Summary: | Objectives. We describe methods used to mitigate the effect of race misclassification in mortality records and the data sets used to improve mortality estimates for American Indians and Alaska Natives (AI/ANs). Methods. We linked US National Death Index (NDI) records with Indian Health Service (IHS) registration records to identify AI/AN deaths misclassified as non-AI/AN deaths. Analyses excluded decedents of Hispanic origin and focused on Contract Health Service Delivery Area (CHSDA) counties. We compared death rates for AI/AN persons and Whites across 6 US regions. Results. IHS registration records merged to 176 137 NDI records. Misclassification of AI/AN race in mortality data ranged from 6.3% in the Southwest to 35.6% in the Southern Plains. From 1999 to 2009, the all-cause death rate in CHSDA counties for AI/AN persons varied by geographic region and was 46% greater than that for Whites. Analyses for CHSDA counties resulted in higher death rates for AI/AN persons than in all counties combined. Conclusions. Improving race classification among AI/AN decedents strengthens AI/ANmortality data, and analyzing deaths by geographic region can aid in planning, implementation, and evaluation of efforts to reduce health disparities in this population. adolescent; adult; aged; American Indian; article; cause of death; child; death certificate; female; health survey; human; infant; information processing; Inuit; male; middle aged; mortality; preschool child; public health service; standard; statistics; United States; very elderly, Adolescent; Adult; Aged; Aged, 80 and over; Alaska; Cause of Death; Child; Child, Preschool; Data Collection; Death Certificates; Female; Humans; Indians, North American; Infant; Inuits; Male; Middle Aged; Mortality; Population Surveillance; United States; United States Indian Health Service
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