AGEING AND PUBLIC STATISTICS
This series of DIALOGUE seminars will provide an opportunity to share experiences and discuss the needs and constraints of the various actors (data producers and users) in the spheres of public policy and research. The aim is to consider possible changes to data collection systems. In this unprecedented context of a pandemic that has hit the elderly, two themes will be examined:
• Session 1. Data on excess mortality in the context of a health crisis.
• Session 2. Data on autonomy in old age.
ÉTAT DES LIEUX
Public statistics is a tool for counting, describing and analysing. It is used to support political objectives, to help build systems, such as social protection, and to monitor their development in the population: civil status data, population censuses, registers, surveys on health, work, the family, housing, etc. Although the needs are not perfectly superimposable, research and public policy often share the same measurement and analysis objectives.
On the basis of common objectives, shared methods and skills, public data collection has evolved. The 'panellisation' of samples or matching between databases increases the relevance of sources for building specific research projects. Administrative sources (e.g. tax, medical, pensions, etc.) have long been inaccessible (in legal terms and in terms of content) or poorly suited to research questions. Today, there are potentially veritable mines of data to be explored, the boundaries of which need to be defined in order to make them operational.
Part from targeted operations, such as surveys on issues of old ages inclusion, poverty or dependency (which we are going to explore), there are still gaps in social statistics, and the oldest age often escape measurement: difficulties in surveying frail people; out-of-scope (e.g. EHPAD)... The number of old and very old people in the samples is often too low to represent the diversity of situations. These observations are now prompting those involved in this field of research to meet and share ideas to design and build data sources that are less 'imperfect'.
MEASURING (EXCESS) MORTALITY IN THE CONTEXT OF HEALTH CRISES: LESSONS FROM THE COVID-19 PANDEMIC
FRIDAY 15 octobER 2021
Salle Sauvy - INED, Campus Condorcet - 9 cours des Humanités, Aubervilliers
A seminar co-organised by the ILVV and the Ined Unit on Mortality, health and Epidemiology
Our populations are experiencing repeated health crises, often severely affecting the older people and causing life expectancy to fluctuate (virulent influenza and gastroenteritis, heat waves, etc.). In 2020, the COVID-19 pandemic gave a universal and multiplied vision of these shocks. It put health information systems in France and elsewhere to the test. On a daily basis, deaths from COVID have become a key indicator. Behind these figures, however, there are many challenges to be met in terms of data collection: timeframes for exhaustive reporting of bulletins and death certificates, coverage of places of death, criteria for identifying deaths due to Covid-19.
These figures, which are rapidly available, meet monitoring and warning objectives, which do not always coincide with the objectives of analysing phenomena. Surveillance and warning missions require rapid data feedback and sensitive observation points. Analysis missions require representative data collection to understand the diversity of situations, identify risks and underlying factors, understand variations, etc How can these missions be reconciled?
The evaluation of health information systems is a necessary step towards reconciling the two sets of objectives and preparing for future health crises. The Mortality, Health and Epidemiology unit of the Institut national d'études démographiques (MSE-Ined) and the Institut de la Longévité des Vieillesses et du Vieillissement (ILVV) are organising a scientific meeting with demographers, epidemiologists and statisticians from Ined, Insee, Santé publique France (SpF), DREES, CNAM and Inserm (CépiDc). The aim is to exchange and cross-fertilise experiences on data from routine systems, surveillance or ad hoc sources, and their limitations. The aim is to explore the complementarity and potential for mutual enrichment of data collection systems.
OVERVIEW OF THE DAY
The first part will be devoted to a presentation of: (1) the sources of statistical data on mortality during the COVID crisis in France; (2) the work carried out by various parties on the assessment of excess mortality and the disparities observed (territorial, social); (3) experiences in other contexts, particularly with a view to international comparison.
The second part will be devoted to sharing the lessons learned from these presentations, as part of a round table discussion bringing together the bodies responsible for the various data collection systems in France.
Emmanuelle Cambois, Giancarlo Camarda, Aline Désesquelles, Michel Guillot, Myriam Khlat, France Meslé, Gilles Pison, Grégoire Rey et Jean-Marie Robine.
Programme (IN FRENCH ONLY)
Partie 1. Les aspects temporels, sociaux et géographiques de la mortalité par COVID-19 : Enjeux méthodologiques
9H30-11H00 - Les sources, leur périmètre et leurs écueils.
- J-M Robine* (Inserm-EPHE-Ined). Panorama des sources de données sur la mortalité en France.
- S. Le Minez* (INSEE). Mesurer la sur-mortalité et ses variations temporelles et géographiques.
- D. Martin* (Inserm CépiDC). Identifier les causes de décès.
- L. Ricroch* et M. Gaini (DREES). Analyser la mortalité hospitalière et en établissements médico-sociaux
11H30-13H00 - Inégalités et facteurs de variation.
- A. Fouillet (Santé publique France) et Grégoire Rey (Inserm CépiDc). Analyse de la mortalité par suicide pendant la crise sanitaire.
- C. Dufouil (Inserm). Les disparités sociales et géographiques des décès par COVID-19.
- M. Khlat et M. Guillot (Ined). Évaluer la surmortalité des populations immigrées liée à la crise.
- F. Canouï-Poitrine* (Hôpital Henri-Mondor). Appréhender la sur-mortalité dans les EHPA
BUFFET SUR PLACE
14h00-15h30 - Les expériences de mesure de la mortalité de crise dans d'autres contextes.
- C. Torres* (Ined-MNHN). La démographie des décès par COVID : une perspective internationale.
- J. Rousselon* (France Stratégie). Conclusions de la note « Point de vue » sur la surmortalité par COVID-19.
- V. Nafilyan* (ONS, UK). L’expérience du Royaume-Uni.
- N. Bustos Sierra* (Sciensano, Belgique). L’expérience de la Belgique.
- G. Pison*, (MNHN-Ined). Le dispositif de surveillance de la surmortalité bovine lors des épizooties.
Partie 2. Dialogue autour des enseignements à tirer de la pandémie, pour la mesure de la mortalité en situation de crise sanitaire
16H00-17H30 Mieux recueillir l'information pour la surveillance et l’analyse
- G. Rey* (Inserm-CépiDc). Les contraintes dans les remontées manuelles et la représentativité des données électroniques.
- C. Caserio* (SpF). L’assemblage des sources diverses.
- L. Espinasse* (INSEE). Les circuits des données d’état-civil.
- A. Rachas *(CNAM). Le potentiel des données du SNDS.
- F. Meslé* (Ined). Transition sanitaire, épidémies, maladies infectieuses aux grands âges : quelles perspectives pour les données de mortalité.
* Les interventions sont disponibles en vidéo ci-dessous
SESSION 2 - AUTONOMY IN OLD AGE: UNDERSTANDING SITUATIONS, RISKS AND FACTORS
A seminar co-organized by ILVV and DREES
While public statistics generally focus little on older age groups, the field of independent living is something of an exception: targeted surveys have shed light on their situations and needs. However, in this field too, there is a lack of data and unanswered questions: changes in the living and health conditions of the older population, the diversity of needs in terms of care, support or assistance, territorial variations, the processes of deterioration in functional health, and finally the factors contributing to the maintenance of autonomy or to frailty.
The reasons for this deficit are linked to methodological challenges, costs (financial and in terms of human resources) and the priorities of data producers: official statistics may be limited in terms of research aspects and research data may be unsuitable for "decision support": coverage (representativeness) and sample size; themes covered; indicators, etc. But beyond priorities, many concerns converge. An inventory of resources and needs could lead to profitable improvements in data collection.
This seminar will contribute to these discussions by organising an exchange between producers and users of statistical, administrative or survey data produced by public bodies and by researchers. The aim will be to describe the objectives and priorities, the statistical needs that are being met and those that are not, and to take a critical look at the existing sources.
OVERVIEW OF THE DAY
The aim is to participate in the strategy to improve the (re)sources available, taking into account the various priorities and constraints. This strategy will involve an inventory of sources to describe the gap between needs and resources. The contribution of this seminar will be to bring to light the criteria that it would be essential to mobilise in this inventory task in order to optimise its impact.
The first round table will focus on data requirements. The participants will share their thoughts on the limits, challenges and potential: panels, sample sizes, diversity of situations, themes, etc
The second round table will take a closer look at the specific difficulties of data collection in the field of autonomy, where the main subjects of analysis often escape measurement.