![]() ![]() Life table comparisons may reveal disparities that can better direct public health efforts, and form the basis for other health assessment tools, such as survival analysis, quality adjusted life years, and years of potential life lost. Researchers engaged in public health surveillance efforts use life tables to measure the overall health of a population, providing a readily understandable estimate of life expectancy at birth. ![]() Mortality rate estimates provide the basis for many health surveillance efforts, including the construction of life tables. ![]() Researchers at NPAIHB have used this registry to improve the accuracy of health data available to the Tribes through linkage with public health data systems. The Northwest Portland Area Indian Health Board (NPAIHB), a health organization operated by the 43 federally recognized Tribes of Idaho, Oregon, and Washington State, established the Northwest Tribal Registry (NTR) Project in 1999 to maintain a registry of AI/AN individuals. 13, 14, 17, 18, 20– 22 Through linkage, race coding on death certificates can be assessed and, where necessary, corrected. Record linkage is a relatively inexpensive and efficient way to address the problem of racial misclassification in estimating morbidity and mortality for AI/ANs. Thus, the result of this racial misclassification is nearly always an underestimation of the disease burden for AI/ANs. 12 Other studies have established that AI/ANs are more likely to be misclassified than other races, 11, 14 yet misclassification of other races as AI/AN is not common. 19 A recent national study comparing death certificate race coding with self-identified race on the Current Population Survey found only 55% agreement for AI/ANs. 11, 17, 18 Misclassification of AI/ANs on death certificates has been demonstrated through multiple methods. Racial misclassification in public health data sources has been well examined, and for AI/ANs, misclassification has been estimated to be as high as 60%. 11– 16 The need to overcome these issues and provide high-quality health data to AI/AN communities is especially important in light of the disparities that have been documented, even using data with these limitations. Vital statistics and surveillance systems are known to contain racial misclassification, in which AI/ANs are coded as another race, resulting in underestimated morbidity and mortality measures. Health indicators collected by federal, state, and local governments are the basis of the surveillance and evaluation that inform health policy decisions however, these data systems are seldom able to generate accurate health measures for the AI/AN population. 10 These statistics are alarming, and yet they fail to adequately convey the profound effect such health inequities have on tribal communities, in which each untimely death impacts the entire Tribe.Īccurate and complete health data are crucial to addressing this health status gap. This population is twice as likely to die from unintentional injuries, diabetes, chronic liver disease, and homicide compared with their NHW counterparts in the Northwest. 9 Northwest AI/ANs also experience significant health disparities for example, mortality rates for this population exceed rates for non-Hispanic white (NHW) Americans for each of the 10 leading causes of death, with the exception of Alzheimer's disease. The Pacific Northwest states of Idaho, Oregon, and Washington State are home to approximately 7% of the nation's AI/AN population. 2 As a group, AI/ANs have a profoundly different experience of morbidity and mortality throughout their lives than the general population: rates of diabetes, injuries, and cancer mortality are substantially higher. ![]() AI/AN population is younger and experiences lower educational and economic attainment than the majority population. 1 AI/ANs represent a heterogeneous group with diverse cultures and histories, coming from more than 560 federally recognized and 100 state-recognized Tribes, as well as numerous additional Tribes currently not recognized by U.S. As of the 2010 Census, 5.2 million people reporting American Indian or Alaska Native (AI/AN) ancestry were living in the United States. ![]()
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