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Ethnicity
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Last modified date:13 August 2007
Collection of ethnic data in DH central statistical collections: a "position statement" update (January 2001)
As stated in the previous position statement in November 1999, there is very strong support within the department, from Ministers and officials and also from data providers, for collection of ethnic data on workforce and clients. This is a top priority, across the range of activity for which DH is responsible.
Principles to be adopted for DH central collections
- It has been agreed within the department statistical division that, in principle, such data should be collected on a basis consistent with the 2001 census categories; with a transition period for datasets where ethnic data are already being collected in whatever form (generally based on 1991 census categories, or variants of them).
The 2001 census ethnic categories
- The list of ethnic categories in the 2001 Census has only recently been confirmed. The list at Annex 1 has 16 main categories, as listed in the annex below. These have resulted from extensive testing by ONS Census Division; the detailed categorisation of exactly which ethnic groups should be included where, will not be finalised by ONS until the end of April.
- It seems sensible for DH collections to have a 17th category "not stated" to cover situations where the information is genuinely lacking for some reason, including "data refused" or "data not asked for". This category is included in the list attached.
- The key point to note is that there is no simple read-across from the existing 1991 census categories to those in the 2001 census, even where the same titles are used. The new "mixed" category has no counterpart in the 1991 census.
Implications for DH central collections
- The current position is that, if we are to maintain consistency in future between DH central collections and Census information, the central collections will need to move over to the new categories at some stage in the future. This would in turn imply a gradual adoption of the "16+1" main ethnic categories as the basis of collection of ethnic data in its returns from now on.
- Given the scale and range of the DH datasets in question, it is extremely unlikely that they could all change over at once. Any changes would need to be agreed under the usual procedures which apply (this is especially important for the larger datasets). And there will be need for discussions with our data providers, on the implications for their own data collections, of any proposed timetable for change.
- Preferably, the "16+1" framework should apply to ALL statistical collections in DH, and ideally other government departments as well. This is to avoid having people with different ethnic categories in different types of provision - Health, Social Services and education/housing, for example.
National versus local data requirement,
- The national ethnic "16+1" framework is much less detailed than is probably appropriate at the local level for local management and monitoring purposes. But it is flexible enough to enable authorities to use more detailed categories if they so wish, by "pulling out" - that is subdividing - the national ethnic categories into the more detailed ones required locally. This should enable authorities to collate their ethnic data to any level of detail they require, whilst at the same time enabling them to reaggregate their data on a consistent basis, to national totals. A more detailed listing showing the codes which ONS intends to use for the coding of "write-in" entries for the 2001 census, is shown at Annex 2.
Data handling implications
1. Census data will relate to 2001 (presumably April). So it may not be necessary, in the case of existing datasets, for us to collect ethnic data on the "new basis" for 2000-2001. On the other hand, in the case of new collections, there is no point at all using the old ethnic categories since they will be overwritten by the new ones within a year.
2. Department of Health statistical datasets which include ethnic data will need to change over at some stage to the new ethnic categories, whether or not they retain the old ones as well. (There is the possibility that the decision will be NOT to change, in a few cases). DH will have to decide for each central collection the timetable for changing over to the new ethnic categories. In practice, a separate decision will probably be needed for each data collection, dependent upon the amount of consultations needed with data users and data suppliers, bearing in mind the impact upon local data systems.3. For each central data collection we will need to decide
- whether all existing records in the dataset/data collection need revisiting/rechecking to update records to the new ethnic categories; or
- we change gear, and from some point onwards (to be determined) we start collecting data on the new ethnic basis; or
- the dataset does not require new ethnic categories.
4. Case (a) seems most appropriate for "stock type" data - eg Social Services workforce data and case (b) for "flow type" data, - eg Hospital Episode Statistics (HES). For example, we might decide that all Social Service workforce records need to be reclassified to the new ethnic categories, but that ethnic data on HES data should switch over to the new ethnic categories from some (preannounced) date. There are unlikely to be many datasets in (c)
5. In the majority of cases which fall into category (b), the "starting assumption" is that the data systems involved will need to be capable of holding ethnic data on the old and new bases, simultaneously during a (possibly extended) transitional period. This means that the "old" and "new" ethnic categories should be allocated appropriate and distinct codes for data handling purposes, to avoid the possibility of confusion between the two categorisations, and to allow time for local data collators to amend their documentation material accordingly.
- There are other aspects which will need to be reviewed as well, for example:
- Is DH making full use of the ethnic data currently being collected?; and
- Are there any statistical datasets where ethnic data are not currently being collected, but should?
Task in prospect for local data collators
- Collecting ethnic data places significant demands on those who collate such information locally. Thus there are over 1 million staff in the health service, and a further 1 million in social services, of whom perhaps 30% are employed by Local Authorities. There are about 11 million HES records each year, for inpatients alone (outpatients would at least double this). Getting ethnic data for all these groups and activities (and where necessary, checking and updating records) is a major undertaking, on any examination of the facts.
Missing data
- It should also be noted that, where ethnic data are supposedly collected already, in many cases such records are frequently wrong or incomplete because of non-response (para 20) or some other reason. This problem will add to the task of updating records.
Notice period
- Given the scale of most of the datasets in question, and the incompleteness of many of the ethnic records within them, a notice period of at least six months to a year is appropriate for any change in ethnic categories (or indeed anything else). This is true both for NHS and Social Services datasets.
Recording of ethnicity
- In the case of staff, it is assumed that ethnic data will be self-reported. In the case of clients, it is less easy to see who should be responsible for deciding - the case of children is particularly tricky in this context. Unless we have a clear-cut set of rules for how ethnicity data are to be collected administratively, the consistency of reporting will be open to doubt.
Non response
- A further problem is that many staff and clients are unwilling to categorise themselves on an ethnic basis, for example because of uncertainty about why this information is being requested.This underscores the need for the Department to explain the context in which the data are to be collected and used - this includes the need to achieve better data linkage between datasets than is generally the case currently.
- The bottom line is that if any group is underreported, for whatever reason, then there is the distinct danger that resources allocated to that group nationally may be less than is justified. NHS and PSS Staff fully appreciate this point, when it is made to them. But the argument does need to be made, and at a senior level.
Liaison with Other Government Departments (OGD)
- DH has consulted with OGD and with LA representatives, CRE and REU etc on "DH ethnic framework", to ensure that it is the same as, or consistent with, ethnic frameworks proposed for use in these other contexts - the point made in para 8 above. Response has so far been very favourable; and so far as we know, there are no dissenters from the proposal which DH has put forward.
Religion
- One further point which may need agreement is whether we will need a field for data on religion, and if so, for what categories. For example, it might be appropriate for measuring service provision and need for certain client groups
- A decision on this point is unlikely until we know whether or not a question on religion is to be included in the (England) census form.
First language if not English
- There is similar uncertainty about the need for a field on "first language if not English" in DH collections.
Department of Health Statistics Division 3
January 2001
Click here for
Annex 1 - The ethnic categories for use in ALL DH statistical collections(the 16+1 listing) and
Annex 2 - the detailed ethnic categories (confirmed by ONS Jan 2001)
Outline "Map" of Ethnic Origin Information in Statistical Collections (Actual or in Planning) and Activities
Topic
Current situation
Statistical Lead
Health Services
Ethnic origin recording on Hospital Episodes Statistics (relates to IMG work on NHS recording of origin in minimum datasets relating to such activity)Collected from 1995-96, so currently have three years worth of ethnic data.
Linda Shurlock
020 7972 5567
Linda.Shurlock@doh.gsi.gov.uk
Ethnic origin of NHS workforce (non-medical and medical and dental manpower) Data from 1997 available. 1998 data available soon. Medical workforce ethnic data collected from 1991 but incomplete in early years.
John Bates
0113 2545878
(medical & dental)
Madeleine Watson
0113 2545891
(non-medical)
Public Health
Ethnic origin recording in Department of Health surveys e.g. health survey, diet and nutrition survey, survey of infant feeding in Asian families.Data on Health Survey from 1991, and other surveys similarly
Anthony Boucher
020 7972 5389
Anthony.Boucher@doh.gsi.gov.uk
Ethnic group on the Regional Drugs Misuse Databases
Collected by DH from April 1996, but not yet complete and reliable. Currently reviewing collection, including categorisation.
Patsy Bailey
020 7972 5551
Patsy.Bailey@doh.gsi.gov.uk
Social Services
Recording of ethnic origin for children looked after by local authorities (and perhaps also other services for children?)
In development for CLA for April 2000. Survey of Local Authority recording carried out in August 1998
Mike Cornish
020 7972 5573
Mike.Cornish@doh.gsi.gov.uk
Statistical contact on ADSS/LGMB occasional surveys of ethnic origin of Social Services workforce
Planned for September 2000. Some data available from LGMB for certain categories of social services staff from 1998
Keith Childs
020 7972 5736
Keith.Childs@doh.gsi.gov.uk
General
Ethnic origin recording in 1991 and 2001 population census
Gillian Goddard
020 7972 5561
Gillian.Goddard@doh.gsi.gov.uk
Possibilities for the future / other interests
There is growing interest in having ethnic origin data in respect of dental training career choice. This may be covered in two (existing) studies of women dentists aspirations, or may need to be covered in a study of its own.
Ethnic origin information health inequalities
Veena Bahl
020 7972 4671
Veena.Bahl@doh.gsi.gov.uk
Additional money for smoking cessation
Consideration being given to need for ethnic origin information
Patsy Bailey
020 7972 5551
Patsy.Bailey@doh.gsi.gov.uk
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