title: Discrepancies in Race and Ethnicity Documentation: a Potential Barrier in Identifying Racial and Ethnic Disparities.
abstract: BACKGROUND
  Data collection on race and ethnicity is critical in the assessment of racial disparities related to health. Studies comparing clinical and administrative data show discrepancies in race documentation and attribution.
  
  
  METHODS
  Self-reported data from two studies were compared to demographics in the electronic health record (EHR) extracted from the Biomedical Translational Research Information System (BTRIS) repository. McNemar and Bhapkar analyses were conducted to quantify the agreement of ethnicity and race between self-reported and EHR data. Pearson's chi-square tests were used to explore the relationship between acculturation, length of time in the USA, country of residence, and how individuals self-reported their race.
  
  
  RESULTS
  The sample (n = 280) was predominantly female (52.1 %), with a mean age of 47 (SD ± 13.74), mean years in the USA were 12.8 (SD ± 11.67) and the majority were born outside of the USA. (55.6 %). Those who self-identified as Hispanic (n = 208) scored a mean of 5.5 (SD ± 3.07) on the short acculturation scale (SAS) that ranges 4 to 20; lower scores indicate less acculturation. A significant difference was found between the way race is reported in the electronic medical record and self-reported data among those people who identified as Hispanic, with significant differences in the white (p < 0.0001) and other (p < 0.0001) categories.
  
  
  CONCLUSIONS
  The misclassification of race is most frequent in those individuals who self-identified as Hispanic. As the Hispanic population in the USA continues to grow, understanding the factors that affect the way that individuals from this heterogeneous population self-report race may provide important guidance in tailoring care to address health disparities.
authors.affiliation: National Institutes of Health (NIH), Clinical Center, 10 Center Drive, Room 2B01, Bethesda, MD, 20892, USA.
authors.forename: M
authors.initials: M
authors.lastname: Magaña López
authors.affiliation: National Institutes of Health (NIH), Clinical Center, 10 Center Drive, Room 2B01, Bethesda, MD, 20892, USA.
authors.forename: M
authors.initials: M
authors.lastname: Bevans
authors.affiliation: National Institutes of Health (NIH), Clinical Center, 10 Center Drive, Room 2B01, Bethesda, MD, 20892, USA.
authors.forename: L
authors.initials: L
authors.lastname: Wehrlen
authors.affiliation: National Institutes of Health (NIH), Clinical Center, 10 Center Drive, Room 2B01, Bethesda, MD, 20892, USA.
authors.forename: L
authors.initials: L
authors.lastname: Yang
authors.affiliation: National Institutes of Health (NIH), Clinical Center, 10 Center Drive, Room 2B01, Bethesda, MD, 20892, USA. gwallen@cc.nih.gov.
authors.forename: G R
authors.initials: GR
authors.lastname: Wallen
keywords: Demographic collection; Ethnicity; Health disparities; Race