Effect of racial/ethnic misclassification of American Indians and Alaskan Natives on Washington State death certificates, 1989-1997.
OBJECTIVE
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.
Stehr-Green
Paul
P
Northwest Tribal Epidemiology Center (The EpiCenter), Northwest Portland Area Indian Health Board, 527 SW Hall, Suite 300, Portland, OR 97201, USA.
Bettles
James
J
Robertson
L Dee
LD
D000413:Alaska / Q000208:ethnology; D000465:Algorithms; D017281:Cost of Illness; D003644:Death Certificates; D004282:Documentation / Q000592:standards*; D005260:Female; D006403:Hematologic Tests / Q000592:standards; D006801:Humans; D007061:Idaho / Q000453:epidemiology; D007198:Indians, North American / Q000145:classification*; D008297:Male; D008498:Medical Record Linkage / Q000592:standards*; D009922:Oregon / Q000453:epidemiology; D011336:Probability; D011786:Quality Control; D012042:Registries / Q000592:standards*; D015203:Reproducibility of Results; D014861:Washington / Q000453:epidemiology