The reporting of race and ethnicity in the National Notifiable Diseases Surveillance System

Abstract

The authors used 1987 data from the Epidemiologic Surveillance Project (ESP) of the Centers for Disease Control to examine the completeness of race-ethnicity reporting in the National Notifiable Diseases Surveillance System. And, to the extent possible, they used ESP to assess racial and ethnic disparities in the occurrence of selected notifiable infectious diseases. For the 30 reporting areas (29 States and the District of Columbia) that provided data to ESP for all of calendar year 1987, approximately 60 percent of case reports were accompanied by specified race-ethnicity for affected persons. This percentage varied widely by disease and State. In general, non-Hispanic whites had morbidity rates (cases per 100,000 population per year) that were among the lowest compared with rates for other groups, and Native Americans commonly had rates that were among the highest. The ranking of morbidity rates among blacks, Hispanics, and Asians and Pacific Islanders varied by disease, although the last group had strikingly higher rates for malaria and tuberculosis. The age distribution of persons with cases was often lower among minority groups than among non-Hispanic whites, but the authors were unable to calculate age-specific or age-adjusted rates. Potential biases that limit interpretation of the findings are reviewed. Efforts to eliminate racial-ethnic disparities in the occurrence of infectious diseases would be aided by effective surveillance data. For the ESP to meet its potential in this regard, however, substantial improvements in the reporting of race-ethnicity for notifiable diseases are needed.