Mixed Race Studies

Impacts of Multiple Race Reporting on Rural Health Policy and Data Analysis

Working Paper No. 73
Working Paper Series
North Carolina Rural Health Research and Policy Analysis Center
Cecil G. Sheps Center for Health Services Research
The University of North Carolina at Chapel Hill

2002-05-01
39 pages

Randy Randolph, M.R.P.

Rebecca Slifkin, Ph.D.

Lynn Whitener, Dr.P.H.

Anna Wulfsberg, M.S.P.H.

This work was supported by Cooperative Agreement 1-U1C-RH-00027-01 with the federal Office of Rural Health Policy.

Introduction

In the 1990s the policy goal of improving the rural minority population’s health status and access to health care gained prominence.  The President’s Initiative on Race, announced in 1998, established goals for improvements in health indicators and declared 2010 as the target year for achieving these goals. In A National Agenda for Rural Minority Health, the National Rural Health Association outlined strategies to realize the President’s goals in rural America. The plan identified three priority areas associated with these goals: Information and Data, Health Policy and Practices, and Health Delivery Systems. All three of these areas require a consistent stream of data describing the racial composition of rural areas and rural residents’ health status. The information and data section recommends that “Data collection systems will incorporate core data sets and employ uniform definitions for relevant terms to facilitate information sharing and comparisons among and across minority populations and nonminority populations as well” (NRHA, 1999).

Recent changes in federal policy will complicate achieving NRHA’s stated goal and measuring the rural success of the Initiative on Race. On October 30, 1997, the U.S. Office of Management and Budget (OMB) announced the first revised federal standards for collecting data on race and ethnicity since 1977. The revisions are to be adopted by all federal agencies working with race-based information.  The modifications to Statistical Policy Directive No. 15, Race and Ethnic Standards for Federal Statistics and Administrative Reporting (the existing policy) contained changes in both content and naming of racial and ethnic categories requiring that respondents be allowed to choose one or more of five race categories: “American Indian or Alaska Native,” “Asian,” “Black or African American,” “Native Hawaiian or Other Pacific Islander,” and “White”; an optional “Other Race” is allowed, but not encouraged, under the rule. Two categories for data on ethnicity—“Hispanic or Latino” and “Not Hispanic or Latino” are offered in a separate question. The separate ethnicity choice is only a change in category naming with the addition of Latino to the category—the option of also including Spanish Origin is permitted. Some of the new race categories defined by the revision to Directive 15 were changes from the 1977 rule. The most obvious change was disaggregating the “Asian or Pacific Islander” category to distinct “Asian” and “Native Hawaiian or Other Pacific Islander” categories. The population covered by the “American Indian or Alaskan Native” category has been expanded from the 1977 classification—which included the indigenous peoples of the United States and Canada—to also include those indigenous to Central America and South America…

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