Racial misclassification of American Indians and Alaska natives by Indian health service contract health service delivery area

M.A. Jim, E. Arias, D.S. Seneca, M.J. Hoopes, C.C. Jim, N.J. Johnson and C.L. Wiggins

American Journal of Public Health, 2014, vol. 104, issue S3, S295-S302

Abstract: Objectives. We evaluated the racial misclassification of American Indians and Alaska Natives (AI/ANs) in cancer incidence and all-cause mortality data by Indian Health Service (IHS) Contract Health Service Delivery Area (CHSDA). Methods. We evaluated data from 3 sources: IHS-National Vital Statistics System (NVSS), IHS-National Program of Cancer Registries (NPCR)/Surveillance, Epidemiology and End Results (SEER) program, and National Longitudinal Mortality Study (NLMS). We calculated, within each data source, the sensitivity and classification ratios by sex, IHS region, and urban-rural classification by CHSDA county. Results. Sensitivity was significantly greater in CHSDA counties (IHS-NVSS: 83.6%; IHS-NPCR/SEER: 77.6%; NLMS: 68.8%) than non-CHSDA counties (IHSNVSS: 54.8%; IHS-NPCR/SEER: 39.0%; NLMS: 28.3%). Classification ratios indicated less misclassification in CHSDA counties (IHS-NVSS: 1.20%; IHS-NPCR/SEER: 1.29%; NLMS: 1.18%) than non-CHSDA counties (IHS-NVSS: 1.82%; IHSNPCR/SEER: 2.56%; NLMS: 1.81%). Race misclassification was less in rural counties and in regions with the greatest concentrations of AI/AN persons (Alaska, Southwest, and Northern Plains). Conclusions. Limiting presentation and analysis to CHSDA counties helped mitigate the effects of race misclassification of AI/AN persons, although a portion of the population was excluded.

Keywords: American Indian; article; cancer registry; classification; ethnology; female; health survey; human; incidence; Inuit; longitudinal study; male; neoplasm; public health service; register; United States, Alaska; Female; Humans; Incidence; Indians, North American; Inuits; Longitudinal Studies; Male; Neoplasms; Population Surveillance; Registries; SEER Program; United States; United States Indian Health Service (search for similar items in EconPapers)
Date: 2014
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Citations: View citations in EconPapers (5)

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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2014.301933_7

DOI: 10.2105/AJPH.2014.301933

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