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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.

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Quality of Race and Hispanic Origin Reporting on Death Certificates in the United States

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  1. 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

  2. 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• Adjusted Death Rates • Adjusted Life Expectancy Estimates • Adjustment Implications for Disparity Estimates • PLEASE DO NOT QUOTE FINDINGS, THEY ARE PRELIMINARY.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

  3. 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.

  4. 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

  5. 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

  6. Study Sample Characteristics • Sample Sizes by Hispanic Origin • Mexican 3,387 • Puerto Rican 520 • Cuban 581 • Central/South American 237 • Other Hispanic 1,209

  7. Factors Affecting Race and Hispanic Origin Reporting Death Certificates • Sex • Age • Nativity (US Born, Foreign Born) • Rural/Urban Status • Region of Residence

  8. Ratios for Race Categories

  9. Ratios for Hispanic Origin Categories

  10. Ratios by Sex for Race Categories

  11. Ratios by Sex for Hispanic Origin Categories

  12. Ratios by Age for Race Categories

  13. Ratios by Age for Race/Hispanic Origin Categories

  14. Ratios by Age for Hispanic Origin Categories

  15. Ratios by Nativity for Race Categories

  16. Ratios by Nativity for Hispanic Origin Categories

  17. Ratios by Urban/Rural Residence for Race Categories

  18. Ratio of Urban/Rural Status for Hispanic Origin Categories

  19. Ratios by Region for Race Categories

  20. Ratios by Region for Hispanic Origin Categories

  21. Distribution of Hispanic Origin Designation on Death Certificate Among Self-Identified Hispanics

  22. Distribution of Hispanic Origin Designation on Death Certificate Among Self-Identified Mexicans

  23. Distribution of Hispanic Origin Designation on Death Certificate Among Self-Identified Puerto Ricans

  24. Distribution of Hispanic Origin Designation on Death Certificate Among Self-Identified Cubans

  25. Distribution of Hispanic Origin Designation on Death Certificate Among Self-Identified Central/South Americans

  26. Distribution of Hispanic Origin Designation on Death Certificate Among Self-Identified Other Hispanics

  27. 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.

  28. 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.

  29. 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.

  30. 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.

  31. 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.

  32. 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

  33. 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

  34. 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

  35. 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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