Bulletin 14 - Issues of identification of Aboriginality
![[Previous]](/images/arr_prev.gif)
![[Next]](/images/arr_next.gif)
![[Top]](/images/arr_top.gif)
Issues of identification of Aboriginality
The study of Aboriginal and Torres Strait Islander peoples' injury
requires calculations based on data systems that may not uniformly identify the
individual's Aboriginality. This could lead to discrepancies. It is
important to understand how the determination is made.
The Aboriginality of the deceased is determined by the coroner in the case of a
sudden or possibly unnatural death. Coroners obtain information from
investigating police officers, including interviews with relatives and
witnesses. Coroners are increasingly aware of the importance of death in
Aboriginal and Torres Strait Islander communities and ensure that
identification of Aboriginality is made so that the proper arrangements with
relatives can be made. The majority of injuries, with the exception of some
fall-related deaths among the elderly, are certified by coroners. Funeral
directors, after contact with families of the deceased, sometimes supply
additional information to registrars of death that may lead to additional cases
being identified as Aboriginal or Torres Strait Islander on the death
certificate. The death certificate provides the information used by ABS to code
Aboriginality. Queensland has only required this information on death
certificates from January 1996, thus it has been impossible to determine the
Aboriginal and Torres Strait Islander injury death rate in that state.
Benham has shown that New South Wales and Victoria stand out as having
substantial under-enumeration of deaths of indigenous persons[7]. The extent
to which this applies to injury is unknown, but it is likely that coronial
investigation of injury cases reduces the proportion of cases where
Aboriginality is not identified.
Aboriginality is identified during hospital admission procedures. Generally the
information is gained by self report from the patient or relatives during the
collection of personal information by clerical staff. Little is known about the
uniformity of these procedures. It is not known, for example, what proportion
of patients or families are asked whether the patient is of Aboriginal or
Torres Strait Islander descent. The practices almost certainly vary from
hospital to hospital and from one geographic region to another. One example[8]
shows that under-identification of Aboriginal and Torres Strait Islander
peoples in Victoria is considerable:
"For the first year of mandatory reporting of Aboriginality of hospital
patients there was a significant increase in the number of Koori admissions.
There were 2683 Koori admissions to public hospitals reported in 1992-93. This
increased to 4212 Koori admissions in public hospitals for 1993-94."
This represents a 57 per cent increase which suggests probable substantial
under-identification in the 1991/92 Victorian data. Even if other states do not
experience such a large discrepancy, it is likely that the level of
underestimation is high and therefore comparative rate ratios between
Aboriginal and Torres Strait Islander peoples and non-Aboriginal people will
underestimate the real difference in risk levels.
Aboriginality is determined by self-reporting at the Census. Detailed studies
by ABS have shown that the proportion of people who indicate that they are of
Aboriginal or Torres Strait Islander descent at the Census is an underestimate.
The Census employs collectors who check forms and use consistent procedures to
ensure that data items are as complete as possible. The method is therefore
more rigorously controlled than those that operate in relation to deaths and
hospitalisations data collections.
It is clear that the process of determination of Aboriginality in routine data
collections is not straightforward. The willingness to identify oneself as of
Aboriginal or Torres Strait Islander descent varies from setting to setting.
The opportunity to obtain information also varies. It is clear that each of the
data sets used for describing injury patterns in the Aboriginal and Torres
Strait Islander peoples are, at best, estimates that contain errors associated
with the way in which information is gained. Furthermore, it is clear that
death, hospitalisation and population estimates are all underestimates of
actual Aboriginal and Torres Strait Islander numbers. It seems most likely that
the underestimation is highest in hospitalisations data, less of a concern in
deaths data and best understood in the population estimates.
7. Benham D. Estimates of the Aboriginal population: review of data sources.
Demography Working Paper: 93/2. Canberra: Australian Bureau of Statistics,
1993.
8. Koori Health Unit, Department of Human Services, Victoria (1996). Koori
illness in the community.
|