National Academies Press: OpenBook

Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement (2009)

Chapter: Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme

« Previous: Appendix D: Subcommittee Member and Staff Biographies
Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×

Appendix E
Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme

The Subcommittee on Standardized Collection of Race/Ethnicity Data for Healthcare Quality Improvement recommends using the Office of Management and Budget (OMB) race and Hispanic ethnicity categories (Asian, Black or African American, Native Hawaiian or Other Pacific Islander, White, American Indian or Alaska Native, and Hispanic or Latino) and using a national standard set of granular ethnicity categories based on ancestry. Not all entities collecting data will include the comprehensive list of granular ethnicity categories in their databases or on their data collection instruments as the categories most important for collection by a health plan in Boston might differ from the categories important for collection by a health system in rural Missouri. These entities can select whatever number of locally relevant categories from the national standard set to present as pre-specified categories for check-off of responses; local lists should also be capable of identifying other ethnicities for all who wish to self-identify by including an open-ended choice of “Other, please specify: __.” The subcommittee believes it is important to supplement the OMB categories by collecting granular ethnicity data and to retain these in data systems so that more detailed analysis and reporting is possible than with the current OMB categories. The number of categories any entity finds necessary for analysis will vary according to the composition of the population being served or studied, whether the size of subgroups is sufficiently large to make statistically reliable comparisons, and whether the pattern of differences experienced by subgroups identifies distinct needs that are not already revealed by data aggregated into broader categories.

The national standard set must be comprehensive of the nation’s population to ensure the capture of even small, geographically isolated population groups that would potentially be important in specific locales for analyses and the provision of culturally and linguistically appropriate care. Furthermore, the set must be responsive to changing demographic trends and thus must be regularly updated.

DEVELOPMENT OF THE TEMPLATE

The subcommittee did not identify a single existing category list believed to be comprehensive enough to serve as a national, standard set. For example, as discussed in Chapter 3, the Centers for Disease Control and Prevention (CDC)/Health Level 7 (HL7) Race and Ethnicity Code Set 1.0 does not include all relevant granular ethnicities. It does not, for instance, include Somali or Russian. The Massachusetts Superset was developed partially because of these noted absences in the CDC/HL7 Code Set and includes granular ethnicities that are locally relevant to the Commonwealth of Massachusetts. Demographic distributions confirm that there may be ethnic groups present

Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×

across the country that may not have a large presence in Massachusetts (e.g., Navajo, which may be of importance in Arizona). Thus, the subcommittee concluded that the Massachusetts Superset provides an ample, but not complete, set of granular ethnicity categories. Similarly, the Kaiser Permanente Granular Ethnicity Code Set was determined to be representative of many, but perhaps not all, granular ethnicities.

To capture all of the granular ethnicities represented in the United States, the subcommittee reviewed the Census Bureau’s Ancestry Code List. The Census Ancestry Code List is compiled from responses to the Census’ open-ended ancestry question, which allows respondents to write in their lineage or ancestry.1 Thus, the list includes a myriad of granular ethnicity categories, ranging from Hausa, an ethnic group in northern Nigeria, to more general responses of European and American.

The CDC/HL7 Code Set, Massachusetts Superset, Census Ancestry Code List, and Kaiser Permanente Granular Ethnicity Code Set interchangeably use country or place names to indicate ethnicities (i.e., Singapore to represent Singaporean). The subcommittee revised the list to represent categories with ethnicities as opposed to places, whenever possible; this is reflected in the subcommittee’s template (Table E-1).

The CDC/HL7 Code Set includes an extensive list of American Indian or Alaska Native categories and codes. Thus, the CDC/HL7 Code Set may serve as the template from which entities can choose locally relevant tribal categories and codes. The Census Ancestry Code list does not include American Indian or Alaska Native tribes. The Massachusetts Superset and the Kaiser Permanente Granular Ethnicity Code Set both include limited lists of locally relevant tribes.

ADAPTION OF THE TEMPLATE TO A NATIONAL STANDARD LIST

The subcommittee presents a cumulative list of granular ethnicity categories from different sources (Table E-1) that may serve as a template from which the Department of Health and Human Services (HHS) should develop a national standard list of granular ethnicity categories with accompanying unique codes (Recommendation 6-1a). Some of these granular ethnicities have already been assigned permanent five-digit unique numerical codes by CDC/HL7. The remaining granular ethnicities included in the subcommittee template also need permanent five-digit unique numerical codes.

To indicate which categories and codes may be similar, the Public Use Microdata Sample File (PUMS) considers some Census ancestry codes to have “corresponding detailed ancestry codes” (i.e., Hausa may be said to correspond with Nigeria).2 The subcommittee concluded that because of the large number of very specific ethnicities included on the Census Ancestry Code List, some ethnicities would be best presented as corresponding with others. Corresponding ethnicities are indicated in Table E-1 using indents. When HHS is developing codes for the granular ethnicity categories included in this template (per Recommendation 6-1a), corresponding ethnicities may have the same codes (i.e., one or more granular ethnicity categories may have the same code).

ROLLUP TO THE OMB RACE AND HISPANIC ETHNICITY CATEGORIES

Locally tailored quality improvement activities may target granular ethnicity groups without needing to relate those groups to a single OMB race category. Collecting race, Hispanic ethnicity, and granular ethnicity data separately, as the subcommittee recommends, allows reporting of the OMB categories when necessary without requiring rollup of the granular ethnicities, provided that individuals respond to all the questions asked. Nonetheless, the subcommittee recognizes that data collected under some circumstances (e.g., a reporting request for OMB-level data where only granular ethnicity is collected) cannot be used or compared with data collected using the OMB race and Hispanic ethnicity categories without the use of a rollup scheme to link granular ethnicities to the OMB categories. To examine both the feasibility and limitations of such schemes, the subcommittee mapped in Table E-1

1

The CDC/HL7 Code Set was developed using write-in responses to the Census questions on race and Hispanic ethnicity, not responses to the Census ancestry question. The Census ancestry list is more comprehensive than the list used to develop the CDC/HL7 Code Set.

2

U.S. Census Bureau. 2007. ACS 1-year PUMS code lists: Ancestry codes. http://www.census.gov/acs/www/Products/PUMS/C2SS/CodeList/2007/Ancestry.htm (accessed June 23, 2009).

Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×

granular ethnicity responses collected from the ancestry question on Census 2000 to the OMB race and Hispanic ethnicity categories. Table E-1 uses the existing CDC/HL7 rollup scheme as a basis; the subcommittee tested the assumptions of those OMB category assignments with responses to the Census race and Hispanic ethnicity questions to determine if 90 percent of respondents giving a specific ancestry response identified with the category to which the CDC/HL7 rollup scheme assigns them.

For most granular ethnicity categories, 90 percent or more of respondents to Census 2000 did self-identify with the OMB category to which the CDC/HL7 rollup would assign them. However, Appendix F identifies a number of granular categories that do not meet the 90 percent threshold, and thus would have “no determinate OMB race classification” if this threshold was adopted. An analyst wanting to roll up the categories in Appendix F to an OMB race group or Hispanic origin would have to defer to existing OMB and Census definitions based on geographic ancestry (see Table 1-1 in Chapter 1 of the report). While many granular ethnicities can be mapped to the OMB Hispanic ethnicity category based on the existing CDC/HL7 roll-up, none of the granular ethnicities associated with the Hispanic ethnicity category can be assigned to an OMB race category with greater than 90 percent certainty. In addition, high percentages of persons who report an American Indian or Alaska Native ancestry have been known to identify as White, multiracial, or “Some Other Race” (see discussion of American Indian or Alaska Natives in Chapter 2). Similarly, substantial portions of respondents who report a Pacific Islander ancestry identify with a race besides with the Native Hawaiian or Other Pacific Islander race category. The tribal groups and Pacific Islander groups have been left by the subcommittee in the American Indian or Alaska Native and Native Hawaiian or Other Pacific Islander race categories, respectively rather than move them to a “no determinate OMB race classification.” There was insufficient data to apply the 90 percent rule to all the individual subcategories under those headings.

Analysts should understand that making an assignment using a 90 percent (or any other percent) threshold or an assignment based solely on geography incurs a higher probability that the rollup assignment misclassifies individuals based upon how they would self-identify their race when asked directly about their race. The rates of misclassification, even for granular ethnicities meeting a 90 percent threshold, underscores the fact that rollup schemes only provide probabilistic assignments useful for analysis at the group or population level, and should never be used to assign an actual race to an individual’s medical record.

Entities may, in some instances, want to aggregate granular ethnicity categories into broader ethnicity categories for analysis or to meet reporting requirements (e.g., aggregating all western European granular ethnicities into a broad “Western European” category). However, the granular ethnicity data should be retained in data systems when the data are shared and for use in future analysis, reporting, and service provision. The subcommittee notes that the Census ancestry code list groups ethnicities partially by geography (e.g., Western European [sans Spanish], South Asian, Sub-Saharan African) and partially by Hispanic ethnicity (e.g., Spanish, Central and South American, and West Indian).3 The Massachusetts Superset includes 31 broader ethnicity categories and 140 subethnicity categories. The sub-ethnicity categories can be aggregated to the broader ethnicity categories as needed for reporting and analysis. The subcommittee concluded though that these mid-level groups should not necessarily collapse into the OMB race categories.

The list of granular ethnicities presented below provides a baseline template for a national standard set of granular ethnicity categories. An entity can decide, based on local circumstances, whether to use 10 or 100 categories from the template for collection and/or analysis. If the entity sees an increase in the use of the “Other, please specify: __” option, it may consider adding categories to its local list. If an organization chooses not to have a preset list of categories, it will need to compile responses according to the template to ensure comparability with data collected by other entities.

3

U.S. Census Bureau. 2001. Ancestry code list. http://factfinder.census.gov/metadoc/ancestry.pdf (accessed June 18, 2009).

Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×

TABLE E-1 Template of Granular Ethnicity Category Lists and Coding Schemes with Rollup to the OMB Race and Hispanic Ethnicity Categories

OMB Race and Hispanic Ethnicity Category

Granular Ethnicity

CDC/HL7 Race and Ethnicity Code Set 1.0

Massachusetts Superseta

Census Ancestry Codesb

Kaiser Permanente Granular Ethnicity Code Setc

Asian

 

2028-9

X

X

 

 

Asian Indian

2029-7

Xa

X

X

 

Kashmir

 

 

X

 

 

Andaman Islander

 

 

X

 

 

Andhra Pradesh

 

 

X

 

 

Assamese

 

 

X

 

 

Goanese

 

 

X

 

 

Gujarati

 

 

X

 

 

Karnatakan

 

 

X

 

 

Keralan

 

 

X

 

 

Madhya Pradesh

 

 

X

 

 

Maharashtran

 

 

X

 

 

Madras

 

 

X

 

 

Mysore

 

 

X

 

 

Nagaland

 

 

X

 

 

Orissa

 

 

X

 

 

Pondicherry

 

 

X

 

 

Rajasthan

 

 

X

 

 

Sikkim

 

 

X

 

 

Tamil Nadu

 

 

X

 

 

Uttar Pradesh

 

 

X

 

 

Bhutanese

2031-3

X

X

 

 

Baram/Burman

 

 

 

X

 

Chinese

2034-7

Xa

X

X

 

Manchurian

 

 

X

 

 

Taiwanese

2035-4

X

X

X

 

Tagalog

 

 

 

X

 

Japanese

2039-6

Xa

X

X

 

Issei

 

 

X

 

 

Nisei

 

 

X

 

 

Sansei

 

 

X

 

 

Vonsei

 

 

X

 

 

Gonsei

 

 

X

 

 

Okinawan

2043-8

 

X

X

 

Iwo Jiman

2048-7

 

 

 

 

Korean

2040-4

Xa

X

X

 

Vietnamese

2047-9

Xa

X

X

 

Katu

 

 

X

 

 

Ma

 

 

X

 

 

Mnong

 

 

X

 

 

Kihn/Viet

 

 

 

X

 

Hmong

2037-0

X

X

X

 

Malay

 

 

 

X

 

Maldivian

2049-5

X

X

 

 

Singaporean

2051-1

X

X

X

 

Punjab

 

 

X

 

 

Cantonese

 

 

X

 

Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×

OMB Race and Hispanic Ethnicity Category

Granular Ethnicity

CDC/HL7 Race and Ethnicity Code Set 1.0

Massachusetts Superseta

Census Ancestry Codesb

Kaiser Permanente Granular Ethnicity Code Setc

 

Mongolian

 

 

X

 

 

Tibetan

 

 

X

 

 

Hong Kong

 

 

X

 

 

Macao

 

 

X

 

 

Ryukyu Islander

 

 

X

 

 

North Bornean

 

 

X

 

 

Formosan

 

 

X

 

 

Montagnard

 

 

X

 

 

Indo Chinese

 

 

X

 

 

Amerasian

 

 

X

 

 

Kazakh/Qazaq

 

 

 

X

 

Kazakhstani

 

 

 

X

 

Bangladeshi

2030-5

X

X

X

 

Nepalese/Nepali

2050-3

X

X

X

 

Bengali

 

 

X

X

 

Pakistani

2044-6

X

X

X

 

Sri Lankan

2045-3

X

X

X

 

Singhalese/Sinhalese

 

 

X

X

 

Veddah

 

 

X

 

 

Burmese

2032-1

X

X

X

 

Shan

 

 

X

 

 

Cambodian

2033-9

Xa

X

X

 

Khmer

 

 

X

X

 

Filipino

2036-2

Xa

X

X

 

Indonesian

2038-8

X

X

X

 

Bornean

 

 

X

 

 

Javanese/Jawa

 

 

X

X

 

Sumatra

 

 

X

 

 

Laotian/Lao

2041-2

Xa

X

X

 

Meo

 

 

X

 

 

Lao Loum/Lowland Lao

 

 

 

X

 

Malaysian

2042-0

X

X

X

 

Thai

2046-1

X

X

X

 

Black Thai

 

 

X

 

 

Western Lao

 

 

X

 

Black or African American

 

2054-5

X

 

 

 

Black

2056-0

X

X

 

 

African American

2058-6

Xa

X

 

 

African

2060-2

Xa

X

 

 

Botswanan

2061-0

X

X

 

 

Djibouti

 

X

X

 

 

Liberian

2063-6

X

X

X

 

Namibian

2064-4

X

X

 

 

Nigerian

2065-1

X

X

X

 

Fulani/Hausa

 

 

X

X

 

Ibo/Igbo

 

 

X

X

Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×

OMB Race and Hispanic Ethnicity Category

Granular Ethnicity

CDC/HL7 Race and Ethnicity Code Set 1.0

Massachusetts Superseta

Census Ancestry Codesb

Kaiser Permanente Granular Ethnicity Code Setc

 

Tiv

 

 

X

 

 

Voruba

 

 

X

X

 

Zairean

2066-9

X

X

 

 

Angolese

 

X

X

 

 

Benin

 

X

X

 

 

Burkina Faso

 

X

 

 

 

Burundi

 

X

X

 

 

Cameroonian

 

X

X

X

 

Central African Republic

 

X

X

 

 

Chad

 

X

 

 

 

Comoros

 

X

 

 

 

Congolese

 

X

X

X

 

Ivoirian/Cote d’Ivoire

 

X

X

X

 

Equatorial Guinea

 

X

X

 

 

Eritrean

 

X

X

X

 

Gabon

 

X

X

 

 

Gambian

 

X

X

 

 

Ghanaian/Ghanian

 

X

X

 

 

Guinea

 

X

X

 

 

Guinea-Bissau

 

X

X

 

 

Lesotho

 

X

X

 

 

Libyan

 

X

X

X

 

Malawi

 

X

X

 

 

Mali

 

X

X

 

 

Mauritanian

 

X

X

 

 

Mauritius

 

X

X

 

 

Mozambique

 

X

X

 

 

Reunion

 

X

 

 

 

Rwanda

 

X

X

 

 

Sao Tome and Principe

 

X

 

 

 

Senegalese/Senegal

 

X

X

 

 

Seychelles

 

X

 

 

 

Afrikaner

 

 

X

 

 

Natalian

 

 

X

 

 

Swazi

 

X

X

 

 

Tanzanian

 

X

X

X

 

Togolese

 

X

X

X

 

Ugandan

 

X

X

X

 

Western Sahara

 

X

 

 

 

Zambian

 

X

X

 

 

Zimbabwean

 

X

X

 

 

Congo Brazzaville

 

 

X

 

 

Corsico Islander

 

 

X

 

 

Niger

 

 

X

 

 

Zulu

 

 

X

 

 

Tanganyikan

 

 

X

 

Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×

OMB Race and Hispanic Ethnicity Category

Granular Ethnicity

CDC/HL7 Race and Ethnicity Code Set 1.0

Massachusetts Superseta

Census Ancestry Codesb

Kaiser Permanente Granular Ethnicity Code Setc

 

Zanzibar Islander

 

 

X

 

 

Upper Voltan

 

 

X

 

 

Volta

 

 

X

 

 

African Islander

 

 

X

 

 

Central African

 

 

X

 

 

Eastern African

 

 

X

 

 

Western African

 

 

X

 

 

Agikuyu/Kikuyu

 

 

 

X

 

Akan

 

 

 

X

 

Amara/Amhara

 

 

 

X

 

Bantu

 

 

 

X

 

Mende

 

 

 

X

 

Oromo

 

 

 

X

 

Shona

 

 

 

X

 

Temne/Temme/Themne

 

 

 

X

 

Tigrinya/Tigray/Tigraway

 

 

 

X

 

Barbadian/Bajan

2068-5

 

 

X

 

Dominica Islander

2070-1

X

X

 

 

Bermudan

 

 

X

 

 

Cayman Islander

 

 

X

 

 

U.S. Virgin Islander

 

 

X

X

 

St Croix Islander

 

 

X

 

 

St John Islander

 

 

X

 

 

St Thomas Islander

 

 

X

 

 

French West Indies

 

 

X

 

 

Guadeloupe Islander

 

 

X

 

 

Cayenne

 

 

X

 

 

Caribbean Islander

 

Xa

 

 

 

Antiguan/Burbudan

 

 

X

 

 

Nevis Islander/Kittitian/Nevisian

 

 

X

X

 

Grenadian

 

 

X

X

 

Vincent-Grenadine Islander

 

 

X

 

 

St Lucia Islander/Saint Lucian

 

 

X

X

 

Afro

 

 

X

 

 

Bahamian

2067-7

 

X

X

 

Jamaican

2072-7

X

X

X

 

Haitian

2071-9

Xa

X

X

 

Tobagoan

2073-5

X

 

 

 

Ethiopian

2062-8

X

X

X

 

Kenyan

 

X

X

X

 

Sierra Leonean

 

X

X

 

 

Somali

 

X

X

 

Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×

OMB Race and Hispanic Ethnicity Category

Granular Ethnicity

CDC/HL7 Race and Ethnicity Code Set 1.0

Massachusetts Superseta

Census Ancestry Codesb

Kaiser Permanente Granular Ethnicity Code Setc

Native Hawaiian or Other Pacific Islander

 

2076-8

X

 

X

 

Polynesian

2078-4

 

X

 

 

Kapingamarangan

 

 

X

 

 

Maori

 

 

X

X

 

Native Hawaiian/Hawaiian

2079-2

 

X

X

 

Part Hawaiian

 

 

 

X

 

Samoan

2080-0

 

X

X

 

Tahitian

2081-8

 

X

X

 

Tongan

2082-6

 

X

X

 

Tokelauan

2083-4

 

X

 

 

Micronesian

2085-9

 

X

 

 

Other Pacific Islander

2500-7

 

X

 

 

Guamanian or Chamorro

 

 

 

X

 

Guamanian

2087-5

 

X

 

 

Chamorro

2088-3

 

X

 

 

Mariana Islander

2089-1

 

 

 

 

Marshallese

2090-9

 

X

 

 

Palauan

2091-7

 

X

 

 

Carolinian

2092-5

 

X

 

 

Kosraean

2093-3

 

X

 

 

Pohnpeian/Ponapean

2094-1

 

X

 

 

Saipanese

2095-8

 

X

 

 

Kiribati/Kirabatese

2096-6

 

X

 

 

Chuukese/Trukese

2097-4

 

X

 

 

Yapese

2098-2

 

X

 

 

Melanesian

2100-6

 

X

 

 

Fijian

2101-4

 

X

X

 

Papua New Guinean

2102-2

 

 

 

 

New Guinean

 

 

X

 

 

Papuan

 

 

X

 

 

Solomon Islander

2103-0

 

X

 

 

New Hebrides

2104-8

 

 

 

 

Australian

 

 

X

X

 

Tasmanian

 

 

X

 

 

Australian Aborigine

 

 

X

 

 

New Zealander

 

 

X

X

 

Cook Islander

 

 

X

 

 

Niuean

 

 

X

 

 

Nauruan

 

 

X

 

 

Tarawa Islander

 

 

X

 

 

Tinian Islander

 

 

X

 

 

New Caledonian

 

 

X

 

 

Vanuatuan

 

 

X

 

 

Chamolinian

 

 

X

 

Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×

OMB Race and Hispanic Ethnicity Category

Granular Ethnicity

CDC/HL7 Race and Ethnicity Code Set 1.0

Massachusetts Superseta

Census Ancestry Codesb

Kaiser Permanente Granular Ethnicity Code Setc

White

 

2106-3

X

X

 

 

Anglo

 

 

X

 

 

European

2108-9

Xa

X

 

 

Central European

 

 

X

 

 

Southern European

 

 

X

 

 

English

2110-5

X

X

X

 

British/Briton

 

 

X

X

 

Channel Islander

 

 

X

 

 

Gibraltar

 

 

X

 

 

British Isles/British Isles origin

 

 

X

X

 

Portuguese

 

Xa

X

X

 

Cornish

 

 

X

 

 

Appalachian

 

 

X

 

 

Pennsylvania German

 

 

X

X

 

Canadian

 

 

X

X

 

Newfoundland

 

 

X

 

 

Nova Scotia

 

 

X

 

 

French Canadian

 

 

X

X

 

Acadian/Cajun

 

 

X

X

 

North American

 

 

X

 

 

French

2111-3

X

X

X

 

Lorraine

 

 

X

 

 

Breton

 

 

X

 

 

Occitan

 

 

X

 

 

German

2112-1

X

X

X

 

Bavaria

 

 

X

 

 

Berlin

 

 

X

 

 

Hamburg

 

 

X

 

 

Hannover

 

 

X

 

 

Hessian

 

 

X

 

 

Lubecker

 

 

X

 

 

Pomeranian

 

 

X

 

 

Saxon

 

 

X

 

 

Sudetenlander

 

 

X

 

 

Westphalian

 

 

X

 

 

East German

 

 

X

 

 

West German

 

 

X

 

 

Prussian

 

 

X

 

 

Irish

2113-9

X

X

X

 

North Irish

 

 

X

 

 

Italian

2114-7

X

X

X

 

Trieste

 

 

X

 

 

Abruzzi

 

 

X

 

 

Apulian

 

 

X

 

 

Basilicata

 

 

X

 

Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×

OMB Race and Hispanic Ethnicity Category

Granular Ethnicity

CDC/HL7 Race and Ethnicity Code Set 1.0

Massachusetts Superseta

Census Ancestry Codesb

Kaiser Permanente Granular Ethnicity Code Setc

 

Calabrian

 

 

X

 

 

Amalfin

 

 

X

 

 

Friulian

 

 

X

 

 

Emilia Romagna

 

 

X

 

 

Rome

 

 

X

 

 

Ligurian

 

 

X

 

 

Lombardian

 

 

X

 

 

Marche

 

 

X

 

 

Molise

 

 

X

 

 

Neapolitan

 

 

X

 

 

Piedmontese

 

 

X

 

 

Puglia

 

 

X

 

 

Sardinian

 

 

X

 

 

Tuscany

 

 

X

 

 

Trentino

 

 

X

 

 

Umbrian

 

 

X

 

 

Valle Daost

 

 

X

 

 

Venetian

 

 

X

 

 

San Marino

 

 

X

 

 

Ladin

 

 

X

 

 

Sicilian

 

 

X

 

 

Herzegovinian

 

X

X

X

 

Polish/Pole

2115-4

X

X

X

 

Kashubian

 

 

X

 

 

Scottish

2116-2

X

X

X

 

Greek

 

X

X

X

 

Cretan

 

 

X

 

 

Cyclades

 

 

X

 

 

Basque

 

 

X

X

 

French Basque

 

 

X

 

 

Spanish Basque

2146-9

 

X

 

 

Azores Islander

 

 

X

 

 

Madeira Islander

 

 

X

 

 

Alsatian

 

 

X

X

 

Andorran

 

 

X

 

 

Austrian

 

 

X

X

 

Tirol

 

 

X

 

 

Belgian

 

 

X

X

 

Walloon

 

 

X

 

 

Scotch Irish

 

 

X

X

 

Flemish/Fleming

 

 

X

X

 

Corsican

 

 

X

 

 

Cypriot

 

 

X

X

 

Greek Cypriot

 

 

X

 

 

Turkish Cypriot

 

 

X

 

 

Danish/Dane

 

 

X

X

 

Faeroe Islander

 

 

X

 

Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×

OMB Race and Hispanic Ethnicity Category

Granular Ethnicity

CDC/HL7 Race and Ethnicity Code Set 1.0

Massachusetts Superseta

Census Ancestry Codesb

Kaiser Permanente Granular Ethnicity Code Setc

 

Dutch

 

 

X

X

 

Frisian

 

 

X

 

 

Norwegian

 

 

X

X

 

Finnish/Finn

 

 

X

X

 

Karelian

 

 

X

 

 

Icelander

 

 

X

X

 

Lapp

 

 

X

 

 

Liechtensteiner

 

 

X

 

 

Luxemburger

 

 

X

X

 

Maltese

 

 

X

X

 

Manx

 

 

X

 

 

Monegasque

 

 

X

 

 

Swedish/Swede

 

 

X

X

 

Aland Islander

 

 

X

 

 

Swiss

 

 

X

X

 

Suisse

 

 

X

 

 

Switzer

 

 

X

 

 

Romansch

 

 

X

 

 

Suisse Romane

 

 

X

 

 

Welsh

 

 

X

X

 

Scandinavian

 

 

X

X

 

Celtic

 

 

X

X

 

Northern European

 

 

X

 

 

Western European

 

 

X

 

 

Bukovina

 

 

X

 

 

Silesian

 

 

X

 

 

Galician

 

 

X

 

 

Eastern European

 

Xa

X

 

 

Carpatho Rusyn

 

 

X

X

 

Carpathian

 

 

X

 

 

Rusyn

 

 

X

 

 

Albanian

 

X

X

X

 

Azerbaijani

 

X

X

X

 

Azeri

 

 

 

X

 

Belorussian/Belarusian

 

X

X

X

 

Bosniak

 

X

 

X

 

Bulgarian

 

X

X

X

 

Croatian/Croat

 

X

X

X

 

Czech

 

X

X

X

 

Moravian

 

 

X

 

 

Czechoslovakian

 

 

X

X

 

Georgian

 

X

X

X

 

Estonian

 

X

X

X

 

Livonian

 

 

X

 

 

Hungarian

 

X

 

X

 

Magyar

 

 

X

 

 

Latvian

 

X

X

X

Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×

OMB Race and Hispanic Ethnicity Category

Granular Ethnicity

CDC/HL7 Race and Ethnicity Code Set 1.0

Massachusetts Superseta

Census Ancestry Codesb

Kaiser Permanente Granular Ethnicity Code Setc

 

Lithuanian

 

X

X

X

 

Macedonian

 

X

X

X

 

Montenegrin

 

X

X

X

 

Romanian

 

X

X

X

 

Moldavian

 

X

X

X

 

Bessarabian

 

 

X

 

 

Wallachian

 

 

X

 

 

Serbian

 

X

X

X

 

Slovak

 

X

X

X

 

Slovene

 

X

X

X

 

Sorbian/Wend

 

 

X

 

 

Ukrainian

 

X

X

X

 

Lemko

 

 

X

 

 

Bioko

 

 

X

 

 

Husel

 

 

X

 

 

Russian

 

Xa

X

X

 

Muscovite

 

 

X

 

 

Ruthenian

 

 

X

 

 

Cossack

 

 

X

 

 

Bohemian

 

 

X

 

 

Finno Ugrian

 

 

X

 

 

Mordovian

 

 

X

 

 

Voytak

 

 

X

 

 

Gruziia

 

 

X

 

 

Soviet Turkic

 

 

X

 

 

Volga

 

 

X

 

 

Kalmyk

 

 

X

 

 

North Caucasian

 

 

X

 

 

North Caucasian Turkic

 

 

X

 

 

Ossetian

 

 

X

 

 

Bashkir

 

 

X

 

 

Chuvash

 

 

X

 

 

Gagauz

 

 

X

 

 

Mesknetian

 

 

X

 

 

Tuvinian

 

 

X

 

 

Yakut

 

 

X

 

 

Soviet

 

 

X

X

 

Tatar

 

 

X

 

 

Soviet Central Asia

 

 

X

 

 

Turkestani

 

 

X

 

 

Uzbeg/Uzbek

 

 

X

X

 

Uzbekistani

 

 

 

X

 

Lebanese

2123-8

X

X

X

 

Windish

 

 

X

 

 

Yugoslavian

 

 

X

X

 

Slavic

 

 

X

X

 

Tajik

 

 

X

 

 

Slavonian

 

 

X

 

Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×

OMB Race and Hispanic Ethnicity Category

Granular Ethnicity

CDC/HL7 Race and Ethnicity Code Set 1.0

Massachusetts Superseta

Census Ancestry Codesb

Kaiser Permanente Granular Ethnicity Code Setc

 

Middle Eastern or North African

2118-8

Xa

 

 

 

Syrian

2125-3

X

X

X

 

Baluchistan

 

 

X

 

 

Pathan/Pashtun

 

 

X

X

 

Israeli

2127-9

X

X

X

 

Algerian

 

X

X

X

 

Transjordan

 

 

X

 

 

Kurdish/Kurd

 

 

X

X

 

Persian

 

 

 

X

 

North African

 

 

X

 

 

Alhucemas

 

 

X

 

 

Berber/Amazigh/Imazighen

 

 

X

X

 

Rio de Oro

 

 

X

 

 

Bahraini

 

 

X

 

 

Kuwaiti

 

X

X

X

 

Omani

 

X

X

 

 

Qatar

 

X

X

 

 

Saudi/Saudi Arabian

 

X

X

X

 

Muscat

 

 

X

 

 

Trucial States

 

 

X

 

 

Bedouin

 

 

X

 

 

Kuria Muria Islander

 

 

X

 

 

South Yemen

 

 

X

 

 

Aden

 

 

X

 

 

United Arab Emirates/Emirati

 

X

X

X

 

Rom

 

 

X

 

 

Afghanistani/Afghan/Afghani

2126-1

X

X

X

 

Dutch West Indian

 

 

X

X

 

Egyptian

2120-4

X

X

X

 

Iranian

2121-2

X

X

X

 

Iraqi

2122-0

X

X

X

 

Jordanian

 

X

X

X

 

Armenian

2109-7

X

X

X

 

Turkish/Turk

 

 

X

X

 

Yemeni

 

X

X

X

 

Palestinian

2124-6

X

X

X

 

Gaza Strip

 

 

X

 

 

West Bank

 

 

X

 

 

Syriac

 

 

X

X

 

Assyrian

2119-6

X

X

X

 

Chaldean

 

 

X

X

 

Mideast

 

 

X

 

 

Arab/Arabic

2129-5

X

X

X

Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×

OMB Race and Hispanic Ethnicity Category

Granular Ethnicity

CDC/HL7 Race and Ethnicity Code Set 1.0

Massachusetts Superseta

Census Ancestry Codesb

Kaiser Permanente Granular Ethnicity Code Setc

American Indian or Alaska Native

 

1002-5

X

 

 

 

American Indian

1004-1

X

 

 

 

 

553 additional categories

 

 

52 additional categories

 

Alaska Native

1735-0

X

 

 

 

Alaska Indian

1737-6

X

 

 

 

 

271 additional categories

 

 

7 additional categories

No determinate OMB race classification

 

 

 

 

 

 

Brazilian

 

Xa

X

X

 

Cape Verdean

 

Xa

X

X

 

Belizean

 

X

X

X

 

Guyanese

 

X

X

X

 

German from Russian

 

 

X

X

 

Creole

 

 

X

X

 

American

 

Xa

X

X

 

Madagascan

2052-9

X

X

 

 

Tunisian

 

X

X

X

 

Surinam

 

 

X

 

 

Trinidadian

2074-3

X

X

X

 

West Indian

2075-0

X

X

X

 

British Virgin Islander

 

 

X

 

 

British West Indian

 

 

X

X

 

Moroccan

 

X

X

X

 

Dominican

2069-3

Xa

X

X

 

South African

 

X

X

 

 

Sudanese

 

X

X

X

 

Dinka

 

 

X

 

 

Nuer

 

 

X

 

 

Fur

 

 

X

 

 

Baggara

 

 

X

 

 

East Indian

 

 

X

X

 

Eurasian

 

 

X

 

Hispanic or Latino

 

2135-2

 

 

 

 

Latin American

 

 

X

 

 

Latino

 

 

X

 

 

Hispanic

 

 

X

 

 

Californio

 

 

X

 

 

Tejano

 

 

X

 

 

Nuevo Mexicano

 

 

X

 

 

Spanish American

 

 

X

 

 

Spanish/Spaniard

2137-8

X

X

X

 

Andalusian

2138-6

 

X

 

 

Asturian

2139-4

 

X

 

 

Castillian

2140-2

 

X

 

 

Catalonian

2141-0

 

X

 

Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×

OMB Race and Hispanic Ethnicity Category

Granular Ethnicity

CDC/HL7 Race and Ethnicity Code Set 1.0

Massachusetts Superseta

Census Ancestry Codesb

Kaiser Permanente Granular Ethnicity Code Setc

 

Belearic Islander

2142-8

 

X

 

 

Gallego

2143-6

 

X

 

 

Valencian

2144-4

 

X

 

 

Canarian

2145-1

 

X

 

 

Salvadoran

2161-8

Xa

X

X

 

Central American

2155-0

Xa

X

 

 

Costa Rican

2156-8

X

X

X

 

Nicaraguan

2159-2

X

X

X

 

Panamanian

2160-0

X

X

X

 

Canal Zone

2163-4

 

X

 

 

Central American Indian

2162-6

X

X

X

 

Guatemalan

2157-6

Xa

X

X

 

Honduran

2158-4

Xa

X

X

 

Mexican

2148-5

Xa

X

X

 

La Raza

2152-7

X

X

 

 

Mexican American

2149-3

X

X

 

 

Mexicano

2150-1

X

X

 

 

Chicano

2151-9

X

X

 

 

Mexican American Indian

2153-5

X

X

X

 

Mexican State

 

 

X

 

 

South American

2165-9

Xa

X

 

 

Argentinean/Argentine

2166-7

 

X

X

 

Bolivian

2167-5

 

X

X

 

Chilean

2168-3

 

X

X

 

Colombian

2169-1

Xa

X

X

 

Ecuadorian

2170-9

 

X

X

 

Paraguayan

2171-7

 

X

X

 

Peruvian

2172-5

 

X

X

 

Uruguayan

2173-3

 

X

X

 

Venezuelan

2174-1

 

X

X

 

South American Indian

2175-8

X

X

X

 

Criollo

2176-6

 

X

 

 

Puerto Rican

2180-8

Xa

X

X

 

Cuban

2182-4

Xa

X

X

Other ethnicity

 

2131-1

Xa

 

 

a The Massachusetts Superset includes 31 ethnicity categories and additional “sub-ethnicities” that are not required for reporting but that an organization can collect, if useful. Acute care hospitals and health plans are required to report the basic OMB race categories along with the 31 granular ethnicity categories noted in this table with a footnote (a).

b The Census Ancestry codes do not roll up to the OMB race and Hispanic ethnicity categories. There are grouped into more broad categories based on geography: Western Europe, Eastern Europe and Soviet Union, Europe, Hispanic (including Spain), West Indies (except Hispanic), Central and South America (except Hispanic), sub-Saharan African, South Asia, Other Asia, Pacific, and North America (except Hispanic).

c The Kaiser Permanente list also includes “Jew/Jewish.”

Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×

This page intentionally left blank.

Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×
Page 183
Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×
Page 184
Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×
Page 185
Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×
Page 186
Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×
Page 187
Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×
Page 188
Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×
Page 189
Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×
Page 190
Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×
Page 191
Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×
Page 192
Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×
Page 193
Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×
Page 194
Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×
Page 195
Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×
Page 196
Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×
Page 197
Suggested Citation:"Appendix E: Subcommittee Template: Developing a National Standard Set of Granular Ethnicity Categories and a Rollup Scheme." Institute of Medicine. 2009. Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement. Washington, DC: The National Academies Press. doi: 10.17226/12696.
×
Page 198
Next: Appendix F: Granular Ethnicities with No Determinate OMB Race Classification »
Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement Get This Book
×
Buy Paperback | $65.00 Buy Ebook | $54.99
MyNAP members save 10% online.
Login or Register to save!
Download Free PDF

The goal of eliminating disparities in health care in the United States remains elusive. Even as quality improves on specific measures, disparities often persist. Addressing these disparities must begin with the fundamental step of bringing the nature of the disparities and the groups at risk for those disparities to light by collecting health care quality information stratified by race, ethnicity and language data. Then attention can be focused on where interventions might be best applied, and on planning and evaluating those efforts to inform the development of policy and the application of resources. A lack of standardization of categories for race, ethnicity, and language data has been suggested as one obstacle to achieving more widespread collection and utilization of these data.

Race, Ethnicity, and Language Data identifies current models for collecting and coding race, ethnicity, and language data; reviews challenges involved in obtaining these data, and makes recommendations for a nationally standardized approach for use in health care quality improvement.

  1. ×

    Welcome to OpenBook!

    You're looking at OpenBook, NAP.edu's online reading room since 1999. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.

    Do you want to take a quick tour of the OpenBook's features?

    No Thanks Take a Tour »
  2. ×

    Show this book's table of contents, where you can jump to any chapter by name.

    « Back Next »
  3. ×

    ...or use these buttons to go back to the previous chapter or skip to the next one.

    « Back Next »
  4. ×

    Jump up to the previous page or down to the next one. Also, you can type in a page number and press Enter to go directly to that page in the book.

    « Back Next »
  5. ×

    Switch between the Original Pages, where you can read the report as it appeared in print, and Text Pages for the web version, where you can highlight and search the text.

    « Back Next »
  6. ×

    To search the entire text of this book, type in your search term here and press Enter.

    « Back Next »
  7. ×

    Share a link to this book page on your preferred social network or via email.

    « Back Next »
  8. ×

    View our suggested citation for this chapter.

    « Back Next »
  9. ×

    Ready to take your reading offline? Click here to buy this book in print or download it as a free PDF, if available.

    « Back Next »
Stay Connected!