1. Enumerating ethnicity in the U. S
Enumerating ethnicity in the U.S. Census: It’s consequence for Hispanic/non-Hispanic cancer rates
Laurie M. DeChello, MPH1,
David I. Gregorio, PhD1,
Rafael Perez-Escamilla, PhD2
1University of Connecticut, School of Medicine
2University of Connecticut, Department of Nutritional Sciences

2. Dependent Children and Child Care Worker Disappearance
Between 1986 and 1987, dependent children disappeared on IRS forms
Between 1987 and 1988, child care workers disappeared on IRS forms
The count of Hispanic persons increased in 2000
-Between 1986 and 1987, 7 million Dependent children disappeared from the US; a consequence of an IRS requirement that only persons with social security numbers could be listed on tax forms
-Between 1987 and 1988, 2.6 million child care workers disappeared from the US: a consequence of another requirement that eligible child care credits on taxes required SSN numbers of providers).
-In both cases, population estimates changed suddenly and markedly.
-The counts of Hispanics increased in 2000, although the actual number of persons did not.

3. What is Ethnicity?
Ethnicity in the 1970 and 1980 U.S. Decennial Censuses
International conference on the Measurement of Ethnicity
A question regarding people’s ethnicity was included in the U.S. census beginning in 1970 on the long form (sample form). In 1980, it was added to the short form (100% form), but had the highest non-response rate of all the questions on the survey
In 1992, the US and Canada organized an international conference on the Measurement of Ethnicity
Conference participants reached a consensus that there was no universally accepted definition of ethnicity

4. Definitions of Ethnicity
Merriam-Webster’s Dictionary: of or relating to large groups of people classed according to common racial, national, tribal, religious, linguistic, or cultural origin or background
U.S. Census Bureau: the heritage, nationality group, lineage, or a country of birth of the person or the person’s parents or ancestors before their arrival in the U.S.

5. What is Hispanic Origin?
Merriam-Webster’s Dictionary: of, relating to, or being a person of Latin American descent living in the U.S.; especially: one of Cuban, Mexican, or Puerto Rican origin
It is important to note that someone who is considered Hispanic can be of any race.

6. U.S. Census Questions 1990 Census 2000 Census
The US Census Bureau changed the way they asked people to determine if they were of Spanish/Hispanic origin or not between the 1990 and 2000 censuses.
The 1990 Census asked the race of a person prior to the question on Hispanic origin. They discovered that some people felt as though the question on Hispanic origin was redundant after already answering a question on race. Therefore, they did not answer the question on Hispanic origin.
The 2000 Census asked the question about Hispanic origin prior to the question determining a person’s race, and the participant was instructed to answer both questions. In 2000, the word “origin” was also removed and “Latino” was added.
The 1990 Census gave examples of other classifications for Hispanic origin; these examples were removed from the 2000 question.

7. Why is Hispanic Origin Collected?
Voting Rights Act
Civil Rights Act
Differences in disease risk
The Census Bureau collects this information because it is used for such things as enforcement of bilingual election rules under the Voting Rights Act
And the monitoring and enforcement of equal employment opportunities under the Civil Rights Act.
From the epidemiologic perspective, for some diseases, Hispanics have different risks than Non-Hispanics.

8. Variability of Hispanic Population Counts
Change in how Hispanics classified themselves
Impact on cancer incidence rates
Some Hispanics changed how they classified themselves depending on the wording and order of the Census questions.
We wanted to know if these changes in how Hispanics were counted would have an impact on Connecticut cancer incidence rates between 1994 and 2000.

9. Population Counts
Connecticut Decennial Census counts from 1990 and 2000
Connecticut population estimates, 1995
Linear projections by gender and ethnicity
using 1990 and 1995
using 1995 and 2000
CT decennial census counts from 1990 and 2000 were obtained by gender and ethnicity, as well as the 1995 population estimates.
Linear projections by gender and ethnicity of population counts were performed from 1994 to 2000 using 1990 and 1995 populations and then reverse projections using 1995 and 2000 population counts.
Therefore, there were 2 sets of population projections.

10. Cancer Incidence Counts
SEER cancer incidence counts, 1994 to 2000
Breast Cancer
Prostate Cancer
Colorectal Cancer
Lung Cancer
Incidence counts were obtained from the Surveillance Epidemiology and End Results software, SEERStat from 1994 to 2000 by gender and ethnicity for breast, prostate, colorectal and lung cancers.

11. SEER Definition of Hispanic
Identify themselves as being of Hispanic origin
Hispanic ethnicity is independent of race
Hispanic data include people who identify themselves as being of Hispanic origin. Hispanic ethnicity is considered independently of race, so Hispanic persons may be of any race.

12. Statistics Incidence data grouped into 3-year periods Incidence rates
Risk ratios
T-tests
Incidence data was grouped into 3-year periods to remove some of the variability between years. These 3-year periods moved incrementally by year, so that there were 5 3-year periods.
Incidence rates were calculated using population projections based on 1990 and 2000 independently and by gender and ethnicity
Risk ratios also by gender and ethnicity were calculated within population projection census years and
T-tests were performed between the census year and Hispanic/Non-Hispanic groups of ratios.

13. Breast Cancer Incidence Rates
-Breast cancer rates increased over time for both Hispanics and non-Hispanics.
-Non-Hispanics had higher incidence rates than Hispanics.
-When using the 1990 Census population counts as the denominator, the rates were higher than those created using the 2000 Census counts.
P-values of the t-test comparing ratios of the incidence rates created by the 1990 and 2000 Census counts were greater than .05, and therefore not significantly different.

14. Prostate Cancer Incidence Rates
-Prostate cancer incidence rates for Hispanics where higher than those for non-Hispanics until the last 3-year period, until possibly the last 3-year period.
-The rates for Hispanics increase, then decrease, while the rates for non-Hispanics do the opposite.
-The rates calculated by the 1990 Census counts were significantly different than those calculated using the 2000 counts.

15. Male Colorectal Cancer Incidence Rates
-The colorectal cancer incidence rates for non-Hispanic males did not change much over time compared to the rates for Hispanic Males
-Their rates increased sharply between the first 2 periods to be higher than the rates of the Non-hispanic males, and then decreased again to just about where they started by the end of our study period.
-Again, the difference between the incidence rates created by the different census counts was significantly different.

16. Female Colorectal Cancer Incidence Rates
-Colorectal cancer incidence rates in Non-Hispanic females increased over time, while the rates for Non-Hispanic females zig-zagged and ended at about where it began.
-However, the rates for non-Hispanic females always remained higher than the Hispanic rates.
-The difference between the rates created by the difference census counts were not significantly different.

17. Male Lung Cancer Incidence Rates
-Lung cancer incidence rates for Non-hispanic males increased within the first 4 periods and were higher than the Hispanic male rates, which increased more sharply than the non-Hispanic males.
-There was not any significant difference between rates created by the different census counts.

18. Female Lung Cancer Incidence Rates
-Lung cancer incidence in females increased in both ethnic groups, but more so in Hispanic women. Although the rates were higher for Non-Hispanic females.
Again, there was no significant difference between the rates created by the different census counts

19. Conclusions 2000 rates lower than 1990 rates
Shift in Hispanic categorization
Significant difference in census year ratios for prostate cancer incidence and male colorectal cancer incidence
Changes in 1990 and 2000 Census forms
Affect on epidemiological statistics
-The rates produced by the 2000 population counts were lower than the rates created by the 1990 population counts in all cancers we looked at.
-Populations change from four sources: births, deaths, migration in and migration out.
-Individuals who now are able to designate themselves as Hispanic are migrating out of the white category and into the Hispanic category. That should make the white population smaller the Hispanic one larger. If nothing else were to change, one could expect larger rates for whites and smaller ones for Hispanics between 1990 and But that’s not the case; both groups have higher rates because of the incidence of cancer is increasing in both groups.
-Although there was not any significant difference in census year ratios for females, there was significant difference when looking at prostate cancer incidence and male colorectal cancer incidence.
-The Census Bureau changed the way they the questions were presented and worded on the 1990 and 2000 censuses.
-Perhaps a large number of males changed the way they classified their ethnicity between the 1990 and 2000 censuses because of these changes in the questions.
-Because of these differences, the prostate cancer and male colorectal cancer incidence rates were significantly different.
-These types of differences in incidence rates can affect how cancer control programs are implemented and evaluated.
-Therefore, when interpreting rates based on rates, one must interpret carefully and leave room for such bias in the data.