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American Indian and Alaska Native Population Figures Used by the Indian Health Service
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Word Perfect Format)
The Indian Health Service (IHS) uses two types of population figures in its various activities -- IHS service population and IHS user population. This statistical note defines these two types of population figures, describes how they are calculated, identifies their limitations, and indicates for what purposes they are used.
Computation of Median Age of a Population from Grouped Data
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COMPUTATION OF MEDIAN AGE FOR THE AMERICAN INDIAN POPULATION BASED ON THE 1990 CENSUS (MODIFIED FILE)
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Lotus 1-2-3 Format)
The median age of a population is the age which divides the population in half, one half being older and the other half being younger than the median. It allows a rough comparison of the age distributions of two populations. This statistical note provides the definition of median age, a description of how it is computed, and a discussion of how it is used. It also includes instruction and discussion on how to use the Lotus 1-2-3 spread sheet on the accompanying file.
Area Program Data Review Protocol
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Indian Health Service (IHS) Headquarters initiated Area Program Data Reviews in FY 1992. Other Headquarters reviews (e.g., the Office of Health Programs' general Program Reviews and its more specific subject matter reviews such as the Medical Records Reviews and Contract Health Services Reviews) do cover various aspects of the IHS patient care information systems. However, no other Headquarters review provides a comprehensive and in-depth look at these information systems involving all the parties that have a role.
Problems in Calculating Rates for a Small Number of Events
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The Indian Health Service (IHS) is comprised of regional administrative units called Area Offices. The Area Offices are divided into basic administrative units called service units. The size of the service units varies considerably from a portion of a county and a population under 1,000 to multiple counties with a combined population of over 80,000. It is often necessary to conduct planning activities at the service unit level and sometimes for smaller geographic areas. This requires calculating morbidity and vital event rates at these levels. As a result, the number of events involved may be quite small. The purpose of this statistical note is to describe the problems in calculating rates for a small number of events and suggest ways of overcoming those problems.
Comparing the Health Status of Populations with Different Age Distributions
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The American Indian and Alaska Native population is considerably younger than the U.S. All Races population. This needs to be taken into account when comparing the health status of Indians, in particular, those residing in the IHS service area, with that of the general population. Since most health conditions prevail at different rates for different age groups (e.g., the prevalence of malignant neoplasms increases with age), it is necessary to make adjustments to achieve an unbiased comparison of morbidity and mortality rates between populations with considerably different age compositions. Crude rates do not take into account this age variation which exists between population groups. According to the 1990 Census, the median age of Indians residing in the IHS service area was 24.2 years, which is 8.7 years less than the figure for the general U.S. population (32.9). This statistical note discusses various ways of compensating for age differences between populations.
Sampling Guidelines and Procedures
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It is frequently necessary to gather information needed for decision-making purposes on a sampling basis. For example, a health care administrator may wish to determine the level of patient satisfaction with the services provided at a facility. Or, an Area planner/statistician may need to verify what proportion of the registered patients living in a service unit are active users. In such cases, it is not necessary or, in most cases, even feasible to interview every patient or review every patient chart. By appropriately designing and implementing a sample survey, the required information can be gathered with statistical confidence. This statistical note provides guidelines and procedures for designing and implementing a basic survey.
Guidelines for Tracking the Indian Health Objectives
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Healthy People 2000: National Health Promotion and Disease Prevention Objectives (HP 2000) is a prevention initiative that embodies a national strategy for significantly improving the health of the American people in the decade preceding the year 2000. In addition to objectives for the general population, sub objectives are also specified for minorities and other special populations to meet the unique needs and health problems of these populations. Thirty-one sub objectives have been established for the American Indian and Alaska Native population. Since HP 2000 is national in scope, the Indian-specific sub objectives pertain for the most part to all U.S. Indians.
Concepts of Urban and Rural and Other Geographic Entities
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There is often confusion regarding how many American Indians and Alaska Natives live in urban versus rural areas. It is often assumed that if a person lives on or near an Indian reservation, then that person resides in a rural area. This is not necessarily the case. For example, Indians living in the urban setting of Tucson, Arizona reside in Pima County near the reservations of the Pascua Yaqui Tribe of Arizona and the Tohono O'odham Nation of Arizona. They are residents of an urban area and also of the Indian Health Service (IHS) service area since Pima County is part of a contract health service delivery area. Much of the confusion concerning urban and rural stems from a misunderstanding of what these concepts mean. The purpose of this statistical note is to clarify the concepts of urban and rural and other geographic entities as they relate to the IHS and the American Indian and Alaska Native population.
Guidelines for Tracking the IHS FY 1999 Performance Plan Indicators
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The Indian Health Service (IHS) submitted its FY 1999 Performance Plan to the Department of Health and Human Services (HHS) in September 1997 and then submitted a revised plan in January 1998. This plan is in compliance with the Government Performance and Results Act (GPRA). The plan includes 25 performance indicators/objectives which were developed by IHS in partnership with Tribes and Urban Projects (I/T/U).
