research questions on race and ethnicity

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Updated Guidance on the Reporting of Race and Ethnicity in Medical and Science Journals

• 1 Executive Managing Editor, JAMA and the JAMA Network, Chicago, Illinois
• 2 Deputy Managing Editor, JAMA Network, Chicago, Illinois
• 3 Managing Editor, JAMA , Chicago, Illinois
• Editorial The Reporting of Race and Ethnicity in Medical and Science Journals Annette Flanagin, RN, MA; Tracy Frey, BA; Stacy L. Christiansen, MA; Howard Bauchner, MD JAMA
• Editorial Guidance on Race, Ethnicity, and Origin as Proxies for Genetic Ancestry in Biomedical Publication W. Gregory Feero, MD, PhD; Robert D. Steiner, MD; Anne Slavotinek, MBBS, PhD; Tiago Faial, PhD; Michael J. Bamshad, MD; Jehannine Austin, PhD, CGC; Bruce R. Korf, MD, PhD; Annette Flanagin, RN, MA; Kirsten Bibbins-Domingo, PhD, MD, MAS JAMA

The goal of this guidance is to provide recommendations and suggestions that encourage fairness, equity, consistency, and clarity in use and reporting of race and ethnicity in medical and science journals. As previously summarized, “terminology, usage, and word choice are critically important, especially when describing people and when discussing race and ethnicity. Inclusive language supports diversity and conveys respect. Language that imparts bias toward or against persons or groups based on characteristics or demographics must be avoided.” 1

With the publication of an earlier version of this guidance, 1 comments were invited, and helpful assessments and comments were received from numerous reviewers, scholars, and researchers, who provided valuable feedback and represented diverse expertise and opinions. After thorough review of these comments (some of which did not agree with others) and additional research and discussion, the guidance was revised and updated, and additional formal review was obtained. In this Editorial, we present the updated guidance, and we sincerely thank the many reviewers for their contributions, each of whom are listed in the Acknowledgment at the end of this article.

This guidance continues to acknowledge that race and ethnicity are social constructs as well as the important sensitivities and controversies related to use of these terms and associated nomenclature in medical and health research, education, and practice. Thus, for content published in medical journals, language and terminology must be accurate, clear, and precise, and must reflect fairness, equity, and consistency in use and reporting of race and ethnicity. The guidance also acknowledges that the reporting of race and ethnicity should not be considered in isolation and should be accompanied by reporting of other sociodemographic factors and social determinants, including concerns about racism, disparities, and inequities, and the intersectionality of race and ethnicity with these other factors.

The guidance defines commonly used terms associated with race and ethnicity and acknowledges that these terms and definitions have changed, that some are out of date, and that the nomenclature will continue to evolve. Other topics addressed include relevant concerns and controversies in health care and research, including the intersectionality of ancestry and heritage, social determinants of health, and other socioeconomic, structural, institutional, cultural, and demographic factors; reporting of race and ethnicity in research articles; use of racial and ethnic collective or umbrella terms, capitalization, and abbreviations; listing racial and ethnic categories in alphabetical order vs order by majority; adjectival vs noun usage for categories of race and ethnicity; geographic origin and regionalization considerations; and brief guidance for journals and publishers that collect demographic data on editors, authors, and peer reviewers. Examples are provided to help guide authors and editors.

This updated guidance on reporting race and ethnicity is being added to the Inclusive Language section of the AMA Manual of Style: A Guide for Authors and Editors as subsection 11.2.3, Race and Ethnicity (see below). 2 This section of the Correct and Preferred Usage chapter of the style manual also includes subsections that address reporting concerns and preferred nomenclature for sex and gender, sexual orientation, age, socioeconomic status, and persons with diseases, disorders, or disabilities. Each of these subsections also will be reviewed and updated.

With this publication, this guidance will be freely available on the JAMA website and in the AMA Manual of Style , 2 and linked from the JAMA Network journals’ Instructions for Authors. Others are welcome to use and cite this guidance.

This guidance is not intended to be final but is presented with the understanding that monitoring will continue, and further updates will be provided as needed. Continual review of the terms and language used in the reporting of race and ethnicity is critically important as societal norms continue to evolve.

Section 11.12.3. Race and Ethnicity

Race and ethnicity are social constructs, without scientific or biological meaning. The indistinct construct of racial and ethnic categories has been increasingly acknowledged, and concerns about use of these terms in medical and health research, education, and practice have been progressively recognized. Accordingly, for content published in medical and science journals, language and terminology must be accurate, clear, and precise and must reflect fairness, equity, and consistency in use and reporting of race and ethnicity. (Note: historically, although inappropriately, race may have been considered a biological construct; thus, older content may characterize race as having biological significance.)

One of the goals of this guidance is to encourage the use of language to reduce unintentional bias in medical and science literature. The reporting of race and ethnicity should not be considered in isolation but should be accompanied by reporting of other sociodemographic factors and social determinants, including concerns about racism, disparities, and inequities, and the intersectionality of race and ethnicity with these other factors.

When reporting the results of research that includes racial and ethnic disparities and inequities, authors are encouraged to provide a balanced, evidence-based discussion of the implications of the findings for addressing institutional racism and structural racism as these affect the study population, disease or disorder studied, and the relevant health care systems. For example, Introduction and Discussion sections of manuscripts could include implications of historical injustices when describing the differences observed by race and ethnicity. Such discussion of implications can use specific words, such as racism , structural racism , racial equity , or racial inequity , when appropriate.

Definitions

The definitions provided herein focus on reporting race and ethnicity. Definitions of broader terms (eg, disparity, inequity, intersectionality, and others) will be included in the overarching Inclusive Language section that contains this subsection.

“Race and ethnicity are dynamic, shaped by geographic, cultural, and sociopolitical forces.” 3 Race and ethnicity are social constructs and with limited utility in understanding medical research, practice, and policy. However, the terms may be useful as a lens through which to study and view racism and disparities and inequities in health, health care, and medical practice, education, and research. 3 - 5 Terms and categories used to define and describe race and ethnicity have changed with time based on sociocultural shifts and greater awareness of the role of racism in society. This guidance is presented with that understanding, and updates have been and will continue to be provided as needed.

The terms race (first usage dating back to the 1500s) and ethnicity (first usage dating back to the late 1700s) 6 have changed and continue to evolve semantically. The Oxford English Dictionary currently defines race as “a group of people connected by common descent or origin” or “any of the (putative) major groupings of mankind, usually defined in terms of distinct physical features or shared ethnicity” and ethnicity as “membership of a group regarded as ultimately of common descent, or having a common national or cultural tradition.” 7 For example, in the US, ethnicity has referred to Hispanic or Latino, Latina, or Latinx people. Outside of the US, other terms of ethnicity may apply within specific nations or ancestry groups. As noted in a lexicographer’s post on the Conscious Style Guide , race and ethnicity are difficult to untangle. 6 In general, ethnicity has historically referred to a person’s cultural identity (eg, language, customs, religion) and race to broad categories of people that are divided arbitrarily but based on ancestral origin and physical characteristics. 6 Definitions that rely on external determinations of physical characteristics are problematic and may perpetuate racism. In addition, there is concern about whether these and other definitions are appropriate or out-of-date 8 and whether separation of subcategories of race from subcategories of ethnicity could be discriminatory, especially when used by governmental agencies and institutions to guide policy, funding allocations, budgets, and data-driven business and research decisions. 9 Thus, proposals have been made that these terms be unified into an aggregate, mutually exclusive set of categories as in “race and ethnicity.” 10 (See Additional Guidance for Use of Racial and Ethnic Collective Terms.)

The term ancestry refers to a person’s country or region of origin or an individual’s lineage of descent. Another characteristic of many populations is genetic admixture , which refers to genetic exchange among people from different ancestries and may correlate with an individual’s risk for certain genetic diseases. 3 Ancestry and genetic admixture may provide more useful information about health, population health, and genetic variants and risk for disease or disorders than do racial and ethnic categories. 3

Although race and ethnicity have no biological meaning, the terms have important, albeit contested, social meanings. Neglecting to report race and ethnicity in health and medical research disregards the reality of social stratification, injustices, and inequities and implications for population health, 3 , 4 and removing race and ethnicity from research may conceal health disparities. Thus, inclusion of race and ethnicity in reports of medical research to address and further elucidate health disparities and inequities remains important at this time.

According to the “Health Equity Style Guide for the COVID-19 Response: Principles and Preferred Terms for Non-Stigmatizing, Bias-Free Language” of the Centers for Disease Control and Prevention (CDC), racism is defined as a “system of structuring opportunity and assigning value based on the social interpretation of how one looks...(“race”), that unfairly disadvantages some individuals and communities, unfairly advantages other individuals and communities, and undermines realization of the full potential of our whole society through the waste of human resources.” 11 Note that racism and prejudice can occur without phenotypic discrimination.

Jones 12 and the CDC style guide 11 have defined 3 levels of racism.

Systemic, institutionalized, and structural racism : “Structures, policies, practices, and norms resulting in differential access to the goods, services, and opportunities of society by ‘race’ (eg, how major systems—the economy, politics, education, criminal justice, health, etc—perpetuate unfair advantage).” 11 The Associated Press (AP) Stylebook advises to not shorten these terms to “racism,” to avoid confusion with the other definitions. 13

Interpersonal and personally mediated racism : “Prejudice and discrimination, where prejudice is differential assumptions about the abilities, motives, and intents of others by ‘race,’ and discrimination is differential actions towards others by ‘race.’ These can be either intentional or unintentional.” 11

Internalized racism : “Acceptance by members of the stigmatized ‘races’ of negative messages about their own abilities and intrinsic worth.” 11

Concerns, Sensitivities, and Controversies in Health Care and Research

There are many examples of reported associations between race and ethnicity and health outcomes, but these outcomes may also be intertwined with ancestry and heritage, social determinants of health, as well as socioeconomic, structural, institutional, cultural, demographic, or other factors. 3 , 4 , 14 Thus, discerning the roles of these factors is difficult. For example, a person’s ancestral heritage may convey certain health-related predispositions (eg, cystic fibrosis in persons of Northern European descent and sickle cell disease reported among people whose ancestors were from sub-Saharan Africa, India, Saudi Arabia, and Mediterranean countries); however, such perceptions have resulted in underdiagnosis of these conditions in other populations. 15

Also, certain groups may bear a disproportionate burden of disease compared with other groups, but this may reflect individual and systemic disparities and inequities in health care and social determinants of health. For example, according to the US National Cancer Institute, the rates of cervical cancer are higher among Hispanic/Latina women and Black/African American women than among women of other racial or ethnic groups, with Black/African American women having the highest rates of death from the disease, but social determinants of health and inequities are also associated with a high prevalence of cervical cancer among these women. 16 The American Heart Association summarizes similar disparities in cardiovascular disease among Black individuals in the US compared with those from other racial and ethnic groups. 17

Identifying the race or ethnicity of a person or group of participants, along with other sociodemographic variables, may provide information about participants included in a study and the potential generalizability of the results of a study and may identify important disparities and inequities. Researchers should aim for inclusivity by providing comprehensive categories and subcategories where applicable. Many people may identify with more than 1 race and ethnicity; therefore, categories should not be considered absolute or viewed in isolation.

However, there is concern about the use of race in clinical algorithms and some health-based risk scores and databases because of inapplicability to some groups and the potential for discrimination and inappropriate clinical decisions. For example, the use of race to estimate glomerular filtration rates among Black adults has become controversial for several reasons. 18 - 21 Oversimplification of racial dichotomies can be harmful, such as in calculating kidney function, especially with racial inequities in kidney care. In this context, health inequities among populations should be addressed rather than focusing solely on differences in racial categories (eg, Black vs White adults with kidney disease). 21 Another example is the Framingham Risk Score, which was originally developed from a cohort of White, middle-class participants in the US included in the Framingham Heart Study and may not accurately estimate risk in other racial and ethnic populations. Similar concerns have been raised about genetic risk studies based on specific populations or that do not include participants from other groups (eg, a genome-wide association study that reports a genetic association with a specific disease or disorder based solely on a population of European descent). 22 Use caution in interpreting or generalizing findings from studies of risk based on populations of individuals representing specific or limited racial and ethnic categories.

Guidance for Reporting Race and Ethnicity in Research Articles

The JAMA Network journals include the following guidance for reporting race and ethnicity and other demographic information in research articles in the Instructions for Authors. 23

Demographic Information

Aggregate, deidentified demographic information (eg, age, sex, race and ethnicity, and socioeconomic indicators) should be reported for research reports along with all prespecified outcomes. Demographic variables collected for a specific study should be indicated in the Methods section. Demographic information assessed should be reported in the Results section, either in the main article or in an online supplement or both. If any demographic characteristics that were collected are not reported, the reason should be stated. Summary demographic information (eg, baseline characteristics of study participants) should be reported in the first line of the Results section of the Abstract.

With regard to the collection and reporting of demographic data on race and ethnicity:

The Methods section should include an explanation of who identified participant race and ethnicity and the source of the classifications used (eg, self-report or selection, investigator observed, database, electronic health record, survey instrument).

If race and ethnicity categories were collected for a study, the reasons that these were assessed also should be described in the Methods section. If collection of data on race and ethnicity was required by the funding agency, that should be noted.

Specific racial and ethnic categories are preferred over collective terms, when possible. Authors should report the specific categories used in their studies and recognize that these categories will differ based on the databases or surveys used, the requirements of funders, and the geographic location of data collection or study participants. Categories included in groups labeled as “other” should be defined.

Categories should be listed in alphabetical order in text and tables.

Race and ethnicity categories of the study population should be reported in the Results section.

Reporting race and ethnicity in this study was mandated by the US National Institutes of Health (NIH), consistent with the Inclusion of Women, Minorities, and Children policy. Individuals participating in the poststudy survey were categorized as American Indian or Alaska Native, Asian, Black or African American, Hispanic or Latino, Native Hawaiian or Other Pacific Islander, or White based on the NIH Policy on Reporting Race and Ethnicity Data. Children’s race and ethnicity were based on the parents’ report. Race was self-reported by study participants, and race categories (Black and White) were defined by investigators based on the US Office of Management and Budget’s Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity. Given that racial residential segregation is distinctively experienced by Black individuals in the US, the analytical sample was restricted to participants who self-identified as Black. In this genome-wide association study, participants were from 8 African countries (ie, Kenya, Mozambique, Namibia, Nigeria, South Africa, Sudan, Uganda, and Zambia). Any Black African group from any of the 8 African countries (mostly of Bantu descent) was included in the Black African cohort. The South African group composed primarily of multiple racial categories, comprising any admixture combination of individuals of European, Southeast Asian, South Asian, Bantu-speaking African, and/or indigenous Southern African hunter-gatherer ancestries (Khoikhoi, San, or Bushmen), was renamed admixed African individuals. The race and ethnicity of an individual was self-reported. Data for this study included US adults who self-reported as non-Hispanic Black (hereafter, Black), Hispanic or Latino, and non-Hispanic White (hereafter, White) individuals. We excluded individuals who self-reported being Asian or of other race and ethnicity (which included those who were American Indian or Alaska Native and Native Hawaiian or Other Pacific Islander) because of small sample sizes.

Additional Guidance for Use of Racial and Ethnic Collective Terms

Specific racial and ethnic terms are preferred over collective terms, when possible. Authors should report the specific categories used in their studies and recognize that these categories will differ based on the databases or surveys used, the requirements of funders, and the geographic location of data collection or study participants.

When collective terms are used, merging of race and ethnicity with a virgule as “race/ethnicity” is no longer recommended. Instead, “race and ethnicity” is preferred, with the understanding that there are numerous subcategories within race and ethnicity. Given that a virgule often means “and/or,” which can be confusing, do not use the virgule construction in this context (see also 8.4, Forward Slash [Virgule, Solidus]).

The general term minorities should not be used when describing groups or populations because it is overly vague and implies a hierarchy among groups. Instead, include a modifier when using the word “minority” and do not use the term as a stand-alone noun, for example, racial and ethnic minority groups and racial and ethnic minority individuals . 11 , 24 However, even this umbrella term may not be appropriate in some settings. Other terms such as underserved populations (eg, when referring to health disparities among groups) or underrepresented populations (eg, when referring to a disproportionately low number of individuals in a workforce or educational program) may be used provided the categories of individuals included are defined at first mention. 25 The term minoritized may be acceptable as an adjective provided that the noun(s) that it is modifying is included (eg, “racial and ethnic minoritized group”). Groups that have been historically marginalized could be suitable in certain contexts if the rationale for this designation is provided and the categories of those included are defined or described at first mention. 11

The nonspecific group label “other” for categorizing race and ethnicity is uninformative and may be considered pejorative. However, the term is sometimes used for comparison in data analysis when the numbers of those in some subgroups are too small for meaningful analyses. The term should not be used as a “convenience” grouping or label unless it was a prespecified formal category in a database or research instrument. In such cases, the categories included in “other” groups should be defined and reported. Authors are advised to be as specific as possible when reporting on racial and ethnic categories (even if these categories contain small numbers). If the numbers in some categories are so small as to potentially identify study participants, the specific numbers and percentages do not need to be reported provided this is noted. For cases in which the group “other” is used but not defined, the author should be queried for further explanation.

The terms multiracial and multiethnic are acceptable in reports of studies if the specific categories these terms comprise are defined or if the terms were predefined in a study or database to which participants self-selected. If the criteria for data quality and confidentiality are met, at a minimum, the number of individuals identifying with more than 1 race should be reported. Authors are encouraged to provide greater detail about the distribution of multiple racial and ethnic categories if known. In general, the term mixed race may carry negative connotations 13 and should be avoided, unless it was specifically used in data collection; in this case, the term should be defined, if possible. To the extent possible, the specific type of multiracial and multiethnic groups should be delineated.

In this study, 140 participants (25%) self-reported as multiracial, which included 100 (18%) identifying as Asian and White and 40 (7%) as Black and White.

Other terms may enter the lexicon as descriptors or modifiers for racial and ethnic categories of people. For example, the term people of color was introduced to mean all racial and ethnic groups that are not considered White or of European ancestry and as an indication of antiracist, multiracial solidarity. However, there is concern that the term may be “too inclusive,” to the point that it erases differences among specific groups. 13 , 26 - 28 There are similar concerns about use of the collective and abbreviated terms for Black, Indigenous, and people of color ( BIPOC ) and Black, Asian, and minority ethnic ( BAME ) (commonly used in the UK). Criticism of these terms has noted that they disregard individuals’ identities, do not include all underrepresented groups, eliminate differences among groups, and imply a hierarchy among them. 13 , 26 - 28 Although these terms may be used colloquially (eg, within an opinion article), preference is to describe or define the specific racial or ethnic categories included or intended to be addressed. These terms should not be used in reports of research, unless the terms are included in a database on which a study is based or specified in a research data collection instrument (eg, survey questionnaire).

In agreement with other guides, 13 , 24 other terms related to colors, such as brown and yellow , should not be used to describe individuals or groups. These terms may be less inclusive than intended or considered pejorative or a racial slur.

In addition, avoid collective reference to racial and ethnic minority groups as “non-White.” If comparing racial and ethnic groups, indicate the specific groups. Researchers should avoid study designs and statistical comparisons of White groups vs “non-White” groups and should specify racial and ethnic groups included and conduct analyses comparing the specific groups. If such a comparison is justified, authors should explain the rationale and specify what categories are included in the “non-White” group.

Capitalization

The names of races, ethnicities, and tribes should be capitalized, such as African American, Alaska Native, American Indian, Asian, Black, Cherokee Nation, Hispanic, Kamba, Kikuyu, Latino, and White. There may be sociopolitical instances in which context may merit exception to this guidance, for example, in an opinion piece for which capitalization could be perceived as inflammatory or inappropriate (eg, “white supremacy”).

Adjectival Usage for Specific Categories

Racial and ethnic terms should not be used in noun form (eg, avoid Asians , Blacks , Hispanics , or Whites ); the adjectival form is preferred (eg, Asian women, Black patients , Hispanic children , or White participants ) because this follows AMA style regarding person-first language. The adjectival form may be used as a predicate adjective to modify the subject of a phrase (eg, “the patients self-identified as Asian, Black, Hispanic, or White”). 11

Most combinations of proper adjectives derived from geographic entities are not hyphenated when used as racial or ethnic descriptors. Therefore, do not hyphenate terms such as Asian American , African American , Mexican American, and similar combinations, and in compound modifiers (eg, African American patient ).

Geographic Origin and Regionalization Considerations

Awareness of the relevance of geographic origin and regionalization associated with racial and ethnic designations is important. In addition, preferred usage may change about the most appropriate designation. For example, the term Caucasian had historically been used to indicate the term White , but it is technically specific to people from the Caucasus region in Eurasia and thus should not be used except when referring to people from this region.

The terms African American or Black may be used to describe participants in studies involving populations in the US, following how such information was recorded or collected for the study. However, the 2 terms should not be used interchangeably in reports of research unless both terms were formally used in the study, and the terms should be used consistently within a specific article. For example, among Black people residing in the US, those from the Caribbean may identify as Black but not as African American, whereas Black people whose families have been in the US for several generations may identify as Black and African American. When a study includes individuals of African ancestry in the diaspora, the term Black may be appropriate because it does not obscure cultural and linguistic nuances and national origins, such as Dominican, Haitian, and those of African sovereign states (eg, Kenyan, Nigerian, Sudanese), provided that the term was used in the study.

The term Asian is a broad category that can include numerous countries of origin (eg, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, Vietnam, and others) and regions (eg, East Asia, South Asia, Southeast Asia). 29 The term may be combined with those from the Pacific Islands as in Asian or Pacific Islander . The term Asian American is acceptable when describing those who identify with Asian descent among the US population. However, reporting of individuals’ self-identified countries of origin is preferred when known. As with other categories, the formal terms used in research collection should be used in reports of studies.

In reference to persons indigenous to North America (and their descendants), American Indian or Alaska Native is generally preferred to the broader term Native American . However, the term Indigenous is also acceptable. There are also other specific designations for people from other locations, such as Native Hawaiian and Pacific Islander . 29 , 30 If appropriate, specify the nation or peoples (eg, Inuit , Iroquois , Mayan, Navajo , Nez Perce , Samoan ). Many countries have specific categories for Indigenous peoples (eg, First Nations in Canada and Aboriginal in Australia). Capitalize the first word and use lowercase for people when describing persons who are Indigenous or Aboriginal (eg, Indigenous people, Indigenous peoples of Canada , Aboriginal people ). Lowercase indigenous when referring to objects, such as indigenous plants .

Hispanic , Latino or Latina , Latinx , and Latine are terms that have been used for people living in the US of Spanish-speaking or Latin American descent or heritage, but as with other terms, they can include people from other geographic locations. 29 , 30  Hispanic historically has been associated with people from Spain or other Spanish-speaking countries in the Western hemisphere (eg, Cuba, Central and South America, Mexico, Puerto Rico); however, individuals and some government agencies may prefer to specify country of origin. 29 - 31  Latino or Latina are broad terms that have been used for people of origin or descent from Cuba, Mexico, Puerto Rico, and some countries in Central America, South America, and the Caribbean, but again, individuals may prefer to specify their country of origin. 29 - 31 When possible, a more specific term (eg, Cuban , Cuban American , Guatemalan, Latin American , Mexican , Mexican American , Puerto Rican ) should be used. However, as with other categories, the formal terms used in research collection should be used for reports of studies. For example, some US agencies also include Spanish origin when listing Hispanic and Latino. The terms Latinx and Latine are acceptable as gender-inclusive or nonbinary terms for people of Latin American cultural or ethnic identity in the US. However, editors should avoid reflexively changing Latino and Latina to Latinx or vice versa and should follow author preference. Authors of research reports, in turn, should use the terms that were prespecified in their study (eg, via participant self-report or selection, investigator observed, database, electronic health record, survey instrument).

Description of people as being of a regional descent (eg, of African, Asian, European, or Middle Eastern or North African descent) is acceptable if those terms were used in formal research. However, it is preferable to identify a specific country or region of origin when known and pertinent to the study.

For the genome-wide association study discovery stage, study participants of African ancestry were recruited from Ghana, Nigeria, South Africa, and the US, where the same phenotype definition was applied to diagnose primary open-angle glaucoma. The second validation meta-analysis included individuals with primary open-angle glaucoma and matched control individuals from Mali, Cameroon, Nigeria (Lagos, Kaduna, and Enugu), Brazil, Saudi Arabia, the Democratic Republic of the Congo, Morocco, and Peru.

For example, it is generally preferable to describe persons of Asian ancestry according to their country or regional area of origin (eg, Cambodian , Chinese , Indian , Japanese , Korean , Sri Lankan , East Asian , Southeast Asian ). Similarly, study participants from the Middle Eastern and North African region should be described using their nation of origin (eg, Egyptian , Iranian , Iraqi , Israeli , Lebanese ) when possible. Individuals of Middle Eastern and North African descent who identify with Arab ancestry and reside in the US may be referred to as Arab American . In such cases, researchers should report how categories were determined (eg, self-reported or selected by study participants or from demographic data in databases or other sources).

Note that Arab and Arab American, Asian and Asian American, Chinese and Chinese American , Mexican and Mexican American , and so on are not equivalent or interchangeable.

For studies that use national databases or include participants in a single country, a term for country of origin can be included if the term was provided at data collection (eg, Chinese American and Korean American for a study performed in the US, or Han Chinese and Zhuang Chinese for a study conducted in China). Again, how these designations were determined (eg, self-reported or selected or by other means) should be reported.

Abbreviations

Generally, abbreviations of categories for race and ethnicity should be avoided unless necessary because of space constraints (eg, in tables and figures) or to avoid long, repetitive strings of descriptors. If used, any abbreviations should be clearly explained parenthetically in text or in table and figure footnotes or legends.

Guidance for Journals and Publishers That Collect Data on Editors, Authors, and Peer Reviewers

Journals and publishers that collect race and ethnicity data on editors, editorial board members, authors, and peer reviewers should follow principles of confidentiality, privacy, and inclusivity and should permit individuals to self-identify or opt out of such identification. The Joint Commitment on Action for Inclusion and Diversity in Publishing is developing an international list of terms for journals and publishers that collect information on race and ethnicity. 32

Journals that collect information on race and ethnicity should not permit editorial decisions to be influenced by the demographic characteristics of authors, peer reviewers, editorial board members, or editors. In addition, the collection and use of such data should respect privacy regulations and be secured to prevent disclosure of personally identifiable information. Individual personally identifiable information of authors and peer reviewers should not be accessible to anyone involved in editorial decisions. Such data may be used in aggregate to benchmark and monitor strategies to promote and improve the diversity of journals.

Corresponding Author: Annette Flanagin, RN, MA, JAMA and the JAMA Network, 330 N Wabash Ave, Chicago, IL 60611 ( [email protected] ).

Conflict of Interest Disclosures: Ms Christiansen is chair and Mss Flanagin and Frey are members of the AMA Manual of Style committee.

Members of the AMA Manual of Style Committee : Stacy L. Christiansen, MA, managing editor, JAMA ; Miriam Y. Cintron, BA, assistant managing editor, JAMA ; Angel Desai, MD, MPH, associate editor, JAMA Network Open , and assistant professor, University of California, Davis; Annette Flanagin, RN, MA, executive managing editor, JAMA and JAMA Network; Phil B. Fontanarosa, MD, MBA, interim editor in chief, JAMA and JAMA Network; Tracy Frey, BA, deputy managing editor, JAMA Network; Iris Y. Lo, BA, assistant deputy managing editor, JAMA Network; Connie Manno, ELS, freelance manuscript editing director, JAMA Network; and Christopher C. Muth, MD, senior editor, JAMA , and assistant professor, Rush University Medical Center.

Additional Contributions: We thank the following individuals for their thoughtful review and comments that helped shape this guidance: Nadia N. Abuelezam, ScD, Boston College William F. Connell School of Nursing; Adewole S. Adamson, MD, MPP, Associate Editor, JAMA Dermatology , University of Texas at Austin, Internal Medicine, Division of Dermatology; Dewesh Agrawal, MD, Children’s National Hospital, and Departments of Pediatrics and Emergency Medicine, George Washington University School of Medicine and Health Sciences; Kristine J. Ajrouch, PhD, Department of Sociology, Eastern Michigan University; Germine H. Awad, PhD, University of Texas at Austin; Maria Baquero, PhD, MPH, senior social epidemiologist, Research and Evaluation Unit, Bureau of Epidemiology Services, Division of Epidemiology, New York City Department of Health and Mental Hygiene; Aisha Barber, MD, MEd, Children’s National Hospital, and Department of Pediatrics, George Washington University School of Medicine and Health Sciences; Ashley Bennett, MD, Children's Hospital Los Angeles; Howard Bauchner, MD, former editor in chief, JAMA and JAMA Network; Khadijah Breathett, MD, MS, Department of Medicine, University of Arizona; Thuy D. Bui, MD, Department of Medicine, Global Health/Underserved Populations Track, University of Pittsburgh School of Medicine; Kim Campbell, BS, senior manuscript editor, JAMA ; Jessica Castner, PhD, RN-BC, editor in chief, Journal of Emergency Nursing ; Linh Hồng Chương, MPH, Department of Health Policy & Management, UCLA Fielding School of Public Health; Francisco Cigarroa, MD, Department of Surgery, Director, Transplant Center, UT Health, San Antonio, and JAMA editorial board member; Desiree M. de la Torre, MPH, MBA, Community Affairs & Population Health Improvement, Children’s National Hospital; Christopher P. Duggan, MD, MPH, Center for Nutrition at Boston Children's Hospital and Harvard Medical School; Torian Easterling, MD, New York City Department of Health and Mental Hygiene; Enrique Escalante, MD, MSHS, director of Diversity Recruitment and Inclusion, Children’s National Hospital, and Department of Pediatrics, George Washington University School of Medicine and Health Sciences; Lisa Evans, JD, Scientific Workforce Diversity Officer, National Institutes of Health; Olanrewaju O. Falusi, MD, Children’s National Hospital; Stephanie E. Farquhar, PhD, MHS, New York City Department of Health and Mental Hygiene; Glenn Flores, MD, Department of Pediatrics, University of Miami Miller School of Medicine, Holtz Children’s Hospital, Jackson Health System; Barbara Gastel, MD, MPH, Texas A&M College of Medicine, Humanities in Medicine; L. Hannah Gould, PhD, New York City Department of Health and Mental Hygiene; Carmen E. Guerra, MD, MSCE, vice chair of Diversity and Inclusion, Department of Medicine, Perelman School of Medicine, University of Pennsylvania; P. Michael Ho, MD, PhD, University of Colorado, Aurora; Said Ibrahim, MD, MPH, MBA, Division of Healthcare Delivery Science & Innovation, Weill Cornell Medicine; Omer Ilahi, MD, Southwest Orthopedic Group; Alireza Hamidian Jahromi, MD, Rush University Medical Center; Quita Highsmith, MBA, chief diversity officer, Genentech; Renee M. Johnson, PhD, MPH, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health; Kamlesh Khunti, PhD, MD, University of Leicester; Trevor Lane, MA, DPhil, AsiaEdit; Cara Lichtenstein, MD, MPH, Children’s National Hospital; Francie Likis, DrPh, editor in chief, Journal of Midwifery & Women's Health ; Preeti N. Malani, MD, MSJ, associate editor, JAMA , and Department of Medicine, Division of Infectious Disease, University of Michigan; Jacqueline McGrath, PhD, RN, School of Nursing, UT Health San Antonio; Michelle Morse, MD, New York City Department of Health and Mental Hygiene; Brahmajee K. Nallamothu, MD, MPH, University of Michigan, Ann Arbor; Peter Olson, MA, manuscript editing coordinator, JAMA Network; Manish Pareek, MD, University of Leicester; Monica Peek, MD, MPH, Department of Medicine, Chicago Center for Diabetes Translational Research, University of Chicago; Jose S. Pulido, MD, MS, MPH, MBA, Wills Eye Hospital, and Departments of Ophthalmology and Molecular Medicine, Mayo Clinic; Zudin Puthucheary, MBBS, PhD, BMedSci, William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, Royal London Hospital, Barts Health NHS Trust; Sanjay Ramakrishnan, MBBS, Nuffield Department of Medicine, University of Oxford; Jeanne M. Regnante, chief health equity and diversity officer, LUNGevity Foundation; Allie Reynolds, Princeton University; Ash Routen, PhD, University of Leicester; James B. Ruben, MD, Folsom, California (retired); Randall L. Rutta, National Health Council; Deborah Salerno, PhD, senior medical writer, Salerno Scientific; Kanade Shinkai, MD, editor, JAMA Dermatology , and Department of Dermatology, University of California San Francisco; Erica S. Spatz, MD, MHS, Yale School of Medicine; Jenna Rose Stoehr, BA, Northwestern University Feinberg School of Medicine; L. Tantay, MA, New York City Department of Health and Mental Hygiene; Ayanna Vasquez, MD, MS, New York City Department of Health and Mental Hygiene; and Jason H. Wasfy, MD, MPhil, Massachusetts General Hospital.

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Flanagin A , Frey T , Christiansen SL , AMA Manual of Style Committee. Updated Guidance on the Reporting of Race and Ethnicity in Medical and Science Journals. JAMA. 2021;326(7):621–627. doi:10.1001/jama.2021.13304

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• v.195(6); 2023 Feb 13

CMAJ ’s new guidance on the reporting of race and ethnicity in research articles

Associated data.

Health equity cannot be achieved without equitable evidence, but equitable evidence does not exist across racial and ethnic groups. For example, in more than 20 000 clinical trials conducted in the United States between 2000 and 2020, fewer than half compared study outcomes among different racial and ethnic groups, and recruitment within them was poorly representative of population demography. 1 The resulting gap in the medical literature skews structures in health care to privilege White populations while disadvantaging others.

Many high-income countries, including Canada, have a long history of racism, which extends to health care and health research. Examples include the Tuskegee Syphilis Study, in which 600 Black men were misinformed over decades about the treatment they were receiving, 2 and Canadian studies of Indigenous children in residential schools who were left to suffer the effects of malnutrition. 3 Health research continues to perpetuate this history of racial discrimination through under-reporting of racism, race and ethnicity.

CMAJ has contributed to inequity by publishing content that ignored race and ethnicity when it was clinically relevant. Recognizing this, we present new guidance for reporting race and ethnicity in research manuscripts submitted to CMAJ ( Box 1 ). We now ask authors to follow this guidance when preparing papers for submission.

Box 1: Guidance for the reporting of race and ethnicity in CMAJ research articles

Articles being considered for publication in CMAJ ’s Research section should adhere to the following guidelines:

• CMAJ encourages the collection, analysis and reporting of data on the race and ethnicity of research participants, in order to provide evidence regarding health effects, disparities and inequities experienced by different racial and ethnic groups.
• CMAJ strongly encourages representation, as study partners, co-investigators and authors, of people from racial and ethnic groups affected by the health context being studied, especially for studies that explore racism, race and ethnicity as determinants of health.
• Authors should explain the purpose and relevance of collecting, analyzing and reporting data on race or ethnicity in their study and what race and ethnicity represent in the context of the research question.
• Race and ethnicity should be listed together with other variables collected and analyzed in the Methods section.
• Race and ethnicity should be reported together with other demographic variables in a table and summarized at the beginning of the Results section.
• As race and ethnicity are inherently social constructs, studies that analyze race and ethnicity should endeavour to explore their effects in the context of other sociodemographic variables and structures.
• Authors should explain whether race and ethnicity were self-identified by study participants or identified by others, providing justification if self-identification was not used.
• Authors should state whether options that participants could select to indicate their race or ethnicity were open-ended or based on fixed categories, listing the categories available, if applicable, and whether participants were allowed to identify as belonging to more than 1 racial or ethnic group.
• If race and ethnicity categories were determined or constrained by external factors (e.g., government legislation), or were originally collected for a purpose different from the purpose of the study being reported, authors should explain this.
• Studies that seek to test genetic hypotheses require collection, analysis and reporting of genetic data.
• Although genetic or biological predispositions to certain diseases may track with specific racial and ethnic groups, researchers should not exclude otherwise eligible participants from other groups capable of developing the disease, as doing so may worsen under-recognition of the disease in such groups.
• Race-based algorithms (e.g., “corrected” creatinine clearance for Black people) should not be used, as such “race corrections” typically oversimplify, creating the potential for inequity and harm.
• Exceptionally, in contexts where genetic characteristics travel very closely with race and ethnicity (e.g., the association between skin pigmentation and vitamin D levels), the rationale and validity of treating race and ethnicity as biological surrogates must be clearly explained and justified.
• Authors should comment on how their social position and identity, including race and ethnicity and their intersection with other factors, might have influenced data collection, analysis and interpretation, and how the researchers addressed power relations throughout the research process.
• In the Interpretation section, for studies that highlight associations of race and ethnicity with health outcomes, authors should discuss how their findings illustrate the intersection of race and ethnicity with other sociodemographic factors in the health context being studied, the role of structural racism in this context and how this might be addressed.
• Terms that imply a hierarchy among races (e.g., “non-White”) should be avoided and preferred terms (e.g., “under-served” or “underrepresented” populations, “historically marginalized groups”) used instead, as contextually appropriate.
• Listing of racial and ethnic groups in tables should be ordered based on an empirical rationale rather than one that implies a hierarchy (e.g., “White” should not automatically be listed first).
• Naming racial and ethnic categories as specifically as is appropriate to the study context is preferred over use of collective categories (e.g., “Indian” would be suitable in the context of some research questions, but in other contexts, “Punjabi” and “Malayali” could be more relevant; “Asian” is usually too generic to be sufficiently informative).
• It is acceptable to pool racial and ethnic groups for analysis when necessary and appropriate, but authors should explain and justify the manner in which this is done and ensure that the individual racial and ethnic groups within each category are identified.
• Racial and ethnic terms should be used in adjective form rather than in noun form (e.g., “Hispanic people,” not “Hispanics”).
• Names of racial, ethnic or tribal groups should be capitalized.
• Authors should use preferred contemporary names for racial and ethnic groups (e.g., White, not Caucasian).
• As preferred names for racial and ethnic groups may vary and may change over time, authors should be guided as much as possible by the preferences of study participants as to their expressed identity.

To create this new guidance, we reviewed sources that inform CMAJ ’s overall reporting style, including the International Committee of Medical Journal Editors (ICMJE) Uniform Requirements for Manuscripts 4 and the American Medical Association (AMA) Manual of Style . 5 We also searched published and grey literature and websites of other medical journals to identify recommendations related to the reporting of race and ethnicity in medical publications. Referring to these sources and reflecting on our own experiences with manuscripts submitted to CMAJ , we synthesized a guidance statement for authors. We refined it iteratively in group discussions with senior CMAJ editors then entered into broad consultation on our draft document from academics with research and policy expertise on the intersection of health, race and ethnicity. At the suggestion of an expert reviewer, we also invited public comment on the draft for a period of 3 months in 2022, by advertisement on our website, in emails to subscribers, in print editions of CMAJ and on CMAJ ’s social media channels. The feedback we received (which can be accessed, together with our responses to the reviewers, in Appendix 1 [available at www.cmaj.ca/lookup/doi/10.1503/cmaj.230144/tab-related-content ]) led to major changes in the language, clarity and focus of the guidance and allowed us to create the final version.

The objective of this guidance is not only to improve and standardize the reporting of race and ethnicity in CMAJ articles, but also to broaden the evidence base so that clinicians, policy-makers and, most importantly, patients can be confident that it includes all people, even those who traditionally face barriers to accessing optimal care. If its objective is to be met, this guidance must apply to all research submitted to CMAJ , not just studies that focus specifically on race and ethnicity. Examination of questions related to diseases and their treatment or health system performance must always consider how data on race and ethnicity are handled. We therefore encourage all researchers to acquire competency in properly evaluating the intersection of race and ethnicity with health. Accordingly, we will encourage authors of research manuscripts to describe, at the time of submission, how their work represents the diversity of racial and ethnic groups affected by the research question being studied and to think beyond race and ethnicity to speak to the impact of racism that may be reflected in their results. Thus, our guidance aspires to be antiracist, anti-colonial and anti-oppressive. Although the guidance was designed with CMAJ ’s Research section in mind, we will apply similar principles for articles in other sections where relevant. Our approach is analogous to actions taken by major granting agencies such as the Canadian Institutes of Health Research to ensure appropriate representation of sex and gender in health research. 6

CMAJ will employ the definitions of race and ethnicity used by the Canadian Institute for Health Information, 7 unless stated otherwise. Race is a social construct used to judge and categorize people based on perceived differences in physical appearance in ways that create and maintain power differentials within social hierarchies. Ethnicity is a multidimensional concept referring to community-belonging and a shared cultural group membership, and is related to sociodemographic characteristics, including language, religion, geographic origin, nationality, cultural traditions, ancestry and migration history, among others. We chose these definitions as they were designed for use in observational research using large databases, the most common type of research that CMAJ publishes. We will accept the use of other definitions of these constructs in CMAJ publications if such definitions are explained and justified.

Our guidance is grounded in science. It therefore emphasizes that race and ethnicity are not biological or genetic constructs, but social and cultural ones, and seeks to root out research that would support practices incompatible with this understanding (e.g., use of race “correction” algorithms). Our guidance considers the intersectional dimensions of race, ethnicity and racism, which typically do not exist in isolation but rather interact with other variables to produce and reproduce inequities. Moreover, our guidance emphasizes respect for the autonomy and agency of research participants in articulating their own identity. It seeks to respect authors and recognize the many different contexts that influence research design, analysis and reporting. For example, research questions focused primarily on group or population effects may not be able to analyze results in every racial or ethnic group with which participants identify.

Although we consider that many of the principles expressed in this guidance document would apply to research among Indigenous populations, we recognize that Indigenous identity differs in important ways from the constructs of race and ethnicity. Accordingly, CMAJ plans to develop separate guidance for reporting of health research involving Indigenous participants.

Preferred language for referring to racial and ethnic groups evolves over time, and we expect that our concept of optimal reporting style for race and ethnicity will evolve accordingly. We will remain attentive to how our guidance is used and perceived and how it affects what CMAJ publishes. We hope that this document may contribute meaningfully to better design and reporting of health research, yielding better information and outcomes for all people.

Supplementary Material

Acknowledgements.

We are indebted to our external reviewers for their invaluable feedback and recommendations that helped create the final version of this guidance: Laura Arbour, Jude Mary Cénat, Barbara Hamilton-Hinch, Régine King, Jeffrey Kwong, Saleem Razack, Baiju Shah and Arjumand Siddiqi. We also thank all our public commentators for their input. We are grateful to the other members of the CMAJ team who participated in the development of this guidance, including Wendy Carroll, Josephine Etowa, Diane Kelsall, Andreas Laupacis, Andrew McRae, Kirsten Patrick, Savita Rani, Erin Russell and Meredith Weinhold.

Competing interests: www.cmaj.ca/staff

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• How to Ask Race &…

Dear Reader,

If demographic benchmarks and trends are essential to your business and the research you conduct (things like age, gender, race, ethnicity, and region) then this newsletter has information you absolutely need to know.

Why? Because the U.S. Census Bureau continues to change how it collects and classifies demographic data. Right now the Bureau is engaged in its every-ten-years BIG census that will survey every household in the nation. It will have a lasting impact on all of us for at least the next ten years.

Our feature article on How to Ask Race & Ethnicity on a Survey highlights what the Census Bureau is doing, and how it will affect your business and the research you conduct.

Other items of interest in this newsletter include: Why Your CEO Loves NPS: It Is Never Audited, and It Never Declines Why You Should Be Using Conjoint Analysis Avoid Numeric Response Scales in Surveys (Here’s Why) Forget the Math: A Conceptual Guide for Good Sampling AI (Artificial Intelligence) Just Rescued Our Survey! New Data on COVID-19 Highlights Crucial Role of Research How to Trap Survey Trolls: Ask Them for a Story Five Best Practices for Keeping Your Data “Anonymous” If Truth Matters, Prove It with a Survey A Video Report Example with Animation and Insight We are also delighted to share with you: Versta Research in the News … which showcases some of our recent work for the Alzheimer’s Association, a customer satisfaction survey highlighted in the latest issue of Quirk’s , and a masterclass for business students at the University of Illinois in Chicago.

As always, feel free to reach out with an inquiry or with questions you may have. We would be pleased to consult with you on your next research effort.

Happy spring,

The Versta Team

How to Ask Race & Ethnicity on a Survey

The most thoroughly tested and validated survey questions ever on the planet are probably the 2020 Census questions on race and ethnicity. Census Bureau researchers have spent tens of millions of dollars over the past decade interviewing hundreds of thousands of Americans about race.

As a result, the Census Bureau has implemented a few changes for the 2020 decennial census, one piece of which involves documenting the race and ethnicity of every person in the United States. Does it mean you should be replicating the Census questions in your own surveys?

Possibly yes, probably no.

To help you sort through the issues, this article describes recent changes to the 2020 Census and helps you assess how the new race and ethnicity questions will likely affect your own research and survey work in the future.

Right now the 2020 Census questions on race and ethnicity may well be the most thoroughly tested and validated survey questions ever on the planet.

Here is what we cover:

• Race and ethnicity are asked differently from years past. We’ll show you the old and the new , and explain why Census Bureau researchers had hoped for even bigger changes.
• The new questions are complex, just like the old ones, which some people find confusing. But survey respondents are resilient. We’ll provide a brief overview of how the questions were validated .
• You will have to incorporate the new questions into your work. There is no choice if you want to reference census data. But should it change your approach to asking about race and ethnicity in your own surveys? We’ll show you our recommended approach.

No, the Census Race & Ethnicity Questions Are Not That Confusing

We’ll start with the second item noted above, because it was a complaint by an industry colleague that prompted us to begin looking at the issue more closely for this newsletter.

Here is what this colleague posted on a market research discussion forum:

The race question is very odd. I don’t think any of us in the research community (quant or qual) would have asked the question this way. The question groupings and listed categories are very odd. And the required open-end is bound to get a bunch of garbage. How on earth will they analyze the open-ends and find meaningful, quantifiable data?

Researchers certainly can act like know-it-alls when it comes to designing surveys (even the ones who don’t really design surveys). I can sympathize, because I, too, am prone to critiquing other people’s surveys. Moreover, I agree that the new race and ethnicity questions are not ideal.

But wait. It turns out the researchers at the U.S. Census Bureau agree as well, so let’s give them the credit they deserve. They know tons more about how to ask these questions than any online critics in the market research industry. In fact, they spent over ten years and millions of dollars testing their questions. Right now the 2020 Census questions on race and ethnicity may well be the most thoroughly tested and validated survey questions ever on the planet.

The Census Bureau conducted the largest quantitative effort ever on how people identify their race and ethnicity.

Way back in 2010 the Bureau conducted an experiment to begin preparing for the 2020 Census. Their experiment was “the largest quantitative effort ever on how people identify their race and ethnicity.” It involved experimental questionnaires mailed to a sample of 488,604 households during the 2010 Census. Then they called over 60,000 of those households to re-interview them by telephone. In addition, they conducted 67 focus groups across the United States and in Puerto Rico with nearly 800 people. A detailed report of their methods and findings are available in a 151-page report .

Even before that effort, the Bureau conducted one-on-one cognitive interviewing to test for misunderstandings or misinterpretations of the wording. Here is what that involved:

The protocol for the cognitive interviews combined verbal think-aloud reports with retrospective probes and debriefing. Each cognitive interview involved two interviewers working together, face-to-face with the respondent. One interviewer read the RI questionnaire as if he or she was conducting the actual phone interview. Meanwhile, another interviewer observed the interview, took notes, and later asked cognitive interview and retrospective debriefing questions after the RI questionnaire was complete. The cognitive interview and probing questions aimed to explore respondents’ understanding of the race and Hispanic origin questions, their typical response to these questions, any variation that they might have in reporting race and origin, and their sense of burden of the interview. The debriefing probes were semi-scripted, allowing the interviewer to probe on things that occurred spontaneously while also covering a set of required material.

Then in 2015 the Bureau launched another round of research. They tested question format (one question vs. two), response categories (including Middle Eastern or North African, for example), instruction wording (using phrases like, “select all that apply,” for example), and question terminology (such as race, origin, ethnicity, etc.)  to test alternative versions of the question, and to understand any potential problems with mode effects (mail questionnaire vs. online vs. in-person). They sampled and mailed to over 1 million households, and selected about 100,000 of those households for follow-up phone interviews. You can read about their methods and findings for this phase of research in a 380-page report .

If only we could all test our survey questions this thoroughly and so painstakingly!

It is true that the current ethnicity and race questions are not ideal (see the next section for why). But it is absolutely not true that the results will be “garbage.” At this point, Census Bureau researchers know a great deal about how people respond to the questions laid out on the census forms. And they know how to code and tabulate the responses to get a valid and reliable profile of our population.

The New vs. the Old

Wondering what all the fuss is about? Here are the new 2020 Census questions on ethnicity and race:

Compare this with 2010:

There is one reason neither version is ideal, and it has nothing to do with open-end boxes. It’s because Hispanic or Latino is asked separately from race, so when Hispanic/Latino respondents get to the question about race, many of them will select “other.”

Census researchers know this. They strongly recommended that Hispanic/Latino be integrated into the race question for the 2020 Census. But they ran up against a 1997 law requiring federal agencies to specify five minimum categories for data on race (American Indian or Alaska Native; Asian; Black or African American; Native Hawaiian or Other Pacific Islander; White) and two categories for data on ethnicity (Hispanic or Latino; Not Hispanic or Latino). The recommended changes to this law were ignored by the White House, and unfortunately Congress did not step in to fix it.

There are, however, some other interesting changes that did not require changes to the law. First, the word Negro has been dropped. Second, most respondents are now asked to specify their origins along with their race. The idea is to capture a more nuanced portrait of which countries, tribes, and regions of the world Americans of all races come from.

How to Ask Race on YOUR Survey

For several years we wrote surveys that replicated the Census’ two-question format asking for race and ethnicity, and we recommended that clients do the same. The reason is that usually you (we) must weight your data to Census benchmarks to ensure representative samples. Or, we need to compare your data to those benchmarks to gain a deeper understanding of your markets.

But clients are just like other Americans! Few of them think of “Hispanic or Latino” as being a category separate from race. So in our analysis and reporting we found ourselves nearly always recoding the data into a single race variable, and then applying that same recoding to Census numbers to make our comparisons.

Over the last few years, then, we landed on this version of a race/ethnicity question for our surveys:

Note that the response options are in alphabetical order, except for the last two lines. We have found that this question works extremely well. Few people use the “other” category. It doesn’t offend or confuse people. And then with just a little bit of simple analysis and coding work, it easily maps onto current and future Census data:

This is how we now recommend most clients ask about race in their surveys, with some exceptions. If you need to track against your historical data, it may not work. If your customers are unique, varied immigrant populations ( like one of our Chicago clients ) you may want different details.

Whatever you do, think carefully about your approach — as carefully and thoughtfully as our colleagues in the Census Bureau have done. Although you cannot test as exhaustively as they have done, you don’t need to. The Census Bureau has provided an amazing foundation of knowledge and data you can feel confident relying on for your own work.

Stories from the Versta Blog

Here are several recent posts from the  Versta Research Blog . Click on any headline to read more.

Why Your CEO Loves NPS: It Is Never Audited, and It Never Declines

The Wall Street Journal recently looked at the number of public companies using NPS as a measure of corporate performance in earnings calls and SEC filings.

Why You Should Be Using Conjoint Analysis

Conjoint lets you probe the depths of why customers prefer one product over another, and it lets you build a model to evaluate multiple product options.

Avoid Numeric Response Scales in Surveys — They Seem Scientific, but They Are Actually Ambiguous and Difficult to Report

If you can avoid using numeric rating scales in your surveys, you should. Why? Because they are often impossible to report in clear and meaningful ways.

Forget the Math — For Good Sampling You Need Equality, Inclusion, and Representation

For most research, pure random sampling (probability-based) is not achievable. But there are other ways to approach sampling. Here is a guide of what you will need.

AI (Artificial Intelligence) Just Rescued Our Survey — We Overlooked a Huge Mistake and a Robot Flagged It for Us

So far, robots and AI have done more harm than good in the world of market research and public opinion polling. But we just experienced a glimmer of AI hope!

Stockpiling and Job Worries: New Data on COVID-19 Highlights Crucial Role of Research

A national survey taken in the first week of widespread disruption from COVID-19 provides crucial data that will help agencies prepare for the crisis.

How to Trap Survey Trolls: Ask Them for a Story

At Versta Research we are now using our superpower of Turning Data Into Stories to help fight trolls and robots by asking just one clever open-end.

Five Best Practices for Keeping Your Data “Anonymous”

Now that sophisticated new algorithms can identify specific individuals in “anonymous” datasets, you need new best practices for how to manage your data.

If Truth Matters, Prove It with a Survey

A recent NYT article about the presidential election provides a perfect example of why journalists need surveys to substantiate the claims of their stories.

Here Is a Video Report That Engages Its Audience with Animation and Insight

One of our clients created a video report from our employee healthcare tracking study as their primary presentation of findings to stakeholders.

Versta Research in the News

Alzheimer’s association releases findings on physician readiness.

Versta Research was commissioned to conduct surveys of physicians and first-year residents about their training, readiness, and expectations for future dementia care. The results were reported by U.S. News & World Report , among other news outlets. Full details are available in the Association’s press release and in the 2020 Alzheimer’s Disease Facts and Figures report. Results are summarized in an infographic and video clip , as well.

Quirk’s Features Versta Research Survey for Chicago Bank

An article about Versta Research’s customer satisfaction survey for Devon Bank in Chicago appears in Quirk’s March/April 2020 print and online edition. The survey had a 25% response rate, far exceeding most online surveys, and was originally featured in our newsletter article, How to Beat Online Surveys with Old-Fashioned Paper .

Versta Research Coaches Business Students on Turning Data Into Stories

Joe Hopper, president of Versta Research, visited emerging new business leaders at the University of Illinois in Chicago for two weeks in February and March. Professor Jeffrey Parker wanted to showcase a better way to analyze and present market research findings.

New Research for Fidelity Investments on Money & Divorce

Fidelity Investments commissioned Versta Research for a new study on how people navigate the process of divorce financially and emotionally. Findings have so far been featured in stories by Reuters , Prevention , and Financial Advisor Magazine . Full details are available from Fidelity’s press release and Divorce and Money Study Fact Sheet .

MORE VERSTA NEWSLETTERS

How epidemiology researchers discuss race and ethnicity

September 28, 2022

How do you study race and racism when there’s no consensus on how these terms are used in research? New research from  a collaborative team of doctoral students at the Carolina Population Center (CPC), three of which are also students at the UNC Gillings School of Global Public Health, tackles this question and provides guidance for researchers across disciplines.

The doctoral students – who come from the fields of epidemiology, sociology, anthropology and health policy – were inspired by Thomas LaVeist’s 1996 article , “Why we should continue to study race… but do a better job: an essay on race, racism and health,” and began to look at how race was conceptualized, operationalized and used in academic research journals.

Their  findings were published recently  in the  American Journal of Epidemiology . Authors Rae Anne Martinez (Epidemiology), Nafeesa Andrabi (Sociology), Andrea Goodwin (Sociology), Rachel Wilbur (Anthropology), Natalie  Smith (Health Policy and Management) and Paul Zivich (Epidemiology) recently answered questions  in an interview with CPC about their work, which was also the subject of a six-part series on thoughtfully using race and ethnicity in population health research on the Interdisciplinary Association for Population Health Science (IAPHS)’s blog.

How were  authors defining (or not defining) race and ethnicity?

We reviewed United States human-subject research from five epidemiology journals: American Journal of Epidemiology, Annals of Epidemiology, Epidemiology, Journal of Clinical Epidemiology, Journal of Epidemiology and Community Health , published between 1995 and 2018. Of all the articles we found, 329 included data on participants’ race and/or ethnicity, and only four of these studies defined race and/or ethnicity. One case combined race and ethnicity into an ethnoracial construct and defined using it as a proxy measure of respondent culture. Two studies referenced the U.S. Census Office of Management and Budget’s definitions, and another conceptualized ethnicity as a marker of cultural beliefs about health. But the remaining 325 studies included race and/or ethnicity data without providing any definitions of the constructs.

Why does that matter?

We believe that the profound absence of definitions of race and/or ethnicity is indicative of a few key issues within the field and, broadly, U.S. society.

First, we may not define race and ethnicity because we believe that what these constructs mean is obvious… but it isn’t. There are competing perspectives on what race “is,” ranging from biologically essentialist views that wrongfully deem race an innate, biological characteristic to social constructionist views that deem race a categorizing system created by people in the last few centuries primarily to enact and establish white Christian supremacy. If we don’t define what race means or say why we’re including it in our research, we assume that it means the same thing to everyone and that it means the same thing across time. This allows for interpretations of the findings that can be biologically essentialist and cause further harm to racialized and minoritized people in the U.S.

There was a stark difference in how race and ethnicity data were treated in comparison to other data, which may represent a broader sense that race and ethnicity exist in the background but don’t matter enough to get words on the page. In contrast, we often found robust definitions for other variables like diabetes, which included information about the use of biomarker data or physician diagnosis, clinical or diagnostic cut-offs, type of diabetes studied, and justification for that type.

Second, we may not define race and/or ethnicity or explain mechanistically why we include them in our study design because we, in fact, don’t know the answer. Instead, we may be participating in the act of ritualistic regression. Increasingly, people living in the U.S., especially people racialized as white, are having to confront the notion of race and racism, yet the extent to which people understand the ideology and systems of racism and race may be limited. This is coming across in our science. What we find are study designs that go through the motion of including race and ethnicity data because we know we should, rather than engaging in meaningful reflection to ask how would race and ethnicity impact the outcomes we are looking at, what measure of race and ethnicity would best be suited for the kinds of research questions we are asking and the extent to which we are actually able to include the dimensions of race and/or ethnicity that are relevant to our studies (i.e., skin tone versus closed-ended self-identification).

How did you get the idea for doing this research?

We are all members of the inaugural “Biosocial” T32 training program cohort here at CPC. Through shared training in the T32 program, we had many discussions regarding our own disciplines and research. We noticed that, across our discipline-specific training, we had all been exposed to critiques, commentaries and recommendations for incorporating race and ethnicity thoughtfully into population health scholarship. These commentaries largely called for population health researchers to abandon practices of ritualistic regression and critically examine and explain the role of these constructs in health scholarship, though differed across subjects. In an early group meeting we discussed Thomas LaVeist’s 1996 article, “Why we should continue to study race… but do a better job: an essay on race, racism, and health,” and thought it was particularly motivating as an early call to action in better conceptualizing, operationalizing and interpreting race in health scholarship.

However, we also noticed a big discrepancy. The larger body of literature we were being exposed to as students didn’t seem to be matching the changes or actions these commentaries were calling for in terms of thoughtfully engaging with race and ethnicity. So, in this project, we set out to understand if our own disciplines – epidemiology, clinical medicine and medical sociology – had risen to these calls for action and if we were doing “a better job” conceptualizing, operationalizing, and using race and ethnicity in health scholarship. (Spoiler – we weren’t – and likely still aren’t.)

What are some of the complications in coding race and ethnicity?

There are a lot, and while we won’t go into detail here, we can share a bit about what stood out.

In the studies we reviewed, racial coding schemes centered whiteness through coding schemes like “white, non-white.” This ties back to the value of defining race and ethnicity and justifying the inclusion of this data in study designs. What is the value of a non-white group, and what can we meaningfully infer about this group within this study design?

We commonly saw an ambiguous “other” category, where authors did not describe who was included in “other” or how to interpret this category within the analyses. The continued reliance and inclusion of this “other” category may systematically be excluding and leading to the erasure of smaller racial and ethnic groups that ultimately may not get attention or distribution of resources despite vulnerabilities or health disparities.

We also found that most studies that included data on participants’ race and ethnicity often collapsed this data into an ethnoracial construct. Again, this is largely happening without defining race and ethnicity and without describing why it’s theoretically appropriate to combine these into one construct. Collapsing race and ethnicity for the purposes of analyses assumes that these two constructs are capturing similar information and have similar relationships to health outcomes such that we can make meaningful comparisons between groups. In the absence of definitions and justifications, it’s unclear whether the decision to use an ethnoracial construct is intentional and motivated by theory or the study question, or unintentional in that it’s a limitation of the data structure or perhaps just ritualistic practice.

What should researchers think of as they do this work?

The elements we examined in our study – construct definitions, measures, coding and scientific rationale – we consider to be “core” or “base” methods. These correspond to relatively simple questions, like “what is this construct? Why is it important to the study question and population? How do I measure it? How do I code it?” We answer these all the time for our exposures, outcomes and primary effect measure modifiers, even if it is not a formalized part of our research practice or analysis plan. That’s just how fundamental they are.

However, these simple questions can be really difficult with respect to constructs that are normalized to be “common sense” or a natural part of the world (i.e., race, ethnicity, gender). We learn race over our lifetimes through interactions and social, political and educational institutions. What “race” is, the number of and boundaries between “racial groups,” and the scientific relevancy of race may all seem so obvious that we rarely, if ever, attempt to explicitly answer these questions. Ultimately, that impacts our science. When we do attempt to answer them, it may be so uncomfortable we are dissuaded from continuing. We may feel overwhelmed in not knowing where to start, we may feel shame in not having started earlier, or we may feel unsure in how to do so “correctly.”

So, more than anything else, we think it is about  actually doing   work to answer these seemingly simple questions. Answering these questions explicitly can help us identify or address internalized misconceptions. Moreover, omitting construct definitions, measures, coding and scientific rationale from publications is a threat to scientific rigor and reproducibility. We do recognize that not everyone is going to be a race scholar, but this is where we can lean on the strength of interdisciplinary teams.

We’ve presented more of these thoughts in an academic blog series: “Thoughtfully Measuring and Interpreting Race In Population Health Research.” Find the full series online .

What are you planning to do next?

Well, we are still working to publish the results from the other disciplines (medicine and medical sociology)!

We also used the empirical evidence from our review to inform the development of interactive workshops for a range of audiences, which covers the theoretical considerations of race and ethnicity in health research, tools for communication, and highlights opportunities for improvement at the individual level. We’ve been offering the workshop to a variety of audiences this past year.

Our next virtual offering of the workshop will be in November hosted by IAPHS, which interested folks can check out on their website .

Is there anything else you’d like to add?

Since 2020, we’ve seen many population health researchers asking “what can I do” and “how do I improve?” when thinking about equitable and just research. There are many changes we can make as individuals and collectively. One of the small steps you can take right now is to take a look at your language. In the manuscript you are working on right now, you can examine the terms you use for racial and ethnic groups (e.g., “Hispanic” vs “Latino,” “Black” vs “African American”), what is being capitalized or not (e.g., “White” or “white”), or how we are describing communities (e.g., “vulnerable”) and the decisions behind these choices.

Language holds a lot of power and history. It can clarify or obscure, justify or delegitimize, and so we should be critical and thoughtful in all aspects of its use.

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Expert Commentary

Race, ethnicity and identity in America: Research roundup

2015 roundup of research on race and ethnicity in the United States, and how self-identification and identification by others can vary depending on personal and societal factors.

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This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License .

by Leighton Walter Kille and John Wihbey, The Journalist's Resource June 16, 2015

This <a target="_blank" href="https://journalistsresource.org/race-and-gender/race-ethnicity-and-identity-in-the-american-21st-century-research-roundup/">article</a> first appeared on <a target="_blank" href="https://journalistsresource.org">The Journalist's Resource</a> and is republished here under a Creative Commons license.<img src="https://journalistsresource.org/wp-content/uploads/2020/11/cropped-jr-favicon-150x150.png" style="width:1em;height:1em;margin-left:10px;">

For millions of Americans, issues of racial and ethnic identification are frequently complicated, a legacy of the country’s endless waves of immigration as well as its long history of slavery and expansion into Native American lands across the continent.

“Passing” as white was not uncommon in the pre-Civil Rights era, when strict separation between African-Americans and whites was generally expected in many places. With the rise of  “minority majority” America , questions of boundaries and overlapping identities continue to grow only more nuanced and complex. Of course, racial categories are  social constructs ; scholars note that even perceived “monolithic” identities such as African-American almost always, genetically speaking, encompass mixed races.

A 2015 Pew Research Center survey found that an estimated 6.9% of Americans identify as multiracial, and a sizable percentage of these individuals report having changed the way they previously thought about their racial identity. By far the largest multiracial group is comprised of mixed Native American-Caucasian ancestry.

Beginning in 2000, the U.S. Census Bureau began allowing for individuals to self-identify as more than one race on its survey forms. The 2010 Census recorded some 9 million people of mixed-race status (2.9% of the population overall), and more than 700,000 persons identified with three or four different races. (The more recent Pew survey, then, suggests that the Census numbers may reflect an under-count.)

The June 2015 controversy over the head of the Spokane Washington NAACP chapter, Rachel Dolezal, who resigned after her biological parents revealed in 2015 that her ancestry was predominantly white with some Native American ancestry, is just the latest chapter in a long, tangled history of racial identity in America — encompassing issues that go well beyond black and white. For example, research has found that after the 9/11 attacks there was a substantial decrease in the probability that Arab and Muslim Americans would self-identify as white. Even among sub-groups, such as Cuban-Americans , there are long-running, intra-community debates over ethnicity and race.

Social scientists continue to study the impact of racial issues across diverse areas, from the way  economic scarcity  can influence perceptions; to issues of law enforcement and criminal justice ; to the way race can shape the mechanisms of policy and politics .

Below is a selection of research on race, ethnicity and identity in the United States.

————————-

“Adolescent Racial Identity Self-Identification of Multiple and ‘Other’ Race/Ethnicities” Harris, Bryn; Ravert, Russell D.; Sullivan, Amanda L. Urban Education , March 2015. doi: 10.1177/0042085915574527.

Abstract: “This mixed-methods study focused on adolescents who rejected conventional singular racial/ethnic categorization by selecting multiple race/ethnicities or writing descriptions of ‘Other’ racial/ethnic identities in response to a survey item asking them to identify their race/ethnicity. Written responses reflected eight distinct categories ranging from elaborative descriptions of conventional race categories to responses refusing the construct of race/ethnicity. Students’ endorsement of multiple or ‘Other’ ethnicities, and the resultant categories, differed by gender, grade, school type, and school compositions. Findings support scholars’ concern that common conceptualizations of race may not capture the complexity of self-identified racial categories among youth.”

“Monoracial and Biracial Children: Effects of Racial Identity Saliency on Social Learning and Social Preferences” Gaither, Sarah E.; et al. Child Development, July 2014, Vol. 85, Issue 6, 2299-2316. doi: 10.1111/cdev.12266.

Abstract: “Children prefer learning from, and affiliating with, their racial in-group but those preferences may vary for biracial children. Monoracial (white, black, Asian) and biracial (black/white, Asian/white) children (N = 246, 3–8 years) had their racial identity primed. In a learning preferences task, participants determined the function of a novel object after watching adults (white, black and Asian) demonstrate its uses. In the social preferences task, participants saw pairs of children (white, black and Asian) and chose with whom they most wanted to socially affiliate. Biracial children showed flexibility in racial identification during learning and social tasks. However, minority-primed biracial children were not more likely than monoracial minorities to socially affiliate with primed racial in-group members, indicating their in-group preferences are contextually based.”

“The Genetic Ancestry of African Americans, Latinos and European Americans across the United States” Bryc, Katarzyna; et al. American Journal of Human Genetics , Vol. 96, 37–53, January 2015. doi: 10.1016/j.ajhg.2014.11.010.

Abstract: “Over the past 500 years, North America has been the site of ongoing mixing of Native Americans, European settlers and Africans (brought largely by the trans-Atlantic slave trade), shaping the early history of what became the United States. We studied the genetic ancestry of 5,269 self-described African Americans, 8,663 Latinos, and 148,789 European Americans who are 23andMe customers and show that the legacy of these historical interactions is visible in the genetic ancestry of present-day Americans. We document pervasive mixed ancestry and asymmetrical male and female ancestry contributions in all groups studied. We show that regional ancestry differences reflect historical events, such as early Spanish colonization, waves of immigration from many regions of Europe, and forced relocation of Native Americans within the U.S. This study sheds light on the fine-scale differences in ancestry within and across the United States and informs our understanding of the relationship between racial and ethnic identities and genetic ancestry.”

“Developmental Flexibility in the Age of Globalization: Autonomy and Identity Development Among Immigrant Adolescents” Fuligni, Andrew; Tsai, Kim M. Annual Review of Psychology , July 2014, Vol. 66, 411-431. doi: 10.1146/annurev-psych-010814-015111.

Abstract: “The socioeconomic and cultural changes that result from an increasingly interconnected world have been speculated to have important implications for the nature of adolescent development. Unfortunately, the historical time necessary for these changes to take place means that definitive research on the impact of globalization necessarily will be slow in forthcoming. Adolescents from immigrant families, however, already experience the social and cultural shifts thought to typify globalization, and an analysis of their experiences could shed light on what to expect as existing national barriers become more permeable. The value of flexibility in the face of great social and cultural change appears to be the dominant theme from research on immigrant youth, although that flexibility can be constrained by socioeconomic, ethnic, and racial stratification systems in host societies. This review highlights the implications of these findings for what may lie ahead for teenagers as globalization continues to expand.”

“Stigmatization and Racial Selection after September 11, 2001: Self-identity Among Arab and Islamic Americans” Mason, Patrick L.; Matella, Andrew. Journal of Migration , October 2014. doi: 10.1186/s40176-014-0020-9.

Abstract: “During the 2000s, Arab and Islamic American racial identity selection was subjected to an exogenous racializing event, viz., public and private reaction to the Al Qaeda attacks of September 11, 2001. The Al Qaeda attacks clearly demarcate a period in which there was a structural increase in the intensity of U.S. stigmatization of persons with Islamic religious affiliation and Arab ethnicity. This stigmatization created an exogenous reduction in the expected payoff to acculturation relative to non-acculturation. This paper uses self-identification as white as its measure of acculturation and the fraction of all hate crimes directed at Muslims as its measure of stigmatization after 9/11. Comparing 2002–2012 to 1996–2001, there is a statistically significant and substantively large decrease in the unconditional and conditional probabilities that Arab and Islamic Americans will self-identify as white.”

“Racial Identity and Well-Being among African Americans” Hughes, Michael; et al. Social Psychology Quarterly , January 2015. doi: 10.1177/0190272514554043.

Abstract: “How racial identity influences self-esteem and psychological well-being among African Americans remains unresolved due to unexplained inconsistencies in theoretical predictions and empirical findings. Using data from the National Survey of American Life (N = 3,570), we tested hypotheses derived from social identity theory and the internalized racism perspective. Findings support social identity theory in showing that African Americans strongly identify with their group and view it very positively. In addition, those who identify more with their group and evaluate it more positively have greater self-esteem, greater mastery, and fewer depressive symptoms. However, findings also support the internalized racism perspective by showing that when group evaluation is relatively negative, racial identification is related to lower mastery and higher depressive symptoms.”

“The Protective Role of Ethnic Identity for Urban Adolescent Males Facing Multiple Stressors” Williams, Joanna L.; et al. Journal of Youth and Adolescence , October 2014, Vol. 43, Issue 10, 1728-1741.

Abstract: ” Having a connection to one’s ethnic heritage is considered a protective factor in the face of discrimination; however, it is unclear whether the protective effects are persistent across multiple stressors. Furthermore, the dimensions of ethnic identity that reflect group pride/connection (affirmation) and exploration of the meaning of group membership (achievement) may operate differently in the face of stress. The present study examined the moderating role of ethnic identity affirmation and achievement on concurrent and longitudinal relationships between exposure to stress (discrimination, family hardship, exposure to violence) and antisocial behavior in a sample of 256 Black and Latino male youth (70% Black) living in low-income urban neighborhoods. Using regression analysis, concurrent associations were examined at age 18, and longitudinal associations were tested 18 months later. We found that, among youth experiencing discrimination, high levels of achievement and low levels of affirmation predicted greater aggressive behavior and delinquency. Low affirmation also predicted more criminal offending in the face of discrimination. The two dimensions operated similarly in the context of family stress, in which case high levels of affirmation and achievement predicted lower levels of antisocial behavior.”

“Redefining Racial Categories: The Dynamics of Identity Among Brazilian-Americans” Fritz, Catarina. Immigrants & Minorities: Historical Studies in Ethnicity, Migration and Diaspora, June 2014, Vol. 3, Issue 1. doi: 10.1080/02619288.2014.909732.

Abstract: “Research based on a sample of Brazilian youth living in Massachusetts reveals a variety of responses to racialisation of their phenotypes. Caught between the fluid patterns of colour categories found in Brazilian society and the more rigid racial stratification that characterises the USA, Brazilian-Americans have followed a variety of strategies to adapt to this situation. By exploring the reactions of these young adults of different appearance along the colour continuum to the constraints of the dominant society, questions concerning the future dynamics of race relations in the USA are raised against a background of the continuing post-racialism debate.”

Keywords: race, ethnicity, self-identity, African-American, Latino, Hispanic, Native American, Indian, Asian, research roundup

About the Authors

Leighton Walter Kille

John Wihbey

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• Research & Reports

The Impact of Reforming Census Questions About Race and Ethnicity

Changes proposed by the government would increase the accuracy, equity, and legitimacy of the decennial count.

• A Fair & Accurate Census

The federal government has taken an important step toward modernizing the census and other federal surveys, with major potential benefits for civil rights. The White House’s Office of Management and Budget has issued a  call for public comments  on its plan to update the way federal surveys ask about race and ethnicity, setting the stage for the first comprehensive changes to those questions since 1997.

This long-awaited overhaul would go a considerable way toward producing data sets that can better serve our increasingly diverse country, and it signals that the federal government is getting more serious about much-needed census reform.

What does the federal government want to change?

The proposed changes involve Statistical Policy Directive No. 15, a policy that governs how federal agencies ask questions about race and ethnicity. This directive is part of a broader set of policies that work together to help ensure the quality and consistency of the data that agencies collect through their surveys. The Office of Management and Budget oversees setting and updating these directives.

What are the flaws in the existing policy?

The current directive has created a variety of problems for the surveys that must adhere to its standards, including the 2020 census. This is how the most recent census asked about race and ethnicity:

The first problem stems from asking people to answer separate questions about their ethnicity and race. Existing policy requires agencies to first ask whether someone is of “Hispanic, Latino, or Spanish origin.” It then asks them to select their race from five primary categories: White; Black or African American; American Indian or Alaskan Native; Asian; or Native Hawaiian or Other Pacific Islander. (Congress passed a law mandating that the census include a “Some Other Race” category.) But many individuals do not think of their race and ethnicity as distinct. For example, many Latino people see their primary identity as Latino; so, when asked a separate question about their race, they often end up selecting “some other race.” More than  26 million Latinos  did so in 2020 — a number that climbs to 45.3 million when including Latinos who selected “some other race” along with one or more additional races. Large numbers of people reporting as “some other race” can create downstream problems. For example, enforcing civil rights law often requires people to identify as a specific race or ethnicity.

The policy also poses an issue for people who identify as Middle Eastern or North African. Currently, the directive encourages them to select “White” as their race and then write in their national origin. But as advocates for federal survey reform have  observed  since the early 1990s, people of Middle Eastern or North African descent do not identify as white. The lack of a specific category essentially renders the community invisible in federal data and denies Middle Eastern and North African Americans a collective voice in political representation.

The directive also lumps together groups of people who may have vastly different experiences and outcomes. For example, Asian American, Native Hawaiian, and Pacific Islander communities include  over 50 detailed race groups  with varying income levels, educational attainment, and health outcomes. The current directive allows but does not require disaggregated data collection of subgroup identities, so agencies often do not go beyond collecting the minimum standard. The lack of detailed federal data perpetuates the model minority myth by masking the important differences that exist across Asian American, Native Hawaiian, and Pacific Islander communities.

The current directive also includes outdated and sometimes offensive terms, such as “Negro” and “Far East,” to describe racial groups.

Many of these issues — like the lack of a Middle Eastern or North African category or the separate race and ethnicity questions — would have been addressed by changes  proposed  in 2016. But they were  scuttled  under the Trump administration, resulting in a 2020 census that still reflected decades-old guidance.

How would the federal government’s proposed changes address these issues?

First, the new directive would combine the race and ethnicity questions into one question. Census Bureau  research  has found that merging the questions and encouraging people to select as many categories as apply to them would lead to more detailed self-identification, fewer people selecting “some other race,” and fewer people skipping the question altogether.

Second, the directive would include a reporting category for people of Middle Eastern or North African descent in the combined race and ethnicity question.

Third, the directive would require federal surveys, where possible, to collect detailed identifications within each race and ethnicity category and standardize subgroup checkboxes and write-in options. For example, an individual could select “Asian,” and within that category, check a box to indicate that they are “Vietnamese” or write in their identification if it’s not reflected in a checkbox (e.g., “Cambodian”).

Fourth, the directive would remove outdated terminology, as well as discontinue the use of the terms “minority” and “majority” (in keeping with recent efforts by the Census Bureau to promote  new ways  of describing racial and ethnic diversity).

Here’s how the new census form might look if these changes are approved:

The request for comments on these changes will close on April 12, and the Office of Management and Budget plans to complete the revisions to the directive no later than the summer of 2024. After that, the Census Bureau will need to create, test, and refine a new questionnaire and work with community groups to ensure that it’s well administered in 2030.

What benefits would these changes have?

Federal surveys following the new directive would produce data that more accurately reflects how people describe their identities and their communities. This is critically important as the nation  becomes  more racially and ethnically diverse, more people identify as more than one race or ethnicity, and immigration and migration patterns change.

More accurate data, in turn, promises significant benefits at the federal, state, and local levels. For example, race and ethnicity data are used to ensure equal employment opportunities, enforce civil rights laws governing everything from redistricting to banking, assess the impact of policies on specific communities, and better tailor programs for public health, education, and other important services to the needs of specific groups. As a result, communities that have long been undercounted — or even statistically invisible — will see their political, legal, and economic power grow.

• • •

While modifying the format of the census form is key to improving the count, there’s still more to do. The Brennan Center’s  report  on improving the census recommends many legal reforms that Congress and the White House should consider. It’s high time to build on the  growing momentum  for census reform and advance the accuracy, equity, and legitimacy of future censuses.

Civil Rights Groups Oppose Citizenship Question and Changes to Apportionment Base 

74 civil rights groups warn about constitutional and practical problems with House bill

New Census Questions Are a Critical Step Toward an Improved 2030 Count

Changes to questions about race and ethnicity will make the count more accurate, equitable, and legitimate, but there’s more work to be done.

Asian Americans and the Making of ‘American’

The benefits of combining ethnic identity with race in the census, momentum gathers to improve 2030 census, making the census work for latinos, census accuracy requires census equity, informed citizens are democracy’s best defense.

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Ethnicity Survey Questions for Questionnaires

What are Ethnicity Survey Questions?

Ethnicity survey questions are a questionnaire that provides information on the background of a respondent, which is based on common ancestry, language, history, society, culture or nation. It is an inherited status based on the society in which one lives. Such information allows the researcher to cross-tabulate and compares the categories to see the variation in responses as well as understand if ethnicity plays a role in the choice of the respondents.

Ethnicity survey questions are one of the types of survey questions, which are usually included to gather demographic data to understand, what factors can influence the choice of the respondent and deduce a pattern. Ethnicity survey questions play a vital role in social science research as well as business research .

Adding in ethnicity survey questions can enable a researcher to determine promotions or pricing and sort response groups, based on their needs and interests. Various ethnicities have different interests and varied disposable incomes, compared to other ethnic groups. Furthermore, with most businesses running online, it is even more important to know your audience to analyze the responses accurately for strategic decisions.

For example, when conducting a survey to understand public opinion about various media sources, respondents raised in a rural Native American culture may respond to such questions differently from someone raised in the urban culture. Hence, it is important to include an ethnicity survey question in a survey such as a media accountability survey to conduct effective research, which includes representatives from all target ethnic groups.

Types of questionnaires where an ethnicity survey question plays a vital role!

Asking demographic survey questions such as ethnicity and race questions can provide researchers from various industries across the public and private sectors with relevant information about any target audience. It can also help you segment the audience, based on ethnicity, race or culture biases and many more, thus helping you to deduce a pattern on how a respondent chooses an option because of their ethnicity or race. A few questionnaires where such a question should be included are as follows:

• Market research
• Business research
• Academic research
• Health-care
• Community and faith-based institutions
• Non Profit programs

Learn More: Demographic Survey Templates

Difference between Ethnicity and Race

There aren’t many people who can accurately describe the difference between ethnicity and race, as we usually tend to put them together in the same group. They are similar in nature, however, there are differences. For instance, a Caucasian can be called white, however, that does not describe his ethnicity. He can be a caucasian from the US, Canada or Ireland. Ethnicity is about tradition, customs, and their origin.

It is about learnings, of where you come from and celebrating the traditions and ideas from a particular region. Ethnicity also gives you an option to choose, because you can change your ethnicity from your own to another. You can move from one region to another, learn their traditions, customs and assimilate their beliefs. The same is not possible with race.

Race is referred to your genetic makeup and biological features. It can be skin color, skin tone eyes, eye color, hair color, etc. It is something that you are born with and cannot be changed.

Thus, to summarize:

• Ethnicity means learned behaviors from different cultures, traditions, and customs from various regions of the world.
• Race means the heritage you were born with, regardless of location or any learned behavior.
• Ethnicity gives you room to accept or reject and change your ethnicity, through the choice of beliefs.
• Race does not allow you to change and cannot be altered, as it is based on biological features.

3 Different ways in which race and ethnicity survey questions can be used in surveys

When creating a survey, the researcher has to make sure he will ask questions about race and ethnicity separately. A researcher can follow the US census bureau method of asking such questions or any other government institution. An ethnicity question, followed by a race question can be a good way to capture accurate data of both race and ethnicity. Following are a few examples of race and ethnicity survey questions asked using different approaches.

Approach 1:

• American Indian or Alaska Native
• Black or African American
• Native Hawaiian or Other Pacific Islander

When asking these question, a researcher can use checkbox questions as respondents can identify themselves as a member of multiple races. The above question can enable a researcher to generalize the respondent in a large group of an ethnic or racial group. However, if the researcher wants in-depth information, the following approach can be asked.

Approach 2:

• No, not of Hispanic, Latino or Spanish origin
• Yes, Mexican, Mexican American, Chicano
• Yes, Puerto Rican
• Yes, other Hispanic, Latino or Spanish origin (Please specify)
• Black, African American
• American Indian or Alaska native (Please specify tribe)
• Asian Indian
• Native Hawaiian
• Guamanian or Chamorro
• Other Asian (Please specify)
• Other Pacific Islander (Please specify)
• Other race (Please specify)

Such a question was used in the 2010 US census form about race and ethnicity. Such a question can give the researcher accurate in-depth information about the respondent. Furthermore, adding open-ended responses will give the respondent, the freedom to write a specific race or ethnicity they identify themselves as. Such questions can help increase the response rate of the survey as well.

Approach 3:

• Other (Please specify)
• Prefer not to say

Such a question is usually preferred nowadays by most survey designers, as ethnicity and race are sensitive topics and many people still find it quite intrusive when asked. Giving the option to skip the question, enables the respondent to feel, that the question is not being forced onto him. Furthermore, an option with an open-ended response also gives the feeling of being all-inclusive and hence leaves out the chance of offending any respondent. Depending on what the data is needed for, any approach can be taken to ask the question.

The Future for Ethnicity and Race survey questions

Since race and ethnicity are sensitive topics, and often emphasize discrimination, government institutions are trying new innovative methods to completely eliminate the use of the word race or ethnicity when asking survey questions. In the future years, questionnaires would just ask the respondent to check categories that describe them. An example of such a question can be as follows:

• White (Eg: German, Irish, English, Italian, Polish, French, etc)
• Hispanic, Latino or Spanish origin (Eg: Mexican or Mexican American, Puerto Rican, Cuban, Salvadoran, Dominican, Colombian, etc)
• Black or African American (Eg: African American, Jamaican, Haitian, Nigerian, Ethiopian, Somalian, etc)
• Asian (Eg: Chinese, Filipino, Asian Indian, Vietnamese, Korean, Japanese, etc)
• American Indian or Alaska Native(Eg: Navajo nation, Blackfeet tribe, Mayan, Aztec, Native Village or Barrow Inupiat Traditional Government, Nome Eskimo Community, etc)
• Middle Eastern or North African (Eg: Lebanese, Iranian, Egyptian, Syrian, Moroccan, Algerian, etc)
• Native Hawaiian or Other Pacific Islander (Eg: Native Hawaiian, Samoan, Chamorro, Tongan, Fijian, etc)
• Some other race, ethnicity or origin

Using such an approach is favored by most people as it avoids the problem of people getting hung up on the terminology. Such a question using category will also allow the respondent to answer it quicker as compared to the other question approaches. Hence using such a question will allow respondents to freely check more than one box if they wish and will lead to a low non-response rate on these questions.

Furthermore, a researcher has to keep a few things in mind when including ethnicity survey questions. It has to be made sure that the information that is being asked is the information that you would need. Express interest in the human characteristics of the respondent and ask them to express aspects of themselves that are relevant to your research topic.

A researcher has to understand that asking such a question is asking for sensitive or private details about the respondent and is a significant ask, hence a researcher should always justify the need for such information and offer rewards to the respondents. You can use QuestionPro for survey questions like income survey questions , Quantitative survey questions, Ethnicity survey questions, and life survey questions.

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“Race” vs. “Ethnicity”: Why These Terms Are So Complex

by Alyssa Pereira

Historic protests against racial inequality. National debates over offensive names of sports team names and conflicts over the place of Confederate monuments in our culture. Arguments about border walls, language barriers—rising tensions over immigration despite an increasingly diverse populace.

In this cultural moment, the concepts of race and ethnicity have never been more important to grasp. They’ve also never been so complicated to untangle.

The words race and ethnicity don’t share a dictionary definition, and yet their meanings sometimes overlap, helping individuals define not just their skin tone and other physical characteristics, but their ancestry and heritage as well. But the uses of these often interrelated terms very often don’t intertwine.

The ways a person might utilize race and ethnicity to define their identity are myriad . These descriptors might be deeply personal. Occasionally, they might even be painful.

As we grapple with our divisions like never before, as we aspire to embrace our diversity like never before, it’s more important than ever to better understand what is meant, exactly, by the words race and ethnicity.

What is race ?

There are many reasons the word race is a heated topic of debate today. One big reason is that, while we popularly use the term to refer to a person’s skin color, the whole idea of defining people that way is a social construct .

Formally defined, race is an arbitrary classification of modern humans, sometimes, especially formerly, based on any or a combination of various physical characteristics, as skin color, facial form, or eye shape.

But the word race also carries much more weight, representing not just one’s features, but their ancestry, historical affiliation, or a shared culture.

To make things more complicated, the US Census officially—and perhaps more broadly—uses race for “a person’s self-identification with one or more social groups.”

Where does race come from?

The word race was first recorded in this form around 1490–1500. English borrowed race from the French race , which derives in turn from the Italian razza , meaning “kind, breed, lineage.” The deeper roots of razza are obscure. The homonym race , in its sense of a “context of speed,” is unrelated, coming from Old Norse.

The word race originally functioned in English much like the word ethnicity . It simply referred to groups of people connected by a common descent or origin, e.g., the English race, or English people.

By the 1700s, the meaning of race began to change. As European colonialism and imperialism spread, white Europeans used race to sort humans by place of origin as well as skin color, creating the social hierarchy which served as the foundation of slavery. Anthropologists, physiologists, and other writers and thinkers in the late 18th and 19th century—including the likes of Thomas Jefferson—wrongly claimed that characteristics of a person’s race innately determined and justified their social superiority or inferiority to others. Those whose race appeared to be white incorrectly believed the color of their skin and other aspects of their appearance meant they were more intelligent, moral, capable—more human, tragically—than those who were not white.

The use of race as a classifier, however, has always been fundamentally flawed because sorting individuals based on their race is an arbitrary practice. Observing a person’s skin color, for example, is not a reliable way to infer a genetic difference or similarity. Rather, skin tone (and hair color) is created by the presence of the pigment melanin .

Visit the informative   About This Word section in our entry for racism to get a deeper look into the meaning and impact of the word.

None of this is to say that race can’t be meaningful to a person—especially members of minority groups who have marginalized and oppressed—who may also associate it with cultural importance. Pop culture movements through the years have led the charge on reclaiming skin tone as a point of pride. In the 1960s, the refrain “Black is beautiful” ignited a sociopolitical revolution. More recently, American music artists like Beyoncé and Jennifer Lopez celebrate their race and heritage through their work.

The use of the word race , however, can still be confusing, especially when compared to ethnicity .

What is ethnicity ?

It’s easy to confuse race and ethnicity . Both words are sometimes, but not always, used to describe a person’s heritage as tied to their ancestry or place of origin. Ethnicity , however, is generally used in reference to a person’s cultural markers, not their physical appearance.

An ethnicity is a social group that shares a common and distinctive culture, religion, or language. It also refers to a person’s ethnic traits, background, allegiance , or association.

Like race , the meaning and use of the word ethnicity has changed over the last few centuries.

Where does ethnicity come from?

Compared to race , ethnicity is more recent, dating back to around 1765–75. It’s based on ethnic , itself a much older word found in the 1300s. Via Latin, ethnic ultimately derives from the Greek éthnos , meaning “nation, people.”

The earliest use of ethnic in English—it’s worth noting while we’re on the topic of social divisions—was as a noun for a “ heathen ” or “ pagan .” At that time, ethnic was also used colloquially to refer to those who originated from nations that weren’t Christian or Jewish.

It wasn’t until the early 1900s that ethnicity was used to refer to social groups of a common ancestry and shared culture. But by the mid-1960s, the adjective ethnic , in white mainstream culture, did develop xenophobic connotations: ethnic came to mean “foreign, or un-American.”

Efforts to counteract these uses are active in many areas of industry, notably in the food business, where ethnic has become an insensitive catchall for “non-white.”

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What defines a person’s ethnicity

So, what are the shared cultural markers of ethnicity ? There are many, and often exist in combination. Here are some of the main ones:

• Language. Ethnicity is often tied to the language someone speaks, such as Spanish, thereby representing a shared cultural history among those who also speak the language.
• Nationality. It is also connected to one’s ties to a specific nation, such as the Philippines. In this instance, a person could describe their ethnicity as Filipino , whether or not they personally speak Tagalog . Many white Americans traditionally identify their ethnicity as Irish or German, as another example, based on where their family emigrated from.
• Religious expression. Ethnicity can also be tied to a religion, particularly when there are social commonalities and longstanding cultural practices involved, as in Judaism or Islam .

Why race and ethnicity are such complex terms

Race and ethnicity have been used as not just descriptors of a person’s physical features or ancestral origin, but throughout history they have also been deployed, sometimes maliciously, as a means to other—if not outright hurt or oppress—someone perceived to be different.

When speaking about someone’s race, we often mean that they are Black, white, Asian, or Indigenous, for example. However, this generalization of races collapses too many differences, not allowing for much variation between, say, Asian and Pacific Islander , or Indigenous , Native American and Australian Aboriginal .

This is where ethnicity can be of assistance. That descriptor can be specific and supplemental to a person’s race , speaking to a person’s culture, ancestry, and sometimes language and religion. For example, a person’s race may be white, but ethnically , they may identify as Italian. Another’s race may be Black, but ethnically , they may be Haitian .

Nevertheless, the meaning of race and ethnicity remain convoluted. Notably, the U.S. Census defines Hispanic not as a race , but an ethnicity, adding that Hispanic people may be of any race.

However, many Hispanic people disagree with that classification, a 2015 Pew Research study found. Two-thirds of Hispanic Americans consider Hispanic as their “ racial background”; half also say Hispanic is also part of their ethnic background. In an earlier study, Pew found one-third of Hispanic Americans checked the box for “some other race” when self-reporting on the 2010 Census. Half chose “white.”

Such an entanglement between race and ethnicity is not exclusive to Hispanic Americans. Many people find their race to be inherently tied to their ethnicity , even though their appearance may not be specific to their personal nationality.

Find out more about the knotty relationship between the terms Hispanic and Latino and what they each actually represent for most. 

How to use race and ethnicity.

So, is there a difference between race and ethnicity ? The short answer? Yes, but it’s very complicated. Use of the words overlap and are very historical and often personal. But very generally speaking, the word race involves shared physical characteristics, especially skin color, and a shared ancestry or historical experience based on that, whereas ethnicity involves shared cultural or national identity, which may include language, nationality, religion, or other customs.

As Jennifer DeVere Brody, Stanford University’s Director of the Center for Comparative Studies in Race & Ethnicity, powerfully sums up the issue of race vs. ethnicity: “Race is something we believe to be heritable, and ethnicity is something learned; however, this masks the history of how race has been used to create these concepts for political power.”

Alyssa Pereira is a freelance writer in San Francisco, California. Her work has been featured on SFGate.com, SPIN Magazine, the San Francisco Chronicle, Paper, Vice, and others.

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Which social media platforms are most common, who uses each social media platform, find out more, social media fact sheet.

Many Americans use social media to connect with one another, engage with news content, share information and entertain themselves. Explore the patterns and trends shaping the social media landscape.

To better understand Americans’ social media use, Pew Research Center surveyed 5,733 U.S. adults from May 19 to Sept. 5, 2023. Ipsos conducted this National Public Opinion Reference Survey (NPORS) for the Center using address-based sampling and a multimode protocol that included both web and mail. This way nearly all U.S. adults have a chance of selection. The survey is weighted to be representative of the U.S. adult population by gender, race and ethnicity, education and other categories.

Polls from 2000 to 2021 were conducted via phone. For more on this mode shift, read our Q&A.

Here are the questions used for this analysis , along with responses, and  its methodology ­­­.

A note on terminology: Our May-September 2023 survey was already in the field when Twitter changed its name to “X.” The terms  Twitter  and  X  are both used in this report to refer to the same platform.

YouTube and Facebook are the most-widely used online platforms. About half of U.S. adults say they use Instagram, and smaller shares use sites or apps such as TikTok, LinkedIn, Twitter (X) and BeReal.

Note: The vertical line indicates a change in mode. Polls from 2012-2021 were conducted via phone. In 2023, the poll was conducted via web and mail. For more details on this shift, please read our Q&A . Refer to the topline for more information on how question wording varied over the years. Pre-2018 data is not available for YouTube, Snapchat or WhatsApp; pre-2019 data is not available for Reddit; pre-2021 data is not available for TikTok; pre-2023 data is not available for BeReal. Respondents who did not give an answer are not shown.

Source: Surveys of U.S. adults conducted 2012-2023.

Usage of the major online platforms varies by factors such as age, gender and level of formal education.

% of U.S. adults who say they ever use __ by …

• RACE & ETHNICITY
• POLITICAL AFFILIATION

This fact sheet was compiled by Research Assistant  Olivia Sidoti , with help from Research Analyst  Risa Gelles-Watnick , Research Analyst  Michelle Faverio , Digital Producer  Sara Atske , Associate Information Graphics Designer Kaitlyn Radde and Temporary Researcher  Eugenie Park .

Follow these links for more in-depth analysis of the impact of social media on American life.

• Americans’ Social Media Use  Jan. 31, 2024
• Americans’ Use of Mobile Technology and Home Broadband  Jan. 31 2024
• Q&A: How and why we’re changing the way we study tech adoption  Jan. 31, 2024

Find more reports and blog posts related to  internet and technology .

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ABOUT PEW RESEARCH CENTER  Pew Research Center is a nonpartisan fact tank that informs the public about the issues, attitudes and trends shaping the world. It conducts public opinion polling, demographic research, media content analysis and other empirical social science research. Pew Research Center does not take policy positions. It is a subsidiary of  The Pew Charitable Trusts .

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