Racial Misclassification of American Indians and Alaska Natives by Indian Health Service Contract Health Service Delivery Area
Racial Misclassification of American Indians and Alaska Natives by Indian Health Service Contract Health Service Delivery Area
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DOI：
10.2105/ajph.2014.301933
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发表时间：
2014-06-01
影响因子：
12.7
通讯作者：
Wiggins, Charles L.
中科院分区：
文献类型：
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作者：
Jim, Melissa A.;Arias, Elizabeth;Wiggins, Charles L.
目标.我们评估了美国印第安人和阿拉斯加原住民（AI/ANs）的癌症发病率和全因死亡率数据的印第安人健康服务（IHS）合同卫生服务提供区（CHSDA）的种族错误分类。我们评估了来自3个来源的数据：IHS-国家生命统计系统（NVSS），IHS-国家癌症登记计划（NPCR）/监测，流行病学和最终结果（SEER）计划和国家纵向死亡率研究（NLMS）。在每个数据源中，我们计算了按性别、IHS地区和CHSDA县城乡分类的敏感性和分类比。CHSDA县（IHS-NVSS：83.6%; IHS-NPCR/SEER：77.6%; NLMS：68.8%）的敏感性显著高于非CHSDA县（IHS-NVSS：54.8%; IHS-NPCR/SEER：39.0%; NLMS：28.3%）。分类比率表明CHSDA县（IHS-NVSS：1.20%; IHS-NPCR/SEER：1.29%; NLMS：1.18%）的错误分类比非CHSDA县（IHS-NVSS：1.82%; IHS-NPCR/SEER：2.56%; NLMS：1.81%）少。种族错误分类在农村县和AI/AN人群最集中的地区（阿拉斯加、西南和北方平原）较少。将介绍和分析限制在CHSDA县有助于减轻AI/AN人种族错误分类的影响，尽管一部分人口被排除在外。
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 (IHS-NVSS: 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%; IHS-NPCR/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.