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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
 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 PLEASE DO NOT QUOTE FINDINGS, THEY ARE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

   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

   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
   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 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
   Sex
   Age
   Nativity (US Born, Foreign Born)
   Rural/Urban Status
   Region of Residence
Ratios for Race Categories
Ratios for Hispanic Origin Categories
Ratios by Sex for Race Categories
Ratios by Sex for Hispanic Origin
           Categories
Ratios by Age for Race Categories
Ratios by Age for Race/Hispanic Origin
               Categories
Ratios by Age for Hispanic Origin Categories
Ratios by Nativity for Race Categories
Ratios by Nativity for Hispanic Origin
             Categories
Ratios by Urban/Rural Residence for Race
               Categories
Ratio of Urban/Rural Status for Hispanic Origin
                 Categories
Ratios by Region for Race Categories
Ratios by Region for Hispanic Origin Categories
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 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 Central/South Americans
Distribution of Hispanic Origin Designation on Death Certificate
             Among Self-Identified Other Hispanics
              Future Applications
   Unadjusted and Adjusted Death Rates for Major Race
    Groups, 2001
                    Unadjusted Adjusted
       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 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 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
Effect of Adjustment on Disparity Estimate
                          Unadjusted         Adjusted
   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 Implications
Effect of Adjustment on Disparity Estimate

                      Unadjusted             Adjusted

  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 Implications
          Rate ratios     Unadjusted   Adjusted

   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.
        Disparity Implications
           Rate ratios        Unadjusted   Adjusted

   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.
           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
              Elizabeth Arias
    National Center for Health Statistics
     3311 Toledo Road, Room 7330
          Hyattsville, MD 20782
         Email: EArias@cdc.gov
         Telephone: 301-458-4727

				
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posted:11/11/2011
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