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also represents barriers to follow-up. Researchers have also documented aspects of Latino culture and values that need to be taken into consideration when conducting research with this population, including the centrality of family and the importance of provider relationships that foster confianza, respeto, and dignidad (trust, respect, and dignity). Reassuring confidentiality and privacy is also important when conducting research on populations, which may be distrustful of government agencies and disclosing private information (Gilliss et al. 2001). Although legal status may play an important role in access to health care, collection of this information without additional safeguards to protect confidentiality and privacy could endanger the health and well-being of research participants or service recipients (Carter-Pokras and Zambrana 2006). Selection Criteria Cohort studies such as the Hispanic Community Health Study often use the National Death Index (NDI), a centralized electronic database containing death information from U.S. death certificates maintained by the National Center for Health Statistics, to help identify deaths among participants (see http://www for more information). Seven NDI selection criteria are used to score whether a submitted record is a match. One criterion uses the social security number; the other six criteria use combinations of name and date of birth. Month of birth is required to match in six of seven selection criteria . However, there has been a sharp increase in the percent of survey respondents who refuse to provide social security numbers. The chances of correct NDI matches can therefore be improved by carefully considering the factors that will be used for matching. The National Center for Health Statistics suggests that collection of the participant’s name as it would appear on legal documents (e.g., driver’s license), father’s name (primer apellido) and mother’s surname (segundo apellido) be considered as well as addressing both the female name change due to marriage. Missing Data Data from the 1997 National Health Interview Survey show that use of common names occurs more frequently among Hispanics than non-Hispanics, with 25.9 percent of Hispanics having one of the twenty-five most common last names, compared with 10 percent of non-Hispanics (pers. comm., Gloria Wheatcroft, National Center for Health Statistics). Survey data for Latinos are also more likely to be missing identification information than for non-Latinos. For example, 66.4 percent of Latinos interviewed during the 2000 National Health Interview Survey were missing their social security number, and 11.5 percent Improvements in Latino Health Data 61 were missing their year of birth, compared with 59 percent and 8.8 percent, respectively, of non-Hispanics. Rates of missing information also vary by Hispanic subgroup. During the 1994 NHIS, 50.9 percent of Latin Americans and 54.1 percent of Mexicans were missing their social security number, compared with 40 percent of Puerto Ricans, 42.2 percent of Cubans, and 43.7 percent of non-Hispanics. Analysts play an important role in decisions regarding whether and how data are collected, which variables will be analyzed, how new variables will be constructed, and whether and how data will be disseminated. However, most researchers do not describe their methods for determining race or ethnicity, or what they assume the variables to mean. Conclusion Despite a slow start, a great deal of progress has been made in the collection of Hispanic health data in the United States. Health researchers and public health planners rely on high quality biometry information. In the instance of Latino health research, this implies, beyond collecting information on structural factors , having accurate descriptors of ethnic subgroups, nativity/immigration statuses , and spoken-language dominance. There are multiple social and cultural variables of potential research interest to serve as potential covariates or for comparisons in more refined analyses. There remain several issues to be resolved. Nevertheless, there are good possibilities that the identified information needs will be addressed in the future. Addressing any health or social problem requires an understanding of the factors that contribute to it. As such, researchers have identified many of these limitations and can now begin a process aimed at closing the quality gap in Hispanic health care information. References Abraido-Lanza, A. F., B. P. Dohrenwend, D. S. Ng-Mak, and J. B. Turner. 1999. The Latino mortality paradox: A test of the “salmon bias” and healthy migrant hypotheses. American Journal of Public Health 89 (10): 1543–1548. Blumberg S. J., J. V. Luke, and M. L. Cynamon...


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