Project Title

Northwest Portland Area Indian Health Board (NPAIHB) Improving Data and Enhancing Access Project (IDEA - NW)

Shortened Title

Improving Data and Enhancing Access - Northwest (IDEA-NW)

Publication Date



American Indians and Alaska Natives (AI/AN) are often misclassified as another (or missing) race in vital records, hospital discharge records, disease registries, and other public health datasets. In the Northwest, misclassification of AI/AN race can range between 30-60%. As a result, the true burden of disease and mortality among AI/ANs is often underestimated. Such inaccuracies can seriously impair public health decision-making and the appropriate allocation of disease control resources. Furthermore, most tribes lack local-level data on the rates and distribution of health events in their populations, which limits their ability to allocate resources to areas of greatest need.

The IDEA-NW Project aims to address these shortcomings by reducing misclassification of AI/AN race in public health data systems in Oregon, Washington, and Idaho. We correct inaccurate race data by linking a registry of known AI/AN individuals (the Northwest AI/AN registry) with state-level hospital discharge systems, trauma registries, cancer registries, vital statistics, and STD/HIV systems. After correcting misclassified race information at the record level, we analyze and disseminate aggregate AI/AN health status data in ways that are locally meaningful for tribal health planning. We repeat linkages with state-level data systems at regular intervals to track health trends and data quality over time.

IDEA-NW works with the states of Oregon, Washington, and Idaho, and serves all 43 federally-recognized tribes in the Northwest. We also partner with organizations that serve urban AI/AN populations in the Northwest, and disseminate our tools and resources to other states and Tribal EpiCenters.

EHR/EMR System or Vendor


Data Types

Electronic Health/Medical Records (EHR or EMR), Patient Registries

Locations of Focus

Oregon, Washington, and Idaho

Population Network Size

Approximately 230,000 American Indians and Alaska Natives live in Oregon, Washington, and Idaho (CDC National Center for Health Statistics Bridge-Race estimate, 2009). The Northwest AI/AN registry represents approximately 84% of this population.

Major Partners

Portland Area Indian Health Service, Seattle Indian Health Board, Oregon Health Authority, Washington Department of Health, Idaho Department of Health and Welfare

CER/PCOR Study Priority Populations

Minority groups

Outcome(s) of Interest

-Improved validity and reliability of AI/AN race data in state health data systems

-Increased availability of accurate health status data for Northwest tribal communities

Suggested Reading

Acknowledgement of Funders

IDEA-NW is supported by grant number R01HS019972 from the Agency for Healthcare Research and Quality, current funding 9/30/2010—9/29/2013, and by grant number AIAMP120012 from the Office of Minority Health, current funding 9/1/2012—8/31/2017.