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Rhodes KL, Echo-Hawk A, Lewis JP, L Cresci V, E Satter D, A Dillard D. Centering Data Sovereignty, Tribal Values, and Practices for Equity in American Indian and Alaska Native Public Health Systems. Public Health Rep 2024; 139:10S-15S. [PMID: 37864519 DOI: 10.1177/00333549231199477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2023] Open
Affiliation(s)
| | - Abigail Echo-Hawk
- Urban Indian Health Institute, Seattle Indian Health Board, Seattle, WA, USA
| | - Jordan P Lewis
- Memory Keepers Medical Discovery Team, Department of Family Medicine & Biobehavioral Health, University of Minnesota Medical School, Duluth Campus, Duluth, MN, USA
| | - Vanesscia L Cresci
- National Telecommunications and Information Administration, US Department of Commerce, Washington, DC, USA
| | - Delight E Satter
- Tribal Public Health Law Program, Center for State, Tribal, Local and Territorial Support, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Denise A Dillard
- Institute for Research to Advance Community Health, Washington State University, Seattle, WA, USA
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Goldman N, Park SS, Beltrán-Sánchez H. Life expectancy among Native Americans during the COVID-19 pandemic: estimates, uncertainty, and obstacles. Am J Epidemiol 2024; 193:846-852. [PMID: 38140861 PMCID: PMC11145904 DOI: 10.1093/aje/kwad244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/15/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023] Open
Abstract
Few reliable estimates have been available for assessing the impact of the COVID-19 pandemic on mortality among Native Americans. Using deidentified publicly available data on deaths and populations by age, we estimated life expectancy for the years 2019-2022 for single-race non-Hispanic Native Americans. Life expectancy in 2022 was 67.8 years, 2.3 years higher than in 2021 but a huge 4-year loss from 2019. Although our life expectancy estimates for 2022 varied under different assumptions about racial/ethnic classification and age misreporting errors, all estimates were lower than the average for middle-income countries. Estimates of losses and gains in life expectancy were consistent across assumptions. Large reductions in COVID-19 death rates between 2021 and 2022 were largely offset by increases in rates of death from unintentional injuries (particularly drug overdoses), chronic liver disease, diabetes, and heart disease, underscoring the difficulties facing Native Americans in achieving reductions in mortality, let alone returning to levels of mortality prior to the pandemic. Serious data problems have persisted for many years, but the scarcity and inadequacy of estimates during the pandemic have underscored the urgent need for timely and accurate demographic data on the Native American population.
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Affiliation(s)
- Noreen Goldman
- Corresponding author: Noreen Goldman, Office of Population Research and Princeton School of Public and International Affairs, 243 Wallace Hall, Princeton University, Princeton, NJ 08544 ()
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Kohn LL, Zullo SW, Manson SM. High Melanoma Rates in the American Indian and Alaska Native Population-A Unique Challenge. JAMA Dermatol 2024; 160:145-147. [PMID: 38150262 DOI: 10.1001/jamadermatol.2023.5225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Affiliation(s)
- Lucinda L Kohn
- Department of Dermatology, University of Colorado, Anschutz Medical Campus, Aurora
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, Aurora
| | - Shannon W Zullo
- Department of Dermatology, University of California, San Francisco
| | - Spero M Manson
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, Aurora
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Gartner DR, Maples C, Nash M, Howard-Bobiwash H. Misracialization of Indigenous people in population health and mortality studies: a scoping review to establish promising practices. Epidemiol Rev 2023; 45:63-81. [PMID: 37022309 DOI: 10.1093/epirev/mxad001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 02/27/2023] [Accepted: 04/03/2023] [Indexed: 04/07/2023] Open
Abstract
Indigenous people are often misracialized as other racial or ethnic identities in population health research. This misclassification leads to underestimation of Indigenous-specific mortality and health metrics, and subsequently, inadequate resource allocation. In recognition of this problem, investigators around the world have devised analytic methods to address racial misclassification of Indigenous people. We carried out a scoping review based on searches in PubMed, Web of Science, and the Native Health Database for empirical studies published after 2000 that include Indigenous-specific estimates of health or mortality and that take analytic steps to rectify racial misclassification of Indigenous people. We then considered the weaknesses and strengths of implemented analytic approaches, with a focus on methods used in the US context. To do this, we extracted information from 97 articles and compared the analytic approaches used. The most common approach to address Indigenous misclassification is to use data linkage; other methods include geographic restriction to areas where misclassification is less common, exclusion of some subgroups, imputation, aggregation, and electronic health record abstraction. We identified 4 primary limitations of these approaches: (1) combining data sources that use inconsistent processes and/or sources of race and ethnicity information; (2) conflating race, ethnicity, and nationality; (3) applying insufficient algorithms to bridge, impute, or link race and ethnicity information; and (4) assuming the hyperlocality of Indigenous people. Although there is no perfect solution to the issue of Indigenous misclassification in population-based studies, a review of this literature provided information on promising practices to consider.
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Affiliation(s)
- Danielle R Gartner
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI 48824, United States
| | - Ceco Maples
- Department of Anthropology, College of Social Science, Michigan State University, East Lansing, MI 48824, United States
| | - Madeline Nash
- Department of Sociology, College of Social Science, Michigan State University, East Lansing, MI 48824, United States
| | - Heather Howard-Bobiwash
- Department of Anthropology, College of Social Science, Michigan State University, East Lansing, MI 48824, United States
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Chin MK, Đoàn LN, Russo RG, Roberts T, Persaud S, Huang E, Fu L, Kui KY, Kwon SC, Yi SS. Methods for retrospectively improving race/ethnicity data quality: a scoping review. Epidemiol Rev 2023; 45:127-139. [PMID: 37045807 DOI: 10.1093/epirev/mxad002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 02/27/2023] [Accepted: 04/04/2023] [Indexed: 04/14/2023] Open
Abstract
Improving race and ethnicity (hereafter, race/ethnicity) data quality is imperative to ensure underserved populations are represented in data sets used to identify health disparities and inform health care policy. We performed a scoping review of methods that retrospectively improve race/ethnicity classification in secondary data sets. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, searches were conducted in the MEDLINE, Embase, and Web of Science Core Collection databases in July 2022. A total of 2 441 abstracts were dually screened, 453 full-text articles were reviewed, and 120 articles were included. Study characteristics were extracted and described in a narrative analysis. Six main method types for improving race/ethnicity data were identified: expert review (n = 9; 8%), name lists (n = 27, 23%), name algorithms (n = 55, 46%), machine learning (n = 14, 12%), data linkage (n = 9, 8%), and other (n = 6, 5%). The main racial/ethnic groups targeted for classification were Asian (n = 56, 47%) and White (n = 51, 43%). Some form of validation evaluation was included in 86 articles (72%). We discuss the strengths and limitations of different method types and potential harms of identified methods. Innovative methods are needed to better identify racial/ethnic subgroups and further validation studies. Accurately collecting and reporting disaggregated data by race/ethnicity are critical to address the systematic missingness of relevant demographic data that can erroneously guide policymaking and hinder the effectiveness of health care practices and intervention.
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Affiliation(s)
- Matthew K Chin
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, United States
| | - Lan N Đoàn
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, United States
| | - Rienna G Russo
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, United States
| | - Timothy Roberts
- NYU Langone Health Sciences Library, NYU Grossman School of Medicine New York, NY 10016, United States
| | - Sonia Persaud
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, United States
- Department of Health Policy and Management, CUNY School of Public Health & Health Policy, New York, NY 10027, United States
| | - Emily Huang
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, United States
| | - Lauren Fu
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, United States
- Georgetown University, Washington DC 20007, United States
| | - Kiran Y Kui
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, United States
- Department of Epidemiology, Columbia Mailman School of Public Health, New York, NY 10032, United States
| | - Simona C Kwon
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, United States
| | - Stella S Yi
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, United States
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Gupta AK, Kasthurirathne SN, Xu H, Li X, Ruppert MM, Harle CA, Grannis SJ. A framework for a consistent and reproducible evaluation of manual review for patient matching algorithms. J Am Med Inform Assoc 2022; 29:2105-2109. [DOI: 10.1093/jamia/ocac175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 09/05/2022] [Accepted: 10/17/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Healthcare systems are hampered by incomplete and fragmented patient health records. Record linkage is widely accepted as a solution to improve the quality and completeness of patient records. However, there does not exist a systematic approach for manually reviewing patient records to create gold standard record linkage data sets. We propose a robust framework for creating and evaluating manually reviewed gold standard data sets for measuring the performance of patient matching algorithms. Our 8-point approach covers data preprocessing, blocking, record adjudication, linkage evaluation, and reviewer characteristics. This framework can help record linkage method developers provide necessary transparency when creating and validating gold standard reference matching data sets. In turn, this transparency will support both the internal and external validity of recording linkage studies and improve the robustness of new record linkage strategies.
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Affiliation(s)
| | - Suranga N Kasthurirathne
- Center for Biomedical Informatics, Regenstrief Institute , Indianapolis, Indiana, USA
- Department of Family Medicine, Indiana University School of Medicine , Indianapolis, Indiana, USA
- Black Dog Institute, University of New South Wales , Sydney, New South Wales, Australia
| | - Huiping Xu
- Department of Biostatistics, Indiana University School of Medicine , Indianapolis, Indiana, USA
| | - Xiaochun Li
- Department of Biostatistics, Indiana University School of Medicine , Indianapolis, Indiana, USA
| | - Matthew M Ruppert
- Department of Medicine, University of Florida Health , Gainesville, Florida, USA
- Precision and Intelligent Systems in Medicine (PrismaP), University of Florida , Gainesville, Florida, USA
| | - Christopher A Harle
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida , Gainesville, Florida, USA
| | - Shaun J Grannis
- Center for Biomedical Informatics, Regenstrief Institute , Indianapolis, Indiana, USA
- Department of Family Medicine, Indiana University School of Medicine , Indianapolis, Indiana, USA
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McClure ES, Gartner DR, Bell RA, Cruz TH, Nocera M, Marshall SW, Richardson DB. Challenges with misclassification of American Indian/Alaska Native race and Hispanic ethnicity on death records in North Carolina occupational fatalities surveillance. FRONTIERS IN EPIDEMIOLOGY 2022; 2:878309. [PMID: 38455305 PMCID: PMC10910913 DOI: 10.3389/fepid.2022.878309] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 10/03/2022] [Indexed: 03/09/2024]
Abstract
As frequently segregated and exploitative environments, workplaces are important sites in driving health and mortality disparities by race and ethnicity. Because many worksites are federally regulated, US workplaces also offer opportunities for effectively intervening to mitigate these disparities. Development of policies for worker safety and equity should be informed by evidence, including results from research studies that use death records and other sources of administrative data. North Carolina has a long history of Black/white disparities in work-related mortality and evidence of such disparities is emerging in Hispanic and American Indian/Alaska Native (AI/AN) worker populations. The size of Hispanic and AI/AN worker populations have increased in North Carolina over the last decade, and North Carolina has the largest AI/AN population in the eastern US. Previous research indicates that misidentification of Hispanic and AI/AN identities on death records can lead to underestimation of race/ethnicity-specific mortality rates. In this commentary, we describe problems and complexities involved in determining AI/AN and Hispanic identities from North Carolina death records. We provide specific examples of misidentification that are likely introducing bias to occupational mortality disparity documentation, and offer recommendations for improved data collection, analysis, and interpretation. Our primary recommendation is to build and maintain relationships with local community leadership, so that improvements in the ascertainment of race and ethnicity are grounded in the lived experience of workers from communities of color.
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Affiliation(s)
- Elizabeth S. McClure
- NC Occupational Safety and Health Education and Research Center, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Danielle R. Gartner
- Department of Epidemiology & Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, United States
| | - Ronny A. Bell
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, United States
- Office of Cancer Health Equity, Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC, United States
- North Carolina American Indian Health Board, Winston-Salem, NC, United States
| | - Theresa H. Cruz
- Department of Pediatrics, University of New Mexico, Albuquerque, NM, United States
- UNM Prevention Research Center, Albuquerque, NM, United States
| | - Maryalice Nocera
- University of North Carolina Injury Prevention Research Center, Chapel Hill, NC, United States
| | - Stephen W. Marshall
- University of North Carolina Injury Prevention Research Center, Chapel Hill, NC, United States
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - David B. Richardson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Environmental and Occupational Health, Program in Public Health, University of California, Irvine, Irvine, CA, United States
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Lan CW, Joshi S, Dankovchik J, Jimenez C, Needham Waddell E, Lutz T, Lapidus J. Racial Misclassification and Disparities in Neonatal Abstinence Syndrome Among American Indians and Alaska Natives. J Racial Ethn Health Disparities 2022; 9:1897-1904. [PMID: 34410606 PMCID: PMC8857293 DOI: 10.1007/s40615-021-01127-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/29/2021] [Accepted: 08/02/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Maternal substance misuse can result in neonatal abstinence syndrome (NAS), a drug withdrawal process in newborns exposed in utero to drugs. This study aimed to examine the effect of racial misclassification of American Indians and Alaska Natives (AI/AN) on rates of NAS in two hospital discharge datasets in the Pacific Northwest. METHODS We conducted probabilistic record linkages between the Northwest Tribal Registry and Oregon and Washington hospital discharge datasets to correct racial misclassification of AI/AN people. We assessed outcomes using International Classification of Disease, Ninth Revision/Tenth Revision, Clinical Modification (ICD-9-CM or ICD-10-CM) diagnosis codes. RESULTS Linkage increased ascertainment of NAS cases among AI/AN by 8.8% in Oregon and by 18.1% in Washington. AI/AN newborns were 1.5 and 3.9 times more likely to be diagnosed with NAS than NHW newborns in Oregon and Washington, respectively. The results showed that newborns residing in rural Washington were 1.4 times more likely to be diagnosed with NAS than those living in urban areas. CONCLUSIONS Correct racial classification is an important factor in improving data quality for AI/AN populations and establishing accurate surveillance to help address the disproportionate burden of neonatal abstinence syndrome among AI/AN. The results highlight the need for programing efforts tailored by insurance status and rurality for pregnant women using substances.
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Affiliation(s)
- Chiao-Wen Lan
- Northwest Portland Area Indian Health Board, 2121 SW Broadway Suite 300, Portland, OR, 97201, USA.
- Northwest Tribal Epidemiology Center, 2121 SW Broadway Suite 300, Portland, OR, 97201, USA.
| | - Sujata Joshi
- Northwest Portland Area Indian Health Board, 2121 SW Broadway Suite 300, Portland, OR, 97201, USA
- Northwest Tribal Epidemiology Center, 2121 SW Broadway Suite 300, Portland, OR, 97201, USA
| | - Jenine Dankovchik
- Northwest Portland Area Indian Health Board, 2121 SW Broadway Suite 300, Portland, OR, 97201, USA
- Northwest Tribal Epidemiology Center, 2121 SW Broadway Suite 300, Portland, OR, 97201, USA
| | - Candice Jimenez
- Northwest Portland Area Indian Health Board, 2121 SW Broadway Suite 300, Portland, OR, 97201, USA
- Northwest Tribal Epidemiology Center, 2121 SW Broadway Suite 300, Portland, OR, 97201, USA
| | | | - Tam Lutz
- Northwest Portland Area Indian Health Board, 2121 SW Broadway Suite 300, Portland, OR, 97201, USA
- Northwest Tribal Epidemiology Center, 2121 SW Broadway Suite 300, Portland, OR, 97201, USA
| | - Jodi Lapidus
- OHSU-PSU School of Public Health, 1805 SW 4th Ave - Mailcode VPT, Portland, OR, 97201, USA
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Wright K, Tapera RM, Stott NS, Sorhage A, Mackey A, Williams SA. Indigenous health equity in health register ascertainment and data quality: a narrative review. Int J Equity Health 2022; 21:34. [PMID: 35279132 PMCID: PMC8917744 DOI: 10.1186/s12939-022-01635-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 02/22/2022] [Indexed: 01/19/2023] Open
Abstract
Background Health registers play an important role in monitoring distribution of disease and quality of care; however, benefit is limited if ascertainment (i.e., the process of finding and recruiting people on to a register) and data quality (i.e., the accuracy, completeness, reliability, relevance, and timeliness of data) are poor. Indigenous peoples experience significant health inequities globally, yet health data for, and about, Indigenous peoples is often of poor quality. This narrative review aimed to (i) identify perceived barriers for the ascertainment of Indigenous peoples on health registers, and (ii) collate strategies identified and used by health registers to support comprehensive ascertainment and high-quality data for Indigenous peoples. Methods A Kaupapa Māori theoretical framework was utilized to guide this work. Four electronic databases were systematically searched for original articles and screened for eligibility. Studies involving health registers with Indigenous population(s) identified were included if either ascertainment or data quality strategies were described. Data extraction focused on the reporting of research involving Indigenous peoples using the CONSIDER checklist domains, ascertainment, and data quality. Results Seventeen articles were included spanning publication between 1992 and 2020. Aspects of four of eight CONSIDER domains were identified to be included in the reporting of studies. Barriers to ascertainment were themed as relating to ‘ethnicity data collection and quality’, ‘systems and structures’, ‘health services/health professionals’, and ‘perceptions of individual and community-level barriers’. Strategies to support ascertainment were categorized as ‘collaboration’, ‘finding people’, and ‘recruitment processes’. Categorized strategies to support data quality were ‘collaboration’, ‘ethnicity data collection and quality’, ‘systems-level strategies’, and ‘health service/health professional-level strategies’. Conclusions Poor-quality data for Indigenous peoples in health registers prevents the achievement of health equity and exemplifies inaction in the face of need. When viewed through a critical structural determinants lens, there are visible gaps in the breadth of strategies, particularly relating to the inclusion of Indigenous peoples in health register and research governance, and actions to identify and address institutional racism. Indigenous led research, meaningful collaboration, and a sharing of knowledge and experiences between health registers is recommended to enable research and health registers that support Indigenous self-determination and health equity.
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Racial Misclassification in Mortality Records Among American Indians/Alaska Natives in Oklahoma From 1991 to 2015. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2020; 25 Suppl 5, Tribal Epidemiology Centers: Advancing Public Health in Indian Country for Over 20 Years:S36-S43. [PMID: 31348189 DOI: 10.1097/phh.0000000000001019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The primary purpose of this study was to compare age-adjusted mortality rates before and after linkage with Indian Health Service records, adjusting for racial misclassification. We focused on differences in racial misclassification by gender, age, geographic differences, substate planning districts, and cause of death. Our secondary purpose was to evaluate time trends in misclassification from 1991 to 2015. DESIGN Retrospective, descriptive study. SETTING Oklahoma. PARTICIPANTS Persons contained in the Oklahoma State Health Department Vital Records. MAIN OUTCOME MEASURES To evaluate the age-adjusted mortality ratio pre- and post-Indian Health Service record linkage (misclassification rate ratio) and to evaluate the overall trend of racial misclassification on mortality records measured through annual percent change (APC) and average annual percent change (AAPC). RESULTS We identified 2 stable trends of racial misclassification upon death for American Indians/Alaska Natives (AI/ANs) from 1991 to 2001 (APC: -0.2%; 95% confidence interval: -1.4% to 1.0%) and from 2001 to 2005 (APC: -6.9%; 95% confidence interval: -13.7% to 0.4%). However, the trend identified from 2005 to 2015 decreased significantly (APC: -1.4%; 95% confidence interval: -2.5% to -0.2%). For the last 5 years available (2011-2015), the racial misclassification adjustment resulted in higher mortality rates for AI/ANs reflecting an increase from 1008 per 100 000 to 1305 per 100 000 with the linkage process. There were an estimated 3939 AI/ANs in Oklahoma who were misclassified as another race upon death in those 5 years, resulting in an underestimation of actual AI/AN deaths by nearly 29%. CONCLUSIONS An important result of this study is that misclassification is improving; however, this effort needs to be maintained and further improved. Continued linkage efforts and public access to linked data are essential throughout the United States to better understand the burden of disease in the AI/AN population.
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Weber TL, Copeland G, Pingatore N, Schmid KK, Jim MA, Watanabe-Galloway S. Using Tribal Data Linkages to Improve the Quality of American Indian Cancer Data in Michigan. J Health Care Poor Underserved 2019; 30:1237-1247. [PMID: 31422999 PMCID: PMC6754728 DOI: 10.1353/hpu.2019.0084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This study examines the extent to which data linkages between Indian Health Service, tribal data, and cancer registries affect cancer incidence rates among American Indians/Alaska Natives (AI/ANs) in Michigan. The incidence of tobacco- and alcohol-associated cancers for 1995-2012 was analyzed to compare rates of the Upper Peninsula (UP) and Lower Peninsula (LP) in Michigan and among AI/ANs and non-Hispanic Whites (NHWs). Complete linkage resulted in 1,352 additional AI/AN cases; 141 cases were linked via IHS records alone, while 373 were linked via tribal records alone; 838 were linked through both IHS and tribal records. Age-adjusted incidence rates for AI/ANs increased from 214.39 per 100,000 to 405.41 per 100,000, similar to that of NHWs after complete linkage (421.46 per 100,000). In the UP, AI/ANs had age-adjusted incidence rates 1.67 times higher than NHWs (596.69 per 100,000 vs. 356.32 per 100,000 respectively). This study indicates a substantial number of AI/AN cancer cases remain misclassified in Michigan.
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Concordance of cancer registry and self-reported race, ethnicity, and cancer type: a report from the American Cancer Society’s studies of cancer survivors. Cancer Causes Control 2018; 30:21-29. [DOI: 10.1007/s10552-018-1091-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 10/23/2018] [Indexed: 01/31/2023]
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Withrow DR, Pole JD, Nishri ED, Tjepkema M, Marrett LD. Cancer Survival Disparities Between First Nation and Non-Aboriginal Adults in Canada: Follow-up of the 1991 Census Mortality Cohort. Cancer Epidemiol Biomarkers Prev 2016; 26:145-151. [DOI: 10.1158/1055-9965.epi-16-0706] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 10/04/2016] [Indexed: 11/16/2022] Open
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Withrow DR, Racey CS, Jamal S. A critical review of methods for assessing cancer survival disparities in indigenous population. Ann Epidemiol 2016; 26:579-591. [PMID: 27431064 DOI: 10.1016/j.annepidem.2016.06.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 05/27/2016] [Accepted: 06/06/2016] [Indexed: 12/24/2022]
Abstract
PURPOSE An increasing cancer burden among indigenous populations has led to a growing literature about survival disparities between indigenous and nonindigenous persons. We aim to describe and appraise methods used to measure cancer survival in indigenous persons in the United States, Canada, Australia, and New Zealand. METHODS We searched Medline, Web of Science, and EMBASE for articles published between 1990 and 2015 that estimated survival in populations indigenous to one of these four countries. We gathered information about data sources, analytical methods, and the extent to which threats to validity were discussed. RESULTS The search retrieved 83 articles. The most common approach to survival analysis was cause-specific survival (n = 49). Thirty-eight articles measured all-cause survival and 11 measured excess mortality attributable to cancer (relative survival). Three sources of information bias common to all studies (ethnic misclassification, incomplete case ascertainment, and incomplete death ascertainment) were acknowledged in a minority of articles. CONCLUSIONS The methodological considerations we present here are shared with studies of cancer survival across other subpopulations. We urge future researchers on this and related topics to clearly describe their data sources, to justify analytic choices, and to fully discuss the potential impact of those choices on the results and interpretation.
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Affiliation(s)
- Diana R Withrow
- Aboriginal Cancer Control Unit, Prevention and Cancer Control, Cancer Care Ontario, Toronto, Canada; Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
| | - C Sarai Racey
- Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sehar Jamal
- Aboriginal Cancer Control Unit, Prevention and Cancer Control, Cancer Care Ontario, Toronto, Canada
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Herman S, Adkins M, Moon RY. Knowledge and beliefs of African-American and American Indian parents and supporters about infant safe sleep. J Community Health 2015; 40:12-9. [PMID: 24859736 DOI: 10.1007/s10900-014-9886-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
To investigate, by using qualitative methods, beliefs among African-American and American Indian families about infant safe sleep practices, barriers to acceptance of prevention recommendations, and more effective messaging strategies. Seventy-three mothers and supporters participated in focus groups. Participants discussed infant sleep practices and effectiveness of safe sleep messages. Data were coded, and themes were developed and revised in an iterative manner as patterns became more apparent. Themes included reasons for and influences on sleep decisions, and concerns about safe sleep recommendations. Parental sleep decisions seemed to be driven by perceptions of what would make their infant most comfortable and safe, and what would be most convenient. Parents were aware of safe sleep recommendations but unaware of the rationale. Because they generally did not believe that their infants were at risk for a sleep-related death, day-to-day decisions seemed to focus on what was most effective in getting their infant to sleep. There appeared to be no distinctions in opinions among African-American and American Indian families. African-American and American Indian families seemed to have similar concerns about infant comfort and safety, and their perceptions about what would be most effective in achieving these goals appeared to be important influences on their sleep practices. Adherence with safe sleep recommendations may be enhanced if health care providers and educational materials discussed rationale underlying recommendations and addressed common parental concerns. It may be beneficial to target educational interventions towards fathers, as they may be untapped sources in implementing safe sleep practices.
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Bigback KM, Hoopes M, Dankovchik J, Knaster E, Warren-Mears V, Joshi S, Weiser T. Using Record Linkage to Improve Race Data Quality for American Indians and Alaska Natives in Two Pacific Northwest State Hospital Discharge Databases. Health Serv Res 2015; 50 Suppl 1:1390-402. [PMID: 26133568 PMCID: PMC4545338 DOI: 10.1111/1475-6773.12331] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To evaluate and adjust for American Indian and Alaska Native (AI/AN) racial misclassification in two hospital discharge datasets in the Pacific Northwest. DATA SOURCES/STUDY SETTING Oregon (2010-2011) and Washington (2011) hospital discharge datasets were linked with the Northwest Tribal Registry (NTR), a registry of AI/AN individuals who accessed services at Indian health facilities in the Northwest. STUDY DESIGN Record linkage was used to match state hospital records to the NTR. A state record was considered misclassified if it matched the NTR and was coded as non-AI/AN or missing race data. Effect of misclassification was evaluated by comparing prelinkage and postlinkage, age-adjusted hospital discharge rates. DATA COLLECTION/EXTRACTION METHODS Researchers used Link Plus 2.0 software (Atlanta, GA, USA) for linkages and SAS 9.4 (Cary, NC, USA) for statistical analyses. PRINCIPAL FINDINGS In Oregon, 55.4 percent of matching records were misclassified (66.5 percent miscoded white, and 22.1 percent were missing race information). In Washington, 44.9 percent of matching records were misclassified (61.8 percent miscoded white, and 32.7 percent were missing race information). Linkage increased ascertainment of AI/AN hospitalizations by 31.8 percent in Oregon and 33.9 percent in Washington. Linkage increased the rate ratio (RR) for AI/AN hospitalizations in comparison to non-Hispanic whites (NHW) from 0.81 to 1.07 in Oregon, and from 1.21 to 1.62 in Washington. CONCLUSION Correction of race in hospital discharge datasets through linkage with a reference file of known AI/AN individuals is an important first step before analytic research on AI/AN health care in the Pacific Northwest can be accomplished with administrative datasets.
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Affiliation(s)
- Kristyn M Bigback
- Address correspondence to Kristyn M. Bigback, M.P.H., Northwest Portland Area Indian Health Board, 2121 SW Broadway, Suite 300, Portland, OR 97201; e-mail:
| | - Megan Hoopes
- Megan Hoopes, M.P.H., is with the OCHIN, Portland, OR
- Jenine Dankovchik, Victoria WarrenMears, Ph.D., Sujata Joshi, M.S.P.H., and Thomas Weiser, M.D., are with the Northwest Portland Area Indian Health Board, Portland, OR
- Elizabeth Knaster, M.P.H., is with the Seattle Indian Health Board, Seattle, WA
| | - Jenine Dankovchik
- Megan Hoopes, M.P.H., is with the OCHIN, Portland, OR
- Jenine Dankovchik, Victoria WarrenMears, Ph.D., Sujata Joshi, M.S.P.H., and Thomas Weiser, M.D., are with the Northwest Portland Area Indian Health Board, Portland, OR
- Elizabeth Knaster, M.P.H., is with the Seattle Indian Health Board, Seattle, WA
| | - Elizabeth Knaster
- Megan Hoopes, M.P.H., is with the OCHIN, Portland, OR
- Jenine Dankovchik, Victoria WarrenMears, Ph.D., Sujata Joshi, M.S.P.H., and Thomas Weiser, M.D., are with the Northwest Portland Area Indian Health Board, Portland, OR
- Elizabeth Knaster, M.P.H., is with the Seattle Indian Health Board, Seattle, WA
| | - Victoria Warren-Mears
- Megan Hoopes, M.P.H., is with the OCHIN, Portland, OR
- Jenine Dankovchik, Victoria WarrenMears, Ph.D., Sujata Joshi, M.S.P.H., and Thomas Weiser, M.D., are with the Northwest Portland Area Indian Health Board, Portland, OR
- Elizabeth Knaster, M.P.H., is with the Seattle Indian Health Board, Seattle, WA
| | - Sujata Joshi
- Megan Hoopes, M.P.H., is with the OCHIN, Portland, OR
- Jenine Dankovchik, Victoria WarrenMears, Ph.D., Sujata Joshi, M.S.P.H., and Thomas Weiser, M.D., are with the Northwest Portland Area Indian Health Board, Portland, OR
- Elizabeth Knaster, M.P.H., is with the Seattle Indian Health Board, Seattle, WA
| | - Thomas Weiser
- Megan Hoopes, M.P.H., is with the OCHIN, Portland, OR
- Jenine Dankovchik, Victoria WarrenMears, Ph.D., Sujata Joshi, M.S.P.H., and Thomas Weiser, M.D., are with the Northwest Portland Area Indian Health Board, Portland, OR
- Elizabeth Knaster, M.P.H., is with the Seattle Indian Health Board, Seattle, WA
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Anderson RN, Copeland G, Hayes JM. Linkages to improve mortality data for American Indians and Alaska Natives: a new model for death reporting? Am J Public Health 2014; 104 Suppl 3:S258-62. [PMID: 24754614 DOI: 10.2105/ajph.2013.301647] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Racial misclassification is a well-documented weakness of mortality data taken from death certificates. As a result, mortality statistics for American Indians and Alaska Natives (AI/ANs) present, at best, an inaccurate and misleading assessment of mortality in this population. Studies evaluating the quality of race/ethnicity reporting on death certificates have linked data from death certificates to other data sources collected when the decedent was still alive (e.g., Census, Current Population Survey). Such studies have shown substantial misclassification of AI/AN decedents. Despite limitations, linking mortality data from death certificates with data from other sources collected when decedents were living provides opportunities to evaluate and correct misclassification of populations such as AI/AN persons and facilitates the calculation and presentation of more accurate mortality statistics.
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Affiliation(s)
- Robert N Anderson
- Robert N. Anderson is with the Division of Vital Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD. Glenn Copeland is with the Division for Vital Records and Health Statistics, Michigan Department of Community Health, Lansing. John Mosely Hayes is with the United South and Eastern Tribes, Tribal Epidemiology Center, Nashville, TN
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Jim MA, Arias E, Seneca DS, Hoopes MJ, Jim CC, Johnson NJ, Wiggins CL. Racial misclassification of American Indians and Alaska Natives by Indian Health Service Contract Health Service Delivery Area. Am J Public Health 2014; 104 Suppl 3:S295-302. [PMID: 24754617 DOI: 10.2105/ajph.2014.301933] [Citation(s) in RCA: 142] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We evaluated the racial misclassification of American Indians and Alaska Natives (AI/ANs) in cancer incidence and all-cause mortality data by Indian Health Service (IHS) Contract Health Service Delivery Area (CHSDA). METHODS We evaluated data from 3 sources: IHS-National Vital Statistics System (NVSS), IHS-National Program of Cancer Registries (NPCR)/Surveillance, Epidemiology and End Results (SEER) program, and National Longitudinal Mortality Study (NLMS). We calculated, within each data source, the sensitivity and classification ratios by sex, IHS region, and urban-rural classification by CHSDA county. RESULTS Sensitivity was significantly greater in CHSDA counties (IHS-NVSS: 83.6%; IHS-NPCR/SEER: 77.6%; NLMS: 68.8%) than non-CHSDA counties (IHS-NVSS: 54.8%; IHS-NPCR/SEER: 39.0%; NLMS: 28.3%). Classification ratios indicated less misclassification in CHSDA counties (IHS-NVSS: 1.20%; IHS-NPCR/SEER: 1.29%; NLMS: 1.18%) than non-CHSDA counties (IHS-NVSS: 1.82%; IHS-NPCR/SEER: 2.56%; NLMS: 1.81%). Race misclassification was less in rural counties and in regions with the greatest concentrations of AI/AN persons (Alaska, Southwest, and Northern Plains). CONCLUSIONS Limiting presentation and analysis to CHSDA counties helped mitigate the effects of race misclassification of AI/AN persons, although a portion of the population was excluded.
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Affiliation(s)
- Melissa A Jim
- Melissa A. Jim is with the Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Albuquerque, NM. Elizabeth Arias is with the Division of Vital Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD. Dean S. Seneca is with the Division of Public Health Capacity Development, Office for State, Tribal, Local and Territorial Support, Centers for Disease Control and Prevention, Atlanta, GA. Megan J. Hoopes is with the Northwest Tribal Epidemiology Center, Northwest Portland Area Indian Health Board, Portland, OR. Cheyenne C. Jim is with Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Albuquerque, NM. Norman J. Johnson is with the National Longitudinal Mortality Study Branch, US Census Bureau, Suitland, MD. Charles L. Wiggins is with the New Mexico Tumor Registry, University of New Mexico Cancer Center, Albuquerque
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Roen EL, Copeland GE, Pinagtore NL, Meza R, Soliman AS. Disparities of cancer incidence in Michigan's American Indians: spotlight on breast cancer. Cancer 2014; 120:1847-53. [PMID: 24676851 DOI: 10.1002/cncr.28589] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 12/17/2013] [Accepted: 12/23/2013] [Indexed: 11/06/2022]
Abstract
BACKGROUND In American Indians (AIs), cancer is a leading cause of mortality, yet their disease burden is not fully understood due to unaddressed racial misclassification in cancer registries. This study describes cancer trends among AIs in Michigan, focusing on breast cancer, in a linked data set of Indian Health Service (IHS), tribal, and state cancer registry data adjusted for misclassification. METHODS AI status was based on reported race and linkage to IHS data and tribal registries. Data with complete linkage on all incident cancer cases in Michigan from 1995 to 2004 was used to calculate age-standardized incidence estimates for invasive all-site and female breast cancers stratified by racial group. For female breast cancers, stage- and age-specific incidence and percent distributions of early- versus late-stage cancers and age of diagnosis were calculated. RESULTS More than 50% of all AI cases were identified through IHS and/or tribal linkage. In the linked data, AIs had the lowest rates of all-sites and breast cancer. For breast cancers, AI women had a greater late-stage cancer burden and a younger mean age of diagnosis as compared to whites. Although the age-specific rate for whites was greater than for AI women in nearly all age groups, the difference in hazard ratio increased with increasing age. CONCLUSIONS Our state-specific information will help formulate effective, tailored cancer prevention strategies to this population in Michigan. The data linkages used in our study are crucial for generating accurate rates and can be effective in addressing misclassification of the AI population and formulating cancer prevention strategies for AI nationwide.
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Affiliation(s)
- Emily L Roen
- University of Michigan School of Public Health, Ann Arbor, Michigan
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Coughlin RL, Kushman EK, Copeland GE, Wilson ML. Pregnancy and birth outcome improvements for American Indians in the Healthy Start project of the Inter-Tribal Council of Michigan, 1998-2008. Matern Child Health J 2014; 17:1005-15. [PMID: 23010860 DOI: 10.1007/s10995-012-1075-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
American Indians living in Michigan experience disproportionately high rates of infant mortality. This 11-year (1998-2008) cohort study evaluated impacts of a Healthy Start (HS) program administered by the Inter-Tribal Council of Michigan (ITCM) on perinatal outcomes. Women who enrolled in ITCM's HS program ("exposed") were compared with non-enrolled ("unexposed") for four outcomes: low birth weight (LBW), small for gestational age, preterm birth, and inadequate prenatal care. To classify exposed and unexposed women and their children, Michigan vital records data were linked with HS enrollment records to identify participants and non-participants among all American Indian births. Logistic regression was used to calculate odds ratios for the four outcomes of interest. Analyses were stratified for high and low access to care based on Medically Underserved Area (MUA) designation for a woman's county of residence. Of 4,149 American Indian births during the period, 872 were to women who enrolled prenatally in HS. Although unstratified analysis showed no differences between HS participants and non-participants, stratified analyses demonstrated that participants from MUA counties had decreased odds of LBW and inadequate prenatal care. Results suggest that in MUA counties where participants and non-participants are at similar risk for poor outcomes, HS may be reducing barriers and improving outcomes. In non-MUA counties participants had similar outcomes as non-participants. These results may reflect a wider disparity in risk factors between the two groups in non-MUA counties. The complex interplay among need, access, and benefit complicates analyses and suggests the importance of more in-depth and focused studies.
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Affiliation(s)
- Rebecca L Coughlin
- Department of Epidemiology, School of Public Health, The University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA.
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Lin G, Ma J, Zhang L, Qu M. Linking cancer registry and hospital discharge data for treatment surveillance. Health Informatics J 2013; 19:127-36. [DOI: 10.1177/1460458212462024] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cancer registry data often lack complete chemotherapy and radiation therapy information. To conduct treatment disparity surveillance, we linked 2005–2009 Nebraska Cancer Registry data with Nebraska hospital discharge data. Due to the high quality of both datasets and the proposed linkage procedure, we had a linkage rate of 97 percent. We demonstrate the utilization of the linked dataset in case finding, treatment update, and treatment surveillance. The results show that the linked dataset is likely to identify up to 5 percent of potential missed cases. We investigated the use of radiation therapy in treating colorectal and breast cancers as case-finding examples. The linked dataset found 12 percent and 14 percent more treatment cases for colorectal and breast cancer patients, respectively.
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Affiliation(s)
- Ge Lin
- University of Nebraska Medical Center, USA
| | | | | | - Ming Qu
- Nebraska Department of Health & Human Services, USA
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Zhang Y, Cohen B, Macaluso M, Zhang Z, Durant T, Nannini A. Probabilistic linkage of assisted reproductive technology information with vital records, Massachusetts 1997-2000. Matern Child Health J 2013; 16:1703-8. [PMID: 21909704 DOI: 10.1007/s10995-011-0877-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
To assess the validity of probabilistic linkage (PL) in combining national surveillance data on assisted reproductive technology (ART) with Massachusetts birth and infant death data, for the purpose of monitoring maternal and child health outcomes of ART. A study conducted in 2006 utilized direct identifiers to match Massachusetts birth records with records on ART procedures performed to Massachusetts residents in fertility clinics located in Massachusetts and Rhode Island, achieving a linkage rate of 87.5%. The present study employed PL using the program Link Plus, without access to direct identifiers. The primary linking variables were maternal and infant dates of birth, and plurality. Ancillary variables such as maternal ZIP code and gravidity helped resolve duplicate matches and capture additional matches. PL linked 5,390 (87.8%) of 6,139 deliveries, correctly identifying 96.4% of the matches previously obtained using deterministic linkage methods. PL yielded a high linkage rate with satisfactory validity; this method may be applied in other states to help monitor the maternal and child health outcomes of ART.
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Affiliation(s)
- Yujia Zhang
- Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS k34, Atlanta, GA 30341-3717, USA.
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Hoopes MJ, Petersen P, Vinson E, Lopez K. Regional differences and tribal use of American Indian/Alaska Native cancer data in the Pacific Northwest. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2012; 27:S73-S79. [PMID: 22281722 DOI: 10.1007/s13187-012-0325-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
In the Pacific Northwest, cancer is a leading cause of morbidity and mortality for American Indians and Alaska Natives (AI/AN). Misclassification of AI/AN race in state cancer registries causes cancer burden to be underestimated. Furthermore, local-level data are rarely available to individual tribes for use in health assessment and program planning. We corrected race coding in the cancer registries of Idaho, Oregon, and Washington using probabilistic record linkage to a file derived from patient registration records from Indian Health Service and a large urban clinic. We calculated cancer incidence and mortality measures by state, comparing AI/AN to non-Hispanic White (NHW) race. Record linkages identified a high prevalence of misclassified race. Differences in AI/AN cancer patterns were identified across the three state region. Compared to NHW, AI/AN experienced disproportionate late stage rates of some screen-detectable cancers. The correct classification of race is a crucial factor in cancer surveillance and can reveal regional differences even within a relatively small area. The availability of local-level cancer data can help inform tribes in appropriate intervention efforts.
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Affiliation(s)
- Megan J Hoopes
- Northwest Tribal Epidemiology Center, Northwest Portland Area Indian Health Board, 2121 SW Broadway Drive, Suite 300, Portland, OR 97201, USA.
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Brown SR, Joshweseoma L, Flood T, Coe K. Process for determining the cancer burden of the Hopi Tribe. Public Health Rep 2010; 125:793-800. [PMID: 21121224 DOI: 10.1177/003335491012500606] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The Hopi Tribe is located in the northeastern part of Arizona on more than one million acres of federally reserved land. Tribally based community research, conducted in collaboration with University of Arizona researchers, has been successfully implemented on Hopi beginning with a cross-sectional community survey in 1993 and continuing with a second survey in 2006. Both surveys identified a strong community interest in cancer. This article reports on the process involved in a third study, in which official Hopi enrollment data were matched with Arizona Cancer Registry data. The process involved bringing in a new partner and obtaining tribal, state, and university approvals, as well as a signed data exchange agreement between the state and the Hopi Tribe. Technical implementation of the data match required computer programming and epidemiologic expertise, as well as an understanding of the community and the culture. Close collaboration among Hopi residents and university epidemiologists was critical.
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Affiliation(s)
- Sylvia R Brown
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., PO Box 245209, Tucson, AZ 85724-5209, USA.
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Soliman AS, Mullan PB, Chamberlain RM. Research training of students in minority and international settings: lessons learned from cancer epidemiology education in special populations. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2010; 25:263-9. [PMID: 20352397 PMCID: PMC4274950 DOI: 10.1007/s13187-010-0099-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2009] [Revised: 01/28/2010] [Accepted: 02/05/2010] [Indexed: 05/06/2023]
Abstract
This article describes the development and evaluation of an NCI-sponsored short-term summer cancer research education program. The study questions examined: the feasibility of conducting a cancer education program in special populations at multiple US and international field sites for masters students; the merit and worth that students and faculty attribute to the program; and students' scholarly and cancer-related career outcomes. Developing a new curriculum, increasing the pool of mentors, utilizing and increasing the number of field sites, and program dissemination were also evaluated. Evidence of the program's success included students' completion of field experiences at multiple sites and their subsequent 70% project-related publication rate, with 79% of trainees reporting themselves as likely to pursue future cancer-related careers. Evaluation-guided future plans for the program include implementing faculty development to further enhance the program outcomes.
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Affiliation(s)
- Amr S Soliman
- Department of Epidemiology, University of Michigan School of Public Health, 109 Observatory St, Ann Arbor, MI 48109, USA.
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