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

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Evaluation of Race and Hispanic Origin Reporting on the US Death Certificate ... Adjusted Death Rates. Adjusted Life Expectancy Estimates ... – PowerPoint PPT presentation

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


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  • PLEASE DO NOT QUOTE FINDINGS, THEY ARE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
  • 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.

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
  • 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.

31
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.

32
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.

33
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.

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_at_cdc.gov
  • Telephone 301-458-4727
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