Methods for Improving the Quality and Completeness of Mortality Data for American Indians and Alaska Natives
Methods for Improving the Quality and Completeness of Mortality Data for American Indians and Alaska Natives
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DOI：
10.2105/ajph.2013.301716
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发表时间：
2014-06-01
影响因子：
12.7
通讯作者：
Roberts, Diana
中科院分区：
文献类型：
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作者：
Espey, David K.;Jim, Melissa A.;Roberts, Diana
目标。我们描述了用于减轻死亡率记录中种族错误分类影响的方法，以及用于改进美洲印第安人和阿拉斯加原住民 (AI/AN) 死亡率估计的数据集。方法。我们将美国国家死亡指数 (NDI) 记录与印度卫生服务 (IHS) 登记记录联系起来，以识别被错误分类为非 AI/AN 死亡的 AI/AN 死亡。分析排除了西班牙裔后裔，重点关注合同医疗服务提供区 (CHSDA) 县。我们比较了美国 6 个地区的 AI/AN 人和白人的死亡率。结果。 IHS 注册记录合并为 176 137 条 NDI 记录。死亡率数据中 AI/AN 种族的错误分类范围从西南部的 6.3% 到南部平原的 35.6%。从 1999 年到 2009 年，CHSDA 县的 AI/AN 人的全因死亡率因地理区域而异，比白人高 46%。对 CHSDA 县的分析导致 AI/AN 人员的死亡率高于所有县的死亡率总和。结论。改进 AI/AN 死者的种族分类可以加强 AI/AN 死亡率数据，按地理区域分析死亡情况可以帮助规划、实施和评估减少该人群健康差距的努力。
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.