Vital and Health Statistics

Series 2, Number 172 August 2016

The Validity of Race and 

Hispanic-origin Reporting on 

Death Certificates in the 

United States: An Update 
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appreciated. 

Suggested citation 

Arias E, Heron M, Hakes JK. The validity of race and Hispanic-origin reporting 

on death certificates in the United States: An update. National Center for Health 

Statistics. Vital Health Stat 2(172). 2016. 

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Vital and Health Statistics
 

Series 2, Number 172 

The Validity of Race and 

Hispanic-origin Reporting on 

Death Certificates in the 

United States: An Update 

Data Evaluation and Methods Research 

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Centers for Disease Control and Prevention 

National Center for Health Statistics 

Hyattsville, Maryland 

August 2016 

DHHS Publication No. 2016–1372 
National Center for Health Statistics 

Charles J. Rothwell, M.S., M.B.A., Director 

Jennifer H. Madans, Ph.D., Associate Director for Science 

Division of Vital Statistics 

Delton Atkinson, M.P.H., M.P.H., P.M.P., Director 

Hanyu Ni, Ph.D., M.P.H., Associate Director for Science 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Contents
 

Abstract	 1 

Introduction 1 

Background 2 

Data and Methods 3 

Evaluation of Race and Hispanic-origin Reporting on Death Certificates		 3 

Effect of Death Certificate Race and Hispanic-origin Misclassification on Mortality Measures 5 

Results 5 

Evaluation of Race and Hispanic-origin Reporting on Death Certificates 5 

Death Certificate Misclassification Effects on Mortality Estimates 8 

Summary and Conclusions 8 

References 9 

Appendix Supporting Tables 17 

Text Figures 

1. Race classification on death certificate of self-identified American Indian or Alaska Native persons on 

Current Population Survey: United States, 1979–1989, 1990–1998, and 1999–2011 6 

2. Hispanic-origin classification on death certificate of self-identified Hispanic persons on Current Population Survey: 

United States, 1999–2011 7 

3.		 Ratio of Hispanic to non-Hispanic white death rate, uncorrected and corrected for death certificate misclassification, 

by age group: United States, 2009–2011 9 

Detailed Tables 

1	 Sensitivity, predictive value positive, and classification ratios, by race and Hispanic origin: National Longitudinal 

Mortality Study, for deaths occurring in 1979–1989, 1990–1998, and 1999–2011 12 

2. Classification ratios, by race and Hispanic origin, sex, and age: National Longitudinal Mortality Study, for deaths 

occurring in 1999–2011 13 

3. Classification ratios, by race and Hispanic origin, region, urban–rural status, coethnic concentration, and nativity: 

National Longitudinal Mortality Study, for deaths occuring in 1999–2011 14 

4. Age-specific and age-adjusted death rates and rate ratios, uncorrected and corrected for death certificate 

misclassification, by race and age: United States, 2009–2011 15 

5. Age-specific and age-adjusted death rates and rate ratios, uncorrected and corrected for death certificate 

misclassification, by Hispanic origin and age: United States, 2009–2011 16 

Appendix Tables 

I. Number of deaths from Current Population Survey and death certificate, by race and Hispanic origin and period: 

National Longitudinal Mortality Study, for deaths occurring in 1979–1989, 1990–1998, and 1999–2011 17 

II. Number of deaths from Current Population Survey and death certificate, by race and Hispanic origin, age, 

and sex: National Longitudinal Mortality Study, for deaths occurring in 1999–2011 18 

III. Number of deaths from Current Population Survey and death certificate, by race and Hispanic origin, region, 

urban–rural status, geographic concentration, and nativity: National Longitudinal Mortality Study, for deaths 

occurring in 1999–2011 20 

IV.		 County and state of death, by Hispanic-origin subgroup: National Longitudinal Mortality Study, for deaths 

occurring in 1999–2011 21 

iii 
Acknowledgments 

The authors thank Robert N. 

Anderson, Chief, Mortality Statistics 

Branch (MSB); Hanyu Ni, Associate 

Director for Science, Division of Vital 

Statistics (DVS); and Jennifer Madans, 

Associate Director for Science, National 

Center for Health Statistics (NCHS), for 

their helpful comments and suggestions. 

The authors are also grateful to the 

National Longitudinal Mortality Study 

(NLMS) team, U.S. Census Bureau, 

for their excellent work in producing 

and maintaining the NLMS database. 

The authors thank Brigham Bastian, 

MSB, for providing content review. 

The report was edited and produced by 

NCHS Office of Information Services, 

Information Design and Publishing Staff: 

Jane Sudol edited the report; typesetting 

was done by Kyung Park; and graphics 

were produced by Odell Eldridge, 

contractor. 

iv 
Abstract 

Objectives 

This report presents the findings 

of an updated 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. 

Methods 

The latest version of the National 

Longitudinal Mortality Study 

(NLMS) was used to evaluate the 

classification of race and Hispanic 

origin on death certificates for deaths 

occurring in 1999–2011 to decedents 

in NLMS. To evaluate change over 

time, these results were compared 

with those of a study based on an 

earlier version of NLMS that evaluated 

the quality of race and ethnicity 

classification on death certificates 

for 1979–1989 and 1990–1998. 

NLMS consists of a series of annual 

Current Population Survey files (1973 

and 1978–2011) and a sample of 

the 1980 decennial census linked 

to death certificates for 1979–2011. 

Pooled 2009–2011 vital statistics 

mortality data and 2010 decennial 

census population data were used to 

estimate and compare observed and 

corrected race- and Hispanic originspecific death rates. 

Results 

Race and ethnicity reporting 

on death certificates continued to 

be highly accurate for both white 

and black populations during the 

1999–2011 period. Misclassification 

remained high at 40% for the 

American Indian or Alaska Native 

(AIAN) population. It improved, 

from 5% to 3%, for the Hispanic 

population, and from 7% to 3% for 

the Asian or Pacific Islander (API) 

population. Decedent characteristics 

such as place of residence and 

nativity affected the quality of 

reporting on the death certificate. 

Effects of misclassification on 

death rates were large for the AIAN 

population but not significant for the 

Hispanic or API populations. 

Keywords: death rates • mortality 

• misclassification • National Vital 

Statistics System 

The Validity of Race and 

Hispanic-origin Reporting on 

Death Certificates in the United 

States: An Update 

by Elizabeth Arias, Ph.D., and Melonie Heron, Ph.D., National Center 

for Health Statistics; and Jahn K. Hakes, Ph.D., U.S. Census Bureau 

Introduction
 

The death certificate is the primary 

source of mortality information in the 

United States. It is used with census 

population counts or estimates to derive 

the basic mortality measure: the death 

rate. Race- and ethnicity-specific death 

rates are essential indicators of health and 

mortality disparities across the various 

racial and ethnic populations in the 

United States. To estimate accurate and 

reliable death rates by race and ethnicity, 

it is imperative that the classification of 

race and ethnicity in both mortality and 

census population data is consistent. 

The likelihood of inconsistency 

between racial and ethnic classification 

on numerators and denominators of 

death rates can be substantial, due 

to the distinct methods in which the 

information is collected in vital statistics 

mortality and census population data 

systems. Reporting of race and ethnicity 

in census data is usually done by a 

respondent who answers the question 

for him- or herself and other members in 

the household (“self-report” is hereafter 

used to refer to race and Hispanic-origin 

reporting on census and survey data). 

The classification of race and ethnicity 

in mortality data, on the other hand, 

is derived from responses to race and 

Hispanic-origin items on the death 

certificate, and, typically, the funeral 

director fills out these items. The funeral 

director is expected to collect this 

information by questioning the decedent’s 

next of kin but may instead rely only on 

observation. 

Prior studies have shown a high 

degree of disagreement between census 

or survey self-report and death certificate 

proxy report of race and ethnicity 

for some U.S. populations (1–4). All 

previous studies have shown that 

agreement between the two sources has 

been excellent for the white and black 

race groups but poor for other groups, 

especially the American Indian or Alaska 

Native (AIAN) population. For these 

latter groups, the problem has been 

mainly net underascertainment on death 

certificates. For example, persons who 

self-identified with a particular group 

while alive are sometimes classified as 

belonging to a different group on their 

death certificates. The most recent such 

findings refer to deaths that occurred to 

National Longitudinal Mortality Study 

(NLMS) decedents in 1990–1998 (4). 

This report presents the results of an 

updated 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 originspecific death rates. The latest NLMS 

version is used to update an evaluation 

study published in 2008. In that study, 

Arias et al. (4) examined the validity 

of race and Hispanic-origin reporting 

on death certificates by comparing race 

and Hispanic-origin classification on the 

death certificates of Current Population 

Survey (CPS) respondents (1973, 1978– 

1998) and a sample of 1980 decennial 

census respondents who died during the 

1979–1998 period to their self-responses 

on the survey forms. The current study 

uses the latest version of NLMS, which 

includes CPS cohorts (1973, 1978–2011) 

Page 1 
Page 2  Series 2, No. 172 

linked to death certificates for deaths 

occurring during 1979–2011, and 

explores the degree of misclassification 

for CPS respondents who died during the 

1999–2011 period. 

The current study explores change 

in the quality of race and Hispanic-origin 

reporting over three decades (1979– 

1989, 1990–1998, and 1999–2011). 

It updates previous findings (4) about 

the relationship between the quality of 

reporting on the death certificate and 

selected decedent characteristics, such 

as age, sex, nativity, geographic region 

of residence, and county-level racial 

and ethnic population concentration. 

The study also explores the effect on 

mortality estimates of racial and ethnic 

misclassification on death certificates by 

comparing two sets of race- and Hispanic 

origin-specific death rates. Using pooled 

2009–2011 vital statistics mortality data 

and U.S. Census 2010 data, observed 

death rates by race and Hispanic origin 

are compared with death rates that have 

been corrected for death certificate 

misclassification. Census data quality and 

its effect on race- and ethnicity-specific 

death rates is briefly reviewed and 

evaluated. 

Background 

Previous findings on race and 

ethnicity misclassification on 

U.S. death certificates 

Arias et al. (4) updated the findings 

of Sorlie et al. (2) and Rosenberg et 

al. (3), using NLMS with CPS files 

(1973 and 1978–1998) linked to death 

certificates for deaths occurring in 

1979–1998. This study found that 

agreement between CPS self-report and 

death certificate proxy report was high 

for the black and white populations but 

considerably lower for other race groups, 

consistent with previous studies (2,3). 

Specifically, for the 1979–1989 period, 

the percentage of CPS respondents 

in a self-identified race group who 

were correctly identified on the death 

certificate were: 99.8% of white, 98.8% 

of black, 55.1% of AIAN, and 84.4% of 

Asian or Pacific Islander (API) persons. 

For the 1990–1998 period, the percentage 

with correct identification on the death 

certificate were: 99.8% of white, 98.1% 

of black, 55.2% of AIAN, and 89.7% of 

API persons. 

Furthermore, Arias et al. (4) 

found that the ratio of CPS race and 

Hispanic-origin death counts to death 

certificate counts, or classification 

ratio, was highly accurate for the white 

and black populations in both time 

periods and improved over time for the 

AIAN and API populations—although 

the improvement was not statistically 

significant. The classification ratios in 

1979–1989 were: white, 1.00; black, 

1.00; AIAN, 1.45; and API, 1.13. The 

ratios in 1990–1998 were: white, 1.00; 

black, 1.01; AIAN, 1.30; and API, 1.07. 

Changes in the ratios over the 2 decades 

were statistically significant only for the 

black population. 

In addition to race classification, 

Arias et al. (4) used NLMS to update 

previous findings on death certificate 

coverage by Hispanic origin. The earlier 

study found that among self-identified 

Hispanic persons, 92.8% were correctly 

identified on the death certificate 

during 1979–1989, and 88.1% during 

1990–1998. The percentages correctly 

identified by Hispanic subgroup for 

both periods were: Mexican, 79.2% for 

1979–1989 and 86.0% for 1990–1988; 

Puerto Rican, 85.8% and 79.7%; Cuban, 

82.1% and 86.6%; Central and South 

American, 32.3% and 64.3%; and Other 

Hispanic, 46.7% and 39.2%. CPS and 

death-certificate agreement improved 

significantly between the time periods for 

Mexican and Central and South American 

persons. 

The classification ratios for 1979– 

1989 were: Hispanic, 1.04; Mexican, 

1.17; Puerto Rican, 1.06; Cuban, 1.05; 

Central and South American, 2.35; and 

Other Hispanic, 0.50. The classification 

ratios for 1990–1998 were: Hispanic, 

1.05; Mexican, 1.06; Puerto Rican, 

1.07; Cuban, 1.04; Central and South 

American, 1.05; and Other Hispanic, 

0.99. Classification ratios improved 

significantly between the time periods for 

Mexican, Central and South American, 

and Other Hispanic populations. 

Arias et al. (4) expanded on previous 

studies by exploring factors associated 

with death certificate misclassification. 

The study found variation in racial and 

ethnic misclassification on the death 

certificate by age, sex, geographic 

region, urban–rural residence, 

coethnic concentration, and nativity 

for the 1990–1998 period. Generally, 

classification ratios were relatively stable 

across age group, age–sex group, region, 

or urban–rural status for the white and 

black populations. However, ratios varied 

considerably across age group and age– 

sex group for the AIAN population and 

most Hispanic subgroups, although this 

was partly a function of small sample 

sizes. For the AIAN and API populations, 

ratios were highly variable by region, 

with better reporting in regions with 

greater numbers of AIAN and API 

residents. Furthermore, for the AIAN, 

total Hispanic, Mexican, and Central and 

South American populations, racial and 

ethnic reporting on the death certificate 

was better in counties with higher 

concentrations of persons from the same 

racial or ethnic group. Classification 

ratios also varied by nativity for the black 

population, with the U.S. born being 

more likely to be classified correctly, and 

for the total Hispanic and most Hispanic 

subgroups, with the foreign born being 

more likely to be classified correctly. 

In summary, previous studies have 

found that incongruence between race 

and ethnicity self-report, in either a 

decennial census or CPS, and proxy 

report on death certificates has not 

been a problem for the white and black 

populations but has been substantial 

for other racial and ethnic groups. For 

some populations, racial and ethnic 

reporting on the death certificate has 

improved over time. Certain factors 

also play an important role in whether 

misclassification occurs and to what 

extent. The expansion of NLMS has 

made it possible to explore the following 

questions: Did the misclassification 

problem increase or decrease during 

the 1999–2011 period for the various 

racial and ethnic groups? Are the same 

factors associated with death certificate 

misclassification? To what extent are 

current death rates biased by race and 

ethnicity misclassification on death 

certificates? 
Series 2, No. 172  Page 3 

Data and Methods
 

Evaluation of Race and 

Hispanic-origin Reporting 

on Death Certificates 

Data 

NLMS consists of data from the CPS 

Annual Social and Economic Supplement 

and a sample of the 1980 decennial 

census combined with death certificate 

information from the National Vital 

Statistics System (NVSS) to identify 

mortality status and cause of death. CPS 

is a multistage, stratified probability 

sample of the U.S. noninstitutionalized 

civilian population, with a response 

rate between 92% and 96% (5). NVSS 

consists of a voluntary contractual 

agreement between the National Center 

for Health Statistics (NCHS) and 

individual registration areas to collect 

the nation’s birth and death information. 

NVSS coverage includes more than 

99% of deaths that occur in all 50 states, 

the District of Columbia, and the U.S. 

territories (6). 

To date, NLMS includes 38 CPS files 

and the April 1980 decennial census file 

covering 1973 and 1978–2011, adding up 

to 3.8 million records. Through linkage 

to NCHS’ National Death Index for the 

1979–2011 period, 559,007 deaths have 

been identified (7). For the analyses 

presented in this report, several files 

were excluded due to the poor quality 

of important variables. Both the raceand Hispanic origin-specific analyses 

exclude the April 1980 decennial census 

file because it is missing a necessary 

population weight variable. The racespecific analysis further excludes the 

March 1973, February 1978, March 

1986, and March 1987 CPS files because 

the race variable is incomplete. 

The race categories used in this study 

include white, black, AIAN, and API, 

based on the Office of Management and 

Budget’s (OMB) 1977 Statistical Policy 

Directive 15, “Race and Ethnic Standards 

for Federal Statistics and Administrative 

Reporting” (8). This directive required 

federal agencies to collect, tabulate, and 

report at minimum the four single-race 

categories listed. OMB’s 1997 “Revisions 

to the Standards for the Classification 

of Federal Data on Race and Ethnicity” 

(9) introduced two major changes. First, 

it increased the minimum number of 

race categories that can be presented 

from four to five by breaking the API 

category into two new categories: Asian 

and Native Hawaiian or Other Pacific 

Islander (NHOPI). Second, it required 

that federal statistical data systems allow 

respondents to select more than one race 

(9). The race categories in this report 

are based on the 1977 OMB directive to 

maintain consistency across the different 

data systems. 

The U.S. Census Bureau 

implemented OMB’s 1997 revision 

starting with the 2000 decennial census. 

CPS implemented the new revision 

beginning in 2003. NVSS registration 

areas also began implementing the new 

standard in 2003, with individual areas 

making the transition at different times 

over the ensuing years. NCHS adopted 

a bridging algorithm that reassigns 

multiple-race persons in mortality and 

census data to make the NVSS and 

Census data systems comparable and to 

produce race-specific mortality estimates 

(10,11). This bridging algorithm uses 

empirically derived probabilities of 

identification with 1977 OMB-standard 

race categories for persons reporting 

multiple racial ancestries, calculated from 

data based on responses to a question 

about primary racial identification posed 

to multiracial subjects of the National 

Health Interview Survey (11). This 

algorithm was also used to bridge the 

race categories in CPS 2003–2011 to the 

1977 OMB standard for this study. 

Hispanic-origin categories used 

in this study include total Hispanic, 

Mexican, Puerto Rican, Cuban, Central 

and South American, and Other Hispanic. 

The latter group includes persons not in 

any of the previous Hispanic categories, 

such as Dominican and Spanish persons, 

as well as Hispanic individuals for whom 

a specific country of origin was not 

ascertained on either CPS or the death 

certificate. The separation of Hispanic 

origin as a distinct ethnic, rather than 

racial, attribute that crosscuts race and 

is measured using a separate item is also 

consistent with the 1977 directive (8). 

The racial and ethnic classification 

system employed in federal population 

surveys and censuses differs from that 

employed by NVSS in an important 

way. Both systems are guided by OMB’s 

standards regarding the racial and 

ethnic categories that should be used 

to obtain, tabulate, and report data by 

federal statistical and administrative 

systems. However, the two systems 

differ in the procedures used to collect 

the information. CPS, like the decennial 

census, relies on the report of persons 

responding for themselves and other 

members of their household, whereas 

the NVSS mortality data system relies 

on a proxy report provided by a funeral 

director based on responses from an 

available informant. (Demographic 

information on the death certificate, 

including race and ethnicity, is recorded 

by a funeral director, who is responsible 

for assuring the completion of the death 

certificate and registering it with state vital 

statistics offices. Information about cause 

of death is provided by the attending 

physician, medical examiner, or coroner.) 

Background information about CPS 

and NVSS mortality data, including the 

history of race and Hispanic-origin data 

collection and death certificate revisions, 

are detailed elsewhere (4,5,12–17). 

Reporting and allocation of 

missing race and Hispanic origin 

The percentage of records in NLMS 

with an unclassified race on CPS is 

0.07%, because missing or unknown 

race is imputed in all of the post-1995 

CPS files included in NLMS. CPS uses 

multiple imputation methods: relational 

imputation, which assigns missing race 

information from someone else in the 

same household or from the preceding 

record; longitudinal edits, which assign 

race based on a respondent’s answer to 

the race question on a previous CPS; 

and “hot deck” allocation, a complex 

procedure in which race is allocated 

based on a hierarchy of highly correlated 

variables (5). 

Race is imputed in approximately 

5% of CPS records (18). 

The level of unknown, not stated, 

or not classifiable race information on 
Page 4  Series 2, No. 172 

original death certificate records has 

consistently been minimal, ranging 

from a high of 0.30% to a low of 0.07% 

between 1979 and 2011 (19). From 1992 

through 2011, 0.01% to 0.49% of original 

death records were coded as “other 

races” (19). The percentage of NLMS 

decedents with missing race on their 

death certificates is zero, as a result of 

the NVSS practice of imputing unknown, 

not stated, or not classifiable race and, 

beginning in 1992, “other races” (19). 

The NVSS imputation technique uses the 

preceding record as the donor (20). 

CPS began imputing unknown 

Hispanic origin in the mid-1980s using 

the same imputation methods used for 

imputing unknown race, but NLMS 

captured some of the CPS files prior to 

imputation. As a result, the percentage 

of CPS records with unknown Hispanic 

origin used in this study is 3% (5,18). 

NVSS imputes unknown Hispanic-origin 

subgroups for reporting states by using 

the state-of-birth item as a source of 

information. If the birthplace is Mexico, 

Puerto Rico, or Cuba, then the Hispanic 

origin is assigned accordingly. If the 

birthplace is elsewhere, then the code 

is “Other and Unknown Hispanic” or 

“Unknown” (20). As a result of this 

imputation, the percentage of unknown 

Hispanic origin in the files used in this 

study is 0.18%. 

No adjustments were made for the 

imputation procedures used by CPS 

and NVSS, but the small fraction of 

records with unknown or unclassified 

race or Hispanic-origin information was 

excluded from the analysis. The final 

samples used for deaths occurring during 

the 1999–2011 period include 231,065 

matched records for the race-specific 

analysis and 265,591 matched records for 

the Hispanic origin-specific analysis. 

Methods 

As in previous studies, race and 

Hispanic origin reported on CPS were 

used as the standard for comparison 

to the death certificate classification. 

Survey and census race and ethnicity 

classification are not without error 

(21–23). However, the assumption is 

made that the information provided by 

a respondent to a survey questionnaire 

about race or Hispanic origin is, on 

average, more valid than proxy reporting 

conducted by a funeral director, who in 

most cases has little personal knowledge 

of the decedent. This decision was 

based on public policy embodied in the 

1997 OMB revision, which emphasizes 

self-identification as the standard for 

collection of racial and ethnic identities. 

To evaluate race and Hispanic-origin 

classification on the death certificate, two 

statistical estimates of death certificate 

misclassification were used. First, 

classification ratios were estimated. 

As defined in Arias et al. (4), these are 

ratios of CPS race and Hispanic-origin 

counts to death certificate counts for the 

sample of identified NLMS decedents. 

For example, the classification ratio for 

the white population is estimated as 

the number of decedents identified as 

white on CPS to the number identified 

as white on the death certificate. This is 

basically a ratio of row to column totals 

in a bivariate table of CPS (row) by death 

certificate (column) classification. It can 

be interpreted as the net difference in 

assignment of white between the two data 

collection systems. The classification 

ratios can be easily interpreted as 

adjustment factors to correct for 

the bias found in death certificates. 

Second, record-level agreement was 

estimated between CPS and the death 

certificates for individual decedents 

through a measure of sensitivity and 

predictive value positive. Sensitivity is 

the percentage of respondents in a CPS 

self-identified race and ethnicity group 

who are correctly identified on the death 

certificate; predictive value positive is 

the percentage of decedents identified by 

the death certificate in a specific race and 

ethnicity group who are self-identified 

in the same group on CPS (all statistics 

presented are weighted by CPS sample 

weights). 

The classification ratios were 

estimated by decedents’ age, sex, nativity, 

urban–rural status, region of residence, 

and degree of coethnic geographic 

concentration at the time of death. As 

in Arias et al. (4), the variables used for 

bivariate analyses were derived from the 

death certificate and include age (0–24, 

25–44, 45–54, 55–64, 65–74, and 75 and 

over), sex, nativity (U.S. born compared 

with foreign born), urban–rural status, 

census region of residence, and degree 

of coethnic geographic concentration 

(see Appendix Tables I–III for sample 

sizes by analysis variables). “Degree of 

coethnic concentration” is a dichotomous 

variable indicating whether the decedent 

died in a county with high concentrations 

of coethnic populations, and it is used 

in the analysis of total Hispanic (and 

subgroups) and AIAN populations. Arias 

et al. (4) hypothesized that for these 

groups more than any other, reporting on 

the death certificate varies significantly 

by whether the death occurred in an area 

with significant numbers of the coethnic 

population. Because race and Hispanicorigin reporting on the death certificate is 

often based on the personal observation 

of the funeral director, correct 

identification for populations where the 

OMB race and ethnicity categories are 

problematic is probably improved if the 

funeral director is coethnic, or familiar 

with the population in question due to its 

high local concentration. 

For the Hispanic population and 

component subgroups, the coethnic 

concentration indicator is defined as 

1) decedent died in a county that is 

within the first 50th percentile of ethnicspecific ranked number of deaths by 

county between 1999 and 2011, and 

2) decedent died outside of this list of 

counties (see Appendix Table IV for a 

list of counties for Hispanic subgroups). 

The concentration measure for the AIAN 

population is defined as 1) decedent died 

in one of the Indian Health Service’s 

Contract Health Service Delivery Areas 

(CHSDA) counties during 1999–2011, 

and 2) decedent died elsewhere. CHSDA 

is composed of 637 counties that contain 

federally recognized tribal land or are 

adjacent to tribal lands (24). 
Series 2, No. 172  Page 5 

Effect of Death Certificate 

Race and Hispanic-origin 

Misclassification on 

Mortality Measures 

To assess the effects on mortality 

measures of race and ethnicity 

misclassification on the death certificate, 

age-specific and age-adjusted death rates 

uncorrected and corrected for racial and 

ethnic misclassification on the death 

certificate were estimated and compared. 

Data 

Pooled numbers of deaths (bridged 

for states reporting multiple race) for 

2009–2011 from NVSS were used for 

death rate numerators. NCHS bridged 

April 1, 2010, census population 

estimates for the four race groups and the 

total Hispanic population were used for 

rate denominators. 

For rate denominators for Hispanic 

subgroups, the Census 2010 Summary 

File 2 was used (25). The NCHS bridged 

population file does not break down the 

Hispanic population by country of origin 

(11). 

The validity and reliability of 

death rates is also affected by biases in 

population counts (the denominators of 

the rates). Racial and ethnic biases in 

census population counts can result from 

question nonresponse, question wording 

effects, and underenumeration (or net 

undercounts) (21–23,26,27). For the 2010 

census, the Census Bureau reported an 

imputation rate for missing information 

of 4.5% for the Hispanic-origin item, and 

4.1% for the race item (28). A related 

problem with the race data is that some 

respondents have preferred to check 

“some other race” instead of one of the 

listed OMB options on the census form. 

Following imputation of missing race 

and Hispanic origin, the Census Bureau 

produces a Modified Race Data Summary 

File that imputes records where the race 

response was “some other race” alone, 

or in combination with another race, 

into one of the OMB race groups (29). 

For Census 2010, the substitution rate 

for “some other race” was 2.8% of the 

total population (25). The Modified Race 

Data Summary File contains the data 

traditionally used by NCHS to estimate 

death rates and to produce the bridged 

race file for data years 2000 and later 

(11). The impact of census allocation 

procedures on vital rate calculations was 

not evaluated. 

As in previous decennial censuses, 

variation occurred in census coverage 

by race and Hispanic origin in the 

2010 census. The Census 2010 

postenumeration survey (Census 

Coverage Measurement Survey, or CCM) 

revealed net undercounts that were 

statistically different from zero for the 

non-Hispanic black population (2.07%), 

AIAN population on reservations 

(4.88%), and Hispanic population 

(1.54%) (30). A statistically significant 

net overcount (–0.84%) was found for 

the non-Hispanic white population. Net 

coverage error for the non-Hispanic 

Asian (0.08% undercount), AIAN offreservation (1.95% overcount), and 

NHOPI (1.34% undercount) populations 

were not statistically significant from 

zero (30). The Census Bureau has 

no plans to use these CCM results to 

adjust population estimates, nor does 

it recommend such adjustment (30). 

Following the Census Bureau’s example, 

the census-based denominators were 

not adjusted for net undercount for the 

four race groups or the total Hispanic 

population. 

Methods 

Age-specific and age-adjusted death 

rates by race and Hispanic origin were 

estimated as: 

Age-specific death rate (ASDRi

) = 

[Di2009 + Di2010 + Di2011] / [Pi2010 × 3] 

and 

Age-adjusted death rate (AADR) = 

∑i

 {([Di2009 + Di2010 + Di2011] / [Pi2010 × 3]) 

× Wi

}, 

where Diyr are number of deaths in 

specific age group i and specific year yr, 

Pi2010 is population in specific age group i 

and year 2010, and Wi is the age-specific 

weight based on the U.S. 2000 standard 

population (31). 

Observed age-specific death rates 

were corrected with the age-specific 

classification ratios derived from NLMS, 

and then age-adjusted death rates were 

re-estimated. The correction was limited 

to age because of the sample size 

restrictions posed by the study sample 

(Appendix Table II). Ideally, adjustments 

of death certificate misclassification 

that take into account all of the factors 

that may be correlated with such 

misclassification, such as nativity and 

place of residence, would be preferable. 

Adjustment was done as: 

ASDRi

 × CRi, 

where ASDRi

 is defined as noted earlier 

and CRi

 is the age-specific classification 

ratio based on NLMS. 

Finally, the observed and corrected 

death rates for minority populations are 

compared with those of the majority 

population to assess how disparities 

between the groups are affected by race 

and Hispanic-origin misclassification on 

death certificates. 

Results 

Evaluation of Race and 

Hispanic-origin Reporting 

on Death Certificates 

Table 1 presents the record-level 

percent agreement and classification 

ratios for each defined race and Hispanicorigin group for deaths occurring during 

three periods: 1979–1989, 1990–1998, 

and 1999–2011. Estimates for the first 

two periods are from the Arias et al. 

2008 study (4). Record-level agreement 

is close to 100% for both the white and 

black populations in all three periods. In 

contrast, record-level agreement for the 

AIAN population is lower in all three 

periods. Over the 3 decades, 51%–55% 

of decedents who self-identified as AIAN 

on CPS were correctly classified on the 

death certificate (sensitivity), and 

72%–80% of decedents identified as 

AIAN on the death certificate had selfidentified as such on CPS (predictive 

value positive). The majority of those 

who self-identified as AIAN but were 

misclassified on the death certificate 

were classified as white in all three 

periods (Figure 1). Record-level 

agreement measures are better for the 

API population overall for the 3 decades. 
Page 6  Series 2, No. 172 

 

 

 

 

 

 

 

Figure 1. Race classification on death certificate of self-identified American Indian or Alaska 

Native persons on Current Population Survey: United States, 1979–1989, 1990–1998, and 

1999–2011 

Sensitivity increased from 84% to 91% 

and predictive value positive remained 

greater than 90%. 

The classification ratios show nearly 

perfect agreement between CPS and 

death certificate counts for the white and 

black populations in all three periods. 

The ratios improved significantly 

for the API population, from 1.07 in 

1990–1998 to 1.03 in 1999–2011. In 

contrast, the classification ratios for the 

AIAN population continued to show very 

poor agreement between CPS and death 

certificate counts—the classification 

ratios did not vary significantly from 1.45 

to 1.40 over the 3 decades. 

For the total Hispanic population, 

agreement between death certificate and 

survey identification remained at or near 

90% across all three periods (Table 1). 

Sensitivity ranged from 93% to 88%, 

while predictive value positive ranged 

from 96% to 91%. The classification 

ratios improved significantly from 1.05 to 

1.03 between 1990–1998 and 1999–2011 

for the total Hispanic population. 

Among Hispanic subgroups, 

agreement between death certificate and 

survey classification counts improved 

significantly between the first two 

periods and remained unchanged 

between 1990–1998 and 1999–2011 for 

the Mexican population (1.06) (Table 1). 

The classification ratios declined for 

the Cuban (from 1.04 to 1.00) and 

Puerto Rican (from 1.07 to 1.01) 

populations between 1990–1998 and 

1999–2011, although the changes were 

not statistically significant. The ratios 

worsened for the Central and South 

American (from 1.05 to 1.21) and the 

Other Hispanic (from 0.99 to 0.86) 

populations between 1990–1998 and 

1999–2011, although the change was 

significant only for the latter. These two 

groups were much more likely to be 

misclassified as a different Hispanicorigin group or as non-Hispanic on the 

death certificate (Figure 2). 

Age and sex 

Table 2 presents classification 

ratios by age and sex for the 1999–2011 

period. Among the four main race 

groups, there is barely any difference by 

sex. With regard to age, the white and 

black populations exhibit practically no 

variation in ratios across the age range. 

The age-specific classification ratios for 

the API population are also relatively 

constant across the age range. Some 

slight variation over the age range is seen 

in the sex- and age-specific classification 

ratios. In contrast, both the sex–age and 

age-specific classification ratios of the 

AIAN population show considerably 

more variation over the age range. 

For the total Hispanic population, 

males had a classification ratio of 1.04 

and females 1.03. Variation across the 

age and sex–age distributions for the total 

Hispanic population is relatively stable. 

The same is the case for the Mexican 

population. On the other hand, large 

variation is seen for the Puerto Rican 

and Cuban populations in the younger 

age and sex–age groups. Considerable 

variation also is seen across the entire age 

range for the Central and South American 

group. The large differences in the ratios 

across these sex–age combinations for the 

various groups are in part a function of 

small sample sizes (Appendix Table II). 

Sex–age patterns for the non-Hispanic 

population by race are consistent with 

those for the main race groups. 

Place of residence 

Table 3 presents classification ratios 

by geographic region and urban–rural 

status of residence at time of death for 

all defined race and Hispanic-origin 

populations. For both the white and 

black populations, there is practically no 

misclassification or variability by either 

region or rural–urban status. In contrast, 

as hypothesized, considerable variability 

is seen across the categories of these 

geographic characteristics for the AIAN 

and API populations. In most cases, the 

variability in the quality of reporting 

is a direct result of the geographic 

distribution of these populations. For 

example, the ratio is perfect (1.00) 

and significantly different for the API 

population in the West than in the other 

three regions (around 1.08), consistent 

with this population’s overwhelming 

concentration in the Western region of the 

United States. 

Coethnic concentration 

Table 3 presents classification ratios 

by coethnic geographic concentration 

for the AIAN and Hispanic populations. 

As described previously, this measure 

is a dichotomous indicator of whether 
 

Series 2, No. 172  Page 7 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Figure 2. Hispanic-origin classification on death certificate of self-identified Hispanic persons on Current Population Survey: United States, 

1999–2011 

a person died in a county where a 

substantial number of coethnic deaths 

took place (Appendix Table III). These 

results show how geographic place 

of death affects death certificate race 

and Hispanic-origin misclassification 

for some populations. For the AIAN 

population, the ratios of CPS to death 

certificate counts vary significantly, from 

a low of 1.17 in areas of high coethnic 

concentration to a high of 1.79 in areas 

with low coethnic concentration. For 

the total Hispanic population, coethnic 

concentration also has an important 

effect, with a classification ratio of 

1.01 in areas of high concentration— 

significantly different from a ratio of 

1.06 outside these areas. The coethnic 

ratios were significantly different across 

domains for the Mexican (1.01 compared 

with 1.12) and Central and South 

American (1.11 compared with 1.34) 

populations. They were similar across 

domains for the Cuban (0.98 compared 

with 1.04) and Puerto Rican (0.99 

compared with 1.03) populations. 

Nativity 

Table 3 also presents classification 

ratios by nativity. For the white 

population, there is a very small but 

statistically significant difference by 

nativity: 1.00 for the U.S. born compared 

with 0.99 for the foreign born. A 

significant difference is noted for the 

black population (1.01 compared with 

1.06), but no significant differences by 

nativity are seen for the AIAN or API 

populations. 

Among the Hispanic population, 

nativity has a significant effect on 

death certificate classification. As 

expected, the foreign born are more 

likely to be correctly classified on the 

death certificate, with a classification 

ratio of 1.01 compared with 1.05 for 

the U.S. born. The differences are 

significant for the Mexican, Central and 

South American, and Other Hispanic 

populations. The better reporting among 

the foreign born is not surprising because 

inquiring about the decedent’s place of 

birth increases the probability that the 

funeral director will correctly assign 

specific Hispanic origin. 

In summary, race classification 

on the death certificate for the white 

and black populations continued to be 

highly accurate. Reporting improved 

significantly over time for the API, total 

Hispanic, and some Hispanic subgroup 

populations, although classification 

became worse for the Central and South 

American and Other Hispanic subgroups 

across the latter two periods, 1990–1998 

and 1999–2011. Classification on the 

death certificate remained very poor 

for the AIAN population. Although the 

standard of comparison used in this study 

is census and survey self-report, it is 

important to note that this standard is not 

without error. For the AIAN population 

in particular, self-report is affected by 

significant variation over time and place 

in how people self-identify (32,33). 

The results of the bivariate analyses 

support the hypothesis that there are 

some decedent characteristics that play 

an important role in whether the death 

certificate classification agrees with 

self-report, as previously reported by 

Arias et al. (4). Among the Hispanic 

population, nativity had an important 

effect on Hispanic-origin classification 

on the death certificate. Similarly, 

among the AIAN, API, and Hispanic 

populations, place of residence also had 

an important effect. Residence in areas 

where coethnics were numerous had 

a positive effect on the quality of race 

and Hispanic-origin classification on the 

death certificate. 
Page 8  Series 2, No. 172 

Death Certificate 

Misclassification Effects on 

Mortality Estimates 

The effects of death certificate 

race and ethnicity misclassification on 

observed death rates are explored in this 

section. Tables 4 and 5 present agespecific and age-adjusted death rates and 

death rate ratios by race and Hispanic 

origin uncorrected and corrected for 

death certificate misclassification, using 

the age-specific classification ratios 

discussed earlier. 

Correction for death certificate 

misclassification makes a large difference 

to both age-specific and age-adjusted 

death rates for the AIAN population. The 

age-adjusted death rate for the AIAN 

population climbs from 84% to 116% 

of that of the white population (Table 

4). It is possible that overall mortality 

for the AIAN population is even greater 

than the adjustment suggests. The AIAN 

death rates, even after correction, are 

extremely low for the older age groups. 

The corrected ratio to the white death rate 

drops from 1.45 for age group 65–74, to 

1.04 for age group 75–84, and further to 

0.86 for age group 85 and over. Table 4 

presents uncorrected and corrected ratios 

of AIAN to white age-specific death rates, 

showing the rapid and steep decline in the 

ratios over the age range. The drop in the 

AIAN age-specific death rates could be a 

function of age misreporting, which has 

been shown to disproportionately affect 

and bias downward mortality at the oldest 

ages (34). It could also be a result of 

changes in self-identification over time, 

as noted earlier. Several studies have 

documented that the growth in the AIAN 

population over the past several decades 

has not been solely a function of true 

demographic change (births, deaths, and 

migration), but a result of increases in 

the number of persons who self-identify 

as AIAN (32,33). It may also reflect the 

much higher mortality at younger ages 

for the AIAN population, which results in 

only the hardiest surviving to the oldest 

ages (35). 

Adjustment has little effect on both 

age-specific and age-adjusted death 

rates for the API population. The ageadjusted death rate for this group changes 

minimally from 57% to 59% of the rate 

of the white population. The ratios of 

API to white age-specific death rates do 

not decline with age but rather present a 

U-shaped distribution that remains well 

below 1.00 throughout the entire age 

range. 

With respect to the Hispanic 

population, two findings emerge 

(Table 5). As Arias et al. (4) found, 

overall mortality, as measured by the 

age-adjusted death rate, remained 

significantly lower than that of the 

non-Hispanic white population 

after correction for death certificate 

misclassification. The age-adjusted death 

rate for the total Hispanic population 

increased from 74% to 76% of that of 

the non-Hispanic white population after 

correction. The age-adjusted death rate 

for Hispanic subgroups also remained 

lower than the rate for the non-Hispanic 

white population after correction for 

death certificate misclassification. The 

rate ratio increased from 0.76 to 0.81 

for the Mexican population, from 0.89 

to 0.90 for the Puerto Rican population, 

from 0.78 to 0.79 for the Cuban 

population, and from 0.51 to 0.62 for the 

Central and South American population. 

The ratio declined from 0.70 to 0.60 for 

the Other Hispanic population. The two 

groups most affected by the correction 

for misclassification were the Central 

and South American and Other Hispanic 

populations. 

Second, the Hispanic mortality 

advantage has a U-shaped pattern and 

is highest between ages 25 and 54; 

however, the advantage at the oldest ages, 

where death rates are highest, is greater 

than at the youngest ages, as shown 

in the Hispanic to non-Hispanic white 

age-specific death rate ratios (Figure 

3). Among the specific subgroups, this 

pattern is also observed in the Mexican 

population. Although the age pattern 

in the Central and South American 

population is somewhat different, the 

mortality advantage for this group as well 

is higher at the oldest ages than at the 

youngest. The older age advantage could 

be a reflection of the salmon bias (return 

migration) effect or age misreporting, 

but neither of these possibilities was 

investigated (32,36). These exercises are 

beyond the focus of this study. 

Summary and 

Conclusions 

The updated evaluation study 

described in this report produced several 

important findings. Most notable is that 

classification of race and ethnicity on 

death certificates improved significantly 

over time for the API and Hispanic 

populations, including several Hispanic 

subgroups. The quality of racial and 

ethnic reporting on death certificates 

for these two populations is now almost 

as good as that of the white and black 

populations, for which reporting has been 

found to be excellent since the 1960s. 

Unfortunately, other notable findings of 

this study are that the quality of reporting 

for the AIAN population remains poor, 

with a classification ratio of 1.40, and that 

the quality of reporting declined for two 

Hispanic subgroups. 

This study also confirms the Arias 

et al. (4) findings that select decedent 

characteristics—such as nativity, and the 

racial and ethnic composition of place 

of residence at death—have important 

effects on the quality of death certificate 

race and ethnicity classification for 

populations that contain significant 

numbers of foreign-born or coethnic 

members. If the country of birth is 

foreign, then the likelihood of being 

correctly classified increases, because 

funeral directors need to complete 

the place-of-birth item on the death 

certificate. Similarly, in areas with 

high numbers of persons of a particular 

race or Hispanic origin, the likelihood 

of correct classification increases as a 

function of increased familiarity with the 

particular population by funeral directors, 

or the increased probability that funeral 

directors will be of the same racial or 

ethnic background in these communities. 

This study also shows that correction 

for death certificate misclassification 

has different effects on mortality 

estimates for the various racial and ethnic 

populations studied. The effect of death 

certificate misclassification on mortality 

estimates for the AIAN population was 

substantial. As reported by Arias et al. 
Series 2, No. 172  Page 9 

 

 

 

 

 

 

 

 

 

 

 

 

 

Figure 3. Ratio of Hispanic to non-Hispanic white death rate, uncorrected and corrected for death certificate misclassification, by age group: 

United States, 2009–2011 

(4), correction changed a relatively large 

AIAN-to-white mortality advantage to a 

relatively large disadvantage. However, 

the effect of correction was minimal for 

the API and Hispanic populations, both of 

which maintained a rather large mortality 

advantage compared with the majority 

population. 

This study provides the most up-todate status of the quality and validity of 

race and Hispanic-origin reporting on 

U.S. death certificates. As a result, it is 

possible to produce mortality estimates 

for numerous race and Hispanic-origin 

populations with confidence. In addition, 

the information generated by this study 

can be used to correct relatively minor 

errors in reporting for some groups. The 

study also confirms that much work needs 

to be done to improve reporting for the 

AIAN population, or that alternative data 

sources, such as linked data systems, will 

be needed to produce valid and reliable 

mortality estimates for this population. 

NCHS, in collaboration with the Census 

Bureau, is undertaking a project that will 

link all persons who self-identified as 

AIAN in the 2010 decennial census with 

NVSS mortality data to both estimate 

mortality measures for the 2010 census 

cohort and develop adjustment factors 

that can be used to correct future NVSS 

mortality data. 

Notwithstanding the positive nature 

of this study and its findings, it has 

important limitations. First, CPS data 

pertain only to the noninstitutionalized 

U.S. population. Second, the effects of 

age misreporting were not addressed, 

which may be a factor in the findings 

regarding the AIAN and Hispanic 

populations. Third, the effects of changes 

over time in how persons self-report race 

and ethnicity were not explored. This 

limitation is of particular importance 

for the AIAN population. Finally, the 

study addresses issues that pertain to 

the 1977 OMB directive regarding race. 

Full implementation of OMB’s 1997 

revision, which mandates the collection 

and recording of multiple race by NVSS, 

will add a complex challenge to the 

production of high-quality U.S. racespecific mortality estimates. 

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Page 12  Series 2, No. 172 

Table 1. Sensitivity, predictive value positive, and classification ratios, by race and Hispanic origin: National Longitudinal Mortality Study, for 

deaths occurring in 1979–1989, 1990–1998, and 1999–2011 

Sensitivity1 Predictive value positive1 Classification ratio1 of CPS2 to death certificate 

Race and Hispanic origin 1979–1989 1990–1998 1999–2011 1979–1989 1990–1998 1999–2011 1979–1989 1990–1998 1999–2011 

Race Percent1 Ratio1

 (standard error) 

White . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99.8 99.8 99.6 99.6 99.5 99.2 1.00 (0.0004) 1.00 (0.0004) 1.00 (0.0003) 

Black . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98.8 98.1 97.2 98.8 98.9 98.0 1.00 (0.002) †

1.01 (0.002) 1.01 (0.002) 

AIAN3

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55.1 55.2 51.4 80.2 71.7 72.1 1.45 (0.096) 1.30 (0.062) 1.40 (0.039) 

API4

 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84.4 89.7 90.8 94.9 95.7 93.2 1.13 (0.029) 1.07 (0.016) ‡1.03 (0.008) 

Hispanic origin 

Total Hispanic . . . . . . . . . . . . . . . . . . . . . . . . 92.8 88.1 88.4 95.9 92.5 91.3 1.04 (0.010) 1.05 (0.008) ‡

1.03 (0.005) 

Mexican . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79.2 86.0 84.6 93.2 91.4 89.9 1.17 (0.021) †

1.06 (0.011) 1.06 (0.007) 

Puerto Rican . . . . . . . . . . . . . . . . . . . . . . . . . 85.8 79.7 83.5 88.8 85.0 84.6 1.06 (0.047) 1.07 (0.036) 1.01 (0.018) 

Cuban . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82.1 86.6 92.2 87.0 90.5 92.6 1.05 (0.069) 1.04 (0.026) 1.00 (0.011) 

Central and South American . . . . . . . . . . . . . 32.3 64.3 60.8 75.9 67.1 73.7 2.35 (0.432) †

1.05 (0.063) 1.21 (0.038) 

Other Hispanic. . . . . . . . . . . . . . . . . . . . . . . . 46.7 39.2 40.7 22.3 38.7 35.2 0.50 (0.042) †

0.99 (0.045) ‡0.86 (0.027) 

Non-Hispanic by race 

Non-Hispanic white . . . . . . . . . . . . . . . . . . . . 99.6 99.6 99.3 99.1 99.2 99.2 1.00 (0.001) 1.00 (0.001) 1.00 (0.0003) 

Non-Hispanic black . . . . . . . . . . . . . . . . . . . . 98.7 98.4 97.6 98.6 98.9 98.1 1.00 (0.004) 1.01 (0.002) 1.00 (0.002) 

Non-Hispanic AIAN3

. . . . . . . . . . . . . . . . . . . . 57.1 55.9 55.1 86.5 71.3 73.3 1.51 (0.209) 1.28 (0.066) 1.33 (0.038) 

Non-Hispanic API4

. . . . . . . . . . . . . . . . . . . . . 77.2 89.5 90.5 97.5 95.4 93.5 1.27 (0.077) †1.07 (0.017) ‡1.03 (0.009) 

†

 Difference in ratios between the 1979–1989 and 1990–1998 periods and between the 1990–1998 and 1999–2011 periods is significant at the 1% level. 

‡

 Difference in ratios between the 1979–1989 and 1990–1998 periods and between the 1990–1998 and 1999–2011 periods is significant at the 5% level.
 

1

Based on weighted data.
 

2

Current Population Survey.
 

3

American Indian or Alaska Native.
 

4

Asian or Pacific Islander.
 
Series 2, No. 172  Page 13 

Table 2. Classification ratios, by race and Hispanic origin, sex, and age: National Longitudinal Mortality Study, for deaths occurring in 

1999–2011 

Age group (years) 

Race and Hispanic origin and sex Total 0–24 25–44 45–54 55–64 65–74 75 and over 

Race Ratio1

 (standard error) 

White . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.00 (0.0003) 0.98 (0.007) 0.99 (0.003) 0.99 (0.002) 1.00 (0.001) 0.99 (0.001) 1.00 (0.0003) 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.00 (0.0004) 0.99 (0.008) 0.99 (0.003) 0.99 (0.002) 1.00 (0.001) 0.99 (0.001) 1.00 (0.0005) 

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.00 (0.0004) 0.98 (0.014) 0.99 (0.005) 0.99 (0.002) 1.00 (0.002) 0.99 (0.001) 1.00 (0.0004) 

Black . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.01 (0.002) 1.04 (0.019) 1.01 (0.007) 1.01 (0.005) 1.00 (0.004) 1.01 (0.004) 1.01 (0.002) 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.01 (0.002) 1.02 (0.018) 1.01 (0.009) 1.01 (0.007) 1.00 (0.006) 1.01 (0.005) 1.01 (0.004) 

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.01 (0.002) 1.08 (0.052) 1.01 (0.012) 1.01 (0.006) 1.01 (0.005) 1.01 (0.005) 1.01 (0.003) 

AIAN2

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.40 (0.039) 1.10 (0.125) 1.32 (0.088) 1.52 (0.123) 1.38 (0.095) 1.57 (0.096) 1.32 (0.063) 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.44 (0.056) 1.02 (0.138) 1.37 (0.107) 1.50 (0.171) 1.51 (0.133) 1.47 (0.121) 1.44 (0.107) 

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.36 (0.055) *1.35 (0.255) 1.21 (0.150) 1.54 (0.174) 1.24 (0.136) 1.69 (0.153) 1.24 (0.077) 

API3

 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.03 (0.008) 1.12 (0.203) 1.07 (0.057) 1.05 (0.037) 1.03 (0.031) 1.08 (0.023) 1.00 (0.009) 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.04 (0.012) *1.22 (0.302) 1.04 (0.067) 1.07 (0.052) 1.08 (0.047) 1.08 (0.031) 1.01 (0.013) 

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.01 (0.011) *0.95 (0.214) 1.12 (0.104) 1.01 (0.052) 0.97 (0.039) 1.08 (0.035) 1.00 (0.012) 

Hispanic origin 

Total Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.03 (0.005) 0.98 (0.045) 1.04 (0.021) 1.06 (0.018) 1.06 (0.013) 1.03 (0.010) 1.02 (0.007) 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.04 (0.007) 0.94 (0.055) 1.06 (0.028) 1.04 (0.021) 1.05 (0.017) 1.05 (0.014) 1.02 (0.010) 

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.03 (0.007) 1.08 (0.075) 1.01 (0.031) 1.10 (0.033) 1.07 (0.022) 1.01 (0.015) 1.02 (0.009) 

Mexican . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.06 (0.007) 1.01 (0.053) 1.06 (0.029) 1.09 (0.026) 1.11 (0.020) 1.06 (0.015) 1.04 (0.010) 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.08 (0.010) 1.00 (0.060) 1.09 (0.040) 1.09 (0.032) 1.12 (0.026) 1.08 (0.021) 1.05 (0.015) 

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.04 (0.010) 1.04 (0.107) 0.99 (0.038) 1.08 (0.043) 1.08 (0.030) 1.04 (0.022) 1.04 (0.014) 

Puerto Rican . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.01 (0.018) *1.43 (0.301) 0.81 (0.069) 1.09 (0.062) 1.01 (0.043) 1.04 (0.040) 1.01 (0.026) 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.01 (0.025) *1.72 (0.466) 0.78 (0.082) 1.02 (0.071) 1.00 (0.063) 1.11 (0.058) 1.01 (0.036) 

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.01 (0.026) *1.04 (0.330) 0.85 (0.118) 1.23 (0.116) 1.01 (0.054) 0.97 (0.055) 1.02 (0.037) 

Cuban . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.00 (0.011) *0.41 (0.205) 1.14 (0.209) 1.13 (0.083) 0.98 (0.045) 1.01 (0.029) 1.00 (0.012) 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.99 (0.017) *0.13 (0.118) *1.30 (0.339) 1.23 (0.142) 0.96 (0.059) 0.99 (0.042) 0.98 (0.017) 

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.02 (0.015) *1.42 (0.509) *0.98 (0.247) 1.01 (0.068) 1.03 (0.061) 1.03 (0.039) 1.02 (0.017) 

Central and South American 1.21 (0.038) *1.87 (0.630) 1.87 (0.301) 1.22 (0.119) 1.17 (0.101) 1.09 (0.063) 1.21 (0.057) 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.19 (0.051) *1.13 (0.322) 1.89 (0.398) 1.16 (0.109) 1.22 (0.130) 1.07 (0.083) 1.16 (0.085) 

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.24 (0.057) – *1.84 (0.455) 1.32 (0.288) 1.11 (0.158) 1.12 (0.097) 1.25 (0.075) 

Other Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.86 (0.027) 0.60 (0.177) 0.86 (0.115) 0.76 (0.086) 0.87 (0.076) 0.83 (0.065) 0.90 (0.038) 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.84 (0.038) *0.54 (0.199) 0.80 (0.133) 0.62 (0.095) 0.78 (0.085) 0.85 (0.095) 0.93 (0.060) 

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.89 (0.039) *0.73 (0.352) 0.99 (0.226) 0.97 (0.162) 1.05 (0.153) 0.81 (0.089) 0.88 (0.049) 

Non-Hispanic by race 

Non-Hispanic white . . . . . . . . . . . . . . . . . . . . . . . . . . 1.00 (0.0003) 1.00 (0.010) 1.00 (0.003) 1.00 (0.002) 1.00 (0.001) 1.00 (0.001) 1.00 (0.0003) 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.00 (0.0005) 1.01 (0.011) 1.00 (0.004) 1.00 (0.002) 1.00 (0.002) 1.00 (0.001) 1.00 (0.001) 

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.00 (0.0004) 0.97 (0.019) 1.00 (0.005) 1.00 (0.003) 1.00 (0.002) 1.00 (0.001) 1.00 (0.0004) 

Non-Hispanic black . . . . . . . . . . . . . . . . . . . . . . . . . . 1.00 (0.002) 1.02 (0.018) 1.00 (0.006) 1.00 (0.004) 1.00 (0.004) 1.01 (0.003) 1.01 (0.002) 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.00 (0.002) 1.01 (0.017) 1.00 (0.007) 1.00 (0.007) 1.00 (0.006) 1.01 (0.005) 1.01 (0.004) 

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.01 (0.002) 1.06 (0.049) 1.00 (0.009) 1.00 (0.005) 1.00 (0.005) 1.01 (0.005) 1.01 (0.003) 

Non-Hispanic AIAN2

. . . . . . . . . . . . . . . . . . . . . . . . . . 1.33 (0.038) 1.02 (0.127) 1.25 (0.079) 1.42 (0.119) 1.28 (0.090) 1.49 (0.091) 1.27 (0.061) 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.34 (0.052) 1.00 (0.146) 1.25 (0.094) 1.37 (0.162) 1.36 (0.125) 1.38 (0.112) 1.36 (0.103) 

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.32 (0.054) *1.07 (0.254) 1.25 (0.145) 1.47 (0.175) 1.21 (0.131) 1.61 (0.148) 1.20 (0.075) 

Non-Hispanic API3

. . . . . . . . . . . . . . . . . . . . . . . . . . . 1.03 (0.009) 1.13 (0.213) 1.08 (0.057) 1.07 (0.040) 1.03 (0.028) 1.08 (0.022) 1.01 (0.010) 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.05 (0.013) *1.22 (0.314) 1.07 (0.068) 1.11 (0.054) 1.07 (0.044) 1.08 (0.030) 1.02 (0.014) 

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.02 (0.012) *0.98 (0.228) 1.10 (0.103) 1.01 (0.059) 0.98 (0.035) 1.09 (0.033) 1.01 (0.013) 

* Figure does not meet standards of reliability or precision. Ratio is unreliable because either the unweighted number of Current Population Survey deaths or the unweighted number of death certificate 


deaths, or both, are based on fewer than 20 deaths.
 

– Quantity zero.
 

1

Based on weighted data.
 

2

American Indian or Alaska Native.
 

3

Asian or Pacific Islander.
 
Table 3. Classification ratios, by race and Hispanic origin, region, urban–rural status, coethnic concentration, and nativity: National Longitudinal Morta

occuring in 1999–2011 

Race Hispanic origin No

Region,

 urban–rural status, 

coethnic Central 

concentration, Puerto and South Other 

and nativity White Black AIAN2 API3 Total Mexican Rican Cuban American Hispanic White B

Region Ratio1 (standard error) 

Northeast . . . . . . . . . . 1.00 (.001) 1.03 (.006) 2.42 (.448) 1.09 (.036) 1.05 (.016) 1.46 (.309) 0.99 (.019) 1.11 (.044) 1.13 (.059) 1.08 (.109) 1.00 (.001) 1.01 

Midwest . . . . . . . . . . . . 1.00 (.0004) 1.01 (.003) 1.17 (.067) 1.08 (.048) 1.02 (.026) 1.10 (.035) 1.07 (.078) 0.93 (.131) 1.80 (.378) 0.56 (.092) 1.00 (.0005) 1.01 

South. . . . . . . . . . . . . . 1.00 (.0005) 1.00 (.002) 1.50 (.081) 1.08 (.041) 1.04 (.007) 1.02 (.010) 1.06 (.047) 0.99 (.011) 1.21 (.060) 1.31 (.107) 1.00 (.001) 1.00 

West . . . . . . . . . . . . . . 0.99 (.001) 1.01 (.007) 1.40 (.056) 1.00 (.008) 1.02 (.008) 1.09 (.011) 1.00 (.077) 0.96 (.071) 1.27 (.083) 0.75 (.027) 1.00 (.001) 1.01 

Urban–rural status 

Urban . . . . . . . . . . . . . 1.00 (.0003) 1.01 (.002) †1.74 (.089) 1.03 (.009) ‡1.03 (.005) ‡1.06 (.008) 1.01 (.018) 1.00 (.011) 1.19 (.038) 0.87 (.031) †1.00 (.0004) ‡1.00 

Rural . . . . . . . . . . . . . . 1.00 (.001) 1.01 (.004) 1.17 (.035) 1.01 (.032) 1.07 (.016) 1.11 (.021) 1.16 (.122) 1.37 (.246) *2.33 (.620) 0.85 (.053) 1.00 (.001) 1.01 

Coethnic
 

concentration
 

Yes. . . . . . . . . . . . . . . . 

... ... †1.17 (.036) ... †1.01 (.005) †1.01 (.008) 0.99 (.020) 0.98 (.009) †1.11 (.046) 0.87 (.035) ... 

No . . . . . . . . . . . . . . . . ... ... 1.79 (.091) ... 1.06 (.009) 1.12 (.013) 1.03 (.030) 1.04 (.027) 1.34 (.064) 0.86 (.042) ... 

Nativity 

U.S. born . . . . . . . . . . . †1.00 (.0003) ‡1.01 (.002) 1.39 (.039) 1.01 (.015) †1.05 (.008) †1.10 (.010) 1.11 (.068) 1.10 (.193) †2.51 (.458) †0.82 (.028) †1.00 (.0003) 1.00 

Foreign born . . . . . . . . 0.99 (.002) 1.06 (.024) *2.35 (.806) 1.04 (.011) 1.01 (.005) 0.99 (.007) 0.98 (.015) 0.99 (.009) 1.14 (.035) 1.08 (.085) 1.01 (.003) 0.99 

† Difference in ratios across the variable categories is significant at the 1% level. 

‡ Difference in ratios across the variable categories is significant at the 5% level. 

* Figure does not meet standards of reliability or precision. Ratio is unreliable because either the unweighted number of Current Population Survey deaths or the unweighted number of death certificate deaths, or bo... Category not applicable. Ratios were not estimated for these racial or ethnic groups.
 1Based on weighted data.
 

2American Indian or Alaska Native.
 

3Asian or Pacific Islander.
 
Table 4. Age-specific and age-adjusted death rates and rate ratios, uncorrected and corrected for death certificate misclassification, by race and age: 

Rate (standard error) Rate ratio 

As reported on death certificate With correction for misclassification AIAN1 to white 

Age (years) White AIAN1 API2 AIAN1 API2 Uncorrected Corrected U

0 . . . . . . . . . . . . . . . . . 541.4 (2.5) 471.6 (14.2) 392.8 (7.6) 518.8 (15.6) 440.0 (8.5) 0.87 0.98 

1–4. . . . . . . . . . . . . . . . 24.8 (0.3) 27.5 (1.7) 15.9 (0.8) 30.3 (1.9) 17.8 (0.8) 1.11 1.25 

5–14 . . . . . . . . . . . . . . 12.5 (0.1) 14.2 (0.8) 9.0 (0.4) 15.6 (0.9) 10.1 (0.4) 1.14 1.27 

15–24. . . . . . . . . . . . . . 65.6 (0.3) 82.6 (1.9) 30.1 (0.6) 90.9 (2.1) 33.7 (0.7) 1.26 1.41 

25–34 . . . . . . . . . . . . . 100.6 (0.3) 122.1 (2.5) 38.6 (0.7) 161.2 (3.3) 41.3 (0.7) 1.21 1.62 

35–44 . . . . . . . . . . . . . 168.4 (0.4) 211.1 (3.5) 68.1 (0.9) 278.6 (4.6) 72.8 (1.0) 1.25 1.67 

45–54 . . . . . . . . . . . . . 396.1 (0.6) 412.5 (5.1) 169.9 (1.6) 626.9 (7.7) 178.4 (1.6) 1.04 1.60 

55–64 . . . . . . . . . . . . . 825.0 (1.0) 772.4 (8.6) 397.4 (2.8) 1,065.8 (11.9) 409.3 (2.9) 0.94 1.29 

65–74. . . . . . . . . . . . . . 1,850.6 (1.8) 1,694.4 (18.6) 970.9 (6.0) 2,660.3 (29.1) 1,048.5 (6.5) 0.92 1.45 

75–84 . . . . . . . . . . . . . 4,824.2 (3.7) 3,813.0 (42.6) 2,873.8 (14.5) 5,033.2 (56.2) 2,873.8 (14.5) 0.79 1.04 

85 and over . . . . . . . . . 14,111.6 (9.8) 9,238.6 (120.4) 9,448.4 (46.2) 12,194.9 (159.0) 9,448.4 (46.2) 0.65 0.86 

Age adjusted . . . . . . . . 743.6 (0.3) 621.6 (3.2) 425.2 (1.1) 858.9 (4.4) 435.1 (1.1) 0.84 1.16 

1American Indian or Alaska Native. 

2Asian or Pacific Islander. 
Table 5. Age-specific and age-adjusted death rates and rate ratios, uncorrected and corrected for death certificate misclassification, by Hispanic origin 

2009–2011 

Hispanic subgroup 

Age (years) Non-Hispanic white Total Hispanic Mexican Puerto Rican Cuban 

Central and S

American 

Rate (standard error) 

0 . . . . . . . . . . . . . . . . . . . . 

1–4. . . . . . . . . . . . . . . . . . . 

5–14 . . . . . . . . . . . . . . . . . 

15–24. . . . . . . . . . . . . . . . . 

25–34 . . . . . . . . . . . . . . . . 

35–44 . . . . . . . . . . . . . . . . 

45–54 . . . . . . . . . . . . . . . . 

55–64 . . . . . . . . . . . . . . . . 

65–74. . . . . . . . . . . . . . . . . 

75–84 . . . . . . . . . . . . . . . . 

85 and over . . . . . . . . . . . . 

535.7 (2.9) 

24.5 (0.3) 12.6 (0.1) 67.0 (0.3) 

106.9 (0.4) 179.7 (0.5) 409.8 (0.7) 839.5 (1.0) 

1,879.8 (1.9) 4,892.6 (3.9) 

14,258.9 (10.1) 

507.6 (4.1) 

23.6 (0.4) 11.4 (0.2) 55.7 (0.5) 72.9 (0.5) 

114.1 (0.7) 278.8 (1.3) 625.2 (2.5) 

1,401.6 (5.3) 

3,652.4 (11.9) 

10,612.0 (36.2) 

504.4 (4.9) 

24.1 (0.5) 11.5 (0.2) 58.4 (0.6) 73.1 (0.7) 

115.2 (0.9) 290.1 (1.8) 655.1 (3.5) 

1,485.6 (7.6) 

3,848.8 (17.2) 

10,611.2 (51.5) 

556.0 (14.4) 

21.2 (1.4) 11.0 (0.7) 50.4 (1.4) 91.3 (2.1) 

165.4 (3.0) 392.9 (4.9) 847.0 (9.0) 

1,769.2 (17.6) 4,269.3 (39.0) 

11,815.2 (118.4) 

372.2 (24.8) 

11.4 (2.2) 

8.4 (1.2) 

39.0 (2.3) 57.5 (3.0) 89.6 (3.3) 

257.2 (5.6) 

621.0 (10.6) 

1,442.2 (17.8) 3,892.9 (34.3) 

12,640.9 (103.3) 

466.9 (12

24.7 (110.8 (051.3 (161.8 (180.0 (1

162.5 (2358.4 (4

870.7 (11

2,426.2 (278,250.0 (96

Age adjusted . . . . . . . . . . . 756.8 (0.3) 559.2 (0.9) 578.2 (1.3) 675.1 (3.0) 589.5 (2.9) 385.3 (2

Corrected for misclassification 

0 . . . . . . . . . . . . . . . . . . . . 

1–4. . . . . . . . . . . . . . . . . . . 

5–14 . . . . . . . . . . . . . . . . . 

15–24. . . . . . . . . . . . . . . . . 

25–34 . . . . . . . . . . . . . . . . 

35–44 . . . . . . . . . . . . . . . . 

45–54 . . . . . . . . . . . . . . . . 

55–64 . . . . . . . . . . . . . . . . 

65–74. . . . . . . . . . . . . . . . . 

75–84 . . . . . . . . . . . . . . . . 

85 and over . . . . . . . . . . . . 

535.7 (2.9) 

24.5 (0.3) 12.6 (0.1) 67.0 (0.3) 

106.9 (0.4) 179.7 (0.5) 409.8 (0.7) 839.5 (1.0) 

1,879.8 (1.9) 4,892.6 (3.9) 

14,258.9 (10.1) 

497.5 (4.0) 

23.1 (0.4) 11.1 (0.2) 54.6 (0.4) 75.8 (0.6) 

118.6 (0.8) 295.5 (1.4) 662.7 (2.7) 

1,443.6 (5.5) 

3,725.4 (12.1) 

10,824.2 (36.9) 

509.5 (5.0) 

24.4 (0.5) 11.6 (0.3) 58.9 (0.6) 77.5 (0.7) 

122.1 (1.0) 316.2 (1.9) 727.2 (3.9) 

1,574.8 (8.1) 

4,002.8 (17.9) 

11,035.7 (53.5) 

1556.0 (14.4) 

121.2 (1.4) 111.0 (0.7) 150.4 (1.4) 

74.0 (1.7) 

134.0 (2.4) 428.2 (5.4) 855.4 (9.0) 

1,840.0 (18.3) 4,312.0 (39.4) 

11,933.4 (119.6) 

1372.2 (24.8) 

111.4 (2.2) 

18.4 (1.2) 139.0 (2.3) 

65.5 (3.4) 

102.2 (3.8) 290.7 (6.4) 

608.6 (10.4) 

1,456.6 (18.0) 3,892.9 (34.3) 

12,640.9 (103.3) 

1466.9 (12

124.7 (1110.8 (0151.3 (1

115.6 (2149.6 (2198.2 (3419.4 (5

949.1 (12

2,935.7 (33

9,982.5 (116

Age adjusted . . . . . . . . . . . 756.8 (0.3) 574.8 (0.9) 609.3 (1.4) 681.6 (3.1) 597.0 (3.0) 468.9 (2

Rate ratios to non-Hispanic white 

Hispanic subgroup 

Total Hispanic corrected Mexican corrected Puerto Rican corrected 

Cuban 

corrected 

Central and S

American corr

No Yes No Yes No Yes No Yes No 

0 . . . . . . . . . . . . . . . . . . . . 

1–4. . . . . . . . . . . . . . . . . . . 

5–14 . . . . . . . . . . . . . . . . . 

15–24. . . . . . . . . . . . . . . . . 

25–34 . . . . . . . . . . . . . . . . 

35–44 . . . . . . . . . . . . . . . . 

45–54 . . . . . . . . . . . . . . . . 

55–64 . . . . . . . . . . . . . . . . 

65–74. . . . . . . . . . . . . . . . . 

75–84 . . . . . . . . . . . . . . . . 

85 and over . . . . . . . . . . . . 

... ... ... ... ... ... ... ... ... ... ... 

... ... ... ... ... ... ... ... ... ... ... 

0.95 

0.96 

0.90 

0.83 

0.68 

0.63 

0.68 

0.74 

0.75 0.75 

0.74 

0.93 

0.94 

0.89 

0.82 

0.71 

0.66 

0.72 

0.79 

0.77 

0.76 0.76 

0.94 

0.98 

0.92 

0.87 

0.68 

0.64 

0.71 

0.78 

0.79 

0.79 

0.74 

0.95 

0.99 

0.93 

0.88 

0.72 

0.68 

0.77 0.87 

0.84 

0.82 

0.77 

1.04 

0.87 

0.88 

0.75 

0.85 

0.92 

0.96 

1.01 

0.94 

0.87 

0.83 

1.04 

0.87 

0.88 

0.75 

0.69 

0.75 

1.04 

1.02 

0.98 0.88 

0.84 

0.69 

0.47 

0.67 

0.58 

0.54 

0.50 

0.63 

0.74 

0.77 

0.80 

0.89 

0.69 

0.47 

0.67 

0.58 

0.61 

0.57 

0.71 

0.72 

0.77 

0.80 

0.89 

0.87 

1.01 

0.86 

0.77 

0.58 

0.45 

0.40 

0.43 

0.46 

0.50 

0.58 

Age adjusted . . . . . . . . . . . ... ... 0.74 0.76 0.76 0.81 0.89 0.90 0.78 0.79 0.51 

... Category not applicable.
 

1Not corrected for misclassification because the classification ratios are not reliable.
 
Series 2, No. 172  Page 17 

Appendix. Supporting Tables 

Table I. Number of deaths from Current Population Survey and death certificate, by race and Hispanic origin and period: National Longitudinal 

Mortality Study, for deaths occurring in 1979–1989, 1990–1998, and 1999–2011 

Race and Hispanic origin 

and source of data 1979–1989 

Number of deaths1 

1990–1998 1999–2011 

Race 

White: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52,390 90,065 202,091 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52,519 90,272 202,965 

Black: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,993 10,010 22,542 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,994 9,941 22,384 

AIAN2

: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 419 754 2,519 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 332 651 2,049 

API3

: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 516 1,155 3,903 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 473 1,120 3,851 

Hispanic origin 

Total Hispanic: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,516 5,140 13,487 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,465 4,855 12,894 

Mexican: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,018 2,887 7,470 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 864 2,622 6,778 

Puerto Rican: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150 527 1,401 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144 496 1,378 

Cuban: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84 532 1,614 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 505 1,591 

Central and South American: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 250 994 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 235 804 

Other Hispanic: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197 944 2,008 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 349 997 2,343 

Non-Hispanic by race 

Non-Hispanic white: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12,786 81,797 185,024 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12,860 82,146 190,317 

Non-Hispanic black: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,960 9,687 22,087 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,960 9,651 22,072 

Non-Hispanic AIAN2

: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 663 2,293 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 588 1,973 

Non-Hispanic API3

: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100 1,126 3,771 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 1,092 3,680 

1

Based on unweighted data. 

2

American Indian or Alaska Native. 

3

Asian or Pacific Islander. 

NOTE: CPS is Current Population Survey. 
Page 18  Series 2, No. 172 

Table II. Number of deaths from Current Population Survey and death certificate, by race and Hispanic origin, age, and sex: National 

Longitudinal Mortality Study, for deaths occurring in 1999–2011 

Age group (years) 

Race and Hispanic origin, 

sex, and source of data Total 0–24 25–44 45–54 55–64 65–74 75 and over 

Race Number of deaths 

White: 

CPS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202,091 1,228 6,312 12,083 21,162 34,733 126,572 

Death certificate . . . . . . . . . . . . . . . . . . . . . . . . . . . 202,965 1,251 6,378 12,203 21,289 34,976 126,867 

Male: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98,014 842 3,941 7,286 12,490 19,335 54,119 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 98,498 858 3,980 7,353 12,569 19,465 54,272 

Female: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104,077 386 2,371 4,797 8,672 15,398 72,453 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 104,467 393 2,398 4,850 8,720 15,511 72,595 

Black: 

CPS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22,542 278 1,515 2,378 3,443 4,564 10,362 

Death certificate . . . . . . . . . . . . . . . . . . . . . . . . . . . 22,384 269 1,507 2,363 3,434 4,527 10,282 

Male: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10,307 203 823 1,217 1,792 2,264 4,006 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 10,251 199 827 1,212 1,796 2,245 3,970 

Female: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12,235 75 692 1,161 1,651 2,300 6,356 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 12,133 70 680 1,151 1,638 2,282 6,312 

AIAN1

: 

CPS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,519 70 274 331 440 568 835 

Death certificate . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,049 63 239 260 364 429 693 

Male: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,343 52 184 185 238 294 390 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 1,054 47 158 143 181 225 300 

Female: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,176 18 90 146 202 274 445 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 995 16 81 117 183 204 393 

API2

: 

CPS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,903 33 168 267 465 673 2,297 

Death certificate . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,851 32 169 260 448 639 2,303 

Male: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,031 19 102 157 262 374 1,117 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 2,003 17 104 152 251 358 1,121 

Female: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,872 14 66 110 203 299 1,180 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 1,848 15 65 108 197 281 1,182 

Hispanic origin 

Total Hispanic: 

CPS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13,487 212 863 1,220 1,847 2,630 6,715 

Death certificate . . . . . . . . . . . . . . . . . . . . . . . . . . . 12,894 203 834 1,152 1,733 2,521 6,451 

Male: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,997 139 560 742 1,098 1,442 3,016 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 6,682 137 534 716 1,026 1,369 2,900 

Female: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,490 73 303 478 749 1,188 3,699 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 6,212 66 300 436 707 1,152 3,551 

Mexican: 

CPS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,470 141 564 728 1,099 1,491 3,447 

Death certificate . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,778 135 511 660 960 1,346 3,166 

Male: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,016 92 383 461 658 838 1,584 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 3,595 88 331 419 561 746 1,450 

Female: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,454 49 181 267 441 653 1,863 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 3,183 47 180 241 399 600 1,716 

Puerto Rican: 

CPS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,401 25 93 165 238 299 581 

Death certificate . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,378 17 107 149 237 296 572 

Male: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 712 17 51 94 133 153 264 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 703 11 62 89 132 144 265 

Female: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 689 8 42 71 105 146 317 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 675 6 45 60 105 152 307 

See footnotes at end of table. 
Series 2, No. 172  Page 19 

Table II. Number of deaths from Current Population Survey and death certificate, by race and Hispanic origin, age, and sex: National 

Longitudinal Mortality Study, for deaths occurring in 1999–2011 —Con. 

Age group (years) 

Race and Hispanic origin, 

sex, and source of data Total 0–24 25–44 45–54 55–64 65–74 75 and over 

Hispanic origin—Con. Number of deaths 

Cuban: 

CPS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,614 5 24 64 116 286 1,119 

Death certificate . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,591 8 25 58 111 281 1,108 

Male: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 759 2 13 34 73 159 478 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 764 6 13 30 71 158 486 

Female: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 855 3 11 30 43 127 641 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 827 2 12 28 40 123 622 

Central and South American: 

CPS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 994 13 69 108 136 221 447 

Death certificate . . . . . . . . . . . . . . . . . . . . . . . . . . . 804 7 42 89 114 188 364 

Male: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 494 8 40 67 82 116 181 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 402 7 24 58 65 101 147 

Female: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 500 5 29 41 54 105 266 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 402 0 18 31 49 87 217 

Other Hispanic: 

CPS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,008 28 113 155 258 333 1,121 

Death certificate . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,343 36 149 196 311 410 1,241 

Male: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,016 20 73 86 152 176 509 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 1,218 25 104 120 197 220 552 

Female: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 992 8 40 69 106 157 612 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 1,125 11 45 76 114 190 689 

Non-Hispanic by race 

Non-Hispanic white: 

CPS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185,024 1,008 5,385 10,706 18,974 31,478 117,472 

Death certificate . . . . . . . . . . . . . . . . . . . . . . . . . . . 190,317 1,029 5,529 11,069 19,576 32,523 120,590 

Male: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89,227 702 3,340 6,421 11,149 17,468 50,146 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 91,907 709 3,426 6,663 11,548 18,110 51,450 

Female: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95,797 306 2,045 4,285 7,825 14,010 67,326 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 98,410 320 2,103 4,406 8,028 14,413 69,140 

Non-Hispanic black: 

CPS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22,087 266 1,463 2,314 3,368 4,484 10,191 

Death certificate . . . . . . . . . . . . . . . . . . . . . . . . . . . 22,072 260 1,478 2,321 3,391 4,475 10,145 

Male: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10,093 195 798 1,184 1,747 2,228 3,940 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 10,103 191 810 1,192 1,772 2,223 3,913 

Female: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11,994 71 665 1,130 1,621 2,256 6,251 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 11,969 69 668 1,129 1,619 2,252 6,232 

Non-Hispanic AIAN1

: 

CPS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,293 61 254 295 395 518 769 

Death certificate . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,973 58 231 249 347 416 671 

Male: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,196 45 170 161 205 261 354 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 1,011 43 153 137 169 218 291 

Female: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,097 16 84 134 190 257 415 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 962 15 78 112 178 198 380 

Non-Hispanic API2

: 

CPS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,771 28 157 256 440 644 2,246 

Death certificate . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,680 29 155 242 425 603 2,226 

Male: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,955 16 96 150 244 356 1,093 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 1,909 15 96 143 238 336 1,081 

Female: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,816 12 61 106 196 288 1,153 

Death certificate. . . . . . . . . . . . . . . . . . . . . . . . 1,771 14 59 99 187 267 1,145 

1

American Indian or Alaska Native.
 

2

Asian or Pacific Islander.
 

NOTE: CPS is Current Population Survey.
 
Table III. Number of deaths from Current Population Survey and death certificate, by race and Hispanic origin, region, urban–rural status, geographic 

National Longitudinal Mortality Study, for deaths occurring in 1999–2011 

Race Hispanic origin 

Region, urban–rural status, Central 

coethnic concentration, Puerto and South Other 

and nativity White Black AIAN1 API2 Total Mexican Rican Cuban American Hispanic White 

Region Number of deaths 

Northeast: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . 42,189 3,051 108 326 1,696 55 819 218 375 229 40,147 

Death certificate. . . . . . . . . . . . . . . 42,408 2,964 43 298 1,554 37 820 195 325 177 40,775 

Midwest: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . 52,779 4,330 628 216 828 577 107 36 44 64 50,510 Death certificate. . . . . . . . . . . . . . . 52,898 4,306 578 201 767 499 98 36 25 109 51,953 

South: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . 64,277 13,489 524 321 5,189 2,910 333 1,254 334 358 57,389 

Death certificate. . . . . . . . . . . . . . . 64,551 13,467 349 297 4,908 2,828 307 1,248 266 259 59,875 

West: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . 42,846 1,672 1,259 3,040 5,774 3,928 142 106 241 1,357 36,978 

Death certificate. . . . . . . . . . . . . . . 43,108 1,647 1,079 3,055 5,665 3,414 153 112 188 1,798 37,714 

Urban–rural status 

Urban: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . 141,378 18,590 932 3,361 11,579 6,269 1,314 1,586 946 1,464 128,186 

Death certificate. . . . . . . . . . . . . . . 142,046 18,478 603 3,294 11,135 5,768 1,297 1,570 789 1,711 131,307 

Rural: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . 60,713 3,952 1,587 542 1,908 1,201 87 28 48 544 56,838 Death certificate. . . . . . . . . . . . . . . 60,919 3,906 1,446 557 1,759 1,010 81 21 15 632 59,010 

Coethnic concentration 

Yes: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . ... ... 1,590 ... 6,279 3,424 646 964 481 1,059 ... 

Death certificate. . . . . . . . . . . . . . . ... ... 1,468 ... 6,197 3,378 645 971 432 1,235 ... 

No: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . ... ... 929 ... 7,208 4,046 755 650 513 949 ... 

Death certificate. . . . . . . . . . . . . . . ... ... 581 ... 6,697 3,400 733 620 372 1,108 ... 

Nativity 

U.S. born: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . 187,700 21,518 2,455 1,909 7,478 5,294 332 63 122 1,667 175,886 

Death certificate. . . . . . . . . . . . . . . 188,333 21,431 2,023 1,895 7,028 4,582 303 55 44 2,044 181,071 

Foreign born: 

CPS . . . . . . . . . . . . . . . . . . . . . . . . 13,186 719 48 1,968 5,934 2,150 1,045 1,538 866 335 8,033 

Death certificate. . . . . . . . . . . . . . . 13,408 654 19 1,933 5,815 2,177 1,062 1,534 755 287 8,130 

... Category not applicable. 1American Indian or Alaska Native. 2Asian or Pacific Islander. 

NOTE: CPS is Current Population Survey. 
Series 2, No. 172  Page 21 

Table IV. County and state of death, by Hispanic-origin subgroup: National Longitudinal 

Mortality Study, for deaths occurring in 1999–2011 

Hispanic subgroup, county, and state Percent of deaths 

Mexican 

Los Angeles, CA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.5 

Bexar, TX. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.5 

Fresno, CA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.3 

El Paso, TX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.2 

Harris, TX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.5 

San Bernardino, CA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2 

Hidalgo, TX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2 

Maricopa, AZ. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.1 

San Diego, CA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.1 

Austin, TX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.1 

Cameron, TX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.6 

Orange, CA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.6 

Cook, IL. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.3 

Riverside, CA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.3 

Webb, TX. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.3 

Chambers, TX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.3 

Nueces, TX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.2 

Pima, AZ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.2 

Frio, TX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.1 

Ventura, CA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.0 

Santa Clara, CA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.0 

Alameda, CA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.8 

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50.4 

Remainder of country . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49.6 

Cuban 

Miami-Dade, FL. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62.4 

Remainder of country . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37.6 

Puerto Rican 

Erie, NY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.5 

Bronx, NY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.8 

New York, NY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.8 

Kings, NY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.4 

Miami-Dade, FL. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.2 

Queens, NY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.7 

Cook, IL. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2 

Philadelphia, PA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2 

Orange, FL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.8 

Broward, FL. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.7 

Los Angeles, CA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.3 

Hartford, CT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.3 

Camden, NJ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.2 

Essex, NJ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.2 

Hillsborough, FL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.2 

Milwaukee, WI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.9 

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50.4 

Remainder of country . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49.6 

Central and South American 

Los Angeles, CA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.0 

Miami-Dade, FL. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.5 

Queens, NY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.9 

New York, NY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.4 

Fresno, CA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.3 

Erie, NY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.9 

Kings, NY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.6 

Bronx, NY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.6 

Broward, FL. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2 

Calhoun, FL. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.9 

San Francisco, CA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.4 

Hudson, NJ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.1 

Jefferson, LA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.0 

Contra Costa, CA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.0 

Montgomery, MD. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.0 

Essex, NJ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.9 

Palm Beach, FL. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.9 

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50.6 

Remainder of country . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49.4 
Vital and Health Statistics 

Series Descriptions 

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Reports describe the programs and data systems of the 

National Center for Health Statistics, and the data collection 

and survey methods used. Series 1 reports also include 

definitions, survey design, estimation, and other material 

necessary for understanding and analyzing the data. 

Series 2. Data Evaluation and Methods Research 

Reports present new statistical methodology including 

experimental tests of new survey methods, studies of vital 

and health statistics collection methods, new analytical 

techniques, objective evaluations of reliability of collected 

data, and contributions to statistical theory. Reports also 

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countries. 

Series 3. Analytical and Epidemiological Studies 

Reports present data analyses, epidemiological studies, and 

descriptive statistics based on national surveys and data 

systems. As of 2015, Series 3 includes reports that would 

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Discontinued Series 

Series 4.	 Documents and Committee Reports 

Reports contain findings of major committees concerned with 

vital and health statistics and documents. The last Series 

4 report was published in 2002; these are now included in 

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Series 5.	 International Vital and Health Statistics Reports 

Reports present analytical and descriptive comparisons of 

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The last Series 5 report was published in 2003; these are now 

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Reports use methods of cognitive science to design, evaluate, 

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Reports present statistics on illness; accidental injuries; 

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Series 11.	 Data From the National Health Examination Survey, the 

National Health and Nutrition Examination Surveys, and 

the Hispanic Health and Nutrition Examination Survey 

Reports present 1) estimates of the medically defined 

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the distribution of the population with respect to physical, 

physiological, and psychological characteristics and 2) 

analysis of relationships among the various measurements. 

As of 2015, these are included in Series 3. 

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The last Series 12 report was published in 1974; these reports 

were included in Series 13, and as of 2015 are in Series 3. 

Series 13.	 Data From the National Health Care Survey 

Reports present statistics on health resources and use of 

health care resources based on data collected from health 

care providers and provider records. As of 2015, these reports 

are included in Series 3. 

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The last Series 14 report was published in 1989; these reports 

were included in Series 13, and are now included in Series 3. 

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Reports contain statistics on health and health-related topics 

from surveys that are not a part of the continuing data systems 

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report was published in 2002; these reports are now included 

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Statistics 

The last Series 16 report was published in 1996. All reports 

are available online; compilations are no longer needed. 

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Reports include analyses by cause of death and demographic 

variables, and geographic and trend analyses. The last Series 

20 report was published in 2007; these reports are now 

included in Series 3. 

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Reports include analyses by health and demographic 

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included in Series 3. 

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The last Series 22 report was published in 1973. Reports from 

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Divorce 

The last Series 24 report was published in 1996. All reports 

are available online; compilations are no longer needed 

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