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

To the Editor: We strongly support Paxton and colleagues in the call for inclusion of year of arrival in routine health datasets to inform improvement in health service provision in Australia.1

We also argue that a consistent and rigorous approach needs to be applied to the use of country of birth (COB) in health research. COB is usually included in routine health data sets and, as an indicator of refugee background, enables research to specifically target populations that for linguistic, cultural or societal reasons may be underrepresented in traditional epidemiological research. How we define source countries of humanitarian entrants, and also group COB by world region, is likely to affect study results.24 National immigration data, matched by period to the study dataset, can be used to identify COBs with high proportions of humanitarian entrants.5 The United Nations’ definitions of world regions can be used as a reproducible framework for grouping countries if required.

Using a consistent method to determine probable refugee background, description…