Public health bodies across Canada, starved of census data, are paying for pricey surveys to collect their own local info but say they’re still flying blind on decisions that affect public health and taxpayer dollars.
As predicted, the national household survey that replaced Statistics Canada’s long-form census has flawed data that becomes more flawed the more granular you get.
“As you start looking at some of these results for smaller populations, the smaller areas, you might see a little bit more volatility in the information. So we are cautioning users,” Marc Hamel, Director General of Statistics Canada’s Census Management Office, told Global News in an interview last year.
“We don’t have [comparative] sources at the small level, very small towns. So we can’t say if the information is in line with reality in these locations.”
That leaves local governments and health officials in the lurch. In many cases they’re still relying on eight-year-old data from the 2006 census, because that’s the most recent, reliable data they have.
They need these numbers to evaluate existing programs and plan new ones; to determine how to reach marginalized populations and decide who needs targeting for which services. Where are immigrants settling? How about young people? Who’s getting their shots, and did an experimental neonatal health program pay off as affected babies grew up? What’s the best way to roll out vaccinations when the next epidemic hits?
Without population data, they say, they don’t know.
Some public health bodies are collecting their own info in an attempt to fill that gap – even though they know it’s still not as good and the costs are so prohibitive they can’t keep it up indefinitely.
British Columbia’s Fraser Health Authority is in the midst of analyzing data it collected from 15,000 people within the Lower Mainland health region (its partner, Vancouver Coastal Health, collected data on a similar sample size in its own area). The health bodies hope to use the information to create an interactive “health atlas” with everything from diabetes to immunization information.
“Obviously, the more of this we do, the better information we have, the better,” said Chief Medical Health Officer Paul Van Buynder. But this is no minor undertaking: You need to find the staff and the cash to make it happen.
“We will do what’s possible, given the financial burden,” Van Buynder said. “Do we have the money? What’s the most efficient way of getting the information we need?”
It’s ironic, he notes, that an ostensibly fiscally conservative government has made it tough to spend public funds in a fiscally responsible way.
“To a certain extent, we are working around the absence of what used to be available to use from the census,” he said.
But “at the end of the day, we still need that info. … There will always be a need of not just looking at the changing demographics but the impacts of what we do. We need to know whether that’s making a difference.”
Toronto Public Health, which told Global News last spring it was instructing employees not to use the national household survey for longitudinal comparisons, hasn’t done its own data collection.
“The scope of collecting census-like data is well beyond our resources,” spokesperson Kris Scheuer said in an email.
“In the absence of the long-form, census, we have been using alternative data sources to address some of the gaps, however, the alternative sources available do not address all of our data needs, including information on where newcomers are located in the city.”
It isn’t unusual for Saskatoon’s health region to conduct population surveys. But most of the time, they have a backbone of reliable census data to measure up against. This year, says Chief Medical Health Officer Cory Neudorf, they had to add questions whose answers they’d normally get from Statistics Canada. They’re scrambling to make up for the underrepresentation of poor people, young people, aboriginal people, transient people, people in rural areas – everyone, in other words, public health officials generally want to target.
But it’s “ad hoc” at best, Neudorf says: “If we wanted to get a 10 per cent sample, we’d be looking at well over $300,000 – and then what? You can’t compare it to anywhere else in the country.”
In many cases, he said, they’re still making decisions or evaluating programs based on 2006 census data, simply because that’s the best they’ve got. But that leaves out everything that’s happened since the recession.
“You’re kind of operating in the dark,” he said.
“The best I think we’d be able to do is to try to see if we can coordinate some local providers of health and social services to say we all agree to do some surveying at regular intervals. But it would be a shadow of the kind of information we had gotten from the long-form census. And I’m not sure all regions would be able to afford that.”
So what happens now?
Industry Canada, the federal body governing Statistics Canada, responded to questions with a link to an April announcement saying Statscan will stick with a short mandatory census and longer national household survey in 2016, as the organization did in 2011.
“The Agency will build on lessons learned in 2011 to provide relevant and timely information on the Canadian population with the objective of producing the best possible quality outcome,” the announcement reads.
Global News is awaiting clarification on what those lessons are.
“The optimist in me would say that we’ll be able to look at this 2011 data and see where it’s fallen short and there will be enough of a response back from decision-makers at local and provincial levels that there will be a reconsideration, so that by 2016 were able to reinstate some sort of a long-form census,” he said.
“The pessimist in me says that, you know, there’s this push on the other side to say, ‘If it’s not measured, we don’t necessarily know that there’s an issue. If we don’t know about it, we don’t have to act on it.’”