Issue Brief 17

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BackgroundAs discussed in the companion to this issue brief1, each

of the federal surveys measures race and ethnicity in a

different way, albeit following certain minimum standards

established by the Office of Management and Budget (OMB).

The surveys also differ on study design aspects such as

target population, sample design, year and frequency of data

collection, and sample size. Exhibit 2 provides an overview of

each survey with respect to frequency of data collection, target

population, the most recent public use data available, and

overall sample size.

Race Data AvailabilityWhile race and ethnicity may be measured at a high level

of detail, this level of detail may not always be available for

data analysis. Race data available in public-use files are often

restricted for confidentiality reasons. As described in our

IntroductionPublicly available data for populations defined by race,

ethnicity, or immigrant group (REI) are necessary

for monitoring disparities in healthcare coverage

and access. In SHADAC’s companion issue brief,

“Measurement of Race, Ethnicity, and Immigrant

Groups in Federal Surveys,”1 we reviewed the way that

selected federal surveys collect information on race,

ethnicity, and immigrant groups and found a relatively

comprehensive collection of measures. Although

detailed information on race and ethnicity are collected

in most surveys, the data available in public-use files

are much more restricted. This brief focuses on the

availability of public use data for race, ethnicity and

immigrant group identifiers.

Policy decisions, funding decisions, and programs to

address disparities typically occur at state and local

levels, but availability of data to inform these initiatives

is problematic at these geographic levels. This brief

provides a review of public use data from selected

federal surveys that collect information on health

insurance coverage and access to care, with attention to

the feasibility of state or local level disparities research.

The general population surveys included in this

assessment are the same surveys assessed in the

companion brief mentioned above.1 These surveys all

measure health insurance coverage and access to care

on an annual or periodic basis. These surveys and their

associated agencies are listed in Exhibit 1.

Data Availability for Race, Ethnicity, and Immigrant Groups in Federal Surveys

July 2009

Census Bureau › CPS: Current Population Survey, 2007› SIPP: Survey of Income and Program Participation, 2004

National Center for Health Statistics› NHIS: National Health Interview Survey, 2007› NHANES: National Health and Nutrition Examination Survey, 2005-2006› NSCH: National Survey of Children’s Health, 2003-2004

Centers for Disease Control and Prevention› BRFSS: Behavioral Risk Factor Surveillance System, 2007

Agency for Healthcare Research and Quality› MEPS: Medical Expenditure Panel Survey – Household Component, 2006

Exhibit 1: Federal Surveys Examined in This Issue Brief

Exhibit 2: Public Use Data Files Examined in This Issue BriefSurvey Periodicity Target Population Most Recent Year of Data Total Observations

CPS Annual Civilian, non-institutionalized U.S. population 2007 206,639

SIPP Panel Civilian, non-institutionalized U.S. population 2004 (wave 1) 441,849

NHIS Annual Civilian, non-institutionalized U.S. population 2007 75,764

NHANES Periodic Civilian, non-institutionalized U.S. population 2005-06 10,348

NSCH Periodic U.S. children < 18 years 2003-04 102,353

BRFSS Annual U.S. adults > 18 years 2007 430,912

MEPS Panel Civilian, non-institutionalized U.S. population 2006 33,961

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› NSCH identifies two single race categories (White and

Black) with a residual other for all states. However, AIAN,

Asian, and NHOPI can be identified for selected states.

› MEPS identifies all five OMB categories for single race

individuals and a residual multiple race category for those

who identified more than one race.

› CPS identifies all five single race categories but also

provides detailed identifiers for many multiple race

combinations.

› BRFSS and NHIS each provide several race variables,

allowing researchers to choose single race categories with

a residual multiple race category or a recode that allocates

multiple race individuals to a race category based on self-

identified preferred race. The NHIS is the only public use

data file with an expanded race variable distinguishing

some Asian subgroups.

Ethnicity Data AvailabilityIn federal surveys, ethnicity refers to Hispanic ethnicity.

The minimum OMB standard for collecting data on ethnicity

includes the following response options: 1) Hispanic/Latino

or 2) Not Hispanic/Latino. Some of the federal surveys we

reviewed collected more information allowing respondents

to specify detailed categories of Hispanic origin (e.g.,

companion brief, the minimum OMB standard for measuring

race is to include: White, American Indian or Alaska Native

(AIAN), Asian, Black or African American, and Native Hawaiian

or other Pacific Islander (NHOPI). Furthermore, respondents

are allowed to select one or more race.

Most of the surveys reviewed in the brief have collected

more detailed information than the OMB minimum standard,

although this level of detail is not necessarily available for

public use. All eight surveys allowed respondents to select

one or more races. For those who select more than one

race, three surveys (NHANES, NHIS, BRFSS) ask a follow-

up question regarding which of the multiple races “best”

identifies the respondent. Exhibit 3 shows race groups

identified in the public use data with unweighted sample

sizes for each group by survey.

In summary:

› NHANES provides a single variable combining responses

to the ethnicity and race questions. It is therefore only

possible to distinguish non-Hispanic White, non-Hispanic

Black, and non-Hispanic Other from all Hispanics.

› SIPP identifies three single race categories (White, Black,

Asian) and a residual other category that includes AIAN,

NHOPI, and multiple race individuals.


Exhibit 3: Unweighted Sample Size for Race Groups in Public Use Data for Selected Federal Surveys

CPS SIPP NHANES NHIS NSCH BRFSS MEPS 2007 2004 2005/06 2007 2003/04 2007 2006

White 164,839 350,093 3,928 56,827 76,403 354,481 25,625

Black 23,532 57,292 2,710 11,813 10,134 34,644 6,097

AIAN 2,793 893 1,017* 6,953 300

Asian 9,208 15,400 4,730 798* 6,657 1,298

Asian Indian 813*

Chinese 1,013*

Filipino 1,180*

Other Asian 1,784*

NHOPI 908 397* 1,170 126

Other 19,064 514 124 4,499 14,743

Multiple 5,359~ 1,377 4,407 8,074 699

Unknown 3,196 6,910 4,190

* Some groups are double-counted in this table. Asian subgroups in NHIS are included in the "Asian" category for NHIS. Asian, AIAN, NHOPI groups in NSCH are included in the "other" category for NSCH.

~ CPS has detailed identifiers for many multiple race combinations.

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corresponding unweighted sample sizes for each group

within surveys.

Unlike data on race and ethnicity, immigrant group data

are limited across the surveys. Two surveys, BRFSS and

the MEPS, do not identify respondents’ place of birth and

consequently provide no data on immigrant group. Two

surveys (SIPP, NSCH) identify whether the respondent was

born in the U.S. or not, while the NHANES distinguishes

those born in the U.S., Mexico, or elsewhere. The NHIS

distinguishes those who are U.S. born from those born in 10

broad global regions including a residual foreign-born category.

Regions identified in the NHIS public use files are based on

countries’ geographic proximity to one another. The CPS

provides the most detailed information for immigrant groups.

In the 2007 CPS data, 149 countries of origin are identified for

respondents. Moreover, detailed country of origin is identified

for mothers and fathers of each respondent in the CPS.

State and Local Level DataSample sizes for race, ethnic or immigrant groups also vary

depending on the state or the REI group of interest. Even

Mexican, Cuban, Puerto Rican, etc.). Exhibit 4 shows ethnicity

group identifiers in the public use data and corresponding

unweighted sample sizes for each survey.

Similar to race data, the level of detail for Hispanic ethnicity

available in the public use files varied across surveys. Three

surveys (SIPP, NSCH, BRFSS) only distinguish Hispanic from

non-Hispanic, while the NHANES additionally distinguishes

Mexican from other Hispanic and non-Hispanic. The CPS,

NHIS, and MEPS provide additional detail on Hispanic origin

so Hispanic subgroups can be disaggregated.

Immigrant Group Data AvailabilityThe term “immigrant” is used here to broadly represent

the distinction between U.S. born and foreign born, and

more specifically to identify foreign-born groups by country

of origin. There are no OMB standards for the collection of

data on immigrant groups. We reviewed data files for each

survey to determine whether respondents could be grouped

as U.S. or foreign born, as well as the availability of detailed

information on country of origin for those identified as foreign

born. Exhibit 5 shows the immigrant group data availability and

Exhibit 4: Unweighted Sample Size for Ethnicity Groups in Public Use Data for Selected Federal Surveys

CPS SIPP NHANES NHIS NSCH BRFSS MEPS

2007 2004 2005/06 2007 2003/04 2007 2006

Not Hispanic or Latino 172,456 392,472 7,152 56,976 88,996 397,547 24,745

Hispanic or Latino 49,377 13,357 31,310

Mexican/Mexican-American 21,648 2,847 7,053

Mexican 6,596

Mexican-American 5,843

Puerto Rican 3,115 1,644 634

Cuban/Cuban-American 1,131 655 254

Dominican (Republic) 500 225

Central or South American 6,196 2,762 902

Other Latin American 39 133

Other Hispanic/Latino/Spanish 2,093 349 342 199

Multiple Hispanic 407

Unknown 2055

Note: Some ethnic categories on this table do not correspond exactly with the categories in Exhibit 3 in our companion issue brief. This is likely due to editing of “other” responses, but specific information has not been provided in the survey documentation.

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Exhibit 5: Unweighted Sample Size for Immigrant Groups in Public Use Data for Selected Federal Surveys

CPS SIPP NHANES NHIS NSCH BRFSS MEPS

2007 2004 2005/06 2007 2003/04 2007 2006

U.S. Born 178,745 394,835 8,799 61,425 97,666 N/A N/A

Foreign Born 47,014 3,738

Mexico, C. America, Caribbean 13,839 8,008

Mexico 961

South America 1,880 877

Europe 2,666 968

Russia 532 198

Africa 834 390

Middle East 519 191

India 1,250 640

Asia 2,116 863

SE Asia 2,859 1,446

Elsewhere 1,399 588 302

Unknown 456 949

NOTE: CPS has 149 countries identified. These were recoded for this table following NHIS categories.

Given that many decisions regarding coverage and access to

care are made at the state and local levels, having good data

to inform practice and policy recommendations and to evaluate

the impact for local REI populations is critical. This paucity of

state and local data for REI groups from the federal surveys

underscores the need for renewed initiatives to improve data

collection and data availability to support state and local level

activities to eliminate health disparities.

Suggested Citation

State Health Access Data Assistance Center. 2009. “REI: Data

availability for Race, Ethnicity, and Immigrant Groups in Federal

Surveys.” Issue Brief #17. Minneapolis, MN: University

of Minnesota.

References1 State Health Access Data Assistance Center. 2009. “REI:

Measurement of Race, Ethnicity, and Immigrant Groups

in Federal Surveys.” Issue Brief #16. Minneapolis, MN:

University of Minnesota.

with publicly available geographic identifiers, the sample sizes

for specific REI groups at lower levels of geography may be

compromised. For example, BRFSS has relatively large samples

of AIAN (n=6,953) and Asian (n=6,657) subpopulations.

However, in Minnesota there are only 27 AIAN and 54 Asian

respondents in the 2007 sample, precluding comprehensive

disparities research for this state that has a large Asian

immigrant population and one of the larger American Indian

populations. Appendix A to this brief shows unweighted sample

sizes for selected REI groups by state for the four surveys that

contain state identifiers in the public use files.

ConclusionsThe U.S. has rich and varied data resources to study health,

healthcare access and health disparities. Yet, there is no

ideal federal survey that will allow for state-level analysis of

disparities in health insurance coverage and access to care

measures for a comprehensive group of disparities populations

defined by race, ethnicity or immigrant group. We believe more

effort must be made to collect and release data that allow for

state-level disparities analysis.

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African American/Black alone AIAN aloneCPS SIPP NSCH BRFSS CPS SIPP NSCH BRFSS

2007 2004 2003 2007 2007 2004 2003 2007Alabama 691 2,948 474 2,018 2 70

Alaska 106 44 56 30 309 270 496

Arizona 101 404 41 83 145 82 166

Arkansas 404 496 243 472 51 79

California 1,178 2,533 142 246 189 100

Colorado 199 329 56 259 47 187

Connecticut 399 938 149 456 10 44

Delaware 630 220 406 461 12 26

Dist. Columbia 1,443 424 1,137 1,654 15 25

Florida 1,324 3,307 289 3,428 26 483

Georgia 1,501 2,947 474 1,438 8 62

Hawaii 22 48 63 31 16 6

Idaho 5 24 12 16 29 69

Illinois 932 2,060 271 509 13 26

Indiana 331 1,232 133 706 12 43

Iowa 123 180 46 82 23 21

Kansas 217 300 67 269 23 80

Kentucky 223 944 119 231 4 38

Louisiana 653 2,550 616 1,338 2 67

Maine 37 27 9 28 18 66

Maryland 1,374 3,497 540 1,331 9 68

Massachusetts 211 732 107 1,074 11 162

Michigan 728 2,119 305 1,242 16 56

Minnesota 243 562 51 120 43 27

Mississippi 826 2,423 655 2,526 28 38

Missouri 429 1,349 199 432 11 57

Montana 10 51 3 18 145 120 404

Nebraska 113 76 44 81 35 88

Nevada 284 96 125 115 44 63

New Hampshire 36 4 9 30 13 52

New Jersey 565 2,264 249 700 18 43

New Mexico 80 60 43 68 297 132 570

New York 1,562 3,210 297 556 24 53

North Carolina 888 1,888 371 2,151 105 259

North Dakota 20 34 11 10 251 92 360

Ohio 752 1,783 232 821 9 68

Oklahoma 264 564 116 442 240 190 487

Oregon 52 308 27 28 81 58

Pennsylvania 623 1,321 200 1,351 3 85

Rhode Island 174 28 110 140 22 46

South Carolina 839 2,841 564 2,143 8 77

South Dakota 41 0 7 16 143 131 606

Tennessee 379 1,476 241 563 24 22

Texas 1,151 2,946 216 1,142 94 222

Utah 11 4 10 21 20 56

Vermont 16 33 12 19 9 54

Virginia 870 4,480 348 755 12 57

Washington 107 356 60 326 41 363

West Virginia 127 64 48 79 1 23

Wisconsin 211 744 113 596 61 119

Wyoming 27 24 18 27 21 101

U.S. territories 1,966 55

TOTAL 23,532 57,292 10,134 34,644 2,793 N/A 1,017 6,953

Appendix A: Unweighted Sample Size for Selected REI Groups by Survey and State

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Asian alone NHOPI aloneCPS SIPP NSCH BRFSS CPS SIPP NSCH BRFSS

2007 2004 2003 2007 2007 2004 2003 2007Alabama 22 12 17 0 2

Alaska 132 24 43 43 15

Arizona 53 236 60 18 18

Arkansas 22 32 15 0 3

California 2,188 4,114 112 439 151 49

Colorado 95 260 129 8 23

Connecticut 151 263 152 5 21

Delaware 134 44 37 0 10

Dist. Columbia 62 16 81 2 6

Florida 147 292 239 13 63

Georgia 133 280 80 1 9

Hawaii 1,448 592 470 2,093 418 397 127

Idaho 24 20 28 7 5

Illinois 360 500 99 6 7

Indiana 25 160 23 0 5

Iowa 90 128 32 5 7

Kansas 81 136 57 2 6

Kentucky 31 108 8 2 1

Louisiana 17 68 40 2 8

Maine 21 0 19 3 6

Maryland 250 657 160 13 15

Massachusetts 190 563 417 0 31

Michigan 114 368 60 0 7

Minnesota 179 244 54 1 2

Mississippi 15 28 17 0 5

Missouri 50 96 27 6 5

Montana 15 4 16 2 20

Nebraska 57 40 31 5 4

Nevada 217 116 66 35 22

New Hampshire 74 64 51 2 8

New Jersey 437 1,085 97 221 7 15

New Mexico 29 33 51 5 7

New York 668 1,375 53 135 1 15

North Carolina 77 188 101 0 21

North Dakota 22 4 18 0 8

Ohio 68 163 53 4 7

Oklahoma 17 40 48 2 10

Oregon 103 260 62 22 11

Pennsylvania 101 280 89 4 12

Rhode Island 106 56 37 3 4

South Carolina 24 152 49 1 6

South Dakota 28 16 11 4 8

Tennessee 40 116 22 4 8

Texas 352 622 233 4 43

Utah 65 52 44 71 17

Vermont 51 0 26 0 5

Virginia 259 528 96 6 21

Washington 259 733 66 479 16 83

West Virginia 14 28 11 0 1

Wisconsin 72 204 30 3 10

Wyoming 19 0 15 1 8

U.S. territories 236 340

TOTAL 9,208 15,400 798 6,657 908 N/A 397 1,170

Appendix A (continued)

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Hispanic ForeignCPS SIPP NSCH BRFSS CPS SIPP NSCH BRFSS

2007 2004 2003 2007 2007 2004 2003 2007Alabama 80 52 93 108 98 124 40

Alaska 143 4 130 65 225 20 60

Arizona 1,208 3,384 772 1,073 535 1,768 144

Arkansas 186 244 149 177 132 156 42

California 8,543 12,864 1,072 1,282 5,886 9,412 186

Colorado 1,101 1,573 464 1,374 516 1,064 108

Connecticut 651 826 293 552 731 1,020 123

Delaware 297 56 213 85 359 64 75

Dist. Columbia 299 20 282 221 396 104 117

Florida 2,414 3,192 545 3,254 2,163 3,588 180

Georgia 455 744 180 165 563 988 78

Hawaii 304 96 340 478 687 320 111

Idaho 319 216 244 298 154 132 50

Illinois 1,098 1,788 366 303 1,011 1,628 78

Indiana 216 912 135 201 151 724 46

Iowa 254 100 129 133 207 280 52

Kansas 287 693 227 361 199 460 49

Kentucky 76 171 88 83 99 360 47

Louisiana 69 165 110 189 75 188 19

Maine 26 28 39 58 110 96 36

Maryland 444 288 195 269 721 1,444 95

Massachusetts 293 637 251 1,670 505 1,764 92

Michigan 272 432 155 134 299 840 65

Minnesota 307 489 116 53 405 756 53

Mississippi 53 60 70 109 55 84 29

Missouri 122 304 111 69 133 336 34

Montana 68 20 87 93 52 40 32

Nebraska 341 140 178 423 240 144 45

Nevada 955 571 680 515 709 364 137

New Hampshire 141 28 71 92 301 108 61

New Jersey 940 1,440 425 688 1,132 2,772 122

New Mexico 1,061 797 992 2,193 214 300 88

New York 1,844 1,989 388 496 2,134 3,380 103

North Carolina 336 646 196 596 336 836 65

North Dakota 81 4 64 57 65 40 33

Ohio 246 259 113 150 248 456 41

Oklahoma 180 525 214 331 121 320 62

Oregon 288 896 313 198 294 892 108

Pennsylvania 292 504 138 243 333 832 56

Rhode Island 459 61 370 329 515 160 118

South Carolina 127 400 140 164 137 468 55

South Dakota 107 48 68 87 106 24 25

Tennessee 139 278 101 58 156 416 29

Texas 5,211 8,785 929 5,344 2,052 3,778 148

Utah 459 224 200 322 321 172 52

Vermont 27 0 46 104 149 16 50

Virginia 402 480 205 217 613 1,388 93

Washington 406 1,266 277 1,188 468 1,768 93

West Virginia 15 4 45 45 26 36 18

Wisconsin 276 602 144 106 225 564 62

Wyoming 265 72 204 228 89 20 33

U.S. territories 4,279

TOTAL 34,183 49,377 13,357 31,310 27,451 47,014 3,738 N/A

Appendix A (continued)

Issue Brief 17

Documents

Transcript of Issue Brief 17