Survey on Racism, Discrimination and Health: Experiences and Impacts Across Racial and Ethnic Groups

Appendix 1

Racial and ethnic groups included in this report are defined using a two-question format. The initial question asks respondents if they are of Latino or Hispanic origin or descent. The second question asks respondents to select as many racial identity groups as apply from a list that includes eight response options: White, Black or African-American, Asian, American Indian, Alaska Native, Native Hawaiian, Pacific Islander, and “some other race” (with a text box for respondents to provide details). The wording for these questions is similar to the standard two-question measure used by the U.S. Census Bureau, other government organizations, and some survey research organizations. Using the two-question format and “select all that apply” for racial identity allows respondents to self-identify into multiple categories that better reflect their racial and/or ethnic identity or identities.

The table below provides some breakdown on the racial and ethnic identities for the Hispanic, Black, Asian, and American Indian and Alaska Native (AIAN) groups. It includes both the unweighted number of interviews and the weighted proportion within each group, including the share who selected only one race (single race), the share who selected more than one race (multiracial), and the share who selected Hispanic ethnicity within each of these groups. About nine in ten Hispanic adults identify as Hispanic and a single race, and at least eight in ten Black and Asian adults identify as a single race and non-Hispanic. By contrast, most AIAN adults identify as multiracial and about one-third identify as Hispanic.

Appendix 2: Reporting on the Experiences of American Indian and Alaska Native Adults

Sample and Population Represented: The KFF Survey on Racism, Discrimination, and Health was designed to include large samples of adults identifying as Black or African American, Latino or Hispanic, and Asian, with the goal of reporting results specifically for these populations. More details on the sampling strategy are available in the project Methodology.

In addition to these planned larger samples, the sample design also yielded 267 interviews with individuals identifying as American Indian (n=263) and/or Alaska Native (n=6). The American Indian and Alaska Native (AIAN) sample includes individuals who identified AIAN as their only racial identity as well as those who selected AIAN and at least one other race, as well as those who identified as having Hispanic and non-Hispanic ethnicity (see Appendix 1 for more details on how racial and ethnic groups were categorized in this analysis).

Limitations and Data Quality Considerations: Given ongoing concerns about data erasure and invisibility of smaller populations, including Indigenous people, KFF has decided to include results for the AIAN population in this report despite some limitations. The following describes the limitations of the sample, adjustments made to make the sample more representative, and considerations for data interpretation.

Because the survey was not explicitly designed to include a representative sample of AIAN people, the research falls short of some recommended best practices for surveying this population. These include advance outreach to Tribal organizations, face-to-face interviews for some groups, and geographic oversampling of federally recognized Indian reservations and other Tribal lands. The small size of the AIAN sample also does not allow for reporting on more detailed groups (such as within the AIAN population by age, geography, and other demographics).

To increase representativeness of the results, the AIAN sample was weighted to the most current demographic data available for this population: the U.S. Census Bureau’s 2022 American Community Survey (ACS). The weighting parameters include education, age by gender, region, nativity (U.S.-born vs. foreign-born), race and ethnicity, and U.S. citizenship.

Researchers also took other steps to assess the representativeness of the AIAN sample. While Tribal lands were not explicitly included in the sampling strategy, the sample was analyzed to assess whether individuals living on federally recognized Indian reservations and other Tribal lands could have responded to the survey using the Census tracts and zip codes of survey respondents. Overall, 19% of respondents in the AIAN sample live in geographic areas where Tribal lands are located, including 25% of those who identify as AIAN alone. In addition, researchers compared this AIAN sample to other federally available data across a series of benchmarks not included in the weighting such as insurance status, insurance type, income, and the use of English in the household.

Despite these efforts, we suggest using caution when interpreting the results of the AIAN sample in the report. The data included may not be reflective of the entirety of experiences of the AIAN adult population. It may particularly fall short of capturing the experiences of those living on federally recognized Indian reservations and other Tribal lands. In addition, the Census data used for weighting is imperfect and may overrepresent the experiences of multiracial AIAN individuals, which may lead to a similar imbalance in the survey results.

KFF is committed to improving our future efforts and working to more fully represent and reflect the diversity of experiences among Indigenous people in our survey and other work.


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