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The purpose of this report was to develop a method for improving the consistency of Indian Health Service (IHS) mortality statistics when compared with race reported for the same decedents obtained from other sources. The principal objectives were 1) to determine the nature and scope of inconsistent identification of race of American Indian and Alaska Native deaths on state death certificates for the IHS user population, and 2) to develop a methodology for adjusting IHS mortality statistics for the level of inconsistency by race identified. As the second phase in a two-stage project, this study analyzed 12,086 records from the National Death Index (NDI) matched to records from the patient registration system maintained by IHS. These records represent persons who presented sufficient proof to indicate that they had some degree of American Indian or Alaska Native ancestry when they sought care at Indian Health Service health care facilities or the IHS-funded health care facilities. This study reviews the race reported on the 12,086 State death certificates of persons who were classified as being of American Indian or Alaska Native ancestry by IHS. The study revealed that on 11 percent of the matched IHS-NDI records the race reported for the decedent was other than American Indian or Alaska Native with the percentage of records with inconsistent classification of race reaching over 28 percent for some IHS areas. The States with the most severe inconsistency in identifying the race of AI/AN decedents were identified, and a method of adjusting IHS mortality statistics was developed.

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Indian Health Service