Toward Global Comparability of Sexual Orientation Data in Official Statistics: A Conceptual Framework of Sexual Orientation for Health Data Collection in New Zealand’s Official Statistics System

Objective. Effectively addressing health disparities experienced by sexual minority populations requires high-quality official data on sexual orientation. We developed a conceptual framework of sexual orientation to improve the quality of sexual orientation data in New Zealand’s Official Statistics System. Methods. We reviewed conceptual and methodological literature, culminating in a draft framework. To improve the framework, we held focus groups and key-informant interviews with sexual minority stakeholders and producers and consumers of official statistics. An advisory board of experts provided additional guidance. Results. The framework proposes working definitions of the sexual orientation topic and measurement concepts, describes dimensions of the measurement concepts, discusses variables framing the measurement concepts, and outlines conceptual grey areas. Conclusion. The framework proposes standard definitions and concepts for the collection of official sexual orientation data in New Zealand. It presents a model for producers of official statistics in other countries, who wish to improve the quality of health data on their citizens. 1. Introduction Robust evidence demonstrates that sexual minority populations 1 have poorer access to care, poorer care, and higher morbidity than heterosexual populations in areas such as mental health, sexual health, and cancer [1–3]. Over the last decade, public health authorities and international health organisations have developed policies to eliminate these health disparities [4–8]. Effectively developing such policies and monitoring their outcomes require official data on sexual orientation that is timely, accurate, reliable, comparable, and of overall high quality [9, 10]. Producers of official health statistics throughout the world have started collecting sexual orientation data by adding sexual orientation questions in official health surveys. The United States Department of Health and Human Services has obtained data on sexual orientation in several surveys since the early 1990s [11]. The United Kingdom Office for National Statistics conducted the Sexual Identity Project from 2006 to 2009 to develop and trial sexual identity questions [12] and recently began the standard implementation of these questions in several surveys [13]. New Zealand’s Official Statistics System (OSS), which comprises around 70 government departments that produce official statistics, has also gained significant experience in this area. More specifically, the Ministry of Health has conducted various health surveys which included