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. 2014 Jun;104 Suppl 3(Suppl 3):S286-94.
doi: 10.2105/AJPH.2013.301716. Epub 2014 Apr 22.

Methods for improving the quality and completeness of mortality data for American Indians and Alaska Natives

David K Espey  1 , Melissa A Jim, Thomas B Richards, Crystal Begay, Don Haverkamp, Diana Roberts
Affiliations

Methods for improving the quality and completeness of mortality data for American Indians and Alaska Natives

David K Espey et al. Am J Public Health. 2014 Jun.

Abstract

Objectives: We describe methods used to mitigate the effect of race misclassification in mortality records and the data sets used to improve mortality estimates for American Indians and Alaska Natives (AI/ANs).

Methods: We linked US National Death Index (NDI) records with Indian Health Service (IHS) registration records to identify AI/AN deaths misclassified as non-AI/AN deaths. Analyses excluded decedents of Hispanic origin and focused on Contract Health Service Delivery Area (CHSDA) counties. We compared death rates for AI/AN persons and Whites across 6 US regions.

Results: IHS registration records merged to 176,137 NDI records. Misclassification of AI/AN race in mortality data ranged from 6.3% in the Southwest to 35.6% in the Southern Plains. From 1999 to 2009, the all-cause death rate in CHSDA counties for AI/AN persons varied by geographic region and was 46% greater than that for Whites. Analyses for CHSDA counties resulted in higher death rates for AI/AN persons than in all counties combined.

Conclusions: Improving race classification among AI/AN decedents strengthens AI/AN mortality data, and analyzing deaths by geographic region can aid in planning, implementation, and evaluation of efforts to reduce health disparities in this population.

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Figures

FIGURE 1—
FIGURE 1—
Percentage distribution of American Indian/Alaska Native (AI/AN) population, by county: United States, 2009. Source. 2013 intercensal bridged single-race population estimates, US Census Bureau/Centers for Disease Control and Prevention/National Cancer Institute, (http://seer.cancer.gov/popdata).
FIGURE 2—
FIGURE 2—
States and Contract Health Service Delivery Area counties by Indian Health Service Region: United States, 2009. Note. CHSDA = Contract Health Service Delivery Area.
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References

    1. National Center for Health Statistics, Division of Vital Statistics. National Vital Statistics System. Available at: http://www.cdc.gov/nchs/nvss.htm. Accessed May 2, 2012.
    1. Arias E, Schauman WS, Eschbach K, Sorlie PD, Backlund E. The validity of race and Hispanic origin reporting on death certificates in the United States. Vital Health Stat. 2008;2(148):1–23. - PubMed
    1. US Department of Health and Human Services, Office of Minority Health. American Indian/Alaska Native profile. Available at: http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=3&lvlid=26. Accessed March 25, 2013.
    1. National Conference of State Legislatures. Federal and state recognized tribes. Available at: http://www.ncsl.org/issues-research/tribal/list-of-federal-and-state-rec.... Accessed April 11, 2013.
    1. Indian Health Service. IHS year 2013 profile. Available at: http://www.ihs.gov/factsheets/index.cfm?module=dsp_fact_profile. Accessed March 20, 2013.

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