Skip to main content
Public Health Reports logoLink to Public Health Reports
. 2005 Jul-Aug;120(4):393–398. doi: 10.1177/003335490512000406

Discrepancies between published data on racial classification and self-reported race: evidence from the 2002 North Carolina live birth records.

Paul A Buescher 1, Ziya Gizlice 1, Kathleen A Jones-Vessey 1
PMCID: PMC1497745  PMID: 16025719

Abstract

OBJECTIVES: We compared data on race as reported by the mother on North Carolina birth certificates with data on race in officially reported statistics. We also determined to what extent differences in the classification of race affect measures of racial disparity in maternal and child health indicators. METHODS: We examined how data on race are collected, coded, and tabulated in North Carolina via live birth certificates, death certificates, the Behavioral Risk Factor Surveillance System (BRFSS) telephone survey, and the Central Cancer Registry case records. We showed how the data on race collected through North Carolina birth and death certificates are translated into 10 fixed racial categories designated by the National Center for Health Statistics (NCHS) for use in official vital statistics. We compared race as reported by the mother on birth certificates to racial tabulations used in the official published birth statistics. We also examined to what extent differences in the determination of race affect measures of racial disparity in maternal and child health indicators. RESULTS: Out of nearly 118,000 live births in North Carolina in 2002, mothers reported more than 600 different versions of race on birth certificates. These entries were collapsed into the 10 standard racial categories outlined in federal coding rules. Approximately two-thirds of mothers of Hispanic ethnicity report their race with a label that can be categorized as "Other" race, but nearly all of these births are re-coded to "white" for the official birth statistics. Measures of racial disparity vary depending on whether self-reported or officially coded race is used. CONCLUSIONS: This study shows that, given the opportunity to report their own race, North Carolinians describe their race using a wide variety of terms and concepts. In contrast, health statistics are usually reported using a few standardized racial categories defined by federal policy. The NCHS rules for coding race should be reexamined. As the ethnic and racial diversity of the United States continues to increase, these rules will become increasingly antiquated.

Full Text

The Full Text of this article is available as a PDF (70.8 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Freeman H. P., Payne R. Racial injustice in health care. N Engl J Med. 2000 Apr 6;342(14):1045–1047. doi: 10.1056/NEJM200004063421411. [DOI] [PubMed] [Google Scholar]
  2. Friedman D. J., Cohen B. B., Averbach A. R., Norton J. M. Race/ethnicity and OMB Directive 15: implications for state public health practice. Am J Public Health. 2000 Nov;90(11):1714–1719. doi: 10.2105/ajph.90.11.1714. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Hahn R. A. Why race is differentially classified on U.S. birth and infant death certificates: an examination of two hypotheses. Epidemiology. 1999 Mar;10(2):108–111. [PubMed] [Google Scholar]
  4. Kaplan Judith B., Bennett Trude. Use of race and ethnicity in biomedical publication. JAMA. 2003 May 28;289(20):2709–2716. doi: 10.1001/jama.289.20.2709. [DOI] [PubMed] [Google Scholar]
  5. Kaufman J. S. How inconsistencies in racial classification demystify the race construct in public health statistics. Epidemiology. 1999 Mar;10(2):101–103. doi: 10.1097/00001648-199903000-00001. [DOI] [PubMed] [Google Scholar]
  6. Krieger N. Analyzing socioeconomic and racial/ethnic patterns in health and health care. Am J Public Health. 1993 Aug;83(8):1086–1087. doi: 10.2105/ajph.83.8.1086. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Mofidi Mahyar, Rozier R. Gary, King Rebecca S. Problems with access to dental care for Medicaid-insured children: what caregivers think. Am J Public Health. 2002 Jan;92(1):53–58. doi: 10.2105/ajph.92.1.53. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Moscou Susan, Anderson Matthew R., Kaplan Judith B., Valencia Lisa. Validity of racial/ethnic classifications in medical records data: an exploratory study. Am J Public Health. 2003 Jul;93(7):1084–1086. doi: 10.2105/ajph.93.7.1084. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Sheldon T. A., Parker H. Race and ethnicity in health research. J Public Health Med. 1992 Jun;14(2):104–110. [PubMed] [Google Scholar]
  10. Thomas S. B. The color line: race matters in the elimination of health disparities. Am J Public Health. 2001 Jul;91(7):1046–1048. doi: 10.2105/ajph.91.7.1046. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Udry J. Richard, Li Rose Maria, Hendrickson-Smith Janet. Health and behavior risks of adolescents with mixed-race identity. Am J Public Health. 2003 Nov;93(11):1865–1870. doi: 10.2105/ajph.93.11.1865. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Public Health Reports are provided here courtesy of SAGE Publications

RESOURCES