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Lack of long-run data prevents us tracking Ireland's social health

ANA CARRIE

Just as Elizabeth Cullen found that inadequate statistics made it impossible to prove a conclusive link between Ireland's growing inequality and declining health, Ana Carrie found that the range of data required to construct an index showing the trend in the well-being of society just did not exist.

The original goal of this paper was to incorporate a variety of Irish social indicators into an aggregate index which would show the general trend in Ireland's social health. I hoped to produce an index going back at least twenty years and to publish an updated index on an annual basis. However, after reviewing the available historical data, I have concluded that it is not possible to produce a meaningful index of social health for Ireland at present. The paper therefore explains why and looks at what might be done to improve Irish social indicators in the future.

The index I had hoped to assemble would have been based on the Fordham Index of Social Health which was first produced at the Fordham Institute for Innovation in Social Policy in 1987. This index is discussed in great detail in the book The Social Health of the Nation: How America is Really Doing by Marc and Marque-Luisa Miringoff.

The Fordham Index is a composite of sixteen separate indicators. These are:

• Infant Mortality
• Child Abuse
• Child Poverty
• Youth Suicide
• Teenage Drug Use
• High School Dropouts
• Teenage Births
• Unemployment
• Wages
• Health Care Coverage
• Poverty, Aged 65+
• Life Expectancy, Aged 65+
• Violent Crime
• Alcohol-Related Traffic Fatalities
• Affordable Housing
• Inequality

The Miringoffs emphasize that these are not necessarily the sixteen most important social indicators but that they were selected on the basis of data availability and international comparability to give a balance between social and socioeconomic concerns, and to reflect the concerns of all age groups.

To compose the Index from the sixteen indicators, each indicator is first scaled from 0 to 100, and then they are averaged to form the Index. The value of 100 is meant to indicate a practical maximum, rather than a theoretical ideal. If unemployment drops to 5% at its lowest, this value would be scaled to 100, even though 3.5% might be attainable in other years or in other countries, and even though 0% might be seen as ideal. Note that if unemployment varied between 5% and 5.5%, the 5.5% value would be scaled to 0, whereas if unemployment varied between 5% and 10%, then 5.5% would be scaled to 90. The Index would reach a value of 100 if each individual indicator were at its optimal value in the same year.

A Fordham-style index for Ireland was produced by Charles M. A. Clark and Catherine Kavanagh and published in 1996 in Progress, Values and Public Policy. Clark and Kavanagh used 15 indicators, adding Net Migration as an important indicator in the Irish context, and omitting inequality and elderly life expectancy. Their conclusion was that during the period 1977 to 1994, the social health of Ireland as measured by the index changed rather little, beginning and ending at a level of approximately 70. Certain indicators improved (infant mortality, school drop-out rate) while others worsened (violent crime, drug use, traffic accidents). This contrasts sharply with per capita GNP, which showed a marked improvement during the same period.

The Miringoffs bemoaned the relative lack of social data in the United States in comparison with data of the economic kind. However, when compared to the Irish situation they had, and have, a wealth of information available. They were able to assemble data for their index from 1970 (and possibly earlier) to today with breakdowns by race, age, gender and region. So what is the situation in Ireland with regard to these statistics?

Infant Mortality, Teenage Births, Unemployment, Youth Suicide, Teenage Drug Use, Life Expectancy, Aged 65+

Irish national data is readily available on infant mortality, teenage births, unemployment and net migration. Infant mortality numbers, but not rates, are available on a county/county borough basis. National data on youth suicide and youth drug use [convictions for drugs-related offences] are available, but both would warrant further research to ensure that they have been consistently gathered over the past 20 years. Elderly life expectancy can be proxied by the death rate amongst over-65s which is available regularly.

Child Abuse
Accurate data on child abuse is simply not available for any historical period, and this fact is acknowledged in a 2001 study which cites hugely varying reported rates of child abuse across the country as evidence of inconsistent data integrity and collection. For example, in 1999, one health board reported 18.4 cases per 1000 children while another reported 4.4, with a national average of 8.4. The study was part of an initiative to overhaul the Department of Health and Children's information infrastructure in the area of child care, and so we can hope that improvements will be made in the future.

Child Poverty Poverty, Aged 65+ Inequality
Data on child poverty and elderly poverty are not produced in Ireland on an annual basis. Clark and Kavanagh used Social Welfare data to produce proxies for these indicators, however this approach is problematic in that social welfare schemes and entitlement thresholds can and do change over time. Census and Household Budget Survey/Living In Ireland data can be analyzed to produce figures, but at this time there is no consistent regular source for this information. Inequality data can be obtained from the same sources with the same difficulties.

High School Dropouts
Of those students who commenced post-primary education in 1994, 81.8% completed their secondary education, known as the adjusted Senior Cycle Retention rate. The report in which this fact was presented opens with the statement, "This is the first published analysis by the Department of Education and Science of school retention in Ireland." Prior to this, data on the percentage of students completing secondary education is available for certain years from census and survey data.

Wages
Wage data is available historically, but only for the industrial sector. Up to 1985, 'Manufacturing' wages were reported but from 1982 to the present, a separate dataset reports 'All Industrial' wages. A dataset can be produced by combining these two time series, but this is not entirely appropriate as they are not measuring the same thing. Also, it is not clear how wages in the industrial sector related to wage levels generally during the time period in question.

Health Care Coverage
It is difficult to know how to measure Health Care Coverage in Ireland. Medical Card coverage is not an appropriate indicator, nor is the number of private health insurance subscribers, as it is quite possible to have neither and still have good access to health care. This is an area where, in the absence of a readily identifiable metric, research should be undertaken to find indicators which go beyond waiting lists and emergency room overcrowding and properly measure access to health care.

Violent Crime
Violent crime data is available in Garda annual reports. Beginning with the 2000 annual report, the PULSE system modernized and defined new categories for the reporting of crime data. For example, chemical weapons offenses were added and Larceny of Horses ceased to exist as a separate category. This change, however beneficial for the future, prevents us from easily comparing crime rates historically.

Alcohol-Related Traffic Fatalities Traffic fatality data is available going back quite far, but unlike the US, the contribution of alcohol is not recorded. If traffic fatality data in itself were determined to be appropriate for a social index, it would need to be adjusted either for population or for car ownership.

Affordable Housing
Affordable housing can be measured in a variety of ways, one which is rather straightforward is to look at the ratio of the average house price to the average industrial wage, although this is looking at the affordability of home ownership rather than simply accommodation and does not take into account the impact of interest rates in making mortgage payments. In 2001, this figure was a multiple of 8.4, which can be contrasted with the figure of 3.5 used by banks when approving mortgages.

Conclusions
A fundamental problem with Irish historical data is its lack of continuity. Where statistics are available, they generally have not been gathered in a consistent manner over the time period in question. Ironically, improvements in the quality of official statistics will almost always come at the cost of continuity. For instance, recent redefinitions in Garda crime information mean that, while this year's data may be more relevant and accurate, it is not possible to make comparisons going back even three years as different definitions were in place at that time. As a researcher, I would urge that where a change is made to a definition, criterion or other factor which will result in a data set being discontinuous from previous values, two sets of data, one from each method, should be produced for the transition year to enable pseudo-continuous index numbers to be produced. Then again, as a realist, I understand that any additional workload at a time of transition will not be welcomed.

In contrast to the US where data is collected for each state, in Ireland regional breakdowns are generally not possible since different government bodies break the country into different regions. For example, crime statistics follow Garda administrative boundaries while health statistics are determined by health board regions. Many statistics are only available at a national level. Government departments should report data using standardized administrative regions, or better yet, report county or sub-county level data to allow end users to construct their own regions.

The statistics which are relevant to our lives are likely to change over time. Twenty years ago, computer ownership would not have been thought of as a meaningful social indicator. Any programme to improve the quality and quantity of social indicators will need to take into account that these indicators will change over time. I do not believe that this is at odds with implementing good statistical practices to ensure that datasets are consistent over decades.

I have mentioned that several government departments are modernising and expanding their data collection systems, and in the future Irish researchers can look forward to a much broader selection of high quality data. A hopeful sign is the Strategy for Statistics, 2003-2008 published by the National Statistics Board, available at: http://www.nsb.ie/publications/StrategyforStatistics2003-2008.pdf (PDF format)

This document discusses the increased demand for social and environmental statistics, brought about in part by the need to evaluate commitments made by the government in social partnership agreements, and proposed policy initiatives to identify, produce and disseminate high quality statistics.

I am also gratified that the Strategy for Statistics calls for more training in data analysis within the public sector and elsewhere. Statistics are meaningless without proper interpretation and a proper context. It is very easy to be seduced by a "hard" fact, when of course any single statistic is only a one-dimensional perspective on a complex reality, subject to a margin of error which may be quite large. A lack of numeracy and statistical training is dangerous in that it allows the unscrupulous to misrepresent statistics, and denies the uninitiated the tools to make their own judgments about the numbers which measure our world.

While the future of Irish social statistics looks reasonably bright, evidently brought about by a combination of internal modernization and external pressure to report on social and environmental issues in a consistent and systematic way, we have irrevocably lost the opportunity to use historical statistics to monitor the economic and social upheavals of the transition to modern Ireland. In view of the statistical problems, I don't feel that the Irish Fordham index constructed by Clark and Kavanagh can be held up for discussion with any greater authority than our own gut feelings of "some things have improved, others have worsened, others stayed the same". This is not tragic since, when such indexes do have a reasonable statistical validity they can of course be abused and given too much importance. It is, however, unfortunate, as the blossoming of regional and local Fordham-like indexes in the United States and elsewhere has given a valuable tool to communities, inspired by the publicity afforded to the original index, that wish to track their progress.