Update Quality of Race and Hispanic Origin Reporting

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 l Evaluation of Race and Hispanic Origin Reporting on the US Death Certificate l l l 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 l l Adjusted Death Rates Adjusted Life Expectancy Estimates

Data Source for US Death Rates l Numerator of rate l 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. l Denominator of rate l 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 l The National Longitudinal Mortality Study l 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) l CPS: National Sample of Households (60, 000 -80, 000), Non. Institutionalized Population, 96% Response Rate l l Deaths Occurring between 1979 -1998 (~252, 000) l 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 l 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) l Example: l l l 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 l Example: l Of all individuals who selected, say, white on CPS, what percentage were actually coded as white on the Death Certificate.

Sample Size l Race l White l Black l AIAN l API 1979 -98 1979 -89 1990 -98 172, 180 19, 719 1, 437 2, 044 64, 600 7, 454 510 661 107, 580 12, 265 927 1, 383

Sample Size l Hispanic l Mexican 1979 -98 1979 -89 1990 -98 4, 452 l Puerto. Rican 760 l Cuban 700 l C/SAmerican 352 l Other. Hisp 1, 338 l Total 9, 568 1, 283 207 104 90 282 1, 966 3, 169 553 596 262 1, 056 7, 602

Factors Affecting Race and Hispanic Origin Reporting on the US Death Certificate Sex l Age l Nativity (US Born, Foreign Born) l Rural/Urban Status l Region of Residence l

Ratios for Race Categories, by Period 1979 -89, 1990 -98

Ratios for Hispanic Origin Categories, by Period 1979 -89, 1990 -98

Ratios for Hispanic Origin Categories, by Period: 1979 -89 & 1990 -98

Ratios by Sex for Race Categories, 1990 -98

Ratios by Sex for Hispanic Origin Categories, 1990 -98

Ratios by Age for Race Categories, 1990 -98

Ratios by Age for Hispanic Origin Categories, 1990 -98

Ratios by Nativity for Race Categories, 1990 -98

Ratios by Nativity for Hispanic Origin Categories, 1990 -98

Ratios by Urban/Rural Residence for Race Categories, 1990 -98

Ratio of Urban/Rural Status for Hispanic Origin Categories, 1990 -98

Ratios by Region for Race Categories, 1990 -98

Ratios by Region 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 l Reporting appears to have improved over time for some groups: AIAN l API l Hispanics l l l There is still considerable variation within the Hispanic community There is still considerable variation by region of residence and nativity AIAN l API l Hispanics l