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Public-private Partnership to establish a Public Health Surveillance System for AIAN

Public-private Partnership to establish a Public Health Surveillance System for AIAN. Indian Health Status Collaborative started in 2003 1. Tribal Health Board California Rural Indian Health Board (CRIHB) 2. Indian Health Service (IHS) Area Office California Area Office

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Public-private Partnership to establish a Public Health Surveillance System for AIAN

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  1. Public-private Partnership to establish a Public Health Surveillance System for AIAN

  2. Indian Health Status Collaborative started in 2003 1. Tribal Health Board California Rural Indian Health Board (CRIHB) 2. Indian Health Service (IHS) Area Office California Area Office 3.State Department of Health Services California Center for Health Statistics 4.University University of California San Francisco

  3. AI / AN in California: LargeCensus Population * US Census 2000, Bridged Estimate Report 2003

  4. 1. California Center for Health Statisticsconcerned about AIAN statistics • Low Population Density AI / AN • 1.6% of state population • 4.3% is largest portion of any county population • High Racial Misclassification of AI / AN • 30% to 70% depending on data type

  5. Example: California Mortality Rate for AI / AN * Year 2000 Rate per 100,000 people, Adjusted with Year 2000 Standard Million Population

  6. AI / AN in Indian Health Service: User Population * Indian Health Service

  7. Tribal Health Programs (THP) Service Areas in 37 of 58 counties Tribally owned and operated, Mainly IHS Funded

  8. 2. Tribal Health Board in California concerned about no AIAN data • Inform IHS funding allocation process • Uses mortality rates by cause (5) • Perception that CA AIAN are healthier • Inform Disparities reduction efforts • Perception that CA AIAN had no disparities • Advocate for fair treatment • Evaluate health impact of disparities in funding of California THP

  9. The Collaborative Links IHS Data to State Data • Use IHS Active User Population data to identify AIAN • Validated Social Security Number (to link) • Other Demographic fields to improve linkage • Link to state health data bases • Deterministic linkage (SSN only) • Probabilistic linkage • Obtain comparable data for Whites

  10. IHS data identifies AIAN which is then linked to state data bases

  11. Racial Misclassification in State Data

  12. Effect of Racial Misclassification on the Disparity in Death Rates

  13. Hospitalization Disparity Rate Ratios by Cause for THP Service Areas • Diabetes • Cardiovascular Disease • Asthma • Tobacco • Alcohol & Drug • Cancer • Preventable

  14. Disparities in Hospitalization Rate Ratios by THP Service Area

  15. Major Factors in Success • Needs of all three groups are served • Long-term commitment (took 5 years) • No turnover in major players • Consistent commitment • Everyone showed up every time to deal with IRB issues • Follow-through • Findings used in testimony, reports and journal articles produced change in perception and funds

  16. California Rural Indian Health Board (CRIHB) California Area Office of the Indian Health services (IHS) California state Center for Health Statistics (CHS) University of California San Francisco (UCSF), Institute for Health Policy Studies James Crouch Margo Kerrigan James Sutocky Carol Korenbrot Chi Kao Sara Ehlers UC Berkeley: Karen Garcia* Sarah Johnson Matthew Pearn Sharon Lee Thanks to Collaborative Members:

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