An Overview of Health Data on American Indians: What Is Available and How Can It Be Analyzed?

Ginger L. Gossman, University of Texas at Austin

Demographic researchers interested in studying American Indians have to navigate murky waters in order to identify and obtain data that contains significant numbers of American Indian respondents. Finding a considerable number of such respondents is important for two reasons. First, it is important if one is to assert findings are statistically significant. If the number of American Indians is small in any cell, those findings may be questionable because they cannot be generalized to the population. Second, small numbers in any cell threaten confidentiality. If confidentiality is a problem, reputable journals will be less inclined to publish the results. This dilemma is especially true for those interested in learning about health differentials for American Indians. Differentials may be surmised as within the group, comparing tribe(s) to tribe(s) or between groups, comparing American Indians to non-Hispanic whites, African Americans, or to Asians for example. Researchers trying to capture differentials within the group will face the greatest challenges to significance and confidentiality because analyzing data by tribe is likely to lead to very small cell numbers. Researchers trying to capture differences based on spatially distribution also face a challenge. Although Census tract data can be used to estimate reservation residence, this information eludes most data collection. Identifying health differences between reservation and non-reservation Indians may prove to have important policy and practice implications. The two most comprehensive sources for American Indian health data are Indian Health Services and the National Center for Health Statistics. Data collected by both of these institutions are limited. Indian Health Services data is potentially an outstanding source for health researchers interested in this population. IHS services are extended to all American Indians who belong to a federally recognized tribe. Data collected includes tribal affiliation as well as demographic and biomedical information. The main limitation of Indian Health Services data is that it is not public use. This research will seek to identify IHS policy on who can access their data and under what circumstances. On the other hand, NCHS is public use. It also collects demographic and biomedical data. However, it does not collect tribal data – limiting its use for studying within group differences. This research will also seek to identify ways, if any, in which NCHS can be coupled with spatial distribution, i.e., Census tract data (STF 3), to estimate reservation residence and/or tribal affiliation. There are also data sources on minority health that may be useful to researchers interested in American Indians. These include data from Substance Abuse and Mental Health Service Administration, National Institute of Health, and the National Institute of Mental Health. In addition, there are a number of data sources of specific health outcomes such as diabetes, tuberculosis, cancer, influenza, hepatitis, obesity, alcoholism, kidney disease, cardiovascular disease, and smoking (http://hsc.unm.edu/nhrd/pglinks.html#AIL). This research will explore the availability of such data sources and the variables considered in data collection and/or analysis. In this presentation, I will also identify the most common sources of Indian health research over the last 10 years and describe their availability and analytical applications, including whether or not these data can be used for contextual research.