groups) could also use the data to effectively improve knowledge of health disparities. At the same time, privacy and confidentiality protections should be in place and enforced to guard against improper uses.

Some states have much experience in the collection, use, and dissemination of data on race, ethnicity, SEP, and language use and acculturation. Other states do not and could learn much from those that do. DHHS can exercise leadership in encouraging states’ collection and use of existing data. DHHS uses the data it collects to produce a number of reports on health disparities, including such efforts as Healthy People 2010 and the National Healthcare Disparities Report. These and other efforts by DHHS agencies to implement research programs to better understand health disparities can serve as useful illustrations of the importance of how data on race, ethnicity, language, and SEP can be used. The federal government can also facilitate the sharing of information about how different states that collect the data use them in policy environments and make them available for outside users. Through these examples as well as the convening of conferences and the provision of training and technical assistance, DHHS could exemplify beneficial uses of this type of data.

RECOMMENDATION 5-2: DHHS should provide guidance and technical assistance to states for the collection and use of data on race, ethnicity, socioeconomic position, and acculturation and language use.

DHHS can consider a number of ways to support states in their collection of these data. One possible way for DHHS to encourage states to collect and use racial and ethnic data is by providing incentives to states in the form of competitive matching grants that target data collection for interventions to minority groups. An example of one such federal-state partnership is the Title V Maternal-Child Health Program (MCH), which provides matching funds to states and requires quantifiable outcomes monitoring, supported by the state data systems. One of the core MCH measures required by Title V is the Black and White Infant Mortality Ratio Performance Measure. The Vital Statistics Cooperative Program is another example of a mechanism with which DHHS can encourage states to collect and use racial and ethnic data in a standardized way. In this program, states are funded by the NCHS to provide standardized data on basic data items cooperatively agreed to by states and the NCHS.

To address gaps in coverage in many administration records, some states link public health data sets. For example, researchers from the New Hampshire State Department of Health and Human Services link data from the New Hampshire State Cancer Registry to state hospital discharge data (Taylor and Liu, 2003). In Ohio, Koroukian, Cooper, and Rimm (2003) linked Medicaid claims data with state cancer registry data to study the accuracy of Medicaid claims data in identifying breast cancer cases. Other



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