Quality of Race and Hispanic Origin Reporting on Death Certificates

Background: Race and Hispanic origin specific death rates are fundamental to our understanding of all-cause and cause-specific mortality differentials between the numerous race and ethnic sub-groups in the United States. Inconsistency in race and ethnic classification has the potential to adversely affect our understanding of the mechanisms associated with racial and ethnic health disparities. This research presents the results of an evaluation study of the validity of race and Hispanic Origin reporting on death certificates in the United States and its impact on race and Hispanic Origin specific death rates. We used the National Longitudinal Mortality Study (NLMS) which includes annual Current Population Survey (CPS) files for years 1973, and 1978-1998 with mortality follow-up for the years 1979 through 1998. To identify race/ethnic misclassification on death certificates we compared race/ethnic self-report on CPS records to proxy report on death certificates for the sample of decedents identified in the NMLS. Using pooled 1999-2001 vital statistics mortality data and Census data, we estimate observed and corrected for death certificate misclassification age-specific and age-adjusted death rates by race and Hispanic origin. Results show that race/ethnic classification on the death certificate is excellent for the white and black population. However, reporting is significantly poorer for other populations. We also observed some improvement over time for some groups. And, as expected, we found that race/ethnic misclassification on death certificates has a significant effect on mortality estimates.