order of the jurisdictions is in reverse order to the coverage estimates. Are differences between jurisdictions a data artefact ? </li></ul>
    20. 21. Life expectancy differentials - Remoteness Areas, 2005-2007 <ul><li>Males Females </li></ul><ul><li>Major Cities 107 105 </li></ul><ul><li>Inner & outer regional 103 102 </li></ul><ul><li>Remote & very remote 90 93 </li></ul><ul><li>Australia 100 100 </li></ul><ul><li>Source: ABS 2009b, Table 2.16 </li></ul><ul><li>Note: ABS assumed that under-identification of Indigenous deaths across Remoteness Areas is consistent across Australia </li></ul>
    21. 22. ABS option 2: Ever Indigenous <ul><li>Indigenous Deaths and Life Expectancy, ‘ ever Indigenous ’ approach </li></ul><ul><li>Registered Indigenous Increase Implied Life expectancy </li></ul><ul><li>Indigenous deaths % Coverage Male Female </li></ul><ul><li>Deaths ( ‘ ever Indigenous ’ ) </li></ul><ul><li>NSW 453 594 31.1 76 68.3 73.6 </li></ul><ul><li>Qld 429 493 14.9 87 67.2 72.7 </li></ul><ul><li>WA 387 422 9.0 92 62.3 67.9 </li></ul><ul><li>NT 341 345 1.2 99 59.9 67.9 </li></ul><ul><li>Australia 1,800 2,123 17.9 85 66.0 71.9 </li></ul><ul><li>Source: ABS 2009a, Appendix 2 </li></ul><ul><li>Note the more realistic coverage estimates. </li></ul><ul><li>ABS warning: ‘ This approach produces life expectancy estimates which are biased as the identification of Indigenous status in the numerator and denominator are inconsistent. ’ </li></ul>
    22. 23. ABS Ever Indigenous: sub-national <ul><li>Comparison of Consistent and Ever Indigenous estimates </li></ul><ul><li> Registered Indigenous deaths Decrease in life Indigenous ( ‘ ever Indigenous ’ ) expectancy Deaths & % increase Male Female </li></ul><ul><li>NSW 453 594 (31.1%) 1.6 1.4 </li></ul><ul><li>Qld 429 493 (14.9%) 1.1 0.9 </li></ul><ul><li>WA 387 422 (9.0%) 2.7 2.5 </li></ul><ul><li>NT 341 345 (1.2%) 1.6 1.3 </li></ul><ul><li>Aust 1,800 2,123 (17.9%) 1.2 1.0 </li></ul><ul><li>Source: ABS 2009a </li></ul>
    23. 24. NSW ever Indigenous estimates <ul><li>Linked NSW death records 2002-2006 and Admitted Patient Data collection, 2001-2006. </li></ul><ul><li>2461 registered Indigenous deaths </li></ul><ul><li>3164 ( 28.6 % increase) using ‘ever Indigenous’ rule </li></ul><ul><li>(ABS ever Indigenous increase was 31.1 %) </li></ul><ul><li>2995 ( 21.7 % increase) using a rule that excludes one identification in hospital where there are multiple records </li></ul><ul><li>No allowance can be made for people not ever reported Indigenous! </li></ul><ul><li>Source: Neville, Taylor, Moore, Madden, Ring, Jackson Pulver and Tickle (in press) </li></ul>
    24. 25. NSW life expectancy estimates <ul><ul><ul><ul><li>ABS published ABS ever Indigenous NSW estimate </li></ul></ul></ul></ul><ul><li>Male 72.1 69.2 69.8 </li></ul><ul><li>Female 77.2 74.6 75.2 </li></ul><ul><li>Source: Tickle and Madden, unpublished </li></ul><ul><li>Notes: </li></ul><ul><li>1 Estimates are for 2004-06 and so are not comparable to earlier tables </li></ul><ul><li>2 Further work is underway in NSW to identify a best practice algorithm for enhanced identification when more than two data sets are linked. Aim is to find an approach that can be used across time and across the various Australian and State data sets. </li></ul>
    25. 26. Life expectancy conclusion <ul><li>ABS made a major change in methodology </li></ul><ul><li>Large change to previous life expectancy estimates </li></ul><ul><li>Data used is limited: ABS data only, small numbers </li></ul><ul><li>ABS has announced intention to repeat census linkage after 2011 census, and to use same methods for estimating life expectancy </li></ul><ul><li>So debate and development of alternatives needs to continue </li></ul>
    26. 27. To sum up <ul><li>Aboriginal and Torres Strait Islander health issues are now receiving serious attention from statisticians </li></ul><ul><li>Long history of neglect reflected community attitudes, but there were bright spots up to 1930 </li></ul><ul><li>There continue to be major controversies </li></ul><ul><li>Statistics influence, and can drive policies </li></ul><ul><li>We have a right to be counted – be counted or don ’ t count </li></ul>
    27. 28. References <ul><li>AABS 2009a, ‘ Experimental Life Tables for Aboriginal and Torres Strait Islander Australians ’ , cat. no.3302.0.55.003 </li></ul><ul><li>ABS 2009b, Experimental Estimates and Projections, Aboriginal and Torres Strait Islander Australians, cat 3238.0 </li></ul><ul><li>ABS & AIHW 2008, ‘ The Health and Welfare of Australia ’ s Aboriginal and Torres Strait Islander Peoples ’ , AIHW cat. no. IHW 21 </li></ul><ul><li>Madden, RC and Jackson Pulver, L. 2009, ’ Aboriginal and Torres Strait Islander Population: More than reported ’ , Australian Actuarial Journal ,Vol 15 Issue 2 pp. 181 – 208 </li></ul><ul><li>Neville, S et al, ‘ Enhancement of reporting of deaths among Aboriginal and Torres Strait Islander peoples in ABS mortality data through linkage with hospital data ’ (in press) </li></ul>

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