Births and Birth Outcomes for Single and MultipleRace American Indian and Alaskan Native Mothers

1
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 Collaboration Past Successes and
Future Challenges Salt Lake City, UT June
3rd 7th, 2007
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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

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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 father
• Categories American Indian or Alaska Native
• Asian
• Black or African American
• Native Hawaiian or Other Pacific Islander
• White
• States that reported multiple-race in 2004

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Background (Continued)
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 Washing
ton

• 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

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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

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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

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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

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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.
9
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
SOURCE CDC/NCHS, National Vital Statistics
System.
10
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
Number of births (in thousands)
More than one race
Bridged race Bridged race One race
AIAN-White AIAN-Black
United States
12 state reporting area
Area and race
SOURCE CDC/NCHS, National Vital Statistics
System.
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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
Rate per women
Data not available
Data not available
More than one race
Bridged race Bridged race One race
AIAN-White AIAN-Black
United States
12 state reporting area
Area and race
SOURCE CDC/NCHS, National Vital Statistics
System.
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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
Age
More than one race
Bridged race Bridged race One race
AIAN-White AIAN-Black
United States
12 state reporting area
Area and race
SOURCE CDC/NCHS, National Vital Statistics
System.
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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
Percent
More than one race
Bridged race Bridged race One race
AIAN-White AIAN-Black
United States
12 state reporting area
Area and race
SOURCE CDC/NCHS, National Vital Statistics
System.
14
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
Percent
More than one race
Bridged race Bridged race One race
AIAN-White AIAN-Black
United States
12 state reporting area
Area and race
SOURCE CDC/NCHS, National Vital Statistics
System.
15
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
Percent
More than one race
Bridged race Bridged race One race
AIAN-White AIAN-Black
United States
12 state reporting area
Area and race
SOURCE CDC/NCHS, National Vital Statistics
System.
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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

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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