Conducting a Repeated Cross-Sectional Survey for 24 Years in a Disadvantaged Community: The Miller Household Survey (1999–2023)

Objectives The objective was to examine demographic, social, and health trends over 24 years in a disadvantaged Sydney community through sustained household surveillance, demonstrating the feasibility of longitudinal community-level health monitoring for informing policy and service delivery whilst building local capacity. This study addresses a gap in Australian community-level health surveillance data, particularly for disadvantaged areas where health needs often differ from broader population patterns. Methods This repeated cross-sectional study conducted household surveys at six time points (1999, 2002, 2005, 2007, 2010, and 2022-2023) using quantitative measures including SF-12 Physical and Mental Health Component Summary scores, demographic data, and structured questions assessing community perceptions. Randomly selected households completed face-to-face interviews, telephone surveys (CATI), written questionnaires, online surveys, or drop-off/pick-up questionnaires lasting 20-45 minutes. Multilingual delivery accommodated Miller's diverse population. Local residents trained as interviewers in 2010 and 2022-2023 enhanced community engagement and trust. Results Adult participation ranged from 180 to 335 participants, with response rates from 17.1% (2007) to 51.6% (2022-2023). Notable demographic changes occurred: population ageing (31.6% over 65 by 2022-2023), growing overseas-born residents (49.8%), and rising educational achievement (55.5% with secondary qualifications or above). SF-12 Physical Component scores fell from 47.1 (2002) to 41.5 (2022-2023). SF-12 Mental Component scores dropped substantially from 48.8 (2002) to 30.6, nearly 20 points below Australian population norms. Social cohesion indicators varied across survey waves, with lower values in 2010 and higher values by 2022-2023. Health service enhancements between 2006-2010 yielded limited benefits, suggesting structural obstacles persist. Conclusion Community surveys were used to create health baselines, monitor changes during urban renewal, and inform policy and service planning. Sustained community-engaged surveillance through varied approaches to data collection is feasible in disadvantaged Australian contexts, uncovering localised health issues whilst supporting targeted public health interventions. Results reveal serious mental health deterioration warranting immediate attention alongside ongoing monitoring to tackle enduring inequalities and strengthen community capacity.