Once-a-decade Census a 'major setback' for health in Australia

27 February, 2015

A proposal from the Australian Bureau of Statistics (ABS) to conduct the Census every ten years instead of five would come at an unacceptable cost to healthcare planning, according to a number of national health peak bodies.

Australian Healthcare and Hospitals Association (AHHA) Chief Executive Alison Verhoeven said that, while the proposal might help the ABS fund its planned IT systems upgrade, significant flow-on effects would negatively impact the Australian healthcare system.

"At a practical level, information from the Census is used in decisions about where hospitals and health services should be located, what services they should provide, and how health funding is distributed," Verhoeven said.

"It is imperative that consideration is given to developing alternative mechanisms to support health systems planning, before introducing wholesale changes to a key national data set such as the Census."

Social, economic, regional and cultural guidance

Public Health Association of Australia (PHAA) Chief Executive Officer Michael Moore said that the social, economic, regional and cultural dimensions of Census data provided essential guidance that could be muddied through the ABS proposal.

"We know that health is determined often by factors outside of the health portfolio by such things as housing, where you live, your remoteness, whether you have a job," Moore said. "If the Census is conducted less frequently, it will be very difficult for the government to focus their policy on the most effective ways to keep people healthy and keep them productive. It's the baseline on which we can understand the health of Australians."

Consumer Health Forum of Australia (CHF) Chief Executive Officer Adam Stankevicius said that, given the pace of change in the health area, it is vital that Australia has a regular snapshot of the population's health as offered by the five-year Census.

"You can't manage what you don't measure," Stankevicius said. "The rapid growth in the incidence of obesity and chronic disease are examples where timely statistics can help us combat these serious population health problems faster. A great strength of Australia's governance is its strong statistical system. We should not weaken it to meet short term bean-counting edicts."

Limiting understanding of population's health needs

Verhoeven said that, in particular, the ABS proposal would limit the country's understanding of the population health needs of Indigenous people and those living in rural and remote areas.

"Less frequent Census data and a reliance on sample-based surveys is of particular concern for these groups that already experience significant health inequity compared with other Australians," Verhoeven said.

As the Census provides the benchmark for population weighting other ABS sample surveys, the health peak bodies are concerned that the robustness of these processes will be lost. This includes concerns around the Australian Census Longitudinal Dataset, a valuable initiative for health research that commenced in 2006, which could be compromised by the ABS proposal.

The health peak bodies also fear that frequent smaller sample size surveys to supplement a ten-yearly Census, as proposed by the ABS, could be vulnerable to funding cutbacks, further undermining the credibility of population data.

While ABS-acknowledged concerns over the length of time it takes to release Census results are important to address, the health peak bodies warn there is no guarantee that the results of a ten-yearly Census would be available in a more timely manner.

"The proposed move to ten-yearly Censuses has been flagged less than three months prior to the Budget announcements by the Australian Statistician, who has publicly commented that the ABS is 'consulting widely with government'," Verhoeven said.

"The Census is such an important asset for the health sector that any changes should be the subject of wide consultation, and should be aimed at improving the data available to inform policy for a strong, productive and health Australia.

The national health peak bodies calling on the Treasurer and Australian Statistician to consult more broadly before taking this decision include the Australian Healthcare and Hospitals Association, the Public Health Association of Australia and the Consumer Health Forum of Australia.