Race and Ethnicity Data in the Electronic Health Records: New Insights Through Comparison with American Community Survey Microdata

The collection of race and ethnicity information varies across data sources which impacts our ability to conduct high quality research focused on population health, generally, and racial and ethnic disparities in health, specifically. This research examines concordance in racial/ethnic identification between two sources by linking individual-level electronic health record (EHR) data (2017-2019) from a public integrated health delivery system in North Carolina to American Community Survey (ACS) microdata (2001-2017). We find that concordance is high for individuals who identify as non-Hispanic Black, non-Hispanic White, and Hispanic but considerably lower for other non-White, non-Hispanic individuals, particularly for American Indian and Alaska Native patients. Given their detailed health information, EHR data have the potential to support research focused on population health and racial and ethnic disparities. Results from this study provide information regarding data quality and future applications of this work to expand population research.