Race and Ethnicity in State Data: the Massachusetts Perspective

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Race and Ethnicity in State Datathe
Massachusetts Perspective

• A presentation for the Maternal and Child Health
  Epidemiology Conference
• Bruce B. Cohen, PhD
• Director of Research and Epidemiology
• Massachusetts Department of Public Health
• Bureau of Health Statistics, Research and
  Evaluation
• December 12, 2001

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Presentation overview

• An overview of the 1997 Revised Standards for the
  collection and tabulation of race and ethnicity
  data
• Federal-state differences in the collection,
  tabulation, and use of race and ethnicity data
• the Massachusetts perspective Massachusetts
  Department of Public Health (MDPH) principles and
  practice

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1997 Revised Standards and OMB 15

• What is OMB 15?
• Office of Management and Budget Directive 15
  set minimum standards for the collection of race
  and ethnicity data for all federal data sets in
  1977
• revised in 1997
• all current surveys must comply with the 1997
  revision by January 1, 2003

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Revised Standards in historical context

• Lessons for states in implementing OMB 15
• race categories change regularly over time
• race categories determined by social and cultural
  context
• ethnicity and national origin categories
• more stable over time
• change to reflect changing demographics, not
  social and cultural context
• highly salient to state and local public health
  practice
• Ref American Anthropological Association
  Response to OMB 15, www.aaanet.org/gvt/ombdraft.
  htm

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1997 Revised StandardsProcess Changes

• changes when self identification is used,
• a method for reporting more than one race should
  be adopted this method should NOT be a
  multiracial category, but rather a multiple
  response to a single question
• a two question format should be used, with the
  Hispanic origin question preceding the race
  question
• when self identification is NOT used (ie.
  observer, proxy or record based)
• a two question format should be used, with the
  Hispanic origin question preceding the race
  question
• a one question format MAY BE used, with
  Hispanic as a race category

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Race Categories Revised Standards vs. OMB 15

• 1997
• white
• black or African American
• American Indian or Alaskan Native
• Asian
• Native Hawaiian or Other Pacific Islander
• NOTE Only the US Census Bureau for the purpose
  of the Census 2000 and NCHS for the 2003 revised
  standard certificates of birth and death have
  been granted variances to include an other
  category

• 1977
• white
• black
• American Indian
• Asian or Pacific Islander

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Categories and Definitions

• American Indian or Alaskan Native
• a person having origins in any of the original
  peoples of North and South America (including
  Central America), and who maintains tribal
  affiliation or community attachment

Source Standards for Maintaining, Collecting and
Presenting Federal Data on Race and Ethnicity
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Categories and Definitions

• Asian
• a person having origins in any of the original
  peoples of the Far East, Southeast Asia, or the
  Indian subcontinent including, for example,
  Cambodia, China, India, Japan, Korea, Malaysia,
  Pakistan, the Philippine Islands, Thailand,
  Vietnam

Source Standards for Maintaining, Collecting and
Presenting Federal Data on Race and Ethnicity
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Categories and Definitions

• Black or African American
• a person having origins in any of the black
  racial groups of Africa. Terms such as Haitian
  or Negro can be used in addition to Black or
  African American

Source Standards for Maintaining, Collecting and
Presenting Federal Data on Race and Ethnicity
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Categories and Definitions

• Hispanic or Latino
• a person of Cuban, Mexican, Puerto Rican, South
  or Central American, or other Spanish culture or
  origin, regardless of race. The term, Spanish
  origin can be used in addition to Hispanic or
  Latino

Source Standards for Maintaining, Collecting and
Presenting Federal Data on Race and Ethnicity
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Categories and Definitions

• Native Hawaiian or other Pacific Islander
• a person having origins in any of the original
  peoples of Hawaii, Guam, Samoa, or other Pacific
  Islands

Source Standards for Maintaining, Collecting and
Presenting Federal Data on Race and Ethnicity
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Categories and Definitions

• White
• a person having origins in any of the original
  peoples of Europe, the Middle East, or North
  Africa

Source Standards for Maintaining, Collecting and
Presenting Federal Data on Race and Ethnicity
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Census 2000 Ethnicity Question

• Is person 1 Spanish/Hispanic/Latino? Mark x in
  the No box if not Spanish/Hispanic/Latino.
• No, not Spanish/Hispanic/Latino
• Yes, Mexican, Mexican Am., Chicano
• Yes, Puerto Rican
• Yes, Cuban
• Yes, other Spanish/Hispanic Latino- print group.

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Census 2000 Race question

• What is Person 1s race? Mark x in one or more
  races
• White
• Black, African American or Negro
• American Indian or Alaskan Native- print name of
  enrolled or principal tribe
• Asian Indian Native Hawaiian
• Chinese Guamanian or Chamorro
• Filipino Samoan
• Japanese Other Pacific Islander- print race
• Korean Some other race- print race
• Vietnamese
• Other Asian- print race

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Revised Standards State vs. Federal Perspective
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Impact of Revised Standards on public health
practice state needs

• more detailed ethnicity data for service
  targeting to high risk individuals and high risk
  communities
• methods for dealing with unique populations in
  Massachusetts, Cape Verdeans, Dominicans
• age\sex\race intercensal denominators
• Uniform guidance from DHHS for implementation for
  collection issues and for tabulation

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Impact of Revised Standards on public health
practice Federal-state differences

• proportions of self-report, observation, and
  record review-based data sets differ in States
• main federal interest--presenting state level
  data main state interest--presenting small area
  data
• states less likely to use imputation techniques
  for missing data or probabilistic and fractional
  assignment methods for bridging

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Recommendations for state implementation

• States need uniform guidance from ALL federal
  agencies for data collection and tabulation
  standards and should partner with Feds to address
  issues
• States should emphasize ethnicity not race
• States should emphasize self-report, if possible
• States should standardize collection and
  reporting within and across agencies

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Revised Standard Massachusetts Department of
Public Health Perspective

• Principles and process
• Current status
• Summary

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Data Collection Principles

• Self Identification is optimal format
• Need for consistency across MDPH
• Need for consistency with federal standards
• The more race/ethnic detail the better
• Additional data on language preference and
  socioeconomic variables is desirable
• Multiple response to a single question

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MDPH Process

• Review of existing race-ethnicity data collection
  efforts
• Agency-wide planning
• Finalizing options
• Outreach,implementation,training

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Current options under review...

• Goal to meet OMB requirements while providing
  State health department maximum flexibility to
  collect and use the data as effectively as
  possible for our own needs
• Option 1 3 question check box approach
• Option 2 modified text approach

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Option 1 Check box approach

• Question 1 Are you Spanish/ Hispanic/Latino?
• ? No (go to Question 2)
• ? Yes, Central American (go to question 3)
• ? Yes, Cuban (go to question 3)
• ? Yes, Dominican (go to question 3)
• ? Yes, Mexican, Mexican American (go to question
  3)
• ? Yes, Puerto Rican (go to question 3)
• ? Yes, Salvadoran (go to question 3)
• ? Yes, South American (go to question 3)
• ? Yes, other-specify_____ (go to question 3)

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Option 1 Check box approach

• Question 2 What is your ethnicity?
• ? African ? European, other
• ? African American ? Filipino
• ? American ? Latin American Indian
• ? Asian Indian ? Haitian
• ? Brazilian ? Japanese
• ? Cambodian ? Korean
• ? Cape Verdean ? Laotian
• ? Caribbean Islander (specify) ? Middle
  Eastern
• ? Chinese ? Portuguese
• ? Eastern European/ Russian ? Vietnamese
• ?Other (specify_______)
• Categories used by US Census and recommended
  NCHS Standard certificate

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Option 1 Check box approach

• 3. What is your race? (mark one or more)
• American Indian/Alaskan Native (specify tribal
  nation_________)
• Asian
• Black, African American, or Negro
• Native Hawaiian or other Pacific Islander
  (specify___________)
• White
• Categories used by US Census and recommended
  NCHS Standard certificate

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Option 2 modified text approach

• 1. Are you Spanish/Hispanic/Latino?
• ? Yes, specify ____________ (go to question 3)
• ? No
• 2. What is your or ethnic group/ ancestry or
  heritage? List up to three _____, _____, ______

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Option 2 modified text approach

• 3. What is your race? (mark one or more)
• American Indian/Alaskan Native (specify tribal
  nation_________)
• Asian
• Black, African American, or Negro
• Native Hawaiian or other Pacific Islander
  (specify___________)
• White
• Categories used by US Census and recommended
  NCHS Standard certificate

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Tabulation Reporting Options

• Full Distribution
• Single Race Lower Bound Distribution
• All Inclusive Upper Bound Distribution
• Single Race Most Common Combinations

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MDPH RecommendationTabulation Reporting

• Single Race Most Common Combinations
• White alone
• Black or African American alone
• American Indian and Alaska Native alone
• Asian alone
• Native Hawaiian and Other Pacific Islander alone
• All multiple race combinations with at least 1
  of observations in data set
• Collapse the less frequently reported
  combinations into one category

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Bridging state trend analyses

• Method for taking data collected under the new
  standard and making it comparable to data
  collected under the old standard. Practically
  speaking, this involves reassigning individuals
  who report multiple races into single race
  categories

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Bridging Methods

• Example based on respondent who is
• white, black Asian
• Smallest Group
• re-coded to Asian
• Largest Group other than White
• re-coded to black
• Largest Group
• re-coded to white

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Other possible MDPH questions

• Language question (wording of question to be
  decided on later--example categories, to be
  decided upon later
• ? English ? Laotian
• ? Spanish ? Korean
• ? Portuguese ? Hmong
• ? Cape Verdean Creole ? Chinese
• ? Haitian Creole ? Russian
• ? Cambodian ? Other (specify)
• ? Vietnamese

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Other possible MDPH questions

• What country where you born in?
• Optional follow-up question What year did you
  move to the United States?

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Outreach,training, implementation

• Outreach
• contractors
• community agencies/advocacy groups
• other state agencies/providers/Federal govt
• Training
• data collectors
• data system designers/implementers
• Implementation
• time line
• issues

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Concluding thoughts

• How are race-ethnicity data being used? Crucial
  to link race-ethnicity data to other SES,
  environmental, linguistic, demographic indicators
• State perspective and needs differ from the
  federal perspective state focus on heterogeneity
  of ethnicity and small area data for service
  delivery and surveillance
• States need consistent federal agency guidance

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Concluding thoughts

• State response to Revised Standard made difficult
  by multiplicity of state data sets and data
  collection modes
• Need input from both substantive program staff
  and data base designers
• Need to process ideas with broader community
• Need to be flexible within boundaries to comply
  with Federal standards
• Need to dedicate time, resources, and personnel
  to effort