Racial Misclassification of American Indians and Alaska Natives by Indian Health Service Contract Health Service Delivery Area.

• Autores: Melissa A. Jim, Elizabeth Arias, Dean S. Seneca, Megan J. Hoopes, Cheyenne Jim, Norman J. Johnson, Charles L. Wiggins
• Localización: American journal of public health, ISSN 0090-0036, Vol. 104, Nº. 0, 2014, págs. 295-302
• Idioma: inglés
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• Resumen

  • 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 [ABSTRACT FROM AUTHOR]