Paul Stehr-Green1, James Bettles, L Dee Robertson. 1. Northwest Tribal Epidemiology Center (The EpiCenter), Northwest Portland Area Indian Health Board, 527 SW Hall, Suite 300, Portland, OR 97201, USA.
Abstract
OBJECTIVES: This study examined effects of racial/ethnic misclassification of American Indians and Alaskan Natives on Washington State death certificates. METHODS: Probabilistic record linkage were used to match the 1989-1997 state death files to the Northwest Tribal Registry. RESULTS: We identified matches for 2819 decedents, including 414 (14.7%) who had been misclassified as non-American Indians and Alaskan Natives on the death certificates. The likelihood of being correctly classified increased 3-fold for each higher level of American Indian and Alaskan Native ancestry (odds ratio = 2.88; 95% confidence interval [CI] = 2.51, 3.30) and decreased by 6.9% per calendar year (95% CI = 2.0, 11.5). CONCLUSIONS: Systematic biases on death certificates in Washington State persist. Methods to reduce misclassification can improve data quality and enhance efforts to measure and reduce racial/ethnic health disparities.
OBJECTIVES: This study examined effects of racial/ethnic misclassification of American Indians and Alaskan Natives on Washington State death certificates. METHODS: Probabilistic record linkage were used to match the 1989-1997 state death files to the Northwest Tribal Registry. RESULTS: We identified matches for 2819 decedents, including 414 (14.7%) who had been misclassified as non-American Indians and Alaskan Natives on the death certificates. The likelihood of being correctly classified increased 3-fold for each higher level of American Indian and Alaskan Native ancestry (odds ratio = 2.88; 95% confidence interval [CI] = 2.51, 3.30) and decreased by 6.9% per calendar year (95% CI = 2.0, 11.5). CONCLUSIONS: Systematic biases on death certificates in Washington State persist. Methods to reduce misclassification can improve data quality and enhance efforts to measure and reduce racial/ethnic health disparities.
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