Dataset Information

Using Record Linkage to Improve Race Data Quality for American Indians and Alaska Natives in Two Pacific Northwest State Hospital Discharge Databases.

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.

SUBMITTER: Bigback KM

PROVIDER: S-EPMC4545338 | biostudies-literature | 2015 Aug

REPOSITORIES: biostudies-literature

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Publications

Using Record Linkage to Improve Race Data Quality for American Indians and Alaska Natives in Two Pacific Northwest State Hospital Discharge Databases.

Bigback Kristyn M KM Hoopes Megan M Dankovchik Jenine J Knaster Elizabeth E Warren-Mears Victoria V Joshi Sujata S Weiser Thomas T

Health services research 20150701

<h4>Objective</h4>To evaluate and adjust for American Indian and Alaska Native (AI/AN) racial misclassification in two hospital discharge datasets in the Pacific Northwest.<h4>Data sources/study setting</h4>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.<h4>Study design</h4>Record linkage was used to match state hospital re ...[more]

PMID: 26133568

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Project description:BackgroundAmerican Indians/Alaska Natives have the highest commercial tobacco use in the United States, resulting in higher tobacco-caused deaths and diseases than the general population. Some American Indians/Alaska Natives use commercial tobacco for ceremonial as well as recreational uses. Because federally recognized Tribal lands are sovereign, they are not subject to state cigarette taxes and smoke-free laws. This study analyzes tobacco industry promotional efforts specifically targeting American Indians/Alaska Natives and exploiting Tribal lands to understand appropriate policy responses in light of American Indians'/Alaska Natives' unique sovereign status and culture.MethodsWe analyzed previously secret tobacco industry documents available at the Truth Tobacco Documents Library (https://industrydocuments.library.ucsf.edu/tobacco/).ResultsTobacco companies used promotional strategies targeting American Indians/Alaska Natives and exploiting Tribal lands that leveraged the federally recognized Tribes' unique sovereign status exempting them from state cigarette taxes and smoke-free laws, and exploited some Tribes' existing traditional uses of ceremonial tobacco and poverty. Tactics included price reductions, coupons, giveaways, gaming promotions, charitable contributions, and sponsorships. In addition, tobacco companies built alliances with Tribal leaders to help improve their corporate image, advance ineffective Youth Smoking Prevention programs, and defeat tobacco control policies.ConclusionsThe industry's promotional tactics likely contribute to disparities in smoking prevalence and smoking-related diseases among American Indians//Alaska Natives. Proven policy interventions to address these disparities including tobacco price increases, cigarette taxes, comprehensive smoke-free laws, and industry denormalization campaigns to reduce smoking prevalence and smoking-related disease could be considered by Tribal communities. The sovereign status of federally recognized Tribes does not prevent them from adopting these measures.ImplicationsAmerican Indians/Alaska Natives suffer disparities in smoking prevalence and smoking-related diseases as compared with other groups. The tobacco industry has used promotional tactics including price reductions, coupons and giveaways, casino and bingo promotions, charitable contributions and sponsorships, and so-called Youth Smoking Prevention (YSP) programs to specifically target American Indians/Alaska Natives and exploit Tribal sovereignty, which likely contribute to disparities in tobacco use and related diseases and deaths among this population. Tribal and public health policy makers should consider rejecting ineffective YSP programs and instead consider adopting proven policy interventions including tobacco price increases, cigarette and casino taxes, comprehensive smokefree laws, and anti-industry denormalization campaigns to reduce smoking and smoking-related disease.

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Dataset Information

Using Record Linkage to Improve Race Data Quality for American Indians and Alaska Natives in Two Pacific Northwest State Hospital Discharge Databases.

Objective

Data sources/study setting

Study design

Data collection/extraction methods

Principal findings

Conclusion

Publications

Using Record Linkage to Improve Race Data Quality for American Indians and Alaska Natives in Two Pacific Northwest State Hospital Discharge Databases.

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