Letters
Social determinants of health
Volume 197 - Issue 10

Lost and found: improving ascertainment of refugee-background Australians in population datasets

Authors:  Georgia A Paxton, Margaret P Kay and Ignacio Correa-Velez

Med J Aust 2012; 197 (10): 552-553. || doi: 10.5694/mja12.10878
Published online: 19 November 2012
To the Editor: Refugee health is an emerging area of clinical care. Over 200 000 humanitarian entrants have settled in Australia over the past 15 years, and the annual humanitarian intake has recently increased to 20 000 people.1 While there is (delayed) information on post-arrival refugee health screening, little is known about the longitudinal outcomes or use of health services in refugee-background Australians, and they remain invisible in existing population ...
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To the Editor: Refugee health is an emerging area of clinical care. Over 200 000 humanitarian entrants have settled in Australia over the past 15 years, and the annual humanitarian intake has recently increased to 20 000 people.1 While there is (delayed) information on post-arrival refugee health screening, little is known about the longitudinal outcomes or use of health services in refugee-background Australians, and they remain invisible in existing population datasets.2 This is a crucial information gap, with significant implications for health care and health policy.

We suggest adding “year of arrival” to population datasets, enabling the combination of “country of birth” and “year of arrival” to be used as a proxy for refugee status. This will improve identification of refugee-background Australians, with additional benefits for migration-related research. Country of birth and year of arrival are demographic details that are easy to collect, and are likely to elicit consistent responses over time. While they are not perfect surrogates for refugee status, they can be used to identify a refugee-like group3,4 and can be compared with Census data collected by the Australian Bureau of Statistics and data from the Department of Immigration and Citizenship.1

Alternatives such as “refugee status” or “visa number” are not easily recorded as demographic variables. Asking “Are you a refugee?” is not necessarily a straightforward (or polite) question, and may be perceived as stigmatising. “Refugee” may be defined in different ways: by visa status, self-perception or the United Nations Refugee Convention. Most humanitarian visas are not designated “refugee” visas, and Australia has over 100 different visa types. Further, people are less likely to identify as refugees with increasing duration of settlement, and some, especially young people, refuse the refugee label.5 Even if refugee status were easy to document, it does not obviate the need to collect country of origin and year of arrival information.

Providing responsive care to vulnerable communities in the era of Medicare Locals and an integrated e-health environment requires datasets that enumerate such communities. Ultimately, improved identification of refugee-background Australians will enable policy and health planning to meet the needs of Australia’s diverse population. More importantly, it will make sure that the right to be counted counts.

Authors

  • Georgia A Paxton1
  • Margaret P Kay2
  • Ignacio Correa-Velez3
  • 1. General Medicine, Royal Children’s Hospital, Melbourne, VIC.
  • 2. Discipline of General Practice, University of Queensland, Brisbane, QLD.
  • 3. School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD.

Correspondence: Georgia.paxton@rch.org.au

Competing interests

No relevant disclosures.

References

View this article on Wiley Online Library