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Quality of Race and Hispanic Origin Reporting on Death Certificates in the United States. Elizabeth Arias, Ph.D. Mortality Statistics Branch Division of Vital Statistics National Center for Health Statistics. Highlights.

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quality of race and hispanic origin reporting on death certificates in the united states
Quality of Race and Hispanic Origin Reporting on Death Certificates in the United States

Elizabeth Arias, Ph.D.

Mortality Statistics Branch

Division of Vital Statistics

National Center for Health Statistics

highlights
Highlights
  • Evaluation of Race and Hispanic Origin Reporting on the US Death Certificate
    • The National Longitudinal Mortality Study
    • Self Reported Race/Ethnicity vs. Proxy Reported Race/Ethnicity
  • Future Applications
    • Adjusted Death Rates
    • Adjusted Life Expectancy Estimates
  • Adjustment Implications for Disparity Estimates
  • PLEASE DO NOT QUOTE FINDINGS, THEY ARE PRELIMINARY. FINAL RESULTS WILL BE PUBLISHED IN THE FALL OF 2004
evaluation of race and hispanic origin reporting on death certificates
Evaluation of Race and Hispanic Origin Reporting on Death Certificates
  • The National Longitudinal Mortality Study
    • Current Population Surveys (CPS) & 1980 Census Data linked, using the NDI, to NCHS Mortality Data
      • 25 Annual March CPS (1973, 1978-1998) and 1980 US Census sub-sample (~2.4 million persons)
      • CPS: National Sample of Households (60,000-80,000), Non-Institutionalized Population, 96% Response Rate
    • Deaths Occurring between 1979-1998 (~253,000)
    • Provides Ability to Compare Race and Hispanic Origin Reported by an Individual While Alive to What Was Reported on their Death Certificate upon Death.
evaluation technique
Evaluation Technique
  • Ratios of Race and Hispanic Origin self report to Race and Hispanic Origin proxy report
  • Ratios are constructed by dividing the number of CPS reported race/Hispanic origin categories (self-identified) by the number of Death Certificate race/Hispanic origin categories (proxy identified)
  • Example: Among all deceased individuals their self reported race and Hispanic Origin compared to what was reported on their death certificate upon death:
    • White Ratio = CPS White / DC White
    • Black Ratio = CPS Black / DC Black
    • AIAN Ratio = CPS AIAN / DC AIAN
    • API Ratio = CPS API / DC API
study sample characteristics
Study Sample Characteristics
  • NLMS March CPS files 1979-1998 linked to Mortality Data 1979-1998
  • Total Sample Size 180,958
  • Sample Sizes by Major Race Categories:
    • White 160,117
    • Black 17,296
    • AIAN 1,347
    • API 1,900
study sample characteristics6
Study Sample Characteristics
  • Sample Sizes by Hispanic Origin
    • Mexican 3,387
    • Puerto Rican 520
    • Cuban 581
    • Central/South American 237
    • Other Hispanic 1,209
factors affecting race and hispanic origin reporting death certificates
Factors Affecting Race and Hispanic Origin Reporting Death Certificates
  • Sex
  • Age
  • Nativity (US Born, Foreign Born)
  • Rural/Urban Status
  • Region of Residence
distribution of hispanic origin designation on death certificate among self identified hispanics
Distribution of Hispanic Origin Designation on Death Certificate Among Self-Identified Hispanics
distribution of hispanic origin designation on death certificate among self identified mexicans
Distribution of Hispanic Origin Designation on Death Certificate Among Self-Identified Mexicans
slide23
Distribution of Hispanic Origin Designation on Death Certificate Among Self-Identified Puerto Ricans
distribution of hispanic origin designation on death certificate among self identified cubans
Distribution of Hispanic Origin Designation on Death Certificate Among Self-Identified Cubans
slide25
Distribution of Hispanic Origin Designation on Death Certificate Among Self-Identified Central/South Americans
slide26
Distribution of Hispanic Origin Designation on Death Certificate Among Self-Identified Other Hispanics
future applications
Future Applications
  • Unadjusted and Adjusted Death Rates for Major Race Groups, 2001

UnadjustedAdjusted

    • White 836.5 836.5
    • Black 1,101.2 1,123.2
    • AIAN 686.7 968.3
    • API 492.1 561.0
    • ADJUSTMENTS ARE CRUDE APPLICATIONS OF RATIOS, THEY ARE NOT FINAL. PLEASE DO NOT QUOTE. THE FINAL ADJUSTMENT FACTORS WILL BE PUBLISHED IN THE FALL OF 2004.
future applications28
Future Applications
  • Unadjusted and Adjusted Death Rates for Hispanic Origin Groups, 2001

Unadjusted Adjusted

    • Total Hispanic 658.7 816.8
    • Mexican 645.9 859.1
    • Puerto Rican 821.1 1,141.3
    • Cuban 590.9 715.0
    • ADJUSTMENTS ARE CRUDE APPLICATIONS OF RATIOS, THEY ARE NOT FINAL. PLEASE DO NOT QUOTE. THE FINAL ADJUSTMENT FACTORS WILL BE PUBLISHED IN THE FALL OF 2004.
future applications29
Future Applications
  • Unadjusted and Adjusted Life Expectancy at Birth, 2002
    • AIAN Population
    • 78.2 (unadjusted)
    • 73.7 (adjusted)
    • ADJUSTMENTS ARE CRUDE APPLICATIONS OF RATIOS, THEY ARE NOT FINAL. PLEASE DO NOT QUOTE. THE FINAL ADJUSTMENT FACTORS WILL BE PUBLISHED IN THE FALL OF 2004.
disparity implications
Disparity Implications

Effect of Adjustment on Disparity Estimate

UnadjustedAdjusted

White 836.5 836.5

Black 1,101.2 1,123.2

AIAN 686.7 968.3

API 492.1 561.0

Hispanic 658.7 816.8

Average 755.0 861.2

ID 22.7 17.1

  • ADJUSTMENTS ARE CRUDE APPLICATIONS OF RATIOS, THEY ARE NOT FINAL. PLEASE DO NOT QUOTE. THE FINAL ADJUSTMENT FACTORS WILL BE PUBLISHED IN THE FALL OF 2004.
disparity implications31
Disparity Implications

Effect of Adjustment on Disparity Estimate

UnadjustedAdjusted

ID 22.7 17.1

Absolute difference in estimate -5.5 percentage points

Relative difference in estimate -32.1 %

  • ADJUSTMENTS ARE CRUDE APPLICATIONS OF RATIOS, THEY ARE NOT FINAL. PLEASE DO NOT QUOTE. THE FINAL ADJUSTMENT FACTORS WILL BE PUBLISHED IN THE FALL OF 2004.
disparity implications32
Disparity Implications
  • Black / White 1.3 1.3 nc
  • AIAN / White 0.8 1.2 nc
  • API / White 0.6 0.7 less
  • Hispanic / White 0.8 1.0 less
    • ADJUSTMENTS ARE CRUDE APPLICATIONS OF RATIOS, THEY ARE NOT FINAL. PLEASE DO NOT QUOTE. THE FINAL ADJUSTMENT FACTORS WILL BE PUBLISHED IN THE FALL OF 2004.

Rate ratiosUnadjustedAdjusted

disparity implications33
Disparity Implications
  • AIAN / Black 0.6 0.9 less
  • API / Black 0.4 0.5 less
  • Hispanic / Black 0.6 0.7 less
  • Hispanic / White 0.8 1.0 less
  • API / AIAN 0.7 0.6 more
  • Hispanic / AIAN 1.0 0.8 more
  • Hispanic / API 1.3 1.5 more
    • ADJUSTMENTS ARE CRUDE APPLICATIONS OF RATIOS, THEY ARE NOT FINAL. PLEASE DO NOT QUOTE. THE FINAL ADJUSTMENT FACTORS WILL BE PUBLISHED IN THE FALL OF 2004.

Rate ratiosUnadjustedAdjusted

disparity implications34
Disparity Implications
  • Adjustment results in lower disparity
    • For summary statistics like the ID
    • In most cases for pair-wise rate ratios
  • However, less disparity results from:
    • Higher rates for
      • AIAN
      • API
      • Hispanic
contact information

Contact Information

Elizabeth Arias

National Center for Health Statistics

3311 Toledo Road, Room 7330

Hyattsville, MD 20782

Email: EArias@cdc.gov

Telephone: 301-458-4727