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IHS Signs New Agreement Supporting Information-Sharing to Tribal Organization

by Lisa Neel, Director of the IHS Tribal Epidemiology Center Program

The Indian Health Service and the Northwest Portland Area Indian Health Board’s Northwest Tribal Epidemiology Center recently signed an agreement supporting a new information-sharing project.

The mission of the Northwest Tribal Epidemiology Center is to collaborate with American Indian tribes in the Northwest to provide health-related research, surveillance, training, and technical assistance to improve the quality of life of American Indians and Alaska Natives.  This complements the IHS mission of raising the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level.

In public health administrative records, American Indians and Alaska Natives are often misidentified as another race. This is known as racial misclassification.  In the Northwest, the Northwest Tribal Epidemiology Center has found that approximately 10 percent of American Indian and Alaska Native birth and death records and up to 60 percent of hospitalization records are misclassified, which makes it hard to accurately measure and describe the health status of Native people.  For example, if an individual is incorrectly listed as another race, the numbers of American Indians and Alaska Natives affected by a disease may appear lower or higher than they actually are. Without accurate health data, tribes cannot make the most informed decisions on how to best serve their people.

Racial misclassification can be a problem in many public records, including:

  • birth certificates,
  • cancer registries,
  • death certificates,
  • emergency department and hospitalization records, and
  • injury reports.

The data-sharing agreement will allow the IHS to provide the Northwest Tribal Epidemiology Center with a list of people who have received health services at IHS, tribal, and urban Indian health programs in the Portland Area.  The list does not include any information about patients’ medical histories and it will not be shared anywhere outside of the Northwest Tribal Epidemiology Center.  The center will compare this list with outside information sources, such as state cancer registries and death records, to check for racial misclassification.  The corrected information will provide more accurate health data to Northwest tribes. 

This activity supports the one of the three major goals of the IHS Strategic Plan, to strengthen IHS program management and operations. Specifically, the Strategic Plan includes the objective of modernizing information technology and information systems to support data driven decisions, and a strategy of data sharing to solidify partnerships with tribal and urban epidemiology centers and other tribal programs and urban Indian organizations.

IHS has planned for this to serve as a pilot project, creating the possibility that other tribal epidemiology centers will launch similar projects in the future.

Related content:

Tribal Epidemiology Centers (TECs)

Division of Epidemiology and Disease Prevention

IHS Locations


Lisa Neel, Director of the IHS Tribal Epidemiology Center Program
Lisa Neel, a citizen of the Cherokee Nation, is the Director of the IHS Tribal Epidemiology Center Program. Lisa has a Master of Public Health degree with an emphasis on maternal and child health from George Washington University and has worked in American Indian and Alaska Native public health for more than fifteen years.