Racial Misclassification of American Indians: Its Effect on Injury Rates in Oregon, 1989 through 1990

Authors: Jonathan R Sugarman, MD, Robert Soderbeig, Jane E. Gordon,, Frederick P. Rivara
Publication Year: 1993
Last Updated: 2019-09-30 12:59:01
Journal: American Journal of Public Health
Keywords: racial misclassification, injury rates, AI/AN disease surveillance, vital records, IHS linkage

Short Abstract: To our knowledge, the extent to which American Indian injury rates are underestimated owing to racial misclassification is unknown. To examine this question, we conducted a study that linked the Oregon Injury Registry with a patient registration file of American Indian Oregon residents registered with the Indian Health Service (IHS). In addition, we examined selected risk factors that might be associated with the likelihood of discordant racial classification between the two data sets. The Oregon Injury Registry is a population-based surveillance system for injuries resulting either in death or in hospital admission for at least 1 calendar day. The Portland Area IHS maintains a computer file of Oregon residents who have registered for services with it. To examine how inconsistent racial classification between the two data sets affected estimated injury rates among American Indians, we calculated age-adjusted rates of injury using three methods.

Abstract: The Oregon Injury Registry is a population-based surveillance system for injuries resulting either in death or in hospital admission for at least 1 calendar day. The Portland Area IHS maintains a computer file of Oregon residents who have registered for services with it. To examine how inconsistent racial classification between the two data sets affected estimated injury rates among American Indians, we calculated age-adjusted rates of injury using three methods. In 1989 and 1990, 301 entries (hospital admissions or fatalities) in the Oregon Injury Registry were coded as American Indian. Of these, 133 (44.2%) were not matched to the IHS patient registration file. An additional 89 persons who were coded as a race other than American Indian on the registry were linked to the IHS file. Two cases coded as American Indian in the registry were listed as non-American Indian in the IHS file. Thus, the number of cases in the registry that were identified as American Indian in at least one of the data sets increased by 29.6% (n = 390) after the data linkage.

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