1. Gonorrhea Data and Challenges In California Indian Country Richelle Harklerode, MPH Associate Epidemiologist California Tribal Epidemiology Center California Rural Indian Health Board

2. Tribal Epidemiology Centers (TECs) = IHS DEDP  = TEC = Not covered by TECs

3. Misclassification What is your race? 53% of AIAN in California are multi-racial CTEC linkage study 60% misclassification in hospitalizations by the state 65% underreporting of deaths by the state 16% underreporting of deaths by IHS h

4. Data Access Tribes IHS State Other federal agencies

5. Geography Indian Health Centers

6. Small Communities Confidentiality Traditions and Social Norms Stigma

7. California Gonorrhea Rates 2004 IHS reported for the 37 counties AIAN = 41.7 Total US = 113.5 2008 CDPH reported AIAN = 36.1 White = 25.1 Total CA = 66.7

8. CDC Gonorrhea Rates for California 2000-2008

9. Thank You! Richelle Harklerode, MPH richelle.harklerode@crihb.net 916-929-9761 x1603 richelle.harklerode@crihb.net