Improving Quality of Mortality Estimates Among Non-Hispanic American Indian and Alaska Native People, 2020.

Details

• Alternative Title:
  American Journal of Epidemiology, 2026, v. 195, no. 3: Improving Quality of Mortality Estimates Among Non-Hispanic American Indian and Alaska Native People, 2020.
• Journal Article:
  American Journal of Epidemiology
• Personal Author:
  Jim, Melissa A. ; Arias, Elizabeth ; Haverkamp, Donald S. ; Paisano, Roberta ; Apostolou, Andria ; Melkonian, Stephanie C.
• Description:
  Racial misclassification on death certificates leads to inaccurate mortality data for American Indian and Alaska Native (AI/AN) populations. We describe methods for correcting for racial misclassification among non-Hispanic AI/AN (NH-AI/AN) populations using data from the year 2020. We linked National Death Index records with the Indian Health Service (IHS) patient registration database to identify AI/AN decedents. Matches were then linked to the National Vital Statistics System mortality data to identify AI/AN individuals who had been misclassified as another race on their death certificates. Analyses were limited to NH-AI/AN and purchased/referred care delivery areas or urban areas. We compared death rates and counts pre- and postlinkage and calculated sensitivity and classification ratios by region, sex, age, cause of death, and urban area. Racial misclassification on death certificates among NH-AI/AN varied by geographic region. Some of the highest racial misclassification occurred in the Southern Plains and Pacific Coast. Death rates for NH-AI/AN people and differences between NH-AI/AN and non-Hispanic White people were larger using the linked data. Improving AI/AN mortality data using linkages between vital statistics data and IHS strengthens data quality and can help address health disparities through public health planning efforts.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • Alaska Natives
  • Death Certificates
  • Female
  • Male
  • Indians, North American
  • Middle Aged
  • Mortality
  • Adult
  • Aged
  More +
• Keywords:
  • American Indian and Alaska Native
  • mortality
  • disparities
  • racial misclassification
  • data linkages
• Source:
  American Journal of Epidemiology, 2026, v. 195, no. 3
• DOI:
  https://doi.org/10.1093/aje/kwaf094
• ISSN:
  0002-9262 ; 1476-6256
• Pubmed ID:
  40320253
• Pubmed Central ID:
  PMC12353377
• Document Type:
  Text
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Genre:
  Journal Article
• Place as Subject:
  United States
• Pages in Document:
  736-747 (22 pdf pages)
• Volume:
  195
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:e21684135e66a38135c10b3f61c4f6581aed0ebec420df74362dfcf679b94aec33388cc76bd9809da3ecafb12a968456b265cbcd1a6f4035e90217eac0de2a2e