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Update: Quality of Race and Hispanic Origin Reporting on Death Certificates in the US. Elizabeth Arias, Ph.D. Mortality Statistics Branch Division of Vital Statistics. Centers for Disease Control and Prevention National Center for Health Statistics. Highlights.
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Update: Quality of Race and Hispanic Origin Reporting on Death Certificates in the US. Elizabeth Arias, Ph.D. Mortality Statistics Branch Division of Vital Statistics Centers for Disease Control and Prevention National Center for Health Statistics
Highlights • Evaluation of Race and Hispanic Origin Reporting on the US Death Certificate • The Problem: death rates for some race and Hispanic origin groups are too low • The Data Collection Process • The National Longitudinal Mortality Study • Self Reported Race/Ethnicity vs. Proxy Reported Race/Ethnicity • Future Applications • Adjusted Death Rates • Adjusted Life Expectancy Estimates
Data Source for US Death Rates • Numerator of rate • Death Certificate=race and Hispanic origin identification is recorded by funeral director as per family member report or, often, as result of his/her observation of decedent. • Denominator of rate • Decennial Census=race and Hispanic origin identification is self-reported or reported by family/household member while individual is still alive.
Evaluation of Race and Hispanic Origin Reporting on the US Death Certificate • 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, 1979-1998) 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 (~252,000) • 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 to proxy report. Ratios are constructed by dividing the aggregate number of CPS reported race/Hispanic origin categories (self-identified) by the number of Death Certificate race/Hispanic origin categories (proxy identified) • Example: • White Ratio = Total CPS White / Total DC White • Black Ratio = Total CPS Black / Total DC Black • AIAN Ratio = Total CPS AIAN / Total DC AIAN • API Ratio = Total CPS API / Total DC API • Percent Agreement between self selected race and Hispanic origin and proxy selected race and Hispanic origin • Example: • Of all individuals who selected, say, white on CPS, what percentage were actually coded as white on the Death Certificate.
Sample Size • Race 1979-98 1979-89 1990-98 • White 172,180 64,600 107,580 • Black 19,719 7,454 12,265 • AIAN 1,437 510 927 • API 2,044 661 1,383
Sample Size • Hispanic 1979-98 1979-89 1990-98 • Mexican 4,452 1,283 3,169 • PuertoRican 760 207 553 • Cuban 700 104 596 • C/SAmerican 352 90 262 • OtherHisp 1,338 282 1, 056 • Total 9,568 1,966 7,602
Factors Affecting Race and Hispanic Origin Reporting on the US Death Certificate • Sex • Age • Nativity (US Born, Foreign Born) • Rural/Urban Status • Region of Residence
Ratios for Hispanic Origin Categories, by Period1979-89, 1990-98
Ratios for Hispanic Origin Categories, by Period: 1979-89 & 1990-98
Ratios by Urban/Rural Residence for Race Categories, 1990-98
Ratio of Urban/Rural Status for Hispanic Origin Categories, 1990-98
Hispanic Origin Distribution on Death Certificate Among Self-Identified Hispanics, 1990-98
Hispanic Origin Distribution on Death Certificate Among Self-Identified Mexicans, 1990-98
Hispanic Origin Distribution on Death Certificate Among Self-Identified Puerto Ricans, 1990-98
Hispanic Origin Distribution on Death Certificate Among Self-Identified Cubans, 1990-98
Hispanic Origin Distribution on Death Certificate Among Self-Identified C/S Americans, 1990-98
Hispanic Origin Distribution on Death Certificate Among Self-Identified AIANs, 1990-98
Hispanic Origin Distribution on Death Certificate Among Self-Identified AIANs, 1990-98
Summary • Reporting appears to have improved over time for some groups: • AIAN • API • Hispanics • There is still considerable variation within the Hispanic community • There is still considerable variation by region of residence and nativity • AIAN • API • Hispanics