Ethnicity Data Quality Flashcards

Question

Wider determinants of health

Answer 1

Measuring Māori health status and need as health is also driven by wider deteminants of health. Education, income, employment, deprivation, racism. Common sources come from Stats NZ, MoE, NZ Health Survey, Te Kupenga.

Answer 2

Health service performance PHO enrolments, hospitalisations, cancer registry, PHARMs, PRIMHB (mental health), immunisation. ASH is a subset of the broader category of PAH Amenable mortality (timely access to high quality care) and preventable mortality (primary prevention) Health workforce Māori rates compared to targets Patient reported unmet need and satisfaction (NZHS and HQSC)

Answer 3

Reducing inequities Life expectancy (StatsNZ), mortality rates (StatsNZ), HALE, YLL Across all diseases, health care and determinants

Answer 4

* How common are different diseases for Māori? * At what level of disease (e.g., stage) are Māori being diagnosed? * Which diseases cause the most deaths in Māori? * How do the above vary by age group, gender, region, SES? * How are these changing over time?

Answer 5

Most population: numbers that have been age-standardised and compared to other ethnic groups “which diseases are the most common for Māori?” or “which diseases cause the greatest numbers of deaths for Māori?” Rankings: most common registrations and greatest number of deaths

Answer 6

Examine patterns of health and healthcare use within the Māori population by factors such as age, gender, location, and deprivation. Who is being affected by conditions or using services and who is not. Ethnicity data quality varies by age and gender so should be considered

Answer 7

In addition to understanding which diseases are the most common or have the highest mortality at a single point in time, it is useful to look at trends over time. The Māori population is ageing over time, increasing the numbers and proportions of Māori in older population groups. Diseases that occur in these older age groups will become more common. To assess whether there is a greater risk of a disease over time, it is necessary to remove the effect of the ageing population from the analysis. Assume the same age pattern at each point in time. Usually not real rates of disease. Māori 2001 population standard - as the population gets olders, becomes less representative. However, calls to update must be balanced against the interruption of time series. Māori have a younger population age structure to nM. Therefore, age standardisation should be applied to comparator groups.

Answer 8

All of the methods to measuring health need, access and quality can be compared to another population group to assess inequities. Comparison of Māori compared to Pākehā, has been criticized as implying that Māori should be seeking to achieve a Pākehā standard. Whether Māori rights to health are being met and indicates the responsiveness of the health system and wider government to address Māori health needs as a right, shifts the focus away from blaming Māori for poor health to highlighting the role of systems in generating disadvantage and privilege. Colonialism and racism as the basic causes of Māori inequities.

Answer 9

Range of methods to grouping or categorising ethnicity data Aggregating groups are prioritised, total response or sole/combination. Depends of the questions being asked. Example - healthcare privilege Numerator = prioritised (Māori) Denominator = sole combination (NZ European) Comparator groups should not be overlapping (total European or total NZ) 1. have clear rationale for the comparator group selected, including in relation to Te Tiriti o Waitangi, 2. select a comparator group that does not overlap with Māori (i.e., is mutually exclusive), 3. understand who is represented in the comparator group, and how this may impact on measured inequities, and 4. understand data quality limitations (including misclassification of ethnicity and missing data) and potential impacts on measured inequities.

Answer 10

The use of Māori/non-Māori analyses acknowledged the fundamental nature of our relationship with the Crown affirmed in Te Tiriti o Waitangi Non-overlapping comparison group non-Māori includes ethnic groups which may skew the data and underestimate the inequities (Pacific).

Answer 11

European as the most socially privileged population Consistent with a Te Tiriti approach in relation to power and equity). Relatively clear who is represented in the sole European comparator group. When sole European is not available, could do nM non Pacific

Answer 12

Count of all people who usually live in NZ or in an area of NZ and who are present on a given census night. Does not include NZ citizens who are overseas or temporary visitors. Ethnicity is sourced, in order of priority, from: self-identified ethnicity from the 2018 Census (84.4%); admin enumerated from the 2013 Census (8.2%); admin enumerated from other administrative data sources (6.2%) e.g., birth registrations and health.

Answer 13

Little documentation about it, no evidence of Maori input into the development (breach of Maori data sovereignty). Lack of information of data quality and limitations. Subset of the NHI Estimate of the population using the health system in NZ in a given time period (previous 12 months). 1. Use health services 2. Enrolled in a PHO 3. Received a COVID-19 vaccination Maori disproportionately represented in the group that is within ERP but not using health services. Not Te Tiriti compliant for analysing Maori health and equity as it does not measure the total population, excluding Maori who have not had access to services. Miss classification (under counting) of Maori who have accessed health services and excludes peoples who have not accessed services. Cannot be used for time-series data because of regular updating and changing size. Also has a 6 month lag for availability. Benefit: HSU is updated annually which means regular access than the 5 yearly census. Avoidance of numerator-denominator bias.

Answer 14

Numerator: number of times an event has occurred in a population Denominator: choose an appropriate denominator usually related to the population or the total events.

Answer 15

The Integrated data infrastructure (IDI) can be used to create an IDI-ERP which is a subset of “currently resident” individuals linked to the IDI spine. It includes individuals known to be alive and based in NZ (using deaths and migration data), with activity in the preceding year within any of health, ACC, taxation, and education datasets; and for those under the age of 5 years, a birth registration or visa approval (excluding visitor and transit visas) and when the record is linked in the IDI spine. The IDI-ERP has been measured to be 2% larger than the official population estimate, with variations by age and ethnicity. Access to IDI is limited to those with access to StatsNZ accredited data lab and expertise which is a concern to Maori data sovereignty, lack of consent for collected data to be included in the IDI, risk to personal privacy and risk of harm from inappropriate framing. Little documentation of the methods and limitations of the dataset. Ethnicity data is source-ranked

Ethnicity Data Quality Flashcards

(39 cards)