social indicators for addressing health inequalities

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Social Indicators

For

Addressing

Health Inequalities

2003


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The State of Queensland

Queensland Health, 2003

Copyright protects this publication. However, Queensland Health has no objection to thismaterial being reproduced with acknowledgment, except for commercial purposes.Permission to reproduce for commercial purposes should be sought from the Policy andQuality Officer, Queensland Health, GPO Box 48, Brisbane Q 4001.

ISBN: 0 7345 2921 X

This document is available on the Queensland Health Internet site at:http://www.health.qld.gov.au/HealthyLiving/social_determinants_HP.htm.

Social Indicators for Addressing Health Inequalities Version 1, 2003, prepared by theSouthern Public Health Unit Network, West Moreton Public Health Unit for Public HealthServices, Queensland Health.

For further information and copies contact:

Southern Public Health Unit NetworkWest Moreton Public Health Unitc/- Ipswich HospitalChelmsford AvenuePO Box 73IPSWICH 4305

Ph: 07 3810 1500Fax: 07 3810 1155

email: [email protected]
http://www.health.qld.gov.au/HealthyLiving/social_determinants_HP.htmhttp://www.health.qld.gov.au/HealthyLiving/social_determinants_HP.htmhttp://www.health.qld.gov.au/HealthyLiving/social_determinants_HP.htm


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FOREWORD

This report aims to serve a growing demand for a compilation of a concise but

comprehensive list of social indicators for use by staff of Public Health

Services in assessing the impact of government policies on health and health

inequalities within Queensland. This initial listing contains 60 individual and

clustered social indicators grouped according to their being identified as either

socioeconomic or community capacity factors. It needs to be acknowledged

however, that in some cases the indicator could be relevant to either

dimension. Public Health Services is continuing its efforts with active

collaboration within Queensland Health to extend the set of indicators andimprove their comparability.

The chosen indicators are listed together with their general information on

sources and definitions. Most of the indicators are readily and easily available

and in the majority of cases accessible through the Internet on a regular basis.

John ScottManagerPublic Health ServicesQueensland Health

July 2003


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Contents

Foreword ...................................................................................................................... 1

Overview of the document...........................................................................................5

PART 1 ............................................................................................................6

AN INTERPRETATIVE GUIDE...................................................................................................6

What are social indicators for?....................................................................................7

The structure of the indicators ....................................................................................7

The use of the indicators .............................................................................................8

Figure 1: National Health Performance Framework...................................................................9

Description of the indicators ..................................................................................... 10

Caution ....................................................................................................................... 10

The future ................................................................................................................... 11

Review process..........................................................................................................13

PART 2 ..........................................................................................................14

SOCIAL INDICATORS ...........................................................................................................14

SOCIOECONOMIC FACTORS.................................................................................................15

Benefits.......................................................................................................................15

1. Dependent children of selected pensioners and beneficiaries as a percentage of

all children aged from 0-15 years by SLA. ................................................................. 152 Proportion of people receiving a pension by type of government

pension/allowance (principal and auxillary, full or part) by gender. ............................. 16

3. Proportion of sole parent pensioners as a percentage of all persons aged 15years and over by gender. ........................................................................................ 16

4. Unemployment benefits by region by sex. ................................................................. 17

Death rates ................................................................................................................. 17

5. Gender differentials in death rates across socioeconomic quintiles for malesand females aged 15 years old and above. ............................................................... 17

Education.................................................................................................................... 18

6. De-enrolment and retention rates in government and non-government schools..........18

7. Proportion of highest level of schooling completed (highest educationalattainment) by age and gender for persons aged 15 years and over. ......................... 18

8. Percentage of year five students achieving the national reading benchmark...............19

9. Percentage of year five students achieving the national numeracy benchmark...........20

Employment ...............................................................................................................20

10. Labour force status by gender and age for persons aged 15 years and over. .............20

11. Number of unemployed and unemployment rates, States/Territories andStatistical Local Areas, June Quarter 2001 to June Quarter 2002. ............................. 21

12. Trends in proportion of employed persons by industry by gender and age..................22

13. Trends in unemployment rates by gender and age groups.........................................22


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14. Trends in participation rates by gender and age groups.............................................23

15. Trends in long-term unemployment as a proportion of total unemployed. ...................23

16. Trends in proportion of employed persons by gender and age. ..................................23

17. Underemployment Populations by State or Territory of usual residence forSeptember 2000. (Includes underemployed workers by sex). ................................... 24

Health Expenditure.....................................................................................................25

18. Health expenditure Australia 2000-01. ......................................................................25

19. Trends in proportion of adults covered by private health insurance in addition toMedicare..................................................................................................................26

20. Trends in proportion of adults holding a Health Care Card by card type andgender.....................................................................................................................26

Housing Costs............................................................................................................ 26

21. Monthly housing loan repayment: Occupied private dwellings being purchased..........27

22. Weekly rent by landlord type: occupied private dwellings being rented.......................27

COMMUNITY CAPACITY.......................................................................................................28Community support services.....................................................................................28

23. Proportion of children receiving formal and informal care by State. ............................28

24. Distribution of health facilities by statistical division....................................................29

25. Proportion of surveyed Queensland communities with limited access to healthyfood basket items...... ............................................................................................... 30

Demography ...............................................................................................................30

26. Collection of demographic indicators available through Queensland Health................30

27. Indigenous population by age, sex and statistical local area (time series)...................31

28. Indigenous population by age (5yr gaps), sex, statistical local areas and health

service districts ........................................................................................................ 31

29. Age (5 yr gaps) by sex by statistical local area and health service districts, Qld..........31

30. Births selected variables as per Perinatal Annual Report, Qld.................................31

31. Proportion of population of postcode in each SLA in Qld (SD, SSD and Districtidentifiers)................................................................................................................31

Ethnicity......................................................................................................................32

32. Ancestry by birthplace of parents. .............................................................................32

33. Birthplace (countries) by sex..................................................................................... 32

34. Birthplace (regions) by sex. ......................................................................................33

35. Distribution of Emerging Communities by Local Government Area.............................3336. Humanitarian entrants by birthplace and region of settlement. ...................................34

37. Language spoken at home by sex. ...........................................................................34

38. Proficiency in spoken English by year of arrival in Australia. ...................................... 35

Family .........................................................................................................................35

39. Family type - families and persons in families in occupied private dwellings(excluding overseas visitors).....................................................................................35

40. Weekly family income by family type: Families in occupied private dwellings.............. 36

Housing needs ...........................................................................................................36

41. Estimated potential SAAP clients and unmet needs by gender, age and State. ..........36

42. Dwelling structure - private dwellings and persons in occupied private dwellings. ....... 37


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43. Dwelling structure by tenure type and landlord type: Occupied private dwellings. ....... 37

44. Number of SAAP support periods of accommodation on the 15th of the month,by month and region, Queensland. ........................................................................... 38

45. Distribution of private dwellings by type of occupancy (rented, beingpurchased). ............................................................................................................. 38

46. State government housing assistance by program and type of assistance,Queensland, 1988-89 to 1997-98. ............................................................................ 39

Income ........................................................................................................................ 39

47. Distribution of weekly individual income by age and gender (persons aged 15years and over)........................................................................................................ 39

48. Distribution of weekly household income by household type. .....................................40

49. Population distribution by index of relative disadvantage Socio EconomicIndexes For Areas (SEIFA).......................................................................................40

50. Type of educational institution attending (full-time/part-time). .....................................41

Safety..........................................................................................................................41

51. Victim of assault in last 12 months. ........................................................................... 42

52. Victim of break-in in last 12 months. .........................................................................42

53. Victim of assault or break-in in last 12 months...........................................................42

54. Victim of domestic violence in the last 12 months (source: Family Services whofunds a domestic violence service for NESB women: the Immigrant WomensEmergency Support Service).................................................................................... 42

55. Feelings of safety at home during day:......................................................................42

56. Crime and Safety - Offences reported by police region and type of offence,Queensland, 1991-92 to 2000-01. ............................................................................ 42

Social supports ..........................................................................................................43

57. Relationship in household by age by sex Persons in occupied privatedwellings. ................................................................................................................ 43

58. Religious affiliation by sex. .......................................................................................43

59. Social Capital (generalised reciprocity and cohesion; community identity;generalised trust; tolerance of diversity; civic trust; community involvement;informal social networks), Queensland...................................................................... 44

Transport .................................................................................................................... 44

60. Method of travel to work by sex: Employed persons (excluding overseasvisitors)....................................................................................................................45


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OVERVIEW OF THE DOCUMENT

This document has been produced as a tool to aid Public Health Service(PHS) staff in addressing health inequalities. It comprises two parts: an

Interpretive Guide and a Social Indicators set.

Part 1: An Interpretative Guide.The guide discusses why social indicators are important in public healthpractice whilst acknowledging that many of the indicators chosen are outsidethe traditional role of the health system. The indicators have been organisedaccording to the framework devised by the National Health PerformanceCommittee.1 Using this framework, upstream determinants are divided intothe categories of socioeconomic and community capacity factors.

A number of possible uses for the indicators are provided including those

suitable for adoption and reporting on the social conditions of whole-of-population and various sub-populations of the Queensland community. Equityis an important component of these factors. As such the indicators help us tounderstand the social environment as a consequence of government policy.

Possible future indicators at the macro level are identified which may beworthwhile for PHS to explore in terms of their impact on health and healthinequalities including activation policies; ecological footprint; healthycommunities index; income inequality; safe communities; and tax burden.

Part 2: Social Indicators.

This section outlines the actual social indicators that have been identifiedunder the categories of socioeconomic and community capacity factors. Eachcategory comprises a number of sub-categories with specific indicators.

The socioeconomic sub-categories include: benefits; death rates; education;employment; health expenditure; and housing costs. The community capacitysub-categories include: community support services; demography; ethnicity;family; housing needs; income; safety; social supports; and transport.

The chosen indicators are by no means exhaustive and have been listedtogether with their general information on sources and definitions. Most arereadily available and easily accessible via the Internet. Wherever possible theactual web address has been provided as the first point of call for theinvestigator.

The indicator set selected for inclusion in this document are aligned with, andcomplement Queensland Healths Health Determinants Reports (formerlyknown as Zonal Indicator reports). The indicators identified in this reportreflect our best understanding as of June 2003, however, it is anticipated thatthis document will be reviewed and updated as the evidence base develops.

1

National Health Performance Committee (2002) National Report on Health SectorPerformance Indicators 2001. A report to the Australian Health Ministers Conference.Brisbane: Queensland Heath.


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Part 1

An Interpretative Guide


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Part 1 An Interpretative Guide

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WHAT ARE SOCIAL INDICATORS FOR?

Socioeconomic and community capacity factors are important determinants ofhealth. Many of the indicators listed within this document are external to the

traditional view of the health system, for example, education, employment,community infrastructure. In order to evaluate the impact of policy on health,it is important to identify need and measure the impact of socioeconomic andcommunity determinants on health outcomes. Reporting of health outcomesagainst social determinants will work towards highlighting the need for andfacilitate inter-sectoral approaches where appropriate to improve healthoutcomes.

The indicator set contained within this document aligns with and complementsthe health indicators reported on within Queensland Healths zonal indicatorreports2

THE STRUCTURE OF THE INDICATORS

The structure applied in this document falls well short of being a full-scaleframework for the collection of social statistics but nevertheless reflects theupstream social dimensions contained within the framework developed bythe National Health Performance Committee (NHPC) (Figure 1)3.

! Socioeconomic factors have been shown to have a clear associationwith health status with lower socioeconomic groups having poorer healththan those better off4. Reporting the socioeconomic factors affecting

health will help to inform public policy. Appropriate indicators includehealth outcomes or health determinants affected by education,employment status, or income.

! Community capacity incorporates information on characteristics that caninfluence health such as housing, community support services andtransport. It also includes measures of local services. Concepts andmeasures of community capacity are currently the focus of much debate,research and development.

2Queensland Health (2001) Health Indicators for Queensland: Southern Zone. Brisbane:

Public Health Services, Queensland Health. Note, reports are also available for the Centraland Northern Zones.3

National Health Performance Committee (2002) National Report on Health SectorPerformance Indicators 2001. A report to the Australian Health Ministers Conference.Brisbane: Queensland Health.4

Turrell, G.; Oldenburg, B.; McGuffog, I. and Dent, R. (1999) Socioeconomic Determinants ofHealth: Towards a National Research Program and a Policy and Intervention Agenda.Canberra: Queensland University of Technology, School of Public Health; Ausinfo.


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THE USE OF THE INDICATORS

The socioeconomic and community capacity indicators in themselves describethe social conditions of the population. To measure change in any particular

context we need to track the performance of the system being affected.Implicit in this process are guiding values that underpin the selectedindicators. As you can see from the NHPC model, the identification ofindicators that incorporate equityare integral to the framework.There are many dimensions of equity including access, opportunity andoutcome. Within and across societies there are likely to be a multitude ofopinions as to what exactly a fair distribution of resources entails or whatconstitutes a just distribution of access opportunities to social services. Withthe performance of any system and the corresponding use of selectedindicators the question needs to be asked, who misses out? is thesituation the same for all people? Equity is reflected in the indicators

contained within this document. The indicators help us to understand change(or the social context) in the social determinants impacting on the populationand the effectiveness of initiatives in achieving the outcomes specified.

Possible uses of the indicators include:

providing baseline information on health determinants from whichprogress can be measured

assistance with future planning of health and community services

developing policy and informing resource allocation decisions

monitoring and evaluation of government policies and practices for theirimpact on communities.

A number of these indicators will be adopted and reported for whole-of-population and various sub-populations such as:

children and young people

adults

older people

indigenous peoples

rural and remote peoples

socioeconomically disadvantaged

ethnicity.

This report will be produced in the Health Determinants Queensland report tobe released in 2004 by Public Health Services, Queensland Health.


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Figure 1: National Health Performance Framework

Health Status and Outcomes (Tier 1)How healthy are Australians?Is it the same for everyone?

Where is the most opportunity for improvement?

Health Conditions Human Function Life Expectancy andWellbeing

Deaths

Prevalence of disease,disorder, injury or traumaor other health-relatedstates.

Alterations to body,structure or function(impairment), activities(activity limitation) andparticipation (restrictions inparticipation).

Broad measures ofphysical, mental, andsocial wellbeing ofindividuals and otherderived indicators such asDisability Adjusted LifeExpectancy (DALE).

Age and/or conditionspecific mortality rates.

Determinants of Health (Tier 2)

Are the factors determining health changing for the better?Is it the same for everyone?Where and for whom are they changing?

EnvironmentalFactors

SocioeconomicFactors

CommunityCapacity

HealthBehaviours

Person-relatedFactors

Physical, chemicaland biological factorssuch as air, water,food and soil qualityresulting fromchemical pollutionand waste disposal.

Socioeconomicfactors such aseducation,employment, percapita expenditureon health, andaverage weeklyearnings.

Characteristics ofcommunities andfamilies such aspopulation density,age distribution,health literacy,housing, communitysupport services andtransport.

Attitudes, beliefsknowledge andbehaviours e.g.patterns of eating,physical activity,excess alcoholconsumption andsmoking.

Genetic relatedsusceptibility todisease and otherfactors such as bloodpressure, cholesterollevels and bodyweight.

Health System Performance (Tier 3)How well is the health system performing in delivering quality health actions to improve the health of all

Australians?Is it the same for everyone?

Effective Appropriate Efficient

Care, intervention or action achievesdesired outcome.

Care/intervention/action provided isrelevant to the clients needs andbased on established standards.

Achieving desired results with mostcost effective use of resources.

Responsive Accessible Safe

Service provides respect for personsand is client orientated and includesrespect for dignity, confidentiality,participation in choices, promptness,quality of amenities, access to socialsupport networks, and choice ofprovider.

Ability of people to obtain health careat the right place and right timeirrespective of income, physicallocation and cultural background.

The avoidance or reduction toacceptable limits of actual orpotential harm from health caremanagement or the environment inwhich health care is delivered.

Continuous Capable Sustainable

Ability to provide uninterrupted,coordinated care or service acrossprograms, practitioners,organisations and levels over time.

An individuals or services capacityto provide a health service based onskills and knowledge.

System or organisations capacity toprovide infrastructure such asworkforce, facilities and equipment,and be innovative and respond toemerging needs (research,monitoring).

Source: National Health Performance Committee (2001) National Health Performance

Framework Report p. 7.


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DESCRIPTION OF THE INDICATORS

The chosen indicators are listed as either socioeconomic or communitycapacity factors. The descriptions include:

a brief rationale to illustrate their relevance to health and healthdeterminants

the potential use by Public Health Service staff

the geographic parameters in which they have been collected

when last reported

the source of the data (in most cases Internet web addresses aregiven)

if applicable, how they could be collected by others.

In most cases individual indicators are given and in others a set of indicatorsbut in all cases they were selected against a range of criteria. It is notanticipated that each criterion will be met for every indicator, rather theselection criteria provided guidance only. The criteria included:

be worth measuring

be measurable for diverse populations

be understood by people who need to act

galvanise action

be relevant to policy and practice measurement over time will reflect results of actions

be feasible to collect and report

comply with national processes of data definitions.

It must be acknowledged that the list of indicators is by no meanscomprehensive. The number of indicators available is immense and so theline had to be drawn somewhere, at a somewhat arbitrary point andconsequently, the reader will note omissions. However, this is an ongoingprocess with the aim to continually develop and improve the list of indicators

over time. In addition, a collection of indicators at a more Regional, StateNational and International levels needs to be collated to enhance the work ofPublic Health Services. In the following section possible indicators for use ata more macro level are given as possibilities for capturing this bigger picture.

CAUTION

Due to the small population numbers in some geographic reporting areas egAustralian Bureau of Statistics (ABS) Collection Districts, caution must beused in the interpretation of individual or small numbers of data points. Thissame caution applies to comparisons between areas or between time periods.

More meaningful data can be generated by aggregating small areas or byextending the reported period beyond a single year.


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Furthermore, ABS randomises demographic cell entries of three persons orless to either zero or three. This leads to inconsistency when some areas ordata entries are aggregated.

THE FUTURE

There are possibly many alternative social indicators that may better suit theneeds of PHS. In the immediate future perhaps we need to identify whatinformation is missing for example, on the accessibility of basic socialservices, or the quality of housing.

Possible future indicators at the macro level which may be worth exploring fortheir impact on health and health inequalities, include

1. Activation policies:Activation policies comprise a range of publicmeasures intended to improve beneficiaries prospects of finding gainful

employment, job-skills of the labour force, and the functioning of the labourmarket. Macroeconomic and structural policies are crucial in fosteringefficient labour market outcomes. Public expenditure on the Active LabourMarket Policies (ALMPs) include the value of cash benefits, employmentservices and fiscal measures, including reductions of social securitycontributions targeted at groups of workers and jobs5..

2. Ecological footprint:The Ecological Footprint6 measures the amount ofnatures resources an individual, a community, or a country consumes in agiven year. Official statistics are used to track consumption and translatethat into the amount of biologically productive land and water area required

to produce the resources consumed and to assimilate the wastesgenerated using prevailing technology. People use resources from all overthe world, and affect faraway places with their pollution, the Footprint is thesum of these areas wherever they are on the planet. This index gets tothe heart of sustainability how much of the earths resources does aperson consume compared to the amount of resources available. In theshort term, it is a measure of intra-generational equity, while in the long-term it is an indicator of whether future generations will be able to meettheir needs.

Components of the Ecological Footprint:

growing crops

grazing animals

harvesting timber

catching fish

accommodating Infrastructure

absorbing carbon dioxide emissions

5

Organisation for Economic Cooperation and Development (2001) Society at a Glance OECD Social Indicators. OECD, pp. 48.6

Redefining Progress: Sustainability Program Ecological Footprint Accounts. [online]http://www.rprogress.org/programs/sustainability/ef/methods/components.html downloaded23

rdOctober 2002.
http://www.rprogress.org/programs/sustainability/ef/methods/components.htmlhttp://www.rprogress.org/programs/sustainability/ef/methods/components.htmlhttp://www.rprogress.org/programs/sustainability/ef/methods/components.htmlhttp://www.rprogress.org/programs/sustainability/ef/methods/components.htmlhttp://www.rprogress.org/programs/sustainability/ef/methods/components.htmlhttp://www.rprogress.org/programs/sustainability/ef/methods/components.htmlhttp://www.rprogress.org/programs/sustainability/ef/methods/components.html


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3. Healthy communities index: This indicator is based on the TasmanianHealthy Communities Survey7, which was designed to measure the healthand wellbeing of the adult Tasmanian population. The survey was alsodesigned to measure those factors that were identified in the researchliterature as being determinants of health and wellbeing. The information

collected enables a better understanding of why some sections of thecommunity experience better levels of health and wellbeing than others.Sections covered in the survey include:

your health

quality of life

personal background

beliefs and behaviours

health conditions and use of services

employment and income community involvement

voluntary work.

Possible uses of the survey:

to provide baseline health and wellbeing information from whichprogress can be measured

to assist with the future planning of health and community services

to research health and wellbeing profiles to assist with needs-based

planning

to research the connections between socio-economic status,employment, family and friendship networks and access to services,and health and wellbeing outcomes

to provide strategic information concerning the factors that determinelevels of health and wellbeing

to develop policy and inform resource allocation decisions.

4. Income inequality: Income distribution statistics inform us about what is

happening in relation to the economy who are winners and who arelosers from economic changes and government policies. From a morenormative viewpoint, ideas about what constitutes fair are closely linkedwith the distribution of income8.

7

Dept of Health and Human Services (1999) First Results of the Healthy Communities Survey1998. Tasmania: Health and Wellbeing Outcomes Unit, Dept of Health and Human Services.8

OECD (2001) op cit p. 64.


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Part 2 Social Indicators

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SOCIOECONOMIC FACTORS

Research has shown a clear link between socioeconomic position and healthoutcomes with people who occupy positions at lower levels of thesocioeconomic hierarchy faring significantly worse in terms of their health.

Specifically, experiencing higher mortality rates for most major causes ofdeath11. People variously classified as low socioeconomic status (SES) havegreater ill-health (both physiological and psychological), and their use ofhealth care services suggest they are less likely to prevent disease or detect itat an early stage. In addition, socioeconomic differences in health are evidentfor both females and males at every stage of the life-course (birth, infancy,childhood and adolescence, and adulthood) and the relationship existsirrespective of how SES and health are measured12.

BENEFITS

For the least well-off members of society it is the benefit system which is theprincipal determinant of living standards. Studies of the budgetingarrangements of poor families have shown that frequently living standardssuch as nutrition are compromised when there is insufficient money to goaround and so placing health at risk13.

1. Dependent children of selected pensioners and beneficiaries as apercentage of all children aged from 0-15 years by SLA.A child, and additional children, presents a much greater impact on thestandard of living of people who are not well off than for better-offhouseholds14. This indicator includes age, disability, newstartallowance; sickness and special benefits; youth training allowance; soleparent pensions and family allowance payments.

Potential use by PHS:indicator of magnitude of a communitys socialprotection system (and at-risk population)

Geographic reporting unit:SLALast reported:Published by Soxail Atlas of Australia 1999Data source:Department of Families data; ABS Labour Force Surveydata includes children without an employed parent and is available onrequest although not published

How could it be collected by PHS staff:available on request fromABS

11

Turrell, G.; Oldenburg, B.; McGuffog, I. and Dent, R. (1999) op cit.12

National Health Strategy (1992) Enough to Make you Sick: How Income and EnvironmentAffect Health. Canberra: National Health Strategy.13

Acheson, D. (1999) Independent Inquiry into Inequalities in Health Report. London: TheStationary Office, pp. 32-36.14

Acheson (1999) op cit p. 33.


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2 Proportion of people receiving a pension by type of governmentpension/allowance (principal and auxillary, full or part) by gender.The differences in incomes between those people on means-testedbenefits and those with other sources of income are a majordeterminant of income inequality 15.


Geographic reporting unit:Centrelink only sells processed data butcan provide any customised tables (as long as the numbers in each cellexceed 20)

Last reported:Centrelink data sets and General Social Survey 2002.ABS 1998 Cat No 4139.3

Data source:Centrelink; General Social Survey (ABS 1998 Cat No4139.3) GSS processed data available April 2003; Microdata not

available until June 2003How could it be collected by PHS staff:available on request fromCentrelink

3. Proportion of sole parent pensioners as a percentage of allpersons aged 15 years and over by gender.Women are more likely than men to take primary responsibility forcaring for children and other family members. Improving the financial,social and environmental conditions in which women in disadvantagedcircumstances care for their families is likely to be an essential part of

any strategy to reduce socioeconomic inequalities in health16

.


Geographic reporting unit:Centrelink only sells processed data butcan provide any customised tables (as long as the numbers in each cellexceed 20)

Last reported:Centrelink data sets (available on request)Data source:Centrelink data setsHow could it be collected by PHS staff: available on request fromCentrelink

15

Kawachi, I.; Kennedy, B. and Wilkinson, R. (eds) (1999) The Society and Population HealthReader: Income Inequality and Health. New York: The New Press.16

Acheson (1999) op cit p. 107.


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4. Unemployment benefits by region by sex.

There is good evidence that unemployment is detrimental to both thephysical and mental health of people and their families with long-termunemployed people being especially at risk17 18. Men who experienceloss of employment are at increased risk of mortality from both cancerand cardiovascular disease compared to employed men19.

Potential use by PHS: needs assessment (eg community needs);project/program reach

Geographic reporting unit: Reports can be modified to suit eg sortedby region types (eg State; LGA; Centrelink Service Centre) by sex bytime period. Data bases to be updated

Last reported: Quarterly 1998.

Data source: QRSIS Regional Statistics (Office of Economic andStatistical Research) http://www.oesr.qld.gov.au/views/regional/qrsis/qrsis_fs.htm

How could it be collected by PHS staff: not applicable

DEATH RATES

Statistics relating to deaths are easily presented as crude death rates ie thenumber of deaths in a year divided by the number of individuals in thecorresponding population.

5. Gender differentials in death rates across socioeconomic quintilesfor males and females aged 15 years old and above.

Men experience higher rates of serious illness, more disability, and dieearlier than women do. Mens mortality rates have consistently provedto be higher than womens for most of the leading causes of death inAustralia20. Socioeconomic status has been implicated in differentialsin death rates for males and females21

Potential use by PHS:indicator of gender and socioeconomicdifferentials in mortality of a community

Geographic reporting unit:Qld

Last reported:1999 based on 1996 data

Data source:Social Atlas of Australia, Vol 4 Queensland

How could it be collected by PHS staff:via the data source; tryCensus data also

17

Marmot, M. (1999) The Solid Facts: The Social Determinants of Health. Health PromotionJournal of Australia, vol. 9, no. 2, pp. 133-139.18

National Health Strategy (1992) Enough to Make You Sick: How Income and EnvironmentAffect Health, Canberra: National Health Strategy.19

Morris, J., Cook, D, and Shaper, A. (1994) Loss of Employment and Mortality. BMJ, vol.308, no. 6937, pp. 1135-1139.20

Australian Institute of Health and Welfare (2000) Australias Health 2000. Canberra: AIHW

Cat No 19,21Queensland Health (2001) Social Determinants of Health The Role of Public Health

Services. Brisbane: Public Health Services, Queensland Health, pp. 54-55.
http://www.oesr.qld.gov.au/views/regional/qrsis/qrsis_fs.htmhttp://www.oesr.qld.gov.au/views/regional/qrsis/qrsis_fs.htmhttp://www.oesr.qld.gov.au/views/regional/qrsis/qrsis_fs.htm


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Potential use by PHS:can contribute to community profile

Geographic reporting unit:Collected with Census. Available for allCensus geographic areas from Collection District level to total Australia

Last reported: 1996; 2001

Data source:Australian Bureau of Statistics - Census data:http://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocument

How could it be collected by PHS staff:individual survey; CensusData

8. Percentage of year five students achieving the national readingbenchmark.Literacy skills are critical for coping effectively in our society. Amongother things, being literate allows people to assimilate information

about health. Adult literacy is also related to infant mortality26. Thisindicator is incorporated in a yearly report to the Minister for Educationwhich covers: statewide and national comparisons regardingQueensland students years three, five and seven, literacy andnumeracy skills of Indigenous students, students with A LanguageBackground Other Than English (LBOTE), students with an EnglishSpeaking Background, rural and urban, and male and female cohorts.

Potential use by PHS:can be used for indicating literacy levels forboys, girls, Indigenous and LBOTE students and impact of programs(eg health promoting schools programs)

Geographic reporting unit: statewide and national comparisons

Last reported:Statewide Student Performance in Aspects of Literacyand Numeracy (2000), p55

Data source:Queensland School Curriculum Council. Report to theMinister for Education - Statewide Student Performance in Aspects ofLiteracy and Numeracy (Queensland Years three, five and sevenTesting Program 2001http://www.qsa.qld.edu.au/yrs1_10/testing_assessment/publications.html

How could it be collected by PHS staff:not applicable

26

National Advisory Committee on Health and Disability (1998) The Social, Cultural andEconomic Determinants of Health in New Zealand: Actin to Improve Health. Wellington, NewZealand: the National Advisory Committee on Health and Disability pp. 28-30.
http://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocumenthttp://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocumenthttp://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocumenthttp://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocumenthttp://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocumenthttp://www.qsa.qld.edu.au/yrs1_10/testing_assessment/publications.htmlhttp://www.qsa.qld.edu.au/yrs1_10/testing_assessment/publications.htmlhttp://www.qsa.qld.edu.au/yrs1_10/testing_assessment/publications.htmlhttp://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocument


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9. Percentage of year five students achieving the national numeracybenchmark.Both literacy and numeracy skills are related to social functioning andhealth assessment 2728. This indicator is incorporated in a yearly reportto the Minister for Education which covers: statewide and national

comparisons regarding Queensland students years three, five andseven, literacy and numeracy skills of Indigenous students, studentswith a Language Background Other Than English (LBOTE), studentswith an English Speaking Background, rural and urban, and male andfemale cohorts.

Potential use by PHS: can be used for indicating literacy levels forboys, girls, Indigenous and LBOTE students and impact of programs(eg health promoting schools programs)Geographic reporting unit: statewide and national comparisonsLast reported:Statewide Student Performance in Aspects of Literacyand Numeracy (2000), p57Data source: Queensland School Curriculum Council. Report to theMinister for Education - Statewide Student Performance in Aspects ofLiteracy and Numeracy (Queensland Years 3,5 and 7 Testing Program2001 http://www.qsa.qld.edu.au/yrs1_10/testing_assessment/publications.htmlHow could it be collected by PHS staff:not applicable

EMPLOYMENT

Employment is central to our role in society. People define themselves andare defined through what they do for a living. Income is one of the main

determinants of poverty, which is closely linked to poor health. Income isprimarily derived from employment.

10. Labour force status by gender and age for persons aged 15 yearsand over.Employment, is a primary source of status in industrialised countrieswhile also significant in providing purpose, social support, structure tolife and a means of participating in society. Unemployment is potentiallya major risk to health for the working age population and their families29

Potential use by PHS:an indicator of community need, programimpact (eg employment initiatives) and basic information for community

profile

Geographic reporting unit: Collected with Census. Available for allCensus geographic areas from Collection District level to total Australia


27

Estrada, C.; Barnes, V; Collins, C. and Byrd, J. (1999) Health literacy and numeracy.JAMA, Vol 282 No 6 p. 527.28

Woloshin, S.; Schwartz, L.; Moncur, M.; Gabriel, S. and Tosteson, A. (2001) Assessingvalues for health: Numeracy matters. Medical Decision Making, Vol 21, No 5, pp. 382-90.29

Acheson, D. (1999) op cit p. 44-50.
http://www.qsa.qld.edu.au/yrs1_10/testing_assessment/publications.htmlhttp://www.qsa.qld.edu.au/yrs1_10/testing_assessment/publications.html


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12. Trends in proportion of employed persons by industry by genderand age.The type of industry within a community can indicate potentialoccupational hazards (eg mining, manufacturing) or the vulnerability ofa community to fluctuating fortunes (eg tourism). Some industries are

characterised by casualisation of labour (eg manufacturing andtourism) or shift work with resultant health effects 3233. The incidenceof low-paid employment (eg young people in the construction industry)gives an indication of the differences across and within communities inthe distribution of earnings and income 34

Potential use by PHS: can indicate fluctuating employment (egcommunities with high tourism and incidence of high casual labour) andhence socioeconomic status

Geographic reporting unit:Collected with Census. Available for allCensus geographic areas from Collection District level to total Australia

Last reported:1996; 2001



13. Trends in unemployment rates by gender and age groups.Unemployment and its accompanying health effects are not distributedevenly throughout the population with unemployment rates being

highest among people aged less than 25 years, and higher in rural thanurban areas. Also, variation over time is a multifactorial phenomenon.

Potential use by PHS: can indicate fluctuations in socioeconomicdisadvantage

Geographic reporting unit:StateLast reported:ABS Labour Force Survey October 2002 (p30). ABSCat No 6203.0

Data source:Australian Bureau of Statistics Census dataHow could it be collected by PHS staff:not applicable

32

Theorell, T. (2000) Working conditions and health. In, Berkman, L. and Kawachi, I. (eds)Social Epidemiology. Oxford: Oxford University Press, pp. 95-117.33

Kasl, S. and Jones, B. (2000) The impact of job loss and retirement on health. In, In,Berkman, L. and Kawachi, I. (eds) Social Epidemiology. Oxford: Oxford University Press, pp.118-136.34

Marmot, M., Siegrist, J., Theorell, T. and Feeney, A. (1999) Health and the PsychosocialEnvironment at Work, in Marmot, M. and Wilkinson, R. (eds.) Social Determinants of Health.New York: Oxford University Press.
http://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocumenthttp://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocumenthttp://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocument


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14. Trends in participation rates by gender and age groups.Participation rate refers to the labour force expressed as a percentageof the civilian population aged 15 years and over35.

Potential use by PHS: can indicate fluctuations in socioeconomicdisadvantage for different age groups, by gender and by birthplace

Geographic reporting unit:Australia

Last reported:ABS Labour Force Survey October 2002. ABS Cat No6203.0 (pp26-27)

Data source:Australian Bureau of Statistics Census data


15. Trends in long-term unemployment as a proportion of totalunemployed.

The impact of unemployment on health is thought to increase with thelength of unemployment, with many chronic physical and mental healthproblems acting as barriers to re-employment36

Potential use by PHS: can indicate fluctuations in socioeconomicdisadvantage associated with length of unemployment and by gender


Last reported:ABS Labour Force Survey October 2002. ABS Cat No6203.0 (p32)

Data source:Australian Bureau of Statistics Census data


16. Trends in proportion of employed persons by gender and age.Amount of esteem and social approval in interpersonal life largelydepends on the type of job, professional training, and level ofoccupational achievement. Furthermore, type and quality ofoccupation and especially the degree of self-direction at work, stronglyinfluence personal attitudes and behavioural patterns in areas that arenot directly related to work, such as leisure, family life, education, andpolitical activity 37.

Potential use by PHS:best practice assessments eg workenvironments regarding effort and reward; control and demand issues


Last reported:1996; 2001

35

New South Wales Department of Health (2002) op cit p. 341.36New South Wales Department of Health (2002) op cit p. 12.

37Marmot, M.; Siegrist, J.; Theorell T. and Feeney, A. (1999) op cit pp. 105-131.


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Data source: Australian Bureau of Statistics - Census data:http://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocument

How could it be collected by PHS staff:ABS Census Data

17. Underemployment Populations by State or Territory of usualresidence for September 2000. (Includes underemployed workersby sex).Underemployment may be time related (ie not working as many hoursas people would prefer) or through inadequate employment situations(ie a persons skills/training may not be fully or appropriately utilised)38.This indicator can reflect people who are socioeconomicallymarginalised and who can exhibit characteristics of people who areunemployed (see above).

Potential use by PHS:indicate fluctuations in socioeconomic

disadvantage associated with underemployment and by gender


Last reported:1999

Data source:ABS Cat No 6265.0. The report includes Australianlabour force status for current and previous years includingunderemployment status; employed persons; part-time workers whowant more work

http://datahub.govnet.qld.gov.au/ausstats/subscriber.nsf/Lookup/D5470CE2AA98FEC

BCA256A7700053010/$File/62650_sep+2000.pdf :


38ABS (2001) Measuring Wellbeing: Frameworks for Australian Social Statistics. Chapter 6:

Work, p. 6. Canberra: Australian Bureau of Statistics.
http://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocumenthttp://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocumenthttp://datahub.govnet.qld.gov.au/ausstats/subscriber.nsf/Lookup/D5470CE2AA98FECBCA256A7700053010/$File/62650_sep+2000.pdfhttp://datahub.govnet.qld.gov.au/ausstats/subscriber.nsf/Lookup/D5470CE2AA98FECBCA256A7700053010/$File/62650_sep+2000.pdfhttp://datahub.govnet.qld.gov.au/ausstats/subscriber.nsf/Lookup/D5470CE2AA98FECBCA256A7700053010/$File/62650_sep+2000.pdfhttp://datahub.govnet.qld.gov.au/ausstats/subscriber.nsf/Lookup/D5470CE2AA98FECBCA256A7700053010/$File/62650_sep+2000.pdfhttp://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocument


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HEALTH EXPENDITURE

Total expenditure on health is the amount spent on health care goods andservices plus capital investment in health care infrastructure. Changes in

health expenditure over time can indicate changes in the level of goods andservices used, either from a population growth perspective or from moreintensive per person use of goods and services 39 and the sources of fundingfor health care.

18. Health expenditure Australia 2000-01.This is a collection of indicators on health expenditure and includes: health expenditure and the general level of economic activity

health expenditure per person

total health expenditure, by State and Territory

sources of health expenditure broad trends in funding

government sources of funds

non-government sources of funds

recurrent expenditure on health goods and services

capital formation

capital consumption by governments

international comparison.

Potential use by PHS: assessment of health service usage; policyimplications; systems advocacy concerning health expenditure

Geographic reporting unit:the latest in an existing series of annualreports on health expenditures for Australia plus time series datacovering the period from 1990-91 to 1999-00. Estimates of healthexpenditure split by State and Territory are provided for each year from1996-97

Last reported:AIHW 2001

Data source:Australian Institute of Health and Welfare (AIHW) 2002.

Health Expenditure Australia 2000-01. Health and Welfare ExpenditureSeries No 14, Cat no HWE 20. Canberra: AIHW.http://www.aihw.gov.au/publications/hwe/hea00-01/hea00-01.pdf


39AIHW (2002) Health Expenditure Australia 2000-01. Health and Welfare Expenditure

Series no. 14. Cat. no. HWE 20. Canberra: AIHW. p. 58.
http://www.aihw.gov.au/publications/hwe/hea00-01/hea00-01.pdfhttp://www.aihw.gov.au/publications/hwe/hea00-01/hea00-01.pdfhttp://www.aihw.gov.au/publications/hwe/hea00-01/hea00-01.pdf


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19. Trends in proportion of adults covered by private health insurancein addition to Medicare.The existence of a universal health insurance scheme in Australia(Medicare) is important to ensuring equity. Since its introduction thelevel of private health insurance has declined. It is based on a levy on

income, and so is progressive in that those who earn more pay more,and everyone receives the same services40.


Geographic reporting unit:State

Last reported:Health Information Centre Omnibus Surveys 2001,2002

Data source:HIC

How could it be collected by PHS staff:contact HIC direct or via yourpublic health unit research officer

20. Trends in proportion of adults holding a Health Care Card by cardtype and gender.Health Care Cards are provided for people receiving governmentincome support benefits (eg unemployment, sickness benefits) andpensions (eg age pension) but is only available for over 18 year olds.


Geographic reporting unit:StateLast reported:Health Information Centre Omnibus Surveys 2001,2002

Data source:HICHow could it be collected by PHS staff:contact HIC direct or via yourPublic Health Unit Research Officer

HOUSING COSTS

Shelter is a pre-requisite for health. However, people who are disadvantagedsuffer both from a lack of housing and from poor quality housing. In addition,the fear of crime compounds the social exclusion of people living indisadvantaged areas 41.

40

Baum, F. (2001) The New Public Health: An Australian Perspective. New York: OxfordUniversity Press, pp. 429-430.41

Acheson (1999) op cit pp. 50-55.


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21. Monthly housing loan repayment: Occupied private dwellingsbeing purchased.As housing costs are generally a fixed expense of families, relativelyhigh housing costs leave less money for other budget items essentialfor health such as a nutritious diet, education, transport, leisure

activities and health services42

.Potential use by PHS:can indicate socioeconomic disadvantage andas such is a component of community profiles


Last reported:ABS 2001Data source:Australian Bureau of Statistics - Census data:http://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocument

How could it be collected by PHS staff:ABS Census Data22. Weekly rent by landlord type: occupied private dwellings being

rented.The need for affordable housing to address the health and wellbeing ofpeople less well off is essential 43. Cost and source of rentalproperties can indicate areas of disadvantage.

Potential use by PHS:can indicate socioeconomic disadvantage andas such is a component of community profiles


Last reported: ABS 1996; 2001



42Queensland Health (2001) op cit. p32.

43Acheson (1999) op cit p. 52.
http://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocumenthttp://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocumenthttp://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocumenthttp://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocumenthttp://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocumenthttp://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocument


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COMMUNITY CAPACITY

Community capacity incorporates information on characteristics ofcommunities that can influence health as it is recognised that individuals are

embedded in societies and populations and consequently, ill health needs tobe considered in the social context. The greatest improvements in populationhealth are likely to be derived from addressing why some populations have aparticular distribution of risk. A social patterning can be seen. For example,people who are poor, have low levels of education, and are socially isolatedare more likely to engage in a wide range of risk-related behaviours and areless likely to engage in heath-promoting ones 44.

COMMUNITY SUPPORT SERVICES

Within a social determinants framework access to community support services

such as childcare, education, and health services is important for both shortand long term benefits. The notion of access to services is steeped in socialjustice principles and is embedded within the National Health PerformanceFramework45. Access is the capacity or potential to obtain a service andincorporates concepts of geographical access, physical/architectural access,cultural/linguistic access, service acceptability and affordability46.

23. Proportion of children receiving formal and informal care by State.Child care refers to arrangements (other than parental care) made forthe care of children under 12 years of age. Formal child care isregulated care which takes place away from the childs home andincludes attendance at preschool, a child care centre, family day careand occasional care. Informal care is care, which is non-regulated andcan take place in the childs home or elsewhere. It includes care byfamily members, friends, neighbours and paid babysitters. Parentsoften use a combination of formal and informal arrangements toprovide for childrens care needs 47. Provision of high quality out-of-home day care, especially if integrated with pre-school education, isassociated with improvement in a range of educational and socialmeasures. Since it is easier to combine paid work and familyresponsibilities when parents have access to high quality day care, it is

a potential mechanism to alleviate family poverty for parents who wishto combine work with parenting 48.

44

Queensland Health (2001) Social Determinants of Health: The Role of Public HealthServices Summary Document. Brisbane: Public Health Services, Queensland Health.45

National Health Performance Committee (2002) National Report on Health SectorPerformance Indicators 2001. A report to the Australian Health Ministers Conference, p. 7.46

Eagar, K.; Garrett, P. and Lin, V. (2001) Health Planning: Australian Perspectives. Crows

Nest: Allen & Unwin, pp. 17-18.47ABS (1999) Child Care. Cat No 4402.0, p. 3.

48Acheson (1999) op cit pp. 67-69.


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Potential use by PHS:This indicator is relevant for helping todetermine need for child care services in Queensland

Geographic reporting unit: States, Territories, Australia

Last reported:ABS 1999 Cat No 4402.0 p13

Data source:ABS Child Care Survey conducted throughout Australiain June 1999. This survey is a continuation of a series of surveys onthis topic conducted since 1969. The previous survey was conductedin March 1996

How could it be collected by PHS staff:Not applicable. Need toaccess results of ABS Child Care Survey for data on both formal andinformal child care. See:http://datahub.govnet.qld.gov.au/Ausstats/subscriber.nsf/Lookup/C827365E22F0613CCA2568F50081F5B5/$File/44020_jun+1999.pdf

and Queensland Department of Families for data on Licensed Child

Care Services 49. See web site:http://www.families.qld.gov.au/childcare/census2000.html

24. Distribution of health facilities by statistical division.Access to effective primary care is influenced by several supplyfactors:

the geographical distribution and availability of primary care staff

the range and quality of primary care facilities

levels of training, education and recruitment of primary care staff

cultural sensitivity, timing and organisation of services to thecommunities served

distance and the availability of affordable and safe means oftransport.

Communities most at risk of ill health tend to experience the leastsatisfactory access to the full range of preventive services 50. Adults oflow socioeconomic status receive more health care than adults ofhigher socioeconomic status 51.

Potential use by PHS: needs assessment concerning service

provision for communitiesGeographic reporting unit: Reports generated through QueenslandRegional Statistical Information System (QRSIS) are flexible with thisparticular indicator listing total health facilities (eg all, private hospitals,public hospital beds, nursing homes, and community health facilities)for Queensland statistical divisions

Last reported:1999/00 (via QRSIS/Office of Economic and StatisticalResearch (OESR)

49

Department of Families (2000) Child Care Census 2000: Licensed Child Care Services in

Queensland.50Acheson (1999) op cit pp. 111-113.
http://datahub.govnet.qld.gov.au/Ausstats/subscriber.nsf/Lookup/C827365E22F0613CCA2568F50081F5B5/$File/44020_jun+1999.pdfhttp://datahub.govnet.qld.gov.au/Ausstats/subscriber.nsf/Lookup/C827365E22F0613CCA2568F50081F5B5/$File/44020_jun+1999.pdfhttp://www.families.qld.gov.au/childcare/census2000.htmlhttp://www.families.qld.gov.au/childcare/census2000.htmlhttp://www.families.qld.gov.au/childcare/census2000.htmlhttp://www.families.qld.gov.au/childcare/census2000.htmlhttp://datahub.govnet.qld.gov.au/Ausstats/subscriber.nsf/Lookup/C827365E22F0613CCA2568F50081F5B5/$File/44020_jun+1999.pdf


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Deaths eg Number and Age-specific Rate/100,000 by Chapters 54,Age and Sex, Central Zone, 1997-2000

Ethnicity eg Language Spoken at Home by Sex, SLA, District, andCSR, Queensland, 1996

Geography eg Census Postcodes & SLAs: Proportion ofPopulation by Postcode in each SLA in Qld (SD, SSD & Districtidentifiers), 2001; Description of the new District ServiceBoundaries (& lists assoc. facilities), 1996

Population-Census Counts eg Age (5yr gps) by Sex byPostcodes, Qld 2001; Indigenous Population: Indigenous/Non-Indigenous by Statistical Local Areas, Zone and Health ServiceDistricts, 2001

Population-Estimated Resident eg ERPs 55: Age (5 yr gps) bySex, Health District and Zone, Qld., 2001

PopulationProjections eg Projections based on ASGC

56

1996from ABS by States and Qld., 1999 to 2019.

Specific demographic indicators available through InfoBank include

27. Indigenous population by age, sex and statistical local area (timeseries)

28. Indigenous population by age (5yr gaps), sex, statistical localareas and health service districts

29. Age (5 yr gaps) by sex by statistical local area and health servicedistricts, Qld

30. Births selected variables as per Perinatal Annual Report, Qld

31. Proportion of population of postcode in each SLA in Qld (SD, SSDand District identifiers)

Potential use by PHS:demographic information provides basiccommunity profile information in that they give a picture of acommunitys population distribution (including ethnicity, age, gender)

Geographic reporting unit: various, depending on indicator

Last reported:various depending on specific indicator

Data source:Health Information Centre available through Info Bank at:

http://qhin.health.qld.gov.au/hic/csu/products/infobank/ib3.htm#subtopic6

How could it be collected by PHS staff:not applicable (collected byHIC)

54

Chapters relates to ICD10 Chapters eg Class 1 Infectious and Parasitic Diseases.55Estimated Resident Populations

56Australian Standard Geographical Classification
http://qhin.health.qld.gov.au/hic/csu/products/infobank/ib3.htm#subtopic6http://qhin.health.qld.gov.au/hic/csu/products/infobank/ib3.htm#subtopic6


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How could it be collected by PHS staff:ABS Census Data; individualsurvey

34. Birthplace (regions) by sex.This is a broad indicator of cultural origins based on broad geographicregions (eg NW Europe) and sub-regions (eg UK, Ireland) of origin.

Potential use by PHS:constitutes ethnicity component of communityprofiles indicating cultural origins



Data source: Australian Bureau of Statistics - Census data:http://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocument


35. Distribution of Emerging Communities by Local Government Area.Queensland is a culturally and linguistically diverse society comprisingover 120 ethnic communities. Some communities are large and wellestablished, due to a long history of migration to Queensland. Othercommunities are relatively small and newly arrived and may lack thecritical mass to develop ethno-specific organisations, informationnetworks, services and advocacy strategies. Such emerging groupsmay not be included in funding, planning and program development

avenues, and may lack advocacy and assistance adequate to thecommunities needs60.

Potential use by PHS:this is an indicator reflecting emerging culturallyand linguistically diverse communities and hence changing needs

Geographic reporting unit:Queensland Local Government Area

Last reported:2002 (based on 1996 Census data)

Data source: Multicultural Affairs Queensland (2002) New andEmerging Communities in Queensland. MAQ, pp 45, Appendix 1.http://www.premiers.qld.gov.au/about/maq/pdfs/nec.pdf


60Multicultural Affairs Queensland (2002) New and Emerging Communities in Queensland.

MAQ.
http://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocumenthttp://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocumenthttp://www.premiers.qld.gov.au/about/maq/pdfs/nec.pdfhttp://www.premiers.qld.gov.au/about/maq/pdfs/nec.pdfhttp://www.premiers.qld.gov.au/about/maq/pdfs/nec.pdfhttp://www.premiers.qld.gov.au/about/maq/pdfs/nec.pdfhttp://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocument


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36. Humanitarian entrants by birthplace and region of settlement.Turbulence in the social and political situation within countries leads toindividuals and families being displaced from their homes. Refuge maybe sought in other countries. Refugees are defined as those who fallunder the various United Nations conventions, protocols or statutes on

this topic. Asylum-seekers are usually people whose applications forrefugee status are pending in the asylum procedure or who areotherwise registered as asylum-seekers61. Humanitarian entrants arefrequently at risk of mental and physical health problems as aconsequence of their being displaced.

Potential use by PHS: this is an indicator reflecting emerging culturallyand linguistically diverse communities and hence changing needs

Geographic reporting unit: Brisbane, Moreton, Darling Downs,Fitzroy, Mackay, Northern Queensland, Far North Queensland

Last reported:2002 (based on 1996 Census data)

Data source:Multicultural Affairs Queensland (2002) New andEmerging Communities in Queensland. MAQ, pp 16

http://www.premiers.qld.gov.au/about/maq/pdfs/nec.pdf


37. Language spoken at home by sex.Migrants from other countries, ethnic minority groups, refugees andpeople seeking asylum are particularly vulnerable to social exclusion,and their children are likely to be at special risk 62. Languagedifficulties may present a barrier to access to health care, socialservices, affordable housing and employment.

Potential use by PHS:constitutes ethnicity component of communityprofiles indicating cultural origins



Data source:Australian Bureau of Statistics - Census data:http://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d002

08f92/fb0ad60108ae958cca256bc000145411!OpenDocument


61

OECD (2001) op cit pp. 30.62Wilkinson, R. and Marmot, M. (1998) The Social Determinants of Health: The Solid Facts.

WHO: p. 14.
http://www.premiers.qld.gov.au/about/maq/pdfs/nec.pdfhttp://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocumenthttp://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocumenthttp://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocumenthttp://www.premiers.qld.gov.au/about/maq/pdfs/nec.pdf


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38. Proficiency in spoken English by year of arrival in Australia.Changes in the leading languages spoken at home can reflect shiftingmigration patterns within and between communities63. Also, seeLanguage spoken at home above.

Potential use by PHS:constitutes ethnicity component of communityprofiles indicating cultural origins and changing migration patternsbetween and within communities





FAMILY

The immediate family and the wider community are the context for individualachievement in other areas of social concern. They are the arenas in whichchildren become socially responsible adults, and individuals gain a sense ofbelonging 64.

39. Family type - families and persons in families in occupied privatedwellings (excluding overseas visitors).An individuals family is often their most fundamental source ofemotional, physical and financial care and support. Individuals andfamilies also receive support and care from the wider community.

Potential use by PHS:indicates family structures within communitiesand is an important component of community profiles




08f92/fb0ad60108ae958cca256bc000145411!OpenDocument


63

New South Wales Department of Health (2002) op cit p. 100.64ABS (2001) Measuring Wellbeing: Frameworks for Australian Social Statistics. Chapter 3:

Family and Community.


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40. Weekly family income by family type: Families in occupied privatedwellings.Families with relatively low living standards are of concern toorganisations that aim to minimise the effects of relative poverty on thewellbeing of families 65. This indicator can indicate disadvantaged

communities.Potential use by PHS:can indicate family and communitysocioeconomic status and is an important component of communityprofiles




08f92/fb0ad60108ae958cca256bc000145411!OpenDocumentHow could it be collected by PHS staff:ABS Census Data

HOUSING NEEDS

In some areas, the health impact of poor quality housing is combined withneighbourhood problems such as substandard community services, highlevels of unemployment, inadequate public transport and recreationalfacilities, environmental hazards and violence66. Homelessness is caused bystructural factors such as poverty, an inadequate supply of affordable housingand unemployment. People may experience family, community or socialisolation as a consequence of, or a precursor to, homelessness67. In addition,health problems faced by homeless people are often exacerbated by thelikelihood that health services may not be available to them because theyhave no fixed address.

41. Estimated potential SAAP clients and unmet needs by gender, ageand State.This publication is one of the Series 5 reports on the SupportedAccommodation Assistance Program (SAAP) National Data Collection1999-2000. The series provides information on people who are

homeless and people who were at risk of being homeless whoaccessed the SAAP in 1999-2000. Indicators include:

support provided in 1999-2000 (provision of services; referral ofservices)

demand for accommodation (demand by clients; demand bypotential clients; meeting the daily demand)

total assistance provided (daily assistance; one-off assistance)

65

ABS (1999) Australian Social Trends 1999. Income & Expenditure Income Distribution:Lower Income Working Families. Australian Bureau of Statistics.66

Queensland Health (2001) op cit pp.32-33.67Commonwealth Advisory Committee on Homelessness (2001) Working Towards a National

Homelessness Strategy. Consultation Paper. CACH, p. 8.


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Potential use by PHS: important needs indicator for homelessness

Geographic reporting unit: in some cases State and Territory tablesare provided

Last reported: 1999-2000

Data source: Australian Institute of Health and Welfare (2001)Demand for SAAP Assistance 1999-2000. A report from the SAAPNational Data Collection. Canberra: AIHW Cat No HOU 60. Online athttp://www.aihw.gov.au/publications/hou/saapndcar00-01qld/index.html


42. Dwelling structure - private dwellings and persons in occupiedprivate dwellings.People without jobs and with family responsibilities and those withspecial needs and outside the labour market graduate towards therented sector. Those with least choice gravitate towards the leastdesirable dwellings and areas. Households living in these areas aredependent on local facilities and low demand housing areas tend to bepoorly served by other services.

Potential use by PHS:An indicator of areas of deprivation





43. Dwelling structure by tenure type and landlord type: Occupiedprivate dwellings.An indicator of home ownership, rental accommodation and publichousing in a community. Compared to owner-occupiers, people whorent their home from a public or private landlord have increasinglyhigher death rates68.




68

Shaw, M.; Dorling, D. and Davey-Smith, G. (1999) Poverty, social exclusion, andminorities. In, Marmot, R. and Wilkinson, R. (eds) Social Determinants of Health. Oxford:Oxford University Press, pp. 211-239.
http://www.aihw.gov.au/publications/hou/saapndcar00-01qld/index.htmlhttp://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocumenthttp://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocumenthttp://www.abs.gov.au/ausstats/abs%40census.nsf/4079a1bbd2a04b80ca256b9d00208f92/fb0ad60108ae958cca256bc000145411!OpenDocumenthttp://www.aihw.gov.au/publications/hou/saapndcar00-01qld/index.html


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44. Number of SAAP support periods of accommodation on the 15thof the month, by month and region, Queensland.This indicator can indicate people in need of accommodation support ina range of Queensland regions. The Supported AccommodationAssistance Program (SAAP) was established in 1985 to consolidate anumber of Commonwealth, State and Territory government programsdesigned to assist people who are homeless or at risk of beinghomeless, including women and children escaping domestic violence69.

Potential use by PHS:important needs indicator for homelessness

Geographic reporting unit: Available on request from AIHW. Regions:Remote and North-West; Cairns and Tablelands; Townsville andsurrounds; Mackay/Whitsundays; Central; Wide Bay Burnett;Toowoomba and South-West; Caboolture and Redcliffe Peninsula;Sunshine Coast; Brisbane; Ipswich/Logan; Gold Coast/Redlands

Last reported:AIHW 2001 (NB not a regular component of SAAPreport)

Data source: AIHW (2001) Demand for SAAP Assistance 1999-2000.A report from the SAAP National Data Collection

How could it be collected by PHS staff: available on request from

AIHW

45. Distribution of private dwellings by type of occupancy (rented,being purchased).An indicator of community households including people who aresocially isolated. Can also be used to indicate homelessness in acommunity as it picks up people living in improvised dwellings.


Geographic reporting unit: Collected with Census. Available for all

Census geographic areas from Collection District level to total AustraliaLast reported: ABS 1996; 2001



69AIHW (2001) Demand for SAAP Assistance 1999-2000. A report from th

social indicators for addressing health inequalities

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