TABLE 3-1 OMB Race and Hispanic Ethnicity Categories According to a One- and Two-Question Format

Responses for Hispanic ethnicity in two-question format

Hispanic or Latino

Not Hispanic or Latino

Responses for race in two-question format

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander (NHOPI)

White

Responses to a single question combining race and Hispanic ethnicity (one-question format)

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

Native Hawaiian or Other Pacific Islander (NHOPI)

White

SOURCE: OMB, 1997b.

analyses of aggregated data (Sequist and Schneider, 2006). While progress has been made in the past few years to incorporate the existing national standard set of categories promulgated by OMB (see Table 3-1) into the collection and presentation of data, many data collection efforts still do not fully employ these basic standard categories.

All health and health care entities are not required to collect data on race and ethnicity, but if they do, the OMB categories are the minimum that a federal agency or recipient of federal funds must include in its categorization and reporting. The OMB standards have acknowledged imperfections, though. The categories are often, as shown by the literature review in Chapter 2, too broad for effectively identifying and targeting disparities in health and health care. Additionally, a substantial portion of Hispanics do not relate to the race options, leading to many Hispanics being reported in Census data as “Some other race” because they do not choose any of the five OMB race categories (del Pinal et al., 2007; NRC, 2006; OMB, 1997a). While OMB allows two formats for the race and Hispanic ethnicity questions—one combining both race and Hispanic ethnicity in a single question and the other asking about them in two separate questions, with the Hispanic ethnicity question being asked first (Table 3-1)—OMB explicitly prefers the latter two-question format (OMB, 1997b). As discussed later in the chapter, the format used may have implications for Hispanic response rates (Baker et al., 2006; Laws and Heckscher, 2002; Taylor-Clark, 2009).

This chapter examines approaches to categorizing race and ethnicity by (1) reviewing the current state of standardized collection of race and ethnicity data, with a focus on the sufficiency of the OMB categories and their uptake in various areas of health care data collection; (2) examining the utility of the continued use of the current OMB categories; and (3) considering how the OMB race and Hispanic ethnicity categories can be combined with locally tailored, more detailed ethnicity categories selected from a national standard set, with standardized coding and rollup procedures, to capture important variations among ethnic groups. The chapter concludes by exploring approaches to eliciting responses on race, Hispanic ethnicity, and granular ethnicity, and reviewing models for data collection.

CURRENT STATE OF STANDARDIZED COLLECTION OF RACE AND ETHNICITY DATA

As previously noted, a variety of entities, many of which fall under the purview of the Department of Health and Human Services’ (HHS’) 1997 inclusion policy, collect race and ethnicity data for a variety of purposes. The HHS inclusion policy mandates the collection of at least OMB race and Hispanic ethnicity data in specific circumstances, such as in administrative records, surveys, research projects, and contract proposals associated with direct



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