| Title | Methods for improving the quality and completeness of mortality data for American Indians and Alaska Natives |
| Publication Type | Journal Article |
| Year of Publication | 2014 |
| Authors | Espey, DK, Jim, MA, Richards, TB, Begay, C, Haverkamp, D, Roberts, D |
| Journal | Am J Public HealthAm J Public Health |
| Volume | 104 Suppl 3 |
| Pagination | S286-94 |
| Date Published | Jun |
| ISBN Number | 1541-0048 (Electronic)<br/>0090-0036 (Linking) |
| Accession Number | 24754557 |
| Keywords | Adolescent, Adult, Aged, Aged, 80 and Over, Alaska, Cause of Death, Child, Child, Preschool, Data Collection/ standards, Death Certificates, Female, Humans, Indians, North American/ statistics & numerical data, Infant, Inuits/ statistics & numerical data, Male, Middle Aged, Mortality/ trends, Population Surveillance, United States, United States Indian Health Service |
| 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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