Editing Roth 2016 (section)

==Major Themes in the Literature: Inconsistencies Across Dimensions==
There are major inconsistencies between race and its associated factors, self-classification and observed race (external observations). We see this manifest in various forms, such as medical records, interviewer classifications, and death certificates (1320).
It is hard to know if the interviewer or health administrator is recording observed race based on appearance or on interaction as well.
In addition, observers also rely on contextual cues, racial stereotypes, and racial classification norms when guessing the race of others (1322). For example, medical examiners were more likely to identify someone as Native American who had died from cirrhosis and were more likely to identify someone as Black who had died from homicide.
Studies have shown that greater interaction leads to greater consistency between self-reported race and observed race.
'''Consequences of inconsistencies''': Being perceived differently from one's self-classification increases stress and leads to negative mental health outcomes by invalidating a person's self-image and identity, threatening social status, or de-legitimizing claims for membership in one's community. Campbell and Troyer (2007) examine psychological distress among those who classify themselves as Native American but are perceived as another race by an observer. Stepanikova (2010) shows that people who believe they are perceived as a lower status race than the one they identify as are more likely to report physical or emotional symptoms of how they were treated as a result of their race (1322).