Data landscape for the National Aboriginal and Torres Strait Islander Health Plan 2021–2031

Review of the data landscape

The Health Plan details 12 priority areas and 52 objectives, which were used as the basis of the data landscape review. The 12 priorities areas are:

• Enablers for Change
  • Priority 1: Genuine shared decision making and partnerships
  • Priority 2: Aboriginal and Torres Strait Islander community controlled comprehensive primary health care
  • Priority 3: Workforce
• Focusing on Prevention
  • Priority 4: Health promotion
  • Priority 5: Early intervention
  • Priority 6: Social and emotional wellbeing and trauma-aware, healing-informed approaches
  • Priority 7: Healthy environments, sustainability and preparedness
• Improving the Health System
  • Priority 8: Identify and eliminate racism
  • Priority 9: Access to person-centred and family-centred care
  • Priority 10: Mental health and suicide prevention
• Culturally informed evidence base
  • Priority 11: Culturally informed and evidence-based evaluation, research and practice
  • Priority 12: Shared access to data and information at a regional level.

Existing measures and data sources were reviewed to assess whether they could be used to report against objectives of the Health Plan. Other indicator reports relevant to the health and wellbeing of First Nations people were reviewed to determine whether they contained any relevant measures, or data sources. Detailed findings are available under Data.

Key resources for the review were the Steering Committee for the Review of Government Service Provision’s Overcoming Indigenous Disadvantage reports and the 3 websites hosted and managed by the AIHW which provide comprehensive, up-to-date information about First Nations health outcomes and relevant factors:

• The Aboriginal and Torres Strait Islander Health Performance Framework (Aboriginal and Torres Strait Islander HPF) website brings together information from numerous sources to provide a comprehensive, up-to-date view of the determinants of health, health system performance and First Nations health outcomes. It is designed to inform policy, service planning, program development and research. The Aboriginal and Torres Strait Islander HPF provides statistical and qualitative information, and information drawn from the latest relevant program evaluations and research. Information for the Aboriginal and Torres Strait Islander HPF website is provided by both the AIHW and the National Indigenous Australians Agency (NIAA).
• The Regional Insights for Indigenous Communities (RIFIC) website brings together a range of regional statistics about the health and wellbeing of First Nations people and their communities, with the aim of providing access to data at a local level, to help communities set their priorities and participate in joint planning with government and service providers.
• The Indigenous mental health and suicide prevention clearinghouse brings together information about First Nations people's wellbeing, mental health and suicide prevention.

The Aboriginal and Torres Strait Islander HPF was a particularly valuable resource, with much information relevant to the Health Plan objectives. The Aboriginal and Torres Strait Islander HPF draws on data from over 60 data collections.  

The data review also looked at the potential for disaggregation available in each data source (see Data Tables: A2) and highlighted areas where there are data gaps. Where data gaps were identified, other data sources were explored to determine whether those gaps could be filled.

Data sources identified and potential for disaggregation

Over 60 national data sources were identified through this stocktake, spanning survey, administrative, Census and linked datasets, detailed in Data Tables: A2. The administrative and ABS Census of Population and Housing data sets listed in Data Tables: A2 have Indigenous status information. The surveys are either First Nations-specific or can be disaggregated by Indigenous status:

• First Nations-specific surveys – some have potential non-Indigenous comparators from other sources. For example, ABS National Health Survey data are often used to source non-Indigenous comparators for ABS National Aboriginal and Torres Strait Islander Health Survey data. Not all variables in the First Nations-specific surveys will have non-Indigenous comparators in other surveys.
• total population surveys – as the sampling is designed for the total population, the sample of First Nations people is often relatively small (and not necessarily representative), and the ability to report and disaggregate data for First Nations people from those surveys is very limited. For example, in the 2019 AIHW National Drug Strategy Household Survey (NDSHS), First Nations people living in non-remote First Nations communities constituted 2.4% of the total sample (or 533 respondents). While this enables high-level results to be reported by Indigenous status, results based on this number of people are subject to high sampling error with limited ability to further disaggregate the data.

An initial assessment of the potential to disaggregate the data by the following categories was also completed:

• age group and sex
• state/territory, and other geographic regions
• disability status
• LGBTQIA+ status (Table 1).

This assessment was based on variables available in each data set. The usefulness of these disaggregations for a particular measure is affected by factors such as sample size and data quality. Even though the option of disaggregation may be available, it may not always be possible to perform robust analysis or publish the data.

Notes

1. Full list of data sources, including frequency and level of disaggregation, is available in Attachment C.
2. This assessment was based on variables available in each data set. The reliability of these disaggregations is affected by factors such as sample size and data quality.

Notes on some data sources

Data sources that exist only in some jurisdictions have not been included in this stocktake.

Over the past few years, the collection of some relevant information has been discontinued, or the data source has not been updated recently. These include:

• ABS National Aboriginal and Torres Strait Islander Social Survey (NATSISS). The NATSISS (or its predecessor the NATSIS) was conducted in 1994, 2002, 2008, and for the last time in 2014-15. The NATSISS collected detailed information on the social and cultural experiences of First Nations people.
• AIHW Online Services Report (OSR) – selected data items discontinued. Information on organisations funded by the Australian Government under its Indigenous Australians’ Health Programme (IAHP) to deliver culturally appropriate primary health care services to First Nations people is available through 2 data collections – the OSR and the national Key Performance Indicators (nKPI) collections. In May 2018 the AIHW was commissioned by the Department of Health and Aged Care to undertake a comprehensive review of these two data collections to refine and improve the usefulness of the collections and reduce reporting burden. The review recommended that several OSR data items be redeveloped, including details of the types of services provided and cultural safety items, among others. At the same time, there was a transition from organisations reporting their data through OCHREStreams to the Department of Health and Aged Care’s Health Data Portal (HDP), and the Aboriginal and Torres Strait Islander Health Services Data Advisory Group (HS DAG) agreed to a temporary removal of selected data items while these were being redeveloped (beginning with the 2018-19 OSR collection). The re-addition of these items was further delayed to ensure their alignment with the NACCHO Core Services and Outcome Framework. Discussions around these items will form part of the planned 2025 OSR/nKPI review.
• AIHW Cultural safety in health care for Indigenous Australians: monitoring framework. The monitoring framework relies on the availability of source data. For the 2023 release, 26 measures out of 48 were updated. New data for the other 22 measures were not available, including 14 for which data are no longer collected. This was due to discontinued surveys or data items, revisions to survey questions or frequency of data collection (see the technical notes of the monitoring framework for details). Development of data and measures in this area need to be mindful of close linkages to Closing the Gap and the development of the next National Health Reform Agreement.

Foundations for a Healthy Life

For this report the focus was on the data related to the objectives of the Health Plan framework. The report does not specifically provide data sources or measures for the holistic context components of the framework:

• Foundations for a healthy life
• The cultural determinants of health & the social determinants of health.

Life course

The Health Plan framework outlines 4 life course stages: healthy babies and children (ages 0–12); healthy youth and adolescents (ages 12–24); healthy adults (ages 25–49); and healthy ageing (ages 50+). The data review includes an assessment of availability of data by age across all data sets, available in Data Tables: A2.

References

SCRGSP (Steering Committee for the Review of Government Service Provision) Overcoming Indigenous Disadvantage, Productivity Commission, accessed 16 October 2024.

AIHW (Australian Institute of Health and Welfare) (2020) National Drug Strategy Household Survey 2019. Drug Statistics series no. 32. PHE 270. Canberra. accessed 23 October 2024.