The Great Plains Tribal Epidemiology Center (GPTEC) produces a variety of products that include data from various sources. The glossary, technical notes, and list of counties described below help in the interpretation of those data products. Note that particular products may come with individual considerations and notes, in which NPTEC has indicated those within these products.
Please reach out to [email protected] if you have any questions regarding GPTEC’s data products or these notes.
A reservation county is defined as “… a county on or within the boundaries of the reservation.”
Generally speaking, tribal level data within GPTEC reports is an aggregation of data from the reservation counties associated with that tribe, where available. Individual GPTEC data products will included references indicating when data is not available for individual topics and reservation counties.
Click here for a List of Reservation Counties by State & Tribe
Glossary and Technical Notes
Age-Adjusted Mortality Rate
According to the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program (SEER*Stat), “an age-adjusted rate is a weighted average of the age-specific (crude) rates, where the weights are the proportions of persons in the corresponding age groups of a standard population”. Essentially, age-adjusted mortality rates provide a mortality rate that is adjusted to reduce the skewing effect of differences in the number of people in each age group.
Age-Adjusted Mortality Rates are calculated by:
- Beginning with the number of deaths related to a particular disease category and age group within the relevant reservation counties to calculate a crude mortality rate for that disease:
Crude Mortality Rate (per 100,000) = Number of Deaths * 100,000
- Computing proportions for each US Standard Population age group (the “age distribution of the standard population”) by dividing the 2000 US Standard Population of each age group by the total 2000 US Standard Population:
Age Distribution of the Standard Population = US 2000 Standard Population of Age Group
Total US 2000 Standard Population
- Calculating the age-adjusted mortality rate by multiplying each crude mortality rate by the proportion within the Age Distribution of the Standard Population:
Age-Adjusted Mortality Rate (per 100,000) = Crude Mortality Rate * Age Distribution of Standard Population Ratio
Source: National Cancer Institute. (n.d.). SEER*Stat tutorials: Calculating age-adjusted rates. Surveillance, Epidemiology, and End Results Program. Retrieved from http://seer.cancer.gov/seerstat/tutorials/aarates/definition.html
American Community Survey Estimates
American Community Survey (ACS) estimates are not counts, but rather provide an average of an area’s characteristics over five years. Data for the ACS is collected annually from residents at randomly selected “housing units” or “group quarters”.
For more information, consult the American Community Survey site for data users here.
Source: United States Census Bureau. (2013). An overview of the American Community Survey [PowerPoint]. Retrieved from http://www.census.gov/acs/www/guidance_for_data_users/training_presentations/
Average Annual Incidence
Average annual incidence provides an average rate of new cases of a disease per 100,000 people over a certain period of time and for a particular population and geographic region.
Average Annual Incidence is calculated by:
- Summing the number of new cases of a disease between 2008 and 2012 for each reservation county in the area of interest, and sum the 2010 census populations for those same counties.
- Computing 5-year “pooled” incidence rate for each reservation county:
Pooled Incidence (per 100,000) = Total number of new cases (county) between 2008 and 2012 * 100,000
Total reservation county population
- Calculating average annual incidence = (per 100,000 people):
Average Annual Incidence (per 100,000) = Pooled Incidence
Causes of Death
Age-adjusted mortality data were provided by the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program, which uses general definitions to aggregate numerous causes of death into more manageable categories. These categories are described – in terms of which International Classification of Disease (ICD) codes that they include – here. For more information about ICD codes and details regarding the current version (used for this analysis), click here.
- “Accidents and Adverse Effects” (ICD-10 codes V01-X59 and Y85-Y86) include motor vehicle accidents and sequelae therein, falls, electrocutions, exposure to flame and smoke, plant exposures and animal/insect bites and stings, accidental poisonings, and exposure-related deaths;
- “Cerebrovascular Diseases” (ICD-10 codes I60-I69) include infarctions (strokes) and other unspecified cerebrovascular occlusion or stenosis;
- “Chronic Obstructive Pulmonary Disease and Allied Cond” (ICD-10 codes J40-J47) include bronchitis, emphysema, asthma, and other unspecified chronic obstructive pulmonary diseases;
- “Diseases of Heart” (ICD-10 codes I00-I09, I11, I13, and I20-I51) include rheumatic diseases, hypertensive heart diseases, ischemic and pulmonary heart and circulatory diseases, and other forms of heart disease;
- “Homicide and Legal Intervention” (ICD-10 codes U01-U02, X85-Y09, Y35, Y87.1, and Y89.0) include assaults, death or injury inflicted by police or military forces, and sequelae therein;
- “Nephritis, Nephrotic Disease and Nephrosis” (ICD-10 codes N00-07, N17-N19, and N25-N27) include kidney and renal diseases and causes of failure;
- “Other Cause of Death” includes any deaths that are not categorized within the ICD-10 system; and,
- “Symptoms, Signs, and Ill-Defined Conditions” (ICD-10 codes R00-R99) include unknown or ill-defined causes of mortality as well as cases of mortality that can only be defined by signs and symptoms that they included.
Source: World Health Organization. (2010). ICD-10, Version 2010 [web portal]. Retrieved from http://apps.who.int/classifications/icd10/browse/2010/en
Federal Poverty Level
The Federal Poverty Level refers to federal poverty guidelines, as established by the federal government on an annual basis. If an individual or household’s income is below the defined poverty threshold – which is scaled based upon the number of individuals in a household and the ages of the householder and their related children – that individual or household is considered to be in poverty. For an individual under 65 years old with no related children, the poverty threshold in 2010 was defined as $11,344.
For additional poverty thresholds for 2010, see Census guidelines here.
Source: United States, Census Bureau. (2013). Definitions. Poverty. Retrieved from https://www.census.gov/hhes/www/poverty/methods/definitions.html
Infant Mortality Rate
The infant mortality rate describes the number of infant deaths per 1,000 live births in a particular time period.
For this report, Infant Mortality Rate was calculated by:
- Summing the number of infant deaths in the relevant reservation counties between 2008 and 2012, as well as the number of live births in that area and time period.
- Calculating the infant mortality rate by dividing the total number of infant deaths by the total number of live births:
Infant Mortality Rate (per 1,000 live births) = Total number of infant deaths between 2008 and 2012 * 1,000
Total number of live births between 2008 and 2012
The classification for races and ethnicities that NPTEC utilizes generally follows those designations used by the US Census Bureau. These classifications are described below:
- “AI/AN” = American Indian/Alaska Native Alone or in Combination with Other Races/Ethnicities
- “AI/AN Alone”, which refers to American Indian/Alaska Native Alone
- “White” = White Alone
- “Other Races” = Other Races (i.e. any besides American Indian/Alaska Native alone or in combination with other races/ethnicities and White alone)
- “All Races” = All Races (aggregated and inclusive of other races in the figure or table)
According to the Census Bureau:
All civilians 16 years old and over are classified as unemployed if they (1) were neither ‘at work’ nor ‘with a job but not at work’ during the reference week, and (2) were actively looking for work during the last 4 weeks, and (3) were available to start a job. Also included as unemployed are civilians who did not work at all during the reference week, were waiting to be called back to a job from which they had been laid off, and were available for work except for temporary illness. Examples of job seeking activity are:
- Registering at a public or private employment office;
- Meeting with prospective employers;
- Investigating possibilities for starting a professional practice or opening a business;
- Placing or answering advertisements;
- Writing letters of application; and,
- Being on a union or professional register.
Source: United States Census Bureau. (2010). American Community Survey, Puerto Rico Community Survey – 2010 subject definitions. P. 62-63. Retrieved from http://www.census.gov/acs/www/Downloads/data_documentation/SubjectDefinitions/2010_ACSSubjectDefinitions.pdf
According to the Census Bureau:
People who had no reported coverage, or whose only health coverage was Indian Health Service, were considered uninsured. For reporting purposes, the Census Bureau broadly classifies health insurance coverage as private health insurance or public coverage. Private health insurance is a plan provided through an employer or union, a plan purchased by an individual from a private company, or TRICARE or other military health care… Public health insurance coverage includes the federal programs Medicare, Medicaid, and VA Health Care (provided through the Department of Veterans Affairs); the Children’s Health Insurance Program (CHIP); and individual state health plans.
Source: United States Census Bureau. (2012). American Community Survey and Puerto Rico Community Survey – 2012 subject definitions. P. 69. Retrieved from http://www.census.gov/acs/www/Downloads/data_documentation/SubjectDefinitions/2012_ACSSubjectDefinitions.pdf