. "2 The Burden of Cancer Among Ethnic Minority and the Medically Underserved Populations." The Unequal Burden of Cancer: An Assessment of NIH Research and Programs for Ethnic Minorities and the Medically Underserved. Washington, DC: The National Academies Press, 1999.
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Reporting" (U.S. Office of Management and Budget, 1997; see Box 2-1). Directive No. 15 requires that all federal agencies collect and report demographic data according to a limited number of racial and ethnic categories, despite criticism that such a classification scheme fails to recognize the increasing ethnic diversity of the U.S. population (U.S. Bureau of the Census, 1998a).
Definitions of race, ethnicity, or origin are not included within the Directive, although the categories and inclusion criteria for the categories are given. OMB specifies four minimum categories for race, which include American Indian or Alaska Native, black or African American, white, and Asian or Pacific Islander. The two categories for data on ethnicity are Hispanic or Latino and Not Hispanic or Not Latino. The latest revisions to the Directive separated the Asian or Pacific Islander populations into two categories, and the term "Hispanic" was changed to "Hispanic or Latino." OMB recommends that these new revisions of the categories be adopted by other federal programs as soon as possible, but the official deadline for adoption of the requirement is January 1, 2003. Modifications to Directive No. 15 were made at the recommendation of the Interagency Committee for the Review of the Racial and Ethnic Standards, which suggested that changes are needed to reflect the nation's population (U.S. Bureau of the Census, 1998a).
A number of scientific and professional organizations have criticized the Directive, stating that the standards lack scientific utility and do not encompass the diverse range of peoples in the United States. For example, the American Anthropological Association (AAA) has commented that OMB has noted the absence of "scientific or anthropological" foundations in developing its categories (American Anthropological Association, 1997). However, the race and ethnicity categories of the Directive are regularly used in federally sponsored scientific research and the interpretations of the findings are often based on the variables of race and ethnicity. (The scientific utility of the concept of race and its use in epidemiologic and health research will be discussed later in this chapter.) AAA also criticized the fact that Directive No. 15 did not explain what is meant by "race" or "origin" or the difference between the two concepts.
In addition, it is not clear whether the race or origins of people were to be chosen by the individual respondent (self-identification) or by others such as interviewers. Many discrepancies in these two methods may arise in the process of sampling populations, although the Bureau of the Census department disagrees (Sink, 1997). In the U.S. census, respondents are allowed to self-identify their racial and ethnic background. In other health research, however, both methods may be used. Further, it is unclear what the impact will be for the reporting of health statistics for population groups of the policy change in the year 2000 census allowing