Advancing cross-sectoral data linkage to understand and address the health impacts of social exclusion: Challenges and potential solutions

Lindsay A Pearce; Rohan Borschmann; Jesse T Young; Stuart A Kinner

doi:10.23889/ijpds.v8i1.2116

Advancing cross-sectoral data linkage to understand and address the health impacts of social exclusion: Challenges and potential solutions

Int J Popul Data Sci. 2023 Jun 7;8(1):2116. doi: 10.23889/ijpds.v8i1.2116. eCollection 2023.

Authors

Lindsay A Pearce^{1

2}, Rohan Borschmann^{1

2

3

4

5}, Jesse T Young^{3

6

7}, Stuart A Kinner^{1

2

3

8}

Affiliations

¹ School of Population Health, Curtin University, Perth, Western Australia, Australia.
² Justice Health Group, Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
³ Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
⁴ Department of Psychiatry; University of Oxford, Oxford, UK.
⁵ Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
⁶ School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia.
⁷ National Drug Research Institute, Curtin University, Perth, Western Australia, Australia.
⁸ Griffith Criminology Institute, Griffith University, Brisbane, Queensland, Australia.

Abstract

The use of administrative health data for research, monitoring, and quality improvement has proliferated in recent decades, leading to improvements in health across many disease areas and across the life course. However, not all populations are equally visible in administrative health data, and those that are less visible may be excluded from the benefits of associated research. Socially excluded populations - including the homeless, people with substance dependence, people involved in sex work, migrants or asylum seekers, and people with a history of incarceration - are typically characterised by health inequity. Yet people who experience social exclusion are often invisible within routinely collected administrative health data because information on their markers of social exclusion are not routinely recorded by healthcare providers. These circumstances make it difficult to understand the often complex health needs of socially excluded populations, evaluate and improve the quality of health services that they interact with, provide more accessible and appropriate health services, and develop effective and integrated responses to reduce health inequity. In this commentary we discuss how linking data from multiple sectors with administrative health data, often called cross-sectoral data linkage, is a key method for systematically identifying socially excluded populations in administrative health data and addressing other issues related to data quality and representativeness. We discuss how cross-sectoral data linkage can improve the representation of socially excluded populations in research, monitoring, and quality improvement initiatives, which can in turn inform coordinated responses across multiple sectors of service delivery. Finally, we articulate key challenges and potential solutions for advancing the use of cross-sectoral data linkage to improve the health of socially excluded populations, using international examples.

Keywords: cross-sectoral; data linkage; health equity; marginalised populations; social determinants of health; social exclusion.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Data Accuracy*
Drive
Health Inequities
Health Personnel
Humans
Social Isolation*

Grants and funding

This work was funded by the Australian National Health and Medical Research Council (NHMRC) award no. GNT1163689. JY receives salary and research support from a National Health and Medical Research Council Investigator Grant (GNT1178027). RB receives salary and research support from a National Health and Medical Research Council Emerging Leadership Investigator Grant (EL2; GNT2008073). The funding body had no additional role in the development of this work.