NCHS Data Brief ■ No. 221 ■ November 2015

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

How Does Cause of Death Contribute to the Hispanic 

Mortality Advantage in the United States?

Elizabeth Arias, Ph.D.; Kenneth D. Kochanek, M.A.; and Robert N. Anderson, Ph.D.

Key findings 

Data from the National 

Vital Statistics System, 

Mortality

● In 2013, life expectancy at 

birth for Hispanic males was 

2.6 years greater than that of 

non-Hispanic white males and 

7.3 years greater than that of 

non-Hispanic black males.

● The Hispanic male 

advantage was due to lower 

death rates from cancer, heart 

disease, unintentional injuries, 

chronic lower respiratory 

diseases, suicide, homicide, 

perinatal conditions, stroke, and 

diabetes.

● Life expectancy at birth for 

Hispanic females was 2.6 years 

greater than that of

non-Hispanic white females 

and 5.7 years greater than that 

of non-Hispanic black females.

● The Hispanic female 

advantage was due to lower 

death rates from cancer, 

heart disease, chronic lower 

respiratory diseases, stroke, 

unintentional injuries, suicide, 

perinatal conditions, diabetes, 

Alzheimer’s disease, and 

kidney disease.

The Hispanic population in the United States has lower overall mortality and 

higher life expectancy at birth than the non-Hispanic white and non-Hispanic 

black populations. The expectation has been that the Hispanic population 

should exhibit a mortality profile that is similar to that of the non-Hispanic 

black population, not one that is advantaged relative to the non-Hispanic 

white population (1–4). In this report, differences in the leading causes of 

death between the Hispanic and non-Hispanic white and black populations are 

explored to determine how they contributed to the life expectancy advantage 

of the Hispanic population in 2013. 

Keywords: life expectancy • race • ethnicity • National Vital Statistics System, 

Mortality

How is the Hispanic mortality advantage reflected in life 

expectancy at birth in 2013? 

Life expectancy at birth for the total U.S. population in 2013 was 78.8 years. 

The Hispanic population had a life expectancy (81.6 years) that was 2.7 years 

0

70

75

80

85

Both sexes Male Female

Age in years

Figure 1. Life expectancy at birth, by Hispanic origin, race, and sex: United States, 2013

NOTE: Life expectancies are based on death rates that have been adjusted for race and Hispanic origin misclassification on death

certificates (2).

SOURCE: CDC/NCHS, National Vital Statistics System, Mortality.

All origins Hispanic Non-Hispanic white Non-Hispanic black

78.8

81.6

78.9

75.1

76.4

79.1

76.5

71.8

81.2

83.8

81.2

78.1
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greater than the non-Hispanic white population (78.9 years) and 6.5 years greater than the 

non-Hispanic black population (75.1 years) (Figure 1). Hispanic females had the highest 

life expectancy at birth (83.8 years), followed by non-Hispanic white females (81.2 years), 

Hispanic males (79.1 years), non-Hispanic black females (78.1 years), non-Hispanic white 

males (76.5 years), and non-Hispanic black males (71.8 years) (5).

What causes of death influenced the difference in life expectancy 

between Hispanic and non-Hispanic white males in 2013? 

● Life expectancy at birth for Hispanic males was higher by 2.6 years than that of

non-Hispanic white males because of lower death rates due to cancer, heart disease, 

unintentional injuries, suicide, chronic lower respiratory diseases, and Parkinson’s 

disease (Figure 2). Lower death rates for these causes accounted for 83% of the 

Hispanic male advantage. 

● Lower cancer mortality for Hispanic males accounted for a gain of 0.741 years in life 

expectancy. Lung cancer alone accounted for 0.442 years or 59.6% of the Hispanic 

male cancer mortality advantage.

● The Hispanic male life expectancy advantage would have been greater if not for higher 

death rates due to homicide, diabetes, chronic liver disease, and HIV disease, which 

accounted for 75.4% of the Hispanic male disadvantage, or a loss of 0.444 years. 

-0.4 -0.2 0.0 0.2 0.4 0.6

Homicide

Diabetes

Chronic liver disease

HIV disease

Parkinson's disease

Chronic lower

respiratory diseases

Suicide

Unintentional injuries

Heart disease

Cancer

Loss or gain in life expectancy in years

Figure 2. Contribution of the leading causes of death to the difference in life expectancy between Hispanic and 

non-Hispanic white males: United States, 2013

SOURCE: CDC/NCHS, National Vital Statistics System, Mortality.

0.741

0.656

0.417

0.386

0.346

0.030

-0.04494

-0.12819

-0.12968

-0.14163

Hispanic

Disadvantage

Advantage

0.8
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What causes of death influenced the difference in life expectancy between 

Hispanic and non-Hispanic black males in 2013?

● Hispanic male life expectancy was 7.3 years greater than that of non-Hispanic black males. 

● Lower death rates for Hispanic males due to heart disease, cancer, homicide, perinatal 

conditions, stroke, unintentional injuries, chronic lower respiratory diseases, diabetes, 

kidney disease, and HIV disease (Figure 3) accounted for 78.9% of the Hispanic male 

advantage. 

● Heart disease accounted for a gain of 1.771 years in life expectancy for Hispanic males. 

Cancer mortality accounted for a gain of 1.425 years. Lung cancer alone accounted for 

0.593 years or 41.6% of the Hispanic male cancer mortality advantage.

● The Hispanic male life expectancy advantage would have been greater if not for higher 

death rates due to chronic liver disease, Parkinson’s disease, and viral hepatitis, which 

accounted for 98.9% of the Hispanic male disadvantage, or a loss of 0.194 years. 

-0.5 0.0 0.5 1.0 1.5 2.0

Chronic liver disease

Parkinson's disease

Viral hepatitis

HIV disease

Kidney disease

Diabetes

Chronic lower

respiratory diseases

Unintentional injuries

Stroke

Perinatal conditions

Homicide

Cancer

Heart disease

Loss or gain in life expectancy in years

Figure 3. Contribution of the leading causes of death to the difference in life expectancy between Hispanic and 

non-Hispanic black males: United States, 2013

SOURCE: CDC/NCHS, National Vital Statistics System, Mortality.

1.771

1.425

0.861

0.334

0.323

0.255

0.238

0.227

0.220

-0.00828

-0.01711

-0.16853

0.215 Hispanic

Disadvantage

Advantage
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What causes of death influenced the difference in life expectancy between 

Hispanic and non-Hispanic white females in 2013?

● Hispanic female life expectancy was 2.6 years greater than that of non-Hispanic white 

females.

● Lower death rates for Hispanic females due to cancer, chronic lower respiratory diseases, 

heart disease, unintentional injuries, suicides, and Alzheimer’s disease (Figure 4) accounted 

for 76.7% of the Hispanic female advantage.

● Cancer accounted for a gain of 0.764 years in life expectancy for Hispanic females. Lung 

cancer alone accounted for 0.512 years or 67% of the Hispanic female cancer mortality 

advantage.

● Higher death rates for Hispanic females due to diabetes, chronic liver disease, perinatal 

conditions, and viral hepatitis accounted for 81.2% of the Hispanic female disadvantage, or 

a loss of life expectancy of 0.275 years. 

-0.4 -0.2 0.0 0.2 0.4 0.6

Diabetes

Chronic liver disease

Perinatal conditions

Viral hepatitis

Alzheimer's disease

Suicide

Unintentional injuries

Heart disease

Chronic lower

respiratory diseases

Cancer

Loss or gain in life expectancy in years

Figure 4. Contribution of the leading causes of death to the difference in life expectancy between Hispanic and 

non-Hispanic white females: United States, 2013

SOURCE: CDC/NCHS, National Vital Statistics System, Mortality.

0.764

0.512

0.422

0.380

0.138

0.064

-0.023

-0.033

-0.041

-0.179

0.8

Hispanic

Disadvantage

Advantage
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What causes of death influenced the difference in life expectancy between 

Hispanic and non-Hispanic black females in 2013?

● Hispanic female life expectancy was 5.7 years higher than that of non-Hispanic black 

females.

● Lower death rates for Hispanic females due to heart disease, cancer, stroke, perinatal 

conditions, diabetes, kidney disease, chronic lower respiratory diseases, unintentional 

injuries, septicemia, and HIV disease (Figure 5) accounted for 75.2% of the Hispanic female 

advantage.

● Heart disease accounted for a gain of 1.437 years in life expectancy for Hispanic females. 

Cancer accounted for 1.220 years and lung cancer alone accounted for 0.424 years or 34.8% 

of the Hispanic female cancer mortality advantage.

● Higher death rates for Hispanic females due to chronic liver disease, Parkinson’s disease, 

and suicides accounted for 91.2% of the Hispanic female disadvantage, or a loss of life 

expectancy of 0.107 years. 

-0.5 0.0 0.5 1.0 1.5 2.0

Chronic liver disease

Parkinson's disease

Suicide

HIV disease

Septicemia

Unintentional injuries

Chronic lower

respiratory diseases

Kidney disease

Diabetes

Perinatal conditions

Stroke

Cancer

Heart disease

Loss or gain in life expectancy in years

Figure 5. Contribution of the leading causes of death to the difference in life expectancy between Hispanic and 

non-Hispanic black females: United States, 2013

SOURCE: CDC/NCHS, National Vital Statistics System, Mortality.

1.437

1.220

0.301

0.301

0.224

0.223

0.199

0.193

0.175

-0.00592

-0.02439

-0.07675

0.133 Hispanic

Disadvantage

Advantage
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Summary

In 2013, the Hispanic population had higher life expectancy at birth than both the non-Hispanic 

white and non-Hispanic black populations. These findings are consistent with those of numerous 

mortality studies conducted over the past 4 decades and are based on life table estimates that 

have been adjusted for race and Hispanic origin misclassification on U.S. death certificates (1–4). 

Approximately 5% of Hispanic decedents are misclassified, while less than 1% of non-Hispanic 

black and 0.5% of non-Hispanic white decedents are misclassified (2). The causes of the Hispanic 

mortality advantage have not been definitively identified.

In this report, the relationship between cause of death and life expectancy was explored to better 

understand the mechanisms behind the life expectancy differentials between the Hispanic and 

each of the non-Hispanic white and non-Hispanic black populations. The difference between 

the Hispanic and non-Hispanic white populations was a function of the Hispanic population 

experiencing lower mortality from cancer, heart disease, chronic lower respiratory diseases, 

unintentional injuries, suicides, Alzheimer’s disease, and Parkinson’s disease. The difference 

between the Hispanic and non-Hispanic black populations was due to the Hispanic population 

having lower mortality from heart disease, cancer, stroke, perinatal conditions, diabetes, 

homicide, unintentional injuries, chronic lower respiratory diseases, kidney disease, HIV disease, 

and septicemia. In both comparisons, the causes of death contributing to the Hispanic advantage 

were the same across sex with minor exceptions. For example, homicide accounts for a large 

portion of the Hispanic male life expectancy advantage relative to non-Hispanic black males, but 

plays no role with respect to the Hispanic female advantage. 

This report is the third in a series of data briefs that explore the causes of death contributing to 

differences in life expectancy between detailed ethnic and racial populations in the United States 

(6,7).

Definitions

Cause-of-death classification: Medical information—including injury diagnoses and external 

causes of injury—that is entered on death certificates filed in the United States is classified and 

coded in accordance with the International Statistical Classification of Diseases and Related 

Health Problems, Tenth Revision (ICD–10) (8). Corresponding cause-of-death categories and 

ICD–10 codes presented in this report are as follows:

Heart disease [Diseases of heart (I00–I09, I11, I13, I20–I51)]

Cancer [Malignant neoplasms (C00–C97)]

Lung Cancer [Malignant neoplasms of trachea, bronchus, and lung (C33–C34)]

Stroke [Cerebrovascular diseases (I60–I69)]

Chronic lower respiratory diseases (J40–J47)

Unintentional injuries [Accidents (V01–X59, Y85–Y86)]

Alzheimer’s disease (G30)
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Diabetes [Diabetes mellitus (E10–E14)]

Suicide [Intentional self-harm (*U03, X60–X84, Y87.0)]

Chronic liver disease [Chronic liver disease and cirrhosis (K70, K73–K74)]

Parkinson’s disease (G20–G21)

Homicide [Assault (*U01–*U02, X85–Y09, Y87.1)]

Perinatal conditions [Certain conditions originating in the perinatal period (P00–P96)]

HIV disease [Human immunodeficiency virus (HIV) disease (B20–B24)]

Kidney disease [Nephritis, nephrotic syndrome, and nephrosis (N00–N07, N17–N19, 

N25– N27)]

Viral hepatitis (B15–B19)

Septicemia (A40–A41)

Life expectancy: The average number of years that a group of infants would live if the group was 

to experience throughout life the age-specific death rates present in the year of birth; also referred 

to as period or current life expectancy (9). 

Data source and methods

All data are from the 2013 mortality file from the National Vital Statistics System. Life table 

methodology is explained in the report “United States Life Tables, 2011” (9). A complete 

description of the Arriaga life table partitioning methodology can be found in references 10 and 

11. There is no information currently available about cause of death misclassification, and there 

is no reason to believe cause of death classification differs by race and ethnicity. The most current 

research shows that the factors associated with the quality of racial and ethnic classification on 

death certificates are predominantly contextual and demographic, including geography, coethnic 

concentration, and nativity (12). 

About the authors

Elizabeth Arias, Kenneth D. Kochanek, and Robert N. Anderson are with CDC’s National Center 

for Health Statistics, Division of Vital Statistics, Mortality Statistics Branch.

References

1. Palloni A, Arias E. Paradox lost: Explaining the Hispanic adult mortality advantage. 

Demography 41(3):385–415. 2004.

2. Arias E. United States life tables by Hispanic origin. National Center for Health Statistics. 

Vital Health Stat 2(152). 2010. 

3. Markides KS, Coreil J. The health of Hispanics in the southwestern United States: An 

epidemiologic paradox. Public Health Rep 101(3):253–65. 1986.
NCHS Data Brief ■ No. 221 ■ November 2015

Suggested citation

Arias E, Kochanek KD, Anderson RN. 

How does cause of death contribute to 

the Hispanic mortality advantage in the 

United States? NCHS data brief, no 221. 

Hyattsville, MD: National Center for Health 

Statistics. 2015.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

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

Nathaniel Schenker, Ph.D., Deputy 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

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4. Sorlie PD, Backlund E, Johnson NJ, Rogot E. Mortality by Hispanic 

status in the United States. JAMA 270(20):2464–8. 1993.

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http://www.cdc.gov/nchs/nvss/mortality_public_use_data.htm.

6. Kochanek KD, Arias E, Anderson RN. How did cause of death contribute 

to racial differences in life expectancy in the United States in 2010? NCHS 

data brief, no 125. Hyattsville, MD: National Center for Health Statistics. 

2013.

7. Kochanek KD, Arias E, Anderson RN. Leading causes of death 

contributing to decrease in life expectancy gap between black and 

white populations: United States, 1999–2013. NCHS data brief, no 218. 

Hyattsville, MD: National Center for Health Statistics. 2015. 

8. WHO. International statistical classification of diseases and related health 

problems, tenth revision. 2nd edition. Geneva, Switzerland. 2004.

9. Arias E. United States life tables, 2011. National vital statistics reports; 

vol 64 no 11. Hyattsville, MD: National Center for Health Statistics. 2015.

10. Arriaga EE. Measuring and explaining the change in life expectancies. 

Demography 21(1):83–96. 1984. 

11. Arriaga E. Changing trends in mortality decline during the last 

decades. In: Ruzicka L, Wunsch G, Kane P, editors. Differential mortality: 

Methodological issues and biosocial factors. Oxford: Clarendon Press. 1989. 

12. Arias E, Schauman WS, Eschbach K, et al. The validity of race and 

Hispanic origin reporting on death certificates in the United States. National 

Center for Health Statistics. Vital Health Stat 2(148). 2008.