Confusing culture: What is the value of self-reported race data?

Objective – In a NIMH funded mental health services research project, 6% of participants unexpectedly self-identified as American Indian. The research was conducted in a section of the rural Midwest with low numbers of American Indians and no proximity to Federally recognized tribes. Two questions arose out of this unexpected occurrence: 1) What are participants' level of identification with American Indian culture? 2) What impact did being American Indian have on participants' mental health services?

Methods – Of the approximately 50 individuals who self-identified as American Indian, 14 interviews were completed before reaching thematic saturation. Interviews were conducted face-to-face and structured by themes derived from the two research questions. The resulting narratives were audio taped, transcribed, and entered into Answr, a qualitative computer program, for coding. Grounded Theory guided the coding process.

Results - Participants' American Indian identification was linked to a family history that included an American Indian grandparent or great-grandparent. None of the participants had any particular knowledge or experience with American Indian culture. Few had informed their mental health provider of their heritage and even fewer felt that sharing this information would either positively or negatively alter their mental health services.

Conclusions – Participants' American Indian identification was based solely on a family heritage that lacked any cultural significance. Most researchers using self-reported race data approach it as being imbued with cultural meaning. Our findings suggest that research based on self-reported race data may result in misjudgments about the health disparities experienced by American Indians.