*2.6. Veterans*

Because of their unique service experience, many permanent, reserve, and ex-serving Australian Defense Force (ADF) members ('veterans') and their families experience challenges beyond those typically experienced by the general Australian population [9,10].

In collaboration with the Australian national government's Departments of Defense and Veterans' Affairs, the AIHW is monitoring and reporting on the health and welfare status of veterans. Outcomes for veterans are compared to those of the broader Australian population, to identify specific risk and protective factors, as well as the social determinants of health and welfare of Australian veterans.

To date, specific analyses in this work program have focused on understanding the following:


Under the veterans' analysis work program, the AIHW integrates ADF personnel data with other governmen<sup>t</sup> datasets to enable identification of veterans in a range of administrative datasets including death registries, Pharmaceutical Benefits Scheme, and Homelessness Support Services. A key development resulting from this work program has been the addition of a veteran identifier flag to the MADIP, which will allow identification of veterans in the broad range of datasets included in MADIP, to inform on aspects such as employment, income, education, and social service use.

The analytical outputs of the veterans' analysis work program are building a profile of Australia's veterans which is helping to drive data improvement, inform development of policy and targeted interventions, and ultimately, improve the wellbeing of Australia's veterans [13].

#### **3. The AIHW Data Integration Process**

Australian governmen<sup>t</sup> entities strongly support data integration, to maximize the benefits and use of governmen<sup>t</sup> data assets and, importantly, to reduce the burden on individual respondents and data providers.

To protect privacy and confidentiality, as well as maximize the public benefit of its research, the AIHW integration program takes place in a secure and regulated environment. The AIHW integration environment is characterized by strict adherence to privacy principles through appropriate governance and approvals, strong strategic partnerships, secure data integration processes, and the creation and maintenance of high-quality data assets.

#### *3.1. Governance and Approvals*

The AIHW's data integration environment adheres to, and is bound by, both mandatory requirements and best practice policies and processes. These include Australian governmen<sup>t</sup> legislation, policy, and guidelines, data security protocols, approval by ethics or human research ethics committees, data custodians and data access committees, and adherence to national and international best practice and frameworks including the *Privacy Act 1988* and the *Australian Privacy Principles (APPs)* [14,15]. The AIHW's data governance framework provides details of our strong data governance arrangements, including descriptions of key concepts, governance structures and roles, and the systems and tools that support them [16]. In addition, the AIHW's privacy policy outlines how the AIHW handles personal information [17].

The AIHW Ethics Committee is established under Section 16 of the *Australian Institute of Health and Welfare Act* [18]. Its functions and membership are prescribed in the *Australian Institute of Health and Welfare (Ethics Committee) Regulations 2018* [19]. All data linkage projects must be approved by the AIHW Ethics Committee and other relevant ethics committees where appropriate. The ethics application must include evidence of consultation with relevant stakeholders, including the general community, to establish their support and trust. Projects are required to be transparent and must make results publicly available. As part of this, information about projects and their outcomes are also published on the AIHW website.

All projects are assessed against the Five Safes, which is an internationally recognized approach to considering strategic, privacy, security, ethical, and operational risks as part of a holistic assessment of the risks associated with data sharing or release [20]. Guided by this framework, the AIHW applies the following criteria to assess all new integration projects and assign a risk rating:


Output is governed by the *Australian Institute of Health and Welfare Act 1987,* and strict review of outputs by AIHW's data integration managers ensures protection of privacy and confidentiality [18].
