The Underreporting of Deaths of American Indian Children in California, 1979 through 1993.
Authors: Myrna Epstein,, Raul Moreno,, Peter Bacchetti,
Publication Year: 1997
Last Updated: 2019-09-30 13:32:36
Journal: American Journal of Public Health
Keywords: racial misclassification, birth records, infant mortality
Short Abstract:
Racial misclassification
of infant deaths among American
Indians has been widely acknowledged
and reported in studies in California
and Montana, Oklahoma, and Washington.
When birth and death files were
linked, the number of deaths for American
Indian infants increased from 20% to
150%, depending on the study.
The objectives of this study were to
determine the extent of racial misclassification
in mortality reported for American
Indian infants and children in California,
provide more accurate data adjusted for
misclassification errors, and ascertain
counties with the highest levels of racial
misclassification in order to improve
reporting.
We identified four times as many
American Indian infants and children as
had been reported on state death certificates. On the
basis of the matched records, we found
that the number of deaths among American
Indian children was 4.1 times greater
than that reported on death certificates.
Misclassification at time of death
was more likely if the child resided in the
more urbanized counties outside of the
Indian Health Service delivery areas Deaths due to injuries were less
likely to be misclassified than deaths due
to other causes. Deaths occurring outside
of the hospital are likely to be investigated,
which may have led to greater
accuracy. Overall rates of misclassification
may be higher in California because
of the heterogeneity of the population and
the large number of American Indians
with Hispanic surnames.
Abstract:
The objectives of this study were to
determine the extent of racial misclassification
in mortality reported for American
Indian infants and children in California,
Misclassification at time of death
was more likely if the child resided in the
more urbanized counties outside of the
Indian Health Service delivery areas Deaths due to injuries were less
likely to be misclassified than deaths due
to other causes. Deaths occurring outside
of the hospital are likely to be investigated,
which may have led to greater
accuracy. Overall rates of misclassification
may be higher in California because
of the heterogeneity of the population and
the large number of American Indians
with Hispanic surnames.
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