births and birth outcomes for single- and multiple-race american indian and alaskan native mothers...

Births and Birth Outcomes for Single- and Multiple-Race American Indian and Alaskan Native Mothers

Brady E. Hamilton, Ph.D.

National Center for Health Statistics (NCHS)

Division of Vital Statistics

Reproductive Statistics Branch

The NAPHSIS/NCHS CollaborationPast Successes and Future

ChallengesSalt Lake City, UT June 3rd – 7th, 2007

Acknowledgements

Stephanie J. Ventura, M.A., NCHS

Joyce A. Martin, M.P.H., NCHS

David P. Johnson, B.S., NCHS

James A. Weed, Ph.D., NCHS

Background

• On October 30, 1997, the Office of Management and Budget (OMB) revised the standards for the classification of Federal data on race and ethnicity, established by Statistical Policy Directive 15 (May 12, 1977)

• The 2003 revision of the U.S. Standard Certificate of Live Birth incorporates, as stipulated by OMB, the minimum set of five categories (see below) used by Federal agencies for identification of race and option to report one or more races for mother and fatherCategories: American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

• States that reported multiple-race in 2004:

Background (Continued)

• Because all states have not yet revised their birth certificates to reflect the new standards, it is necessary to ‘‘bridge’’ birth data for multiple-race mothers (and fathers)

• “Bridging” is the process whereby multiple-race data is imputed into the single race categories of the 1977 OMB race standard (four races) within the NCHS edit program

• For discussion of bridging procedure, see

NCHS Procedure for Multiple-Race and Hispanic Origin Data: Collection, Coding, Editing, and Transmitting (released May 7, 2004), available at: www.cdc.gov/nchs /data/dvs/Multiple_race_docu_5-10-04.pdf

California

Florida (from March 1 only)

Hawaii

Idaho

Kentucky

Michigan (for selected facilities only)

Minnesota

New Hampshire (from July 19 only)

New York State (excluding NYC)

Ohio

Pennsylvania

South Carolina

Tennessee

Utah

Washington

Objective

• Compare characteristics and outcomes of births for bridged-race, single-race and multiple-race American Indian and Alaskan Native (AIAN) mothers

• Identify issues associated with collecting and processing multiple-race AIAN data

Data Collection and Analysis

• Data based on 2004 births to residents of California, Hawaii, Idaho, Kentucky, Minnesota, New York State, Ohio, Pennsylvania, South Carolina, Tennessee, Utah, and Washington (that occurred in these states)

• Excludes data for Florida, New Hampshire, and Michigan

• Data for U.S. bridged race based on all (bridged) AIAN births

• Race is self-reported by mother and recorded from checkbox items and literals

• Excludes data for race categories with fewer than 500 births

• Results shown are preliminary, DO NOT QUOTE OR CITE

Categories

• One race: Single-race AIAN

• More than one race: Multiple-race AIAN, AIAN reported in combination with one or more other races (i.e., White, Black, Asian, and or NHOPI)

• AIAN-White: AIAN in combination with White

• AIAN-Black: AIAN in combination with Black

• Bridged AIAN: Single-race AIAN and a portion of multiple-race AIAN imputed to AIAN alone

More than two races

0.3%

Two races1.6%

One race98.1%

Distribution of births to mothers reporting one, two, and more than two races: 12 state reporting area, 2004

SOURCE: CDC/NCHS, National Vital Statistics System.

Percentage of births to AIAN mothers reporting one race or more than one race and percentage of births to

AIAN mothers reporting two-races or more than two races: 12 state reporting area, 2004


AIAN only52.4%

AIAN with one or more other races47.6%

AIAN-White66.0%

Black-AIAN12.5%

More than two races

18.8%

AIAN-NHOPI0.6%

AIAN-Asian2.1%

0

10

20

30

40

50

Area and race

Bridged race Bridged race One race AIAN-White AIAN-BlackMore

than one raceUnited

States12 state reporting

area


Number of births to AIAN women: bridged race, United States, and bridged race, one race, more than one race, and two-races in selected combinations, 12 state reporting area,

2004

Nu

mb

er

of

bir

ths (

in t

hou

san

ds)

Total fertility rate for AIAN women: bridged race, United States, and bridged race, one race, more than one race, and two-races in selected combinations, 12 state reporting area,

2004

0

1

2

3

Rate

per

wom

en

Area and race


than one raceUnited


area


Data not available

Data not available

Mean age at first birth for AIAN women: bridged race, United States, and bridged race, one race, more than one

race, and two-races in selected combinations, 12 state reporting area, 2004

0

10

20

30

40

Ag

e

Area and race


than one raceUnited


area


Percentage of births to unmarried mothers for AIAN women: bridged race, United States, and bridged race, one race,

more than one race, and two-races in selected combinations, 12 state reporting area, 2004

0

10

20

30

40

50

60

70

80

90

100

Perc

en

t

Area and race


than one raceUnited


area


Percentage of preterm births for AIAN women: bridged race, United States, and bridged race, one race, more than one

race, and two-races in selected combinations, 12 state reporting area, 2004

0

10

20

Perc

en

t

Area and race


than one raceUnited


area


Percentage low birthweight births for AIAN women: bridged race, United States, and bridged race, one race, more than one race, and two-races in selected combinations, 12 state

reporting area, 2004

0

5

10

15

Perc

en

t

Area and race


than one raceUnited


area


Summary and Conclusion

• Women reporting AIAN in any combination (either single-race or multiple-race) were about equally likely to report their race alone as to report other races (more than one race)

• Differences between single-race and multiple-race (more than one race and two-race) mothers were significant

• Differences between single-race and bridged race mothers were not significant

• Differences between single-race AIAN and multiple-race AIAN mothers illustrate the importance of reporting and analyzing race in detailed multiple combinations

Summary and Conclusion (Continued)

• Findings were based on twelve states that differ markedly in terms of socio-economic and demographic characteristics from each other and from the US

• More detailed analysis is needed to better understand the confounding and contextual factors associated with the findings

• AIAN tribes differ markedly and may not be affected similarly by the reporting of more than one race

• Characteristics of Births to Single- and Multiple-Race Women: California, Hawaii, Pennsylvania, Utah and Washington, 2003 (released May 3, 2007), available at: www.cdc.gov/nchs/data/nvsr/nvsr55/nvsr55_15.pdf

births and birth outcomes for single- and multiple-race american indian and alaskan native mothers...

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