Series 2, Number 148 October 2008

TheValidity of Race and

Hispanic Origin Reporting

on Death Certificates in the

United States
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Suggested citation

Arias E, Schauman WS, Eschbach K, Sorlie PD, Backlund E. 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.

Library of Congress Cataloging-in-Publication Data

The validity of race and Hispanic origin reporting on death certificates in the

United States / [by Elizabeth Arias...et al.].

p. ; cm. -- (Vital and health statistics. Series 2 ; no. 148)

‘‘October 2008.’’

Includes bibliographical references.

ISBN 0–8406–0627–3

1. Death certificated--United States--Evaluation. 2. Minorities--United

States--Mortality--Statistics--Evaluation.3. Hispanic Americans--Mortality-­

Statistics--Evaluation. I. Arias, Elizabeth. II. National Center for Health Statistics

(U.S.) III. Series: Vita and health statistics. Series 2, Data evaluation and

methods research ; no. 148.

[DNLM: 1. Death Certificates--Statistics. 2. Continental Population Groups-­

statistics & numerical data. 3. Hispanic Americans--statistics & numerical data.

W2 A N148vb no. 148 2008]

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Series 2, Number 148

TheValidity of Race and

Hispanic Origin Reporting

on Death Certificates in the

United States

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

October 2008

DHHS Publication No. (PHS) 2009–1348
National Center for Health Statistics

Edward J. Sondik, Ph.D., Director

Jennifer H. Madans, Ph.D., Acting Co-Deputy Director

Michael H. Sadagursky, Acting Co-Deputy Director

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

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

Planning, Budget, and Legislation

Michael H. Sadagursky, Associate Director for

Management and Operations

Lawrence H. Cox, Ph.D., Associate Director for Research

and Methodology

Linda B. Torian, Acting Director for Information Technology

Linda B. Torian, Acting Director for Information Services

Linda T. Bilheimer, Ph.D., Associate Director for Analysis

and Epidemiology

Charles J. Rothwell, M.S., Director for Vital Statistics

Jane E. Sisk, Ph.D., Director for Health Care Statistics

Jane F. Gentleman, Ph.D., Director for Health Interview

Statistics

Clifford L. Johnson, M.S.P.H., Director for Health and

Nutrition Examination Surveys

Division of Vital Statistics

Charles J. Rothwell, M.S., Director for Vital Statistics

Robert N. Anderson, Ph.D., Chief, Mortality Statistics

Branch
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 ................................................................................................... 7 

Evaluation of Race and Hispanic Origin Reporting on Death Certificates ........................................... 7 

Death Certificate Misclassification Effects on Mortality Estimates ................................................. 9 

Discussion ............................................................................................... 11 

Summary and Conclusions ................................................................................ 11 

References ............................................................................................... 11 

Appendix I............................................................................................... 17 

Hispanic Origin Reporting on Death Certificate and Percentage Unknown for Reporting States by Year.................. 17 

Appendix II .............................................................................................. 19 

Tables 1–3 Study Sample Sizes by Selected Variables .......................................................... 19 

Appendix III ............................................................................................. 24 

Listing of Counties and State of Death During the 1990–1998 Period for Hispanic Origin Subgroups ................... 24 

Text Figures

1.	 Race distribution on death certificate among self-identified American Indian or Alaska Natives and Asian or Pacific 

Islanders: United States, 1979–1989 and 1990–1998 ........................................................ 7 

2.	 Assignment to nonspecific Hispanic status (other Hispanic) on the death certificate for self-identified specific 

Hispanic subgroup origin: United States, 1979–1989 and 1990–1998 .......................................... 8 

3.	 Ratios of age-specific death rates, uncorrected and corrected: Hispanic and non-Hispanic white.................... 10 

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 and 1990–1998 .......................................... 13 

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

occurring in 1990–1998 .............................................................................. 14 

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

National Longitudinal Mortality Study, for deaths occurring in 1990–1998 ..................................... 15 

4.	 Age-specific and age-adjusted death rates and rate ratios by race and age: Uncorrected and corrected for death 

certificate misclassification ........................................................................... 15 

5.	 Age-specific and age-adjusted death rates and rate ratios to non-Hispanic white, by Hispanic origin and age, 

uncorrected and corrected for death certificate misclassification: United States, 1999–2001 ....................... 16 

i
Appendix Tables

I. Table I. Appendix for Table 1, Number of deaths from the Current Population Survey and death certificate by race,

Hispanic origin, and period: National Longitudinal Mortality Study for deaths occurring in 1979–1989 and

1990–1998......................................................................................... 19

II. Appendix for Table 2, number of deaths from the Current Population Survey and death certificate by race,

Hispanic origin, age, and sex: National Longitudinal Mortality Study for deaths occurring in 1990–1998 ............ 20

III Appendix for Table 3, number of deaths from the Current Population Survey and death certificate by race,

Hispanic origin, region, urban-rural status, geographic concentration, and nativity: National Longitudinal Mortality

Study for deaths occurring in 1990–1998 ................................................................ 23

ii
Objectives

This report presents the results of an The Val

evaluation study of the validity of race

and Hispanic origin reporting on death

certificates in the United States and its

impact on race- and Hispanic

origin-specific mortality estimates.

Methods

The National Longitudinal Mortality

Study (NLMS) was used to evaluate

death certificate classification of race

and Hispanic origin by comparing deat

certificate with survey race-ethnicity

classifications for a sample of

decedents identified in NLMS. NLMS

consists of a series of annual Current

Population Survey files (1973 and

1978–1998) linked to death certificates

for years 1979–1998. To identify and

measure the effect of race-ethnicity

misclassification on death certificates

on mortality estimates, pooled

1999–2001 vital statistics mortality data

and population data from the 2000

census were used to estimate and

compare observed and corrected (for

death certificate misclassification)

race-ethnicity specific death rates.

Results

Race and ethnicity reporting on the

death certificate continues to be

excellent for the white and black

populations. It remains poor for the

American Indian or Alaska Native

(AIAN) population but is reasonably

good for the Hispanic and Asian or

Pacific Islander (API) populations.

Decedent characteristics such as place

of residence and nativity have an

important effect on the quality of

reporting on the death certificate. The

effects of misclassification on mortality

estimates were most pronounced for

the AIAN population, where correcting

for misclassification reverses a large

AIAN over white mortality advantage to

a large disadvantage. Among the

Hispanic and API populations,

adjustment for death certificate

misclassification did not significantly

affect minority-majority mortality

differentials.

Keywords: race c hispanic origin c

death certificate c death

rates c mortality c health disparities

h

idity of Race and

Hispanic Origin Reporting on

Death Certificates in the

United States

by Elizabeth Arias, Ph.D., National Center for Health Statistics;

William S. Schauman, M.S., U.S. Census Bureau; Karl Eschbach,

Ph.D., University of Texas at San Antonio; Paul D. Sorlie, Ph.D.,

National Heart, Lung, and Blood Institute; and Eric Backlund, M.S.,

U.S. Census Bureau

for the estimation of vital rates. Each of Introduction these data sources, population censuses

and death certificates, employ distinct

Death certificates are the primary race and ethnicity reporting procedures.

source of mortality data in the United On the one hand, reporting of race and

States. They provide the numerator for ethnicity for a census is left to a

death rates, whereas census population respondent, who answers the question

estimates provide the denominator. In for him- or herself and other members

turn, death rates serve as the basic in the household through selfmeasure of the impact of mortality on a administered questionnaires. On the

population. Race- and Hispanic other hand, reporting on a death

origin-specific death rates are used to certificate is typically the responsibility

calculate all-cause and cause-specific of a funeral director who must gather

mortality differentials between the this information from next of kin or

numerous racial and ethnic subgroups in often rely on personal observation.

the United States. Incongruence between Differences in reporting of race or

race and Hispanic origin classification ethnicity for the same person across the

on numerators and denominators of two systems may be especially

death rates has the potential to seriously problematic for racial and ethnic

bias race- and ethnicity-specific populations for which a large share of

mortality differentials. all marriages is intergroup marriages. In

Inconsistency between race and the United States, these include

Hispanic origin classification on American Indian or Alaska Natives

numerators and denominators of death (AIAN), Native Hawaiians or Other

rates is inherent in a statistical system Pacific Islanders (NHOPI), Asians, and

that relies on two distinct data sources Hispanics.

This report was prepared under the general direction of Charles J. Rothwell, Director, Division of Vital

Statistics, and Robert N. Anderson, Chief, Mortality Statistics Branch (MSB). The authors are grateful to

Mark Flotow, Illinois Center for Health Statistics, and Robert N. Anderson, Julia Holmes, Charles

Rothwell, and Jennifer Madans, National Center for Health Statistics, for their insightful 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. Betzaida

Tejada-Vera and Jiaquan Xu, MSB, provided content review and tabulation assistance. This report was

edited by Megan M. Cox and Demarius V. Miller, CDC/CCHIS/NCHM/Division of Creative Services,

Writer-Editor Services Branch, and typeset by Jacqueline M. Davis, CDC/CCHIS/NCHM/Division of

Creative Services; graphics were produced by Jarmila G. Ogburn, CDC/CCHIS/NCHM/Division of

Creative Services.

Page 1
Indeed, previous evaluation studies

of the agreement between census (or

survey) self-report and death certificate

proxy report of race and ethnicity have

shown that the level of agreement

between the two sources varies

significantly by racial or ethnic grouping

(1,2,3). According to these studies,

agreement between the two sources has

been found to be excellent for the white

and black race groups but less than ideal

for other race groups or for the Hispanic

population. For groups other than the

white and black race groups, the

problem has primarily been one of net

underascertainment on the death

certificate. Persons who self-identified

with a particular group while alive are

sometimes classified as belonging to a

different group on their death

certificates. These findings are now

quite dated. The most recent refer to

deaths that took place during the 1980s

(2,3).

This report presents the results of

an evaluation study of the validity of

race and Hispanic origin reporting on

death certificates in the United States

and its impact on race- and Hispanic

origin-specific death rates. The National

Longitudinal Mortality Study (NLMS) is

used to evaluate death certificate reports

of race and ethnicity compared with

survey race-ethnicity classifications for

members of Current Population Survey

(CPS) cohorts (1973 and 1978–1998)

linked to death certificates for deaths

occurring in years 1979–1998. This

study updates and expands on the

evaluation studies carried out by Sorlie,

Rogot, and Johnson and Rosenberg et

al. that used an earlier release of NLMS

(2,3).

Drawing on the increased sample

size and longer follow-up period of the

more recent NLMS release, this study

adds to extant knowledge on the topic in

two significant ways. First, change over

time in the quality of reporting on the

death certificate is explored. Second, the

study explores 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 hypothesis is that for

some race groups and for the entire

Hispanic population, these

characteristics profoundly influence the

quality of race and ethnicity

classification on the death certificate.

To identify and measure the effect

of death certificate race-ethnicity

misclassification on mortality estimates,

two sets of race- and Hispanic

origin-specific death rates are estimated

and compared. Using pooled 1999–2001

vital statistics mortality data and data

from the 2000 census, both observed

death rates by race and Hispanic origin

and death rates that have been corrected

for death certificate misclassification are

estimated. The role of census data

quality and its effect on race- and

ethnicity-specific death rates is also

briefly reviewed and evaluated.

Background

Previous studies of race and

ethnicity misclassification on

death certificates in the

United States

Evaluation studies of race

misclassification on the death certificate

date back to the 1960s. Hambright

(1969) was the first study to examine

the congruence between death certificate

and census race classification at the

national level and was based on the

1960 Census-Death Certificate Matched

Record Study that consisted of a sample

of 340,000 death certificates linked to

the 1960 decennial census (1).

Agreement between census self-report

and death certificate proxy report was

found to be very high for the white and

black race groups but considerably

lower for other race groups. Using

census self-identification as the standard

for comparison, the study found that

99.8% of self-identified whites, 98.2%

of self-identified blacks, 79.2% of

self-identified American Indians, and

86.9% of self-identified ‘‘others’’ were

correctly identified on the death

certificate.

National level evaluation studies

were not carried out again until the

1990s, primarily because of the lack of

appropriate data. The creation of NLMS

provided the opportunity to examine this

issue once again. Using NLMS, which

at the time consisted of nine annual CPS

files (1973 and 1978–1985) linked to

mortality data for the years 1979–1985,

Sorlie, Rogot, and Johnson (2) found

similar results as the Hambright study

(1). Sorlie and coauthors found that

99.2% of self-identified whites, 98.2%

of self-identified blacks, 73.6% of

self-identified AIAN, and 82.4% of

self-identified Asian or Pacific Islanders

(API) were correctly classified on the

death certificate. Using NLMS with CPS

files (1973 and 1978–1985) with an

additional 4 years of mortality follow-up

(1979 through 1989), Rosenberg et al.

(3) reported the following percentage of

correct identification on the death

certificate: white (99.8), black (98.6),

AIAN (57.4), and API (82.5).

The only exception to the consistent

findings of these three studies appears to

be the quality of reporting for the AIAN

population. Between the Hambright and

the Rosenberg et al. studies (1,3),

agreement between census self- and

death certificate proxy reporting for this

population declined from 79.2% to

57.4%. However, the populations

studied were slightly different: the

Hambright study did not include Aleut

or Eskimo in the American Indian

category, whereas the NLMS AIAN

category does. Nevertheless, a sharp

decline was observed in the agreement

between self-report and proxy report for

the AIAN population between the two

NLMS-based studies; from 73.6% to

57.4% agreement. This large change is

likely a result of the unprecedented

growth in the number of persons

identifying themselves as AIAN since

the 1960s, an increase that did not

primarily occur through natural increase,

but rather a rise over time in the

acceptability of claiming AIAN racial

identity among persons of mixed AIAN

and non-AIAN ancestry (4).

Hispanic origin classification issues

did not come to the national fore until

the 1980s. The 1980 census was the first

decennial census that included a

Hispanic origin question on the

questionnaire distributed to all

households. Similarly, states did not

begin to include a Hispanic origin

question on their death certificates until

1978. In 1978, only 18 states included

this item on their death certificates (5).

Page 2 [ Series 2, Number 148
Series 2, Number 148 [ Page 3

As a result, the first study to evaluate

the quality of Hispanic origin reporting

on death certificates at the national level

included only deaths occurring in a

select number of states. In addition to

race classification, Sorlie, Rogot, and

Johnson (2) used NLMS with mortality

follow-up for the years 1979 through

1985 to evaluate death certificate

coverage by Hispanic origin (for the

1979–1985 period, an item on Hispanic

origin was included on the death

certificate of 21 states). They found that

among self-identified Hispanics, 89.7%

were correctly identified on the death

certificate. The percentage correctly

identified by Hispanic subgroups was

found to be the following: Mexican

(84.9), Puerto Rican (85.9), Cuban

(80.0), and ‘‘other Hispanic’’ (47.6).

Based on the unweighted samples

presented in Sorlie, Rogot, and Johnson,

Rosenberg et al. reported the following

ratios of CPS to death certificate counts:

Hispanic (1.07, (600/563)), Mexican

(1.11, (417/375)), Puerto Rican (1.04,

(71/68)), Cuban (1.07, (30/28)), and

other Hispanic (0.89, (82/92)) (2,3).

In summary, these studies all find

that incongruence between race-ethnicity

self-report in either a decennial census

or the CPS and proxy report on death

certificates has been very low for the

white and black populations but more

substantial for other racial and ethnic

groups. The expansion of NLMS has

now made it possible to re-examine this

problem and answer some important

questions. Did the problem increase or

decrease during the 1990s for the

various racial and ethnic groups? What

factors are associated with death

certificate misclassification? How

seriously are death rates biased by race

and ethnicity misclassification on death

certificates?

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 of approximately

95% (6). NVSS consists of a voluntary

contractual agreement between the

National Center for Health Statistics

(NCHS) and individual registration areas

to collect the U.S. birth and death

information. NVSS coverage includes

over 99% of deaths that occur in all 50

states, the District of Columbia, and the

U.S. territories (7).

To date, NLMS includes 26 files

covering years 1973 and 1978–1998 that

add up to 2.3 million records. Through

linkage to NCHS’ National Death Index

for the 1979 through 1998 period,

252,627 deaths have been identified.

The Hispanic origin-specific analysis is

based on the sample of decedents

identified in the March 1973, February

1978, March 1979, April 1980, August

1980, December 1980, and March

1981–March 1998 CPS files. The

race-specific analysis excludes CPS files

March 1973, February 1978, March

1986, and March 1987 because the CPS

race variable is incomplete in these files.

The race categories used in this

study include white, black, AIAN, and

API and are 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 a minimum the four single-race

categories listed above. 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 falling in any of

the previous Hispanic categories, such

as Dominicans and Spaniards, as well as

Hispanic persons for whom specific

country of origin was not ascertained in

either the 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 requirements of the

1977 directive (8).

The race and ethnicity 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 Statistical Directive regarding

the race and ethnicity 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.

(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.)

CPS has collected information on

race since 1946. The original CPS race

classification was based on the

interviewer’s determination of the

subject’s race as white, Negro, or other.

Following OMB’s 1977 Statistical

Directive 15, CPS expanded the race

categories to include white, black,

AIAN, and API and switched from

interviewer observation to interviewee

report (self-report and report by other

household members). Beginning with

the October 1978 survey, respondents

have been asked to identify their race
Page 4 [ Series 2, Number 148

and that of other household members,

while being presented with a flashcard

with a list of choices (9). Similarly, CPS

interviewers were instructed to show

respondents a flashcard with a list of

choices to identify their ethnicity (9).

NVSS includes mortality data

compiled by NCHS through cooperative

agreements with individual registration

areas, including the 50 states, the

District of Columbia, New York City,

American Samoa, Guam, Northern

Mariana Islands, Puerto Rico, and the

Virgin Islands (10,11). To attain

maximum comparability across the

registration areas and produce

national-level vital statistics data, U.S.

standard certificates and reports that

contain the basic elements necessary for

the collection and publication of

comparable national and local vital

statistics are produced and periodically

revised (10,11).

A race item has been a part of the

U.S. Standard Death Certificate since

the first standard was issued in 1900.

Between the 1900 and 1989 revisions,

the race item underwent some minor

changes from a simple fill-in box

labeled ‘‘color’’ to a fill-in box labeled

‘‘race,’’ as well as the inclusion of

sample terms for guidance and a request

for specificity. The greatest change in

this item took place with the 2003

revision, which incorporated the

requirements of OMB’s 1997 ‘‘Revision

to Standards for the Classification of

Federal Data on Race and Ethnicity’’

(12). The 1997 OMB revision

introduced two major changes. First, it

increased the minimum number of race

categories that can be presented from

four to five by breaking up the API

category into two new categories: Asian

and NHOPI. Second, it required that

federal statistical data systems allow

respondents to select more than one race

(12). As of data year 2006, only 23

states had adopted the 2003 Standard

Death Certificate revision.

A Hispanic origin item did not

become a part of the U.S. Standard

Death Certificate until the 1989 revision.

However, prior to this revision, some

states included a Hispanic origin item

on the death certificate. For instance, in

1979 (the first year of mortality

follow-up in NLMS), 20 states recorded

Hispanic origin on the death certificate,

although a significant number of these

reported high rates of missing

information on this item. By 1990, only

Louisiana, New Hampshire, and

Oklahoma still did not include a

Hispanic origin item on their death

certificates, and the majority of

reporting states had missing rates

substantially below 1% on this item.

State coverage was complete beginning

in 1997 (see Appendix I for distribution

of Hispanic origin reporting on death

certificates by year and state).

Reporting and allocation of

missing race and Hispanic

origin

After accounting for incomplete

race information (as noted above), the

percentage of NLMS records with a race

assignment not falling into any of the

OMB categories, mainly ‘‘some other

race,’’ was 0.06% on the CPS and

0.27% on the death certificate. The

percentage of records with an

unclassified race on the CPS is

practically zero because missing or

unknown race is imputed. CPS uses a

complex hot deck procedure in which

race is allocated based on a hierarchy of

highly correlated variables. Race is

imputed in approximately 5% of records

(13). The percentage of unknowns on

race on death certificates is less than

0.5% as a result of the NVSS practice

of imputing unknown race and,

beginning in 1992, ‘‘all other races’’

(14). The imputation technique

employed is to use the preceding record

as the donor. The level of missing race

information on original death certificate

records has consistently been minimal,

ranging from a high value of 0.30% to a

low value of 0.08% between 1979 and

1998 (15).

After removing records from states

that did not include a Hispanic origin

item on their death certificates (see

Appendix I), the percentage of records

in the study sample with unknown

Hispanic origin was 0.29% on the CPS

and 0.59% on the death certificates.

CPS began imputing unknown Hispanic

origin in the mid-1980s using the same

hot deck method used for imputing

unknown race (13). NVSS imputes

unknown Hispanic origin subgroups for

reporting states by using the state of

birth item as a source of information. If

birth place is Mexico, Puerto Rico, or

Cuba, then the Hispanic origin is

accordingly assigned. If birth place is

elsewhere, then the code is ‘‘Other and

Unknown Hispanic’’ or ‘‘Unknown’’

(14).

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 analyses. The final

study samples include 161,302 matched

records for the race-specific analysis and

114,869 matched records for the

Hispanic origin-specific analysis.

Methods

As in previous studies, race and

Hispanic origin reported on the CPS

were used as the standard for

comparison with the death certificate

classification. Survey and census race

and ethnicity classification are not

without error (16,17). 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 has little personal

knowledge of the decedent. This

decision is also 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

produced. First, ratios were estimated of

CPS race and Hispanic origin counts to

death certificate counts for the sample

of identified NLMS decedents described

above (referred to hereafter as

‘‘classification ratios’’). For example,

the classification ratio for the white

population is estimated as the number of

decedents identified as white on the

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
Series 2, Number 148 [ Page 5

certificate (column) classification. It can

be interpreted as the net difference in

assignment of white between the two

data collection systems. The

classification ratios are the same as the

ratios reported by Rosenberg et al. (3)

and 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-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-ethnicity group who are selfidentified in the same group on the 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 time of

death for the 1990–1998 period only.

The bivariate analyses were restricted to

this period because the state coverage of

Hispanic origin is substantially better in

the 1990s than in the 1980s. As

discussed above, over the 1979–1998

period, the number of states that

included a Hispanic origin item on their

death certificates increased significantly;

from 20 states in 1979 to all 50 states

and the District of Columbia by 1997

(see Appendix I). Additionally, more

recent estimates of death certificate

misclassification were preferred for use

as death rate adjustment factors.

The variables chosen for bivariate

analyses are derived from the death

certificate and include age (0–24 years,

25–44 years, 45–54 years, 55–64 years,

65–74 years, and 75 years 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 II 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

because it was 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 a significant

number of the coethnic population or

not. Because race and Hispanic origin

reporting on the death certificate is often

based on the personal observation of the

funeral director, correct identification for

populations where the OMB raceethnicity categories are problematic is

probably improved if the funeral

director is coethnic or familiar with the

population in question because of 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 falls

within the first 50th percentile of

ethnic-specific ranked number of deaths

by county during the 1990s, and 2)

decedent died outside this list of

counties (see Appendix III for a list of

counties). For the AIAN population, the

measure was constructed by focusing on

counties in the service area of the U.S.

Indian Health Service in the 1990s.

These counties contain Indian

reservations and adjacent areas. From

this group, 276 counties were selected

where, in the 2000 census, AIANs

reporting a single-race only were at least

70% of persons reporting an AIAN race

in combination with another race (the

list of 276 counties are available from

authors upon request). The concentration

measure for AIANs is therefore defined

as 1) decedent died in one of these 276

counties during the 1990s and 2)

decedent died elsewhere.

Effect of Death Certificate

Race and Hispanic Origin

Misclassification on

Mortality Measures

To assess the effects of race and

ethnicity misclassification on the death

certificate on mortality measures,

age-specific and age-adjusted death rates

uncorrected and corrected for racial and

ethnic misclassification on the death

certificate are estimated and compared.

Data

Pooled number of deaths for years

1999–2001 from NVSS were used for

death rate numerators, and NCHS

bridged April 1, 2000, population census

estimates for the four race groups and

the total Hispanic population were used

for rate denominators. Because the U.S.

Census Bureau implemented OMB’s

1997 revision with the 2000 decennial

census but the NVSS registration areas

had not, NCHS adopted a bridging

algorithm that reassigns multiple-race

persons in census-based denominators to

single-race categories in order to make

comparable the two systems and

produce race-specific mortality estimates

(18). This bridging algorithm uses

empirically derived probabilities of

identification with 1977 OMB-standard

race categories for persons reporting

multiple racial ancestries, which is

calculated from data from a question

about primary racial identification posed

to multiracial subjects of the National

Health Interview Survey (18).

For rate denominators for Hispanic

subgroups, the Census 2000 Summary

File 2 was used. The NCHS bridged

population file does not break down the

Hispanic population by country of origin

(18). The 1% Public Use Microdata

Sample (PUMS) of the 2000 decennial

census was also used to estimate

adjusted population counts for Hispanic

subgroups. Other analyses have shown

that the 2000 census contained a

significant level of underenumeration of

Hispanic subgroups (this problem is

discussed fully below).

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) (16,17,19). For the 2000

census, the U.S. Census Bureau reported

an imputation rate for missing

information of 4.4% for the Hispanic

origin item and 4.1% for the race item

(20). A related problem with the race

data is that some respondents have
Page 6 [ Series 2, Number 148

preferred to check ‘‘some other race’’

instead of one of the listed options on

the census form. Following imputation

of missing race and Hispanic origin, the

U.S. 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. For the 2000

census, the substitution rate for ‘‘some

other race’’ was 6.6% of the total

population (21). The Modified Race

Data Summary File is the data that has

been traditionally used by NCHS to

estimate death rates and was used to

produce the bridged-race file for data

years 2000 and later (18). The impact of

census allocation procedures on vital

rate calculations was not evaluated.

Unlike the case in previous

decennial censuses, no significant net

undercount was found in the 2000

census for the major race groups or the

total Hispanic population. The 2000

census postenumeration survey

(Accuracy and Coverage Evaluation

Survey (ACE)) revealed minimal and

statistically insignificant net undercounts

by race and Hispanic origin (19). For

example, net undercounts were found to

be statistically different from zero for

only the non-Hispanic white (-1.13%

(overcount)) and non-Hispanic black

populations (1.84%). The net undercount

estimates for other race groups and the

total Hispanic population were found to

be not statistically different from zero

(net undercounts: Hispanics, 0.71%;

non-Hispanic Asian, -0.75%; NHOPI,

2.12%; AIAN on reservations, -0.88%;

and AIAN off reservations, 0.62% (19).

ACE also produced some unexplained

results that led the U.S. Census Bureau

to decide against adjusting the census

population count, which is used for

intercensal population estimates (19).

Following the U.S. Census Bureau’s

example, the census-based denominators

were not adjusted for net undercount for

the four race groups or the total

Hispanic population.

On the other hand, there appears to

have been a significant degree of

underenumeration of specific Hispanic

subgroups in the 2000 census

(16,22,23). A postcensus evaluation

study (Alternative Questionnaire

Experiment) revealed that the 2000

census Hispanic origin question

produced a significantly greater

proportion of Hispanics reporting a

general term (Hispanic, Latino, or

Spanish) rather than a specific country

of origin than did the 1990 census

Hispanic question (23). Changes in

question wording is suspected as a cause

for the increase. The 2000 question

removed examples of countries from the

write-in section and replaced the word

‘‘origin’’ with the word ‘‘Latino’’ (23).

Cresce and Ramirez used 2000

census questions on birthplace and

ancestry to estimate the proportion of

respondents giving a general Hispanic

term that could be recategorized into a

specific country of origin category (23).

Among Hispanics responding with a

generic term in 2000 (16% of the total

Hispanic population), they found that

28.8% could be recategorized by using

birthplace and 25.2% by using ancestry,

leaving 7.5% in the nonspecific

Hispanic category (23). (The percentage

giving a generic response in 2000 after

adjustment (7.5%) closely matches the

percentage giving a similar response in

pooled 1990–2005 CPS data (8.0%).

The CPS question can be assumed to

elicit better responses because

respondents are given a country-specific

list from which to select. Furthermore,

both analysis of CPS and the 2000

census revealed that the majority of

these respondents were born in

California, Texas, New Mexico, and

Colorado. CPS shows that these are

predominantly third or higher generation

Hispanic Americans who are

descendants of early Spanish immigrants

or a segment of the Mexican population

who were never technically immigrants

because they resided in what used to be

Mexico. These Hispanic Americans

probably no longer identify with a

specific country of origin.)

Confirming the effect of removal of

country-specific examples from the 2000

census Hispanic question, the groups

gaining the most numbers when

birthplace and ancestry were considered

were those who did not have a

country-specific checkbox and who were

expected to write in their country of

origin. The percentage increase in

numbers for these groups was as

follows: Spaniards (68.7%), Central

Americans (34.4%), South Americans

(30.1%), and Dominicans (25.0%).

Gaining significantly smaller numbers

when birthplace and ancestry were taken

into account, as expected, were

Mexicans (6.9%), Puerto Ricans (4.0%)

and Cubans (5.0%) because the 2000

census Hispanic origin question included

country-specific check boxes for these

three populations.

Methods

Age-specific and age-adjusted death

rates by race and Hispanic origin were

estimated as follows:

Age-specific death rate (ASDRi

) =

[Di1999 + Di2000 + Di2001]/[Pi2000 * 3]

and

Age-adjusted death rate (AADR) = ∑i

{([Di1999 + Di2000 + Di2001] / Pi2000 *3])

* Wi

},

where Diyr are number of deaths in

specific age group i and specific year yr,

Pi2000 is population in specific age

group i and year 2000, and Wi is the

age-specific weight based on the U.S.

standard population (24).

Observed age-specific death rates

were corrected with the age-specific

classification ratios derived from NLMS,

and then age-adjusted death rates were

reestimated. The correction was limited

to age because of the sample size

restrictions posed by the study sample

(see Appendix II). Ideally, adjustments

of death certificate misclassification that

take into account all the factors that

may be correlated with such

misclassification, such as nativity and

place of residence, would be preferable.

Adjustment is done as follows:

ASDRi * CRi

,

where ASDRi is defined above and CRi

is the age-specific classification ratio

based on NLMS.

For the Hispanic subgroups, the 1%

PUMS was used to replicate the

simulation carried out by Cresce and

Ramirez (23) by age, and the

age-specific death rates were corrected

by reestimating population counts for

the specific country of origin categories

using information on country of birth

and ancestry.
Percent 

100 

90 

80 

70 

60 

50 

40 

30 

20 

10 

0 

AIAN 1979–1989 

40.8 

4.2 

55.1 

0.0 

41.9 

2.9 

55.2 

0.1 

14.2 

0.8 0.6 

White 

84.4 

9.7 

Black 

0.3 0.3 

AIAN 

89.7 

API 

AIAN 1990–1998 API 1979–1989 API 1990–1998 

NOTE: AIAN is American Indian or Alaska Native; API is Asian or Pacific Islander.
 

SOURCE: National Longitudinal Mortality Study.
 

Figure 1. Race distribution on death certificate among self-identified American Indian or Alaska Natives and Asian or Pacific Islanders:

United States, 1979–1989 and 1990–1998

Series 2, Number 148 [ Page 7

Results 

Evaluation of Race and

Hispanic Origin Reporting

on Death Certificates

Table 1 presents the record-level

percentage agreement and classification

ratios for each defined race and

Hispanic origin group for deaths

occurring during two periods:

1979–1989 and 1990–1998. Recordlevel agreement is close to 100% for

both the white and black populations in

both periods, which is consistent with

the findings of Hambright; Sorlie,

Rogot, and Johnson; and Rosenberg et

al. (1–3). In contrast, record-level

agreement for the AIAN population is

significantly lower in both periods. Only

about 55% of decedents who

self-identified as AIAN on the CPS

were correctly classified on the death

certificate in both periods (sensitivity),

and 80% (1979–1989) and 72%

(1990–1998) of decedents identified as

AIAN on the death certificate had

actually self-identified as such on the

CPS in the two periods (predictive value

positive). Record-level agreement

measures are significantly better for the

API population, with sensitivity

measures of 84% (1979–1989) and 90%

(1990–1998) in the two periods and

predictive value positive measures of

95% (1979–1989) and 96% (1990–

1998).

Also consistent with previous

studies is the close to perfect agreement

between CPS and death certificate

counts for the white and black

populations in both periods studied.

Likewise, the classification ratios reflect

significantly poorer agreement between

CPS and death certificate counts for the

AIAN and API groups. The

classification ratios were 1.45 for the

AIAN population and 1.13 for the API

population in the earlier period. The

ratios declined over time from 1.45 to

1.30 for the AIAN population and from

1.13 to 1.07 for the API population,

although these changes were not

statistically significant.

For a better perspective on how

persons self-identifying as AIAN and

API on the CPS were classified on the

death certificate, Figure 1 presents death

certificate race distributions by period of

study for these two groups.

Approximately 41% (1979–1989) and

42% (1990–1998) of self-identified

AIAN decedents were classified as

white on the death certificate in the two

periods. For the API population, the

percentage classified as white on the

death certificate declined from

approximately 14% to 10% between the

two periods.

Correspondence between death

certificate and survey identification of

all Hispanics was high in both the

1979–1989 and 1990–1998 periods,
Page 8 [ Series 2, Number 148

declining slightly between the two

periods measured at both record and

aggregate levels (Table 1). The

sensitivity and predictive value positive

estimates declined slightly between the

two periods but were always near or

above 90%. The classification ratio was

1.04 in the 1979 to 1989 period,

meaning that the survey responses

identified an additional 4% of Hispanics

compared with death certificates. The

Hispanic classification ratio of 1.04

suggests greater reliability of Hispanic

origin reporting on the death certificate

than the ratio of 1.07 reported by

Rosenberg et al. (3). This interpretation

is supported by the fact that these

sample sizes are more than twice as

large as those used by Rosenberg and

coauthors. In the 1990s, the

classification ratio increased to 1.05

(Table 1). However, the difference

between the two time periods was not

statistically significant.

Agreement between death certificate

and survey classification improved

significantly between the two periods

for Mexicans, Central and South

Americans, and other Hispanics as

measured by the classification ratios

and, for the former two, by the measure

of sensitivity. The proportion of

Mexicans and Central and South

Americans falling in the other Hispanic

group on the death certificate due to

missing information on country of origin

declined from 17% to 7% (Mexicans)

and 26% to 8% (Central and South

Americans) between 1979–1989 and

1990–1998 (see Figure 2).

Age and sex

Table 2 presents classification ratios

by age and sex for the 1990–1998

period. Among the four main race

groups, there is not much difference by

sex. With respect 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. There is

some slight variation over the age-range

in the sex- and age-specific

classification ratios. In contrast, both the

age-specific and sex-age-specific

classification ratios of the AIAN

population exhibit considerably more

variation over the age range. For

instance, the ratios vary from a low of

1.05 in age group 0–24 years to a high

of 1.61 in age group 65–74 years. One

might argue that the greater variability

exhibited by the AIAN population is a

function of the relatively small sex-age

specific and age-specific sample sizes.

However, the API sample sizes are also

relatively small and yet the ratios are

more consistent across the age range

(see Appendix II, Table II).

For the total Hispanic population,

the difference between males and

females is minimal, with males

exhibiting a slightly lower ratio (1.04

compared with 1.06). Variation across

the age distribution for the total

Hispanic population is relatively stable.

In contrast, with the exception of the

Mexican population, the classification

ratios vary significantly across the age

range in both the sex-age specific and

age-specific ratios. The large differences

in the ratios across the age range may

be a function of the small

17.1 

4.2 

7.4 

25.5 

6.9 

5.2 

4.3 

7.8 

0 

5 

10 

15 

20 

25 

30 

Mexican Puerto Rican Cuban Central and South American 

1979–1989 1990–1998 

SOURCE: National Longitudinal Mortality Study. Percent 

Figure 2. Assignment to nonspecific Hispanic status (other Hispanic) on the death certificate for self-identified specific Hispanic

subgroup origin: United States, 1979–1989 and 1990–1998
Series 2, Number 148 [ Page 9

sample sizes observed for some

Hispanic subgroups, sex, and age

combinations (see Appendix III).

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 urban-rural status. In contrast

(and as hypothesized) there is

considerable variability 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 nearly perfect

(1.01) for the API population in the

West but about 1.30 in the other three

regions, consistent with this population’s

overwhelming concentration in the

Western region of the United States. As

per the 2000 census, 48% of Asians and

76% of NHOPI resided in the West.

Similarly, reporting is much better in

regions where the AIAN population is

more numerous, such as the West and

Midwest, and in rural areas.

Coethnic concentration

Table 3 presents classification ratios

by coethnic geographic concentration for

the AIAN and Hispanic populations. As

noted previously, this measure is a

dichotomous indicator of whether a

person died in a county where a

substantial number of coethnic deaths

took place or not (see Appendix III; a

list of counties of concentration for the

AIAN population is available from the

authors upon request). These results

show most dramatically 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 1.02 in areas

of high coethnic concentration to a high

of 1.63 in areas with low coethnic

concentration. For the total Hispanic

population, coethnic concentration also

has a significant effect, with a

classification ratio of 1.02 in areas of

high concentration compared with 1.08

outside these areas. The ratios are

significantly (statistically) closer to 1.00

for Mexicans and Central and South

Americans in areas with high coethnic

concentration. Although the ratios for

Cubans and Puerto Ricans show the

same pattern, they are not statistically

significant.

Nativity

Finally, Table 3 also presents

classification ratios by nativity. For the

white population, there is practically no

misclassification or variability in the

nativity ratios. There is some difference

in classification for the black population,

with the U.S. born being more likely to

be classified correctly. For both the API

and AIAN populations, the ratios

suggest better reporting for the U.S.

born, but the differences are not

statistically significant.

Among the Hispanic population,

nativity has a significant effect on death

certificate classification. As expected,

the foreign born are considerably more

likely to be correctly classified on the

death certificate than the U.S. born, with

a classification ratio of 1.02 compared

with 1.07 for the U.S. born. This

relationship holds for subgroup reporting

for Mexicans (1.01 compared with

1.09), Puerto Ricans (1.04 compared

with 1.14), Cubans (1.02 compared with

1.92), and Central and South Americans

(1.04 compared with 1.30), although

U.S.-born ratios are unreliable for the

latter two groups because of the very

small number of U.S.-born decedents of

these nationalities in the study sample.

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, consistent with

previous studies, race and ethnic

classification on the death certificate for

the white and black population was

found to be excellent. Likewise,

reporting was found to be significantly

poorer for other groups, especially for

the AIAN population. However, some

improvement was found in reporting and

coverage over time for some groups.

This is especially true for the Hispanic

population. By 1997, all 50 states and

the District of Columbia included a

Hispanic origin item on the death

certificate, and by 1990, the

overwhelming majority of states had

missing rates of less than 1% on this

item. 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. Among the Hispanic

population, nativity had an important

effect on Hispanic origin classification

on the death certificate. Likewise,

among AIANs, APIs, and Hispanics,

place of residence also had an important

effect. For all three populations,

residence in areas where coethnics were

numerous had a positive effect on the

quality of race-ethnicity classification on

the death certificate.

Death Certificate

Misclassification Effects on

Mortality Estimates

In this next section, the effects of

death certificate race and ethnicity

misclassification on observed death rates

are explored. Tables 4 and 5 present

age-specific 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 above.

With respect to race, 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 85% to 111% of that of the

white population (Table 4). However,

overall mortality for the AIAN

population is probably even greater than

the adjustment suggests. The extremely

low death rates (even after correction)

for the older age groups, where the
Page 10 [ Series 2, Number 148

corrected ratio to the white death rate

drops from 1.51 in age group 65–74

years to 0.99 in age group 75–84 years

and further to 0.76 in age group 85

years and over is unrealistic. Table 4

presents uncorrected and corrected ratios

of AIAN to white age-specific death

rates, which show 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

downwards mortality at the oldest ages

(25). It could also be a result of

generational differences in selfidentification (4).

Adjustment has little effect on both

age-specific and age-adjusted death rates

for the API population. The age-adjusted

death rate for this group changes

minimally from 60% to 64% 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 interesting findings

emerge (see Table 5). First, 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 79% to 83% of that of

the non-Hispanic white population after

correction. The same pattern was

evident by Hispanic subgroup after

correction for both death certificate and

census misclassification. The ratio

remained 0.88 for the Mexican

population and 0.81 for the Cuban

population. It increaseed from 0.93 to

0.96 for the Puerto Rican population

and from 0.45 to 0.76 for the other

Hispanic population. The ratio declines

from 0.87 to 0.70 for the Central and

South American population. As

expected, the two groups most affected

by the correction for census

misclassification were the Central and

South American and other Hispanic

populations because the members of

these groups were considerably more

likely to give a general Hispanic term

rather than a specific country of origin

(16,22,23).

Second, the Hispanic mortality

advantage increases with age as shown

in the Hispanic to non-Hispanic white

age-specific death rate ratios (see

Figure 3). Among the specific

subgroups, this pattern is observed

mainly in the Mexican or Central and

South American populations but not at

all in the Cuban or other Hispanic

populations. The older age advantage

could be a reflection of the ‘‘salmon

bias’’ (return migration) effect or age

misreporting, but neither of these

possibilities were investigated (25,26).

These exercises are beyond the focus of

this study.

0.70 

0.80 

0.90 

1.10 

0 1–4 5–14 15–24 25–34 35–44 45–54 55–64 65–74 75–84 85 and 

over 

Observed Corrected 

Age in years 

SOURCE: National Longitudinal Mortality Study and National Vital Statistics System. 

1.00 

Ratio 

Figure 3. Ratios of Hispanic to non-Hispanic white age-specific death rates, uncorrected and corrected for death certificate

misclassification: United States 1999–2001
Series 2, Number 148 [ Page 11

Discussion 

Summary and Conclusions

This evaluation of race and

Hispanic origin reporting on death

certificates revealed three important

findings. First, consistent with the

results of previous studies, agreement

between self-report and death certificate

proxy report was found to be excellent

for the white and black populations but

poor for the AIAN population. Second,

agreement between survey and death

certificate classification improved for

some groups, especially specific

Hispanic subgroups, between the 1980s

and the 1990s. Third, select decedent

characteristics, such as nativity and

population composition of place of

residence at death, have important

effects on the quality of death certificate

race-ethnicity classification for

populations that contain significant

numbers of foreign-born members or do

not fit neatly into the OMB raceethnicity categories.

This study also showed that

correction for death certificate

misclassification had variable impact on

mortality estimates for the different

racial and ethnic populations studied.

The effect of death certificate

race-ethnicity misclassification on

mortality estimates for the AIAN

population was substantial. Correction

changed a relatively large AIAN-towhite mortality advantage to a relatively

large disadvantage. On the other hand,

the effect of correction was minimal for

the API and Hispanic populations. Both

maintained a rather large mortality

advantage in comparison with the

majority population.

In summary, this study presents

both optimistic and pessimistic

conclusions regarding the state and

future of U.S. race- and ethnicityspecific mortality estimates. On the

positive side, one of the most important

findings is that national coverage of the

Hispanic population in NVSS is

complete and robust; all registration

areas of NVSS include a Hispanic origin

item on their death certificates, and the

missing rate on this item is miniscule.

Another positive finding is that

relatively minor adjustments are needed

to correct for death certificate

race-ethnicity misclassification in order

to produce reliable mortality estimates

for the API and Hispanic populations.

This bodes well for studies of racial and

ethnic mortality disparities.

On the negative side, important

problems were observed in U.S. Census

Bureau population estimates that

negatively affect mortality measures for

Hispanic subgroups. This is especially

troubling as researchers are becoming

ever more aware of the important

intragroup differences in the health and

mortality profiles of the Hispanic

population. Similarly troubling were the

results for the AIAN population. The

degree of misclassification on the death

certificate for this population is

substantial and showed no improvement

over time. Although this study was able

to quantify the extent of such

misclassification, the reliability of the

corrected mortality estimates for this

population at the national level is

uncertain. As noted in the ‘‘Results,’’

even after correction, mortality estimates

for the older segments of this population

appear unrealistic.

This study has some limitations.

First, CPS data pertain only to the

noninstitutionalized U.S. population.

Second, the effects of age-misreporting

was not addressed, which may be a

factor in the findings regarding the

AIAN and Hispanic populations. Third,

the possible cohort effects of

race-ethnicity self-report were not

explored, which may be important

especially for the AIAN population.

Lastly, this study addressed issues that

pertain to the 1977 OMB directive

regarding race. The full implementation

of OMB’s 1997 revision, which

mandates the collection and recording of

multiple-race by NVSS, will add a new

and complex challenge to the production

of high-quality U.S. race-specific

mortality estimates.

References

1.Hambright Z. Marital status, race,

nativity, and country of origin on the

death certificate and matching census

record. National Center for Health

Statistics. Vital Health Stat 2(34). 1969.

2.Sorlie PD, Rogot E, Johnson NJ.

Validity of demographic characteristics

on the death certificate. Epidemiology

3(2):181–4. 1992.

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Johnson NJ, MacDorman MF, Hoyert

DL, et al. Quality of death rates by

race and Hispanic origin: A summary

of current research, 1999. National

Center for Health Statistics. Vital

Health Stat 2(128). 1999.

4.Passel JS. The growing American

Indian population, 1960–1990: Beyond

demography. In: Sandefur GD,

Rindfuss RR, Cohen B, editors.

Changing numbers, changing needs:

American Indian demography and

public health. Washington, DC: The

National Academy of Sciences. p.

79–102. 1996.

5.Maurer JD, Rosenberg HM, Keemer

JB. Deaths of Hispanic origin, 15

reporting states, 1979–81. National

Center for Health Statistics. Vital

Health Stat 20(18). 1990.

6.U.S. Census Bureau, Current

Population Survey. Design and

methodology. Technical paper 63RV.

2002.

7.National Center for Health Statistics.

Mortality technical appendix. Vital

statistics system: Available from:

http://www.cdc.gov/nchs/datawh/statab/

pubd/ta.htm.

8.Office of Management and Budget.

Race and ethnic standards for federal

statistics and administrative reporting.

Statistical policy directive 15. 1977.

9.U.S. Department of Labor. Counting

minorities: A brief history and a look at

the future. In: Report on the American

workforce. Washington, DC: U.S.

Department of Labor. p. 15–53. 2001.

10.Tolson GC, Barnes JM, Gay GA,

Kowaleski JL. The 1989 revision of the

U.S. standard certificates and reports.

National Center for Health Statistics.

Vital Health Stat 4(28). 1991.

11.Hetzel AM. U.S. Vital Statistics

System, major activities and

developments, 1950–95. Hyattsville,

MD: National Center for Health

Statistics. 1997.

12.Office of Management and Budget.

Revisions to the standards for the

classification of federal data on race

and ethnicity. Federal register

62FR58782–58790. 1997.

13.U.S. Census Bureau. National

Longitudinal Mortality Study, 2007.

Reference manual, version 2. Available
Page 12 [ Series 2, Number 148

from: http://www.census.gov/nlms/.

2007.

14.	 National Center for Health Statistics.

Instruction manual, part 4:

Demographic classification and coding

instructions for death records.

Hyattsville, MD: National Center for

Health Statistics. 1993.

15.	 National Center for Health Statistics.

Vital statistics of the US, Volume II,

Mortality, Part A. 1979–1998.

16.	 Cresce AR, Schmidley AD, Ramirez

RR. Identification of Hispanic ethnicity

in census 2000: Analysis of data quality

for the question on Hispanic origin.

Population Division working paper no.

75. Suitland, MD: U.S. Census Bureau.

2004.

17.	 del Pinal J, Schmidley D. Matched race

and Hispanic origin responses from

census 2000 and Current Population

Survey February to May 2000.

Population Division working paper No.

79. Suitland, MD: U.S. Census Bureau.

2005.

18.	 Ingram DD, Parker J, Schenker N,

Weed J, Hamilton B, Arias E, et al.

United States census 2000 population

with bridged race categories. National

Center for Health Statistics. Vital

Health Stat 2(135). 2003.

19.	 Mulry M. Summary of accuracy and

coverage evaluation for census 2000.

Research report series, statistics no.

2006–3. Suitland, MD: U.S. Census

Bureau. 2006.

20.	 U.S. Census Bureau. 2000 Census of

Population and Housing. Summary File

1, United States. 2001.

21.	 U.S. Census Bureau. Modified race

data summary file, 2000 Census of

Population and Housing. Technical

Documentation. Available from:

http://www.census.gov/popest/archives/

files/MRSF-01-US1.html. September,

2002.

22.	 Logan JR. Hispanic populations and

their residential patterns in the

metropolis. Report prepared at the

Lewis Mumford Center for

Comparative Urban and Regional

Research, University at Albany: Albany,

NY. Available from: http://

www.albany.edu/mumford. May 8,

2002.

23.	 Cresce AR, Ramirez RR. Analysis of

general Hispanic responses in census

2000. Population Division working

paper no. 72. Suitland, MD: US Census

Bureau. 2003.

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standardization of death rates:

Implementation of the year 2000

standard. National vital statistics

reports; vol 47 no 3. Hyattsville, MD:

National Center for Health Statistics.

1998.

25.	 Preston SH, Elo IT, Stewart Q. Effects

of age misreporting on mortality

estimates at older ages. Popul Stud

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26.	 Palloni A, Arias E. Paradox lost:

Explaining the Hispanic adult mortality

advantage. Demography 41(3):385–415.

2004.
Series 2, Number 148 [ Page 13

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

for deaths occurring in 1979–1989 and 1990–1998

 Predictive value Ratio1 of CPS2

Sensitivity positive to death certificate

Group 1979–1989 1990–1998 1979–1989 1990–1998 1979–1989 1990–1998

Race

White. . . . . . . . . . . . . . . . . . . . . 99.8 99.8 99.6 99.5 1.00 (.0004) 1.00 (.0004)

Black ..................... 98.8 98.1 98.8 98.9 1.00 (.002) †

1.01 (.002)

AIAN3 .................... 55.1 55.2 80.2 71.7 1.45 (.096) 1.30 (.062)

API4 ..................... 84.4 89.7 94.9 95.7 1.13 (.029) 1.07 (.016)

Hispanic origin

Hispanic ................... 92.8 88.1 95.9 92.5 1.04 (.010) 1.05 (.008)

Mexican ................... 79.2 86.0 93.2 91.4 1.17 (.021) †

1.06 (.011)

Puerto Rican ................ 85.8 79.7 88.8 85.0 1.06 (.047) 1.07 (.036)

Cuban .................... 82.1 86.6 87.0 90.5 1.05 (.069) 1.04 (.026)

Central and South American ...... 32.3 64.3 75.9 67.1 2.35 (.432) †

1.05 (.063)

Other Hispanic ............... 46.7 39.2 22.3 38.7 0.50 (.042) †

0.99 (.045)

Non-Hispanic by race

Non-Hispanic white ............ 99.6 99.6 99.1 99.2 1.00 (.001) 1.00 (.001)

Non-Hispanic black ............ 98.7 98.4 98.6 98.9 1.00 (.004) 1.01 (.002)

Non-Hispanic AIAN ............ 57.1 55.9 86.5 71.3 1.51 (.209) 1.28 (.066)

Non-Hispanic API ............. 77.2 89.5 97.5 95.4 1.27 (.077) †

1.07 (.017)

† Difference in ratios across the two time periods is significant at the 1% level.

1

Ratio based on weighted data.

2

Current Population Survey.

3

American Indian or Alaska Native.

4

Asian or Pacific Islander.

NOTE: Standard errors in parentheses.
Table

1998

2. Classification ratios by race, Hispanic origin, age, and sex: National Longitudinal Mortality Study, for deaths occurring in 1990–

Race, Hispanic

and source

origin, sex,

of data Total

0–24

years

25–44

years

45–54

years

55–64

years

65–74

years

75 years

and over

Race

White. . . . . . . . . . . . . . . . . . . . .

Male ..................

Female. . . . . . . . . . . . . . . . .

Black .....................

Male ..................

Female. . . . . . . . . . . . . . . . .

AIAN2 ....................

Male ..................

Female. . . . . . . . . . . . . . . . .

API3 .....................

Male ..................

Female. . . . . . . . . . . . . . . . .

Hispanic origin

Hispanic ..................

Male ..................

Female. . . . . . . . . . . . . . . . .

Mexican. . . . . . . . . . . . . . . . . .

Male ..................

Female. . . . . . . . . . . . . . . . .

Puerto Rican. . . . . . . . . . . . . . .

Male ..................

Female. . . . . . . . . . . . . . . . .

Cuban...................

Male ..................

Female. . . . . . . . . . . . . . . . .

Central and South American .....

Male ..................

Female. . . . . . . . . . . . . . . . .

Other Hispanic .............

Male ..................

Female. . . . . . . . . . . . . . . . .

Non-Hispanic white ............

Male ..................

Female. . . . . . . . . . . . . . . . .

Non-Hispanic black ............

Male ..................

Female. . . . . . . . . . . . . . . . .

Non-Hispanic AIAN ............

Male ..................

Female. . . . . . . . . . . . . . . . .

Non-Hispanic API .............

Male ..................

Female. . . . . . . . . . . . . . . . .

1.00 (.0004)

1.00 (.001)

1.00 (.0004)

1.01 (.002)

1.01 (.003)

1.01 (.002)

1.30 (.062)

1.29 (.076)

1.31 (.101)

1.07 (.016)

1.08 (.025)

1.05 (.019)

1.05 (.008)

1.04 (.011)

1.06 (.012)

1.06 (.011)

1.07 (.014)

1.05 (.017)

1.07 (.036)

1.08 (.052)

1.05 (.046)

1.04 (.026)

1.08 (.037)

1.00 (.035)

1.05 (.063)

1.07 (.099)

1.04 (.079)

0.99 (.045)

0.88 (.054)

1.16 (.079)

1.00 (.001)

1.00 (.001)

1.00 (.001)

1.01 (.002)

1.01 (.003)

1.00 (.002)

1.28 (.066)

1.30 (.083)

1.25 (.106)

1.07 (.017)

1.09 (.026)

1.04 (.020)

0.99 (.005)

0.99 (.006)

0.99 (.009)

1.02 (.010)

1.02 (.012)

1.01 (.013)

1.05 (.182)

1.06 (.207)

*1.00 (–)

1.03 (.104)

*0.96 (.129)

1.11 (.168)

0.96 (.053)

0.98 (.069)

0.91 (.060)

0.98 (.050)

1.04 (.056)

*0.82 (.098)

*0.87 (.272)

*0.79 (.314)

*1.20 (.224)

*1.00 (–)

*1.00 (–)

–

*1.00 (.411)

*1.01 (.582)

*1.00 (–)

*0.96 (.345)

*0.87 (.320)

*1.71 (1.78)

1.00 (.009)

1.00 (.012)

1.00 (.014)

1.00 (.008)

1.00 (.009)

1.01 (.014)

1.17 (.176)

*1.17 (.196)

*1.20 (.276)

1.06 (.102)

*1.02 (.121)

*1.11 (.168)

0.99

0.99

1.00

1.01

1.02

1.01

1.16

1.31

0.87

1.07

1.09

1.03

1.06

1.07

1.01

1.09

1.14

0.96

1.16

1.12

1.27

1.09

*1.22

*0.91

0.74

0.72

*0.78

0.88

0.83

*1.04

0.99

0.99

1.00

1.01

1.01

1.00

1.14

1.30

0.85

1.05

1.06

1.02

(.003)

(.004)

(.004)

(.006)

(.009)

(.006)

(.132)

(.168)

(.196)

(.088)

(.117)

(.127)

(.026)

(.027)

(.061)

(.044)

(.047)

(.093)

(.107)

(.127)

(.197)

(.163)

(.292)

(.068)

(.146)

(.182)

(.180)

(.146)

(.170)

(.277)

(.004)

(.004)

(.007)

(.005)

(.009)

(.004)

(.147)

(.189)

(.216)

(.093)

(.124)

(.131)

Ratio1

1.00 (.002)

1.00 (.003)

1.00 (.003)

1.00 (.006)

1.01 (.011)

0.99 (.005)

1.38 (.190)

1.24 (.208)

1.55 (.338)

1.04 (.043)

1.01 (.049)

1.08 (.077)

1.05 (.025)

1.02 (.028)

1.12 (.050)

1.15 (.039)

1.15 (.051)

1.15 (.062)

0.96 (.083)

1.03 (.093)

0.84 (.152)

*1.21 (.163)

*1.10 (.108)

*2.26 (1.55)

0.86 (.151)

*0.65 (.149)

*1.29 (.337)

0.79 (.138)

0.67 (.136)

1.14 (.373)

0.99 (.003)

0.99 (.003)

0.99 (.004)

1.00 (.007)

1.01 (.010)

0.99 (.007)

1.25 (.182)

1.04 (.156)

1.51 (.375)

1.03 (.041)

1.03 (.054)

1.04 (.065)

1.00

0.99

1.00

1.01

1.02

1.01

1.23

1.47

0.96

1.09

1.08

1.10

1.03

1.03

1.02

1.05

1.04

1.06

1.05

1.04

1.06

1.07

1.18

0.91

1.18

*1.26

*1.08

0.82

0.77

0.89

0.99

0.99

1.00

1.01

1.02

1.01

1.24

1.42

0.99

1.15

1.16

1.14

(.001)

(.002)

(.002)

(.006)

(.008)

(.007)

(.155)

(.237)

(.198)

(.054)

(.067)

(.091)

(.020)

(.024)

(.034)

(.025)

(.033)

(.038)

(.047)

(.066)

(.061)

(.079)

(.095)

(.130)

(.169)

(.198)

(.281)

(.110)

(.141)

(.173)

(.002)

(.002)

(.003)

(.006)

(.008)

(.008)

(.171)

(.243)

(.240)

(.067)

(.088)

(.103)

1.00

1.00

1.00

1.01

1.00

1.01

1.61

1.40

1.92

1.10

1.13

1.06

1.07

1.06

1.08

1.08

1.08

1.08

1.20

1.26

1.13

1.12

1.12

1.12

1.03

*1.19

*0.92

0.93

0.82

1.12

0.99

1.00

0.99

1.00

1.01

1.01

1.47

1.31

1.71

1.09

1.13

1.05

(.001)

(.001)

(.001)

(.004)

(.005)

(.005)

(.208)

(.235)

(.392)

(.037)

(.063)

(.030)

(.017)

(.024)

(.023)

(.023)

(.032)

(.032)

(.090)

(.149)

(.084)

(.046)

(.054)

(.086)

(.127)

(.239)

(.138)

(.094)

(.110)

(.171)

(.001)

(.001)

(.001)

(.003)

(.005)

(.004)

(.201)

(.234)

(.365)

(.036)

(.063)

(.029)

1.00 (.0004)

1.00 (.001)

1.00 (.0005)

1.01 (.003)

1.01 (.005)

1.00 (.004)

1.24 (.092)

1.19 (.111)

1.28 (.144)

1.05 (.020)

1.06 (.033)

1.03 (.019)

1.05 (.012)

1.03 (.018)

1.07 (.017)

1.04 (.016)

1.02 (.021)

1.05 (.023)

0.98 (.052)

1.00 (.078)

0.96 (.069)

1.00 (.032)

1.01 (.051)

0.98 (.041)

1.18 (.109)

1.46 (.277)

1.07 (.109)

1.14 (.071)

1.02 (.088)

1.26 (.113)

1.00 (.0005)

1.00 (.001)

1.00 (.001)

1.00 (.003)

1.01 (.005)

1.00 (.004)

1.26 (.104)

1.35 (.138)

1.20 (.148)

1.04 (.020)

1.07 (.031)

1.01 (.022)

* Figure does not meet standards of reliability or precision.

deaths or both are based on fewer than 20 deaths. 

– Quantity zero. 

1

Ratio based on weighted data. 

2

American Indian or Alaska Native. 

3

Asian or Pacific Islander. 

NOTE: Standard errors in parentheses.

Ratio is unreliable because either the unweighted number of Current Population Survey deaths or the unweighted number of death certificate 

Page 14 [ Series 2, Number 148
ce and Hispanic origin by region, urban-rural status, coethnic concentration, and nativity: National Longitudinal Mortality Study, for deaths

Classification ratio1

Race Hispanic by specific origin Non-Hispanic by race

Central and

Puerto South Other

Black AIAN2 API3 Total Mexican Rican Cuban American Hispanic White Black AIAN2 API3

3 (.008) *1.92 (.494) 1.27 (.115) 1.08 (.028) *1.47 (.452) 1.12 (.037) 0.99 (.081) 1.05 (.123) 1.00 (.142) 1.00 (.001) 1.02 (.007) 2.05 (.579) 1.21 (.106)

1 (.004) 1.13 (.102) 1.29 (.135) 1.02 (.040) 1.05 (.052) 0.98 (.197) *1.56 (.405) *1.91 (.742) 0.72 (.175) 1.00 (.001) 1.01 (.004) 1.12 (.099) 1.32 (.145)0 (.002) 1.49 (.143) 1.28 (.103) 1.05 (.012) 1.02 (.014) 0.99 (.103) 1.04 (.026) 1.04 (.108) 1.37 (.153) 1.00 (.001) 1.00 (.002) 1.64 (.226) 1.34 (.113)

2 (.010) 1.22 (.085) 1.01 (.013) 1.04 (.011) 1.10 (.017) 0.95 (.086) 1.05 (.151) 1.00 (.083) 0.89 (.045) 0.99 (.001) 1.01 (.010) 1.17 (.083) 1.01 (.014)

 

1 (.002) 1.60 (.151) 1.08 (.018) 1.05 (.008) 1.05 (.011) 1.09 (.036) 1.04 (.026) 1.06 (.064) 1.01 (.053) 1.00 (.001) 1.00 (.002) 1.57 (.165) 1.08 (.018)

 

1 (.004) 1.12 (.054) 0.98 (.035) 1.05 (.026) 1.16 (.038) *0.49 (.149) *1.13 (.277) *0.84 (.218) 0.88 (.077) 1.00 (.001) 1.01 (.004) 1.11 (.057) 0.98 (.035)

 

. . . **1.02 (.037)

 . . . **1.02 (.008) **1.02 (.011) 1.04 (.042) 1.02 (.025) **0.99 (.078) **0.70 (.043) . . . . . . . . . . . .

 

. . . 1.63 (.143) . . . 1.08 (.014) 1.11 (.019) 1.09 (.058) 1.10 (.059) 1.12 (.101) 1.19 (.073) . . . . . . . . . . . .

 

 

 

1 (.002) 1.30 (.062) 1.03 (.028) **1.07 (.013) **1.09 (.016) 1.14 (.133) *1.92 (.558) *1.30 (.381) 0.98 (.049) **1.00 (.0004) 1.01 (.002) 1.27 (.066) 1.04 (.028) 

9 (.040) *1.22 (.440) 1.09 (.020) 1.02 (.008) 1.01 (.011) 1.04 (.028) 1.02 (.023) 1.04 (.063) 1.05 (.111) 0.99 (.003) 1.00 (.041) *1.31 (.578) 1.08 (.021)

 

ecision. 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.

ated for these racial or ethnic groups.

nsions is significant at the 1% level.

 

Indian or Alaska Native. 3Asian or Pacific Islander. NOTE: Standard errors in parentheses.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ted death rates and rate ratios by race and age, uncorrected and corrected for death certificate misclassification: United States, 1999–2001

As reported on death certificate With correction for misclassification Rate ratios to white

AIAN1 API2 AIAN API AIAN to white API to white

E3 Rate SE Rate SE Rate SE Rate SE Uncorrected Corrected Uncorrected Corrected

 

.6

.3.1

.3

.3

.4

.6

.2

.2

.1

.7

.3

 

641.9

42.819.5

102.5

136.6

232.3

416.9

933.8

2,191.8

4,510.49,588.6

718.0

 

19.9

2.61.0

2.5

3.2

4.1

6.4

13.0

27.2

57.0

149.3

4.2

 

453.4

23.012.4

40.0

43.7

84.0

201.8

514.4

1,304.7

3,522.3

10,302.5

510.4

 

9.6

1.10.5

0.8

0.8

1.22.1

4.5

9.0

21.1

71.0

1.7

 

673.9

45.020.4

107.7

158.5

269.6575.5

1,148.9

3,529.8

5,594.5

11,893.3

941.3

 

20.4

2.61.1

2.6

3.4

4.47.5

14.4

34.5

63.4

166.3

4.9

467.0

23.712.8

41.2

 

46.8

89.9

210.0

560.8

1,435.5

3,699.1

10,819.8

542.0

9.7

1.10.5

0.9

0.8

1.2

2.1

4.7

 

9.4

21.6

72.8

1.7

1.06

1.421.16

1.38

1.48

1.29

1.07

0.99

0.94

0.80

0.610.85 

1.11

1.491.22

1.44

1.72

1.49

1.48

1.22

1.51

0.99

0.76

1.11

 

0.75

0.760.74

0.54

0.47

0.46

0.52

0.55

0.56

0.63

0.66

0.60

 

0.77

0.780.76

0.55

0.51

0.50

0.54

0.60

0.61

0.66

0.69

0.64

 

or Pacific Islander. 3Standard error.

Series 2, Number 148 [ Page 15
ted death rates and rate ratios by Hispanic origin and age, uncorrected and corrected for death certificate misclassification: United States,

anic white Total Hispanic Mexican Puerto Rican Cuban

Central and

South American Other Hispanic

SE1 Rate SE Rate SE Rate SE Rate SE Rate SE Rate SE

3.0

0.3

0.1

0.30.3

0.40.7

1.3

2.34.2

11.9

 0.4

592.2

30.2

15.3

72.785.5

158.1335.8

748.1

1,820.34,378.5

11,962.0

672.1

 

5.10.6

0.3

0.60.7

1.01.9

3.87.5

17.0

51.4

1.3

 

653.6

34.9

17.6

83.191.2

163.1

360.4

848.1

2,120.55,012.3

13,051.1

753.7

 

6.6

0.8

0.4

0.80.9

1.4

2.7

5.8

11.8

26.8

81.2

2.0

 

700.8

25.6

15.6

70.2

119.3

262.3

516.4

1,022.42,191.04,949.1

12,296.5

798.1

 

19.1

1.8

0.9

2.02.7

4.1

7.0

12.824.555.2

160.9

4.2

 

475.5

22.7

15.4

56.166.8

149.7

343.4

740.6

1,701.74,539.7

13,843.7

692.8

 

36.0

3.9

2.0

3.83.5

4.8

8.6

13.220.945.4

134.0

3.8

 

864.2

50.9

25.2

96.6

107.5

169.0332.2729.7

1,964.64,827.3

13,836.7

743.1

 

26.8

3.3

1.5

2.4

2.3

3.1

5.7

11.9

27.567.9

220.7

5.2

 

289.2

13.1

6.1

30.9

39.3

86.3

175.8

369.0

961.2

2,532.47,712.5

381.8

 

7.9

0.90.40.9

1.1

1.7

3.0

5.9

11.9

27.587.3

2.1 

 

3.0

0.3

0.1

0.30.3

0.40.7

1.3

2.34.2

11.9

0.4

568.5

29.0

 

14.7

 69.8 90.7

167.7352.8

771.0

1,948.84,600.1

12,567.3

705.5

5.00.6

0.3

0.60.7

1.0

 1.9 3.9 7.8 17.4

52.7

1.3

606.2

32.3

15.7

76.092.6

157.0

378.4

845.1

2,180.24,844.7

12,953.4

 

747.9

6.2

0.7

0.3

0.80.9

1.3

2.6

5.7

11.6

25.4

79.0

2.0

 

Corrected for

608.0

21.1

13.0

59.2

133.3

292.6

477.9

1,066.62,682.94,860.2

11,620.7

818.1

 

misclassification

17.8

1.6

0.8

1.82.8

4.3

6.6

13.027.454.7

153.6

4.2

 

 

346.8

20.1

14.7

52.172.3

155.5

398.3

758.6

1,774.24,334.7

13,456.1

690.5

 

26.3

3.5

1.9

3.5

3.7

4.8

9.0

13.120.643.4

130.2

3.7

 

606.3

36.3

17.8

70.9

61.1

88.2

202.3654.5

1,442.94,242.8

11,692.5

596.7

 

18.8

2.4

1.1

1.8

1.5

1.9

3.79.8

19.955.0

171.7

4.0

 

441.2

21.3

9.7

56.4

71.9

146.3252.2564.9

1,477.74,550.6

13,600.7

645.9

 

12.3

1.4

0.6

1.7

2.1

3.0

4.89.9

18.946.3

144.0

3.5 

Rate ratios to non-Hispanic white

Total Hispanic

corrected

Mexican

corrected

Puerto Rican

corrected

Cuban

corrected

Central and

South American

corrected

Other Hispanic

corrected

No Yes No Yes No Yes No Yes No Yes No Yes

 

...

...

...

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

1.00

1.02

0.91

0.990.930.870.860.790.770.770.76

0.79

 

0.96

0.98

0.87

0.950.990.930.910.820.830.810.80

0.83

 

1.10

1.18

1.04

1.130.990.900.920.890.900.880.83

0.88

 

1.02

1.10

0.94

1.031.000.870.980.900.930.850.82

0.88

 

1.18

0.86

0.93

0.951.291.441.321.080.930.870.78

0.93

1.02

0.71

0.77

 0.80 1.46 1.63 1.24 1.13 1.15 0.86 0.74

0.96

0.80

0.77

0.91

0.760.720.820.880.780.720.800.88

0.81

0.58

0.68

0.87

0.710.790.861.03

 0.81 0.76 0.76 0.85 

0.81

1.45

1.72

1.50

1.311.160.930.850.770.830.850.88

0.87

 

1.02

1.23

1.05

0.960.670.490.520.700.620.750.74

0.70

 

0.49

0.44

0.36

0.420.420.480.450.390.410.450.49

0.45

 

0.74

0.72

0.58

0.770.790.810.650.600.630.800.86

0.76 

or. NOTE: For the Hispanic subgroups, the death rates are corrected for Census misclassification in addition to death certificate misclassification.

Page 16[ Series 2, Number 148
Certificate and Percentage Unknown for Reporting States by Year

979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998

---- - -

2.9

4.1

1.3

5.3

---

---

 --- 4.3 2.8 --- 4.5 3.9 --- 

1.6 - - - --- 

7.7 --- --- --- --- 7.5 --- --- 6.1 

1.6 --- 

8.5 8.6

7.6

---

5.6

9.3

---

- - -------

---

---- - -

1.9

42.0

54.0

4.7

---

------

4.1

 

1.3

 --- 4.1 3.5 --- 10.3 - - - --- 34.0 --- --- --- --- 6.4 --- --- 5.6 29.0 --- 25.6 1.1 6.9 --- 14.5 8.5

---

- - -------

---

---- - -

2.0

37.5

55.2

4.2

---

------

4.01.1

---

4.0

 

3.4

 --- 10.3 - - - --- 30.1 --- --- --- --- 5.8 --- --- 5.6 22.6 --- 20.9 0.9 4.9 --- 13.9 7.7

---

- - -------

---

---- - -

1.8

37.7

52.8

3.4

---

------

3.50.7

---

3.93.3

---

9.1

 - - - --- 24.2 --- --- --- --- 5.5 --- --- 5.0 21.3 --- 18.6 5.3 4.8

---

10.8

6.8

---

- - ----

---

---

---- - -

1.6

35.7

16.2

2.2

---

------

2.90.6

---

3.83.0

---

9.1

- - ----

21.1

 --- --- --- --- 5.2 --- --- 4.7 21.9 --- 18.3 0.7 4.9

---

10.6

6.3

---

- - ----

---

---

---- - -

1.1

26.3

4.9

1.7

---

------

3.00.6

---

3.82.8

---

8.6

- - ----

20.9

---------

 --- 4.2 --- --- 4.3 28.1 --- 18.0 0.6 4.8

---

8.4

5.8

---

- - ----

---

---

---- - -

1.2

9.2

2.1

1.3

---

------

2.90.5

---

4.02.9

---

8.1

- - ----

21.6

---------

---

3.5

---

 --- 4.0 31.4 --- 16.3 0.6 7.2

---

8.2

5.8

---

- - ----

---

---

---- - -

1.2

3.7

2.0

1.1

---

------

2.70.6

---

3.82.8

---

7.6

- - ----

21.1

---------

---

3.1

---

---

3.6

33.2

 --- 13.1 0.6 8.3

---

7.6

5.5

---

- - ----

---

---

---- - -

1.6

3.5

1.8

1.1

---

------

2.90.5

---

3.92.6

---

7.1

- - ----

20.6

---------

---

3.0

---

---

3.8

34.9

---

11.7

0.5

 8.9

---

7.9

5.2

---

- - ----

---

---

2.3

- - -

1.0

3.2

1.3

1.2

---

------

2.20.4

---

3.81.4

---

6.7

2.2

---

11.7

---------

---

2.0

---

6.3

3.5

28.3

---

11.6

0.46.0

2.8

7.0

 

4.4

---

0.6

---

4.8

---

1.2

2.9

0.2

0.9

0.6

0.1

---

1.30.4

0.50.2

0.0

1.10.5

0.12.7

0.6

---

9.0

17.5

0.71.7

0.1

1.4

0.3

2.81.1

0.1

---

0.5

0.13.6

0.4

2.6

0.6

---

0.0

 0.1 0.8

0.2

0.60.2

0.2

0.9

0.5

0.1

20.2

0.10.30.60.1

0.1

0.80.5

0.1

2.9

0.7

---

6.8

2.30.51.3

0.2

1.5

0.2

1.61.1

0.1

---

0.7

0.18.4

0.1

3.0

0.3

---

0.10.10.7

0.1

 

0.20.6

0.2

0.3

0.3

0.1

6.3

0.10.20.60.2

0.1

0.90.2

0.1

2.6

0.8

0.2

5.7

2.40.51.1

0.2

0.2

0.2

0.91.0

2.3

---

0.7

0.28.7

0.1

2.5

0.3

---

0.00.00.9

0.1

 

0.10.9

0.3

0.3

0.3

0.1

6.7

0.30.30.50.2

0.1

0.70.1

0.1

2.4

0.20.3

4.9

2.70.50.9

0.2

0.2

0.2

0.80.9

2.5

---

0.7

0.19.5

0.1

2.2

0.5

---

0.10.11.1

0.1

 

0.10.2

0.3

0.4

0.3

0.1

2.2

0.40.30.40.3

0.0

0.80.1

0.1

2.4

0.10.2

3.2

1.80.10.7

0.1

0.1

0.2

0.81.0

0.4

6.6

0.7

0.19.9

0.1

2.6

0.4

---

0.10.00.7

0.1

 

0.10.2

0.3

0.3

0.1

0.0

0.3

0.30.20.50.2

0.0

0.70.1

0.1

2.2

0.10.3

3.7

0.00.11.0

0.1

0.1

0.2

0.81.1

2.2

4.5

0.1

0.11.9

0.1

2.5

0.2

---

0.10.00.7

0.1

 

0.10.3

1.2

0.3

0.1

0.0

0.3

0.20.40.40.1

0.0

1.00.2

0.1

2.1

0.10.2

3.3

0.00.10.9

0.1

0.1

0.2

0.60.9

2.5

4.4

1.8

0.11.5

0.0

2.7

0.4

---

0.10.01.1

0.1

 

0.10.1

0.3

0.4

0.1

0.1

0.3

0.20.40.50.1

0.0

1.20.1

0.1

1.9

0.10.3

2.6

0.00.10.8

0.8

0.2

0.2

0.50.9

2.2

2.5

0.2

0.11.3

0.0

2.2

0.7

---

0.10.01.3

0.1

 

0.10.0

0.3

0.1

0.1

0.0

0.7

0.20.40.40.1

0.0

1.00.1

0.0

1.5

0.10.3

2.2

0.00.10.8

0.6

0.1

0.1

0.20.6

1.4

2.3

0.1

0.11.3

0.0

2.9

1.3

0.0

0.10.01.2

0.0

 

0.10.2

0.3

0.1

0.1

0.1

0.6

0.10.40.30.1

0.0

1.00.1

0.0

1.3

0.10.2

1.4

0.00.10.8

0.5

0.2

0.1

0.50.4

0.1

2.6

0.1

0.01.4

0.0

3.3

0.90.0

0.00.01.0

0.0

 

Series 2, Number 148[ Page 17
Certificate and Percentage Unknown for Reporting States by Year—Con.

979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998

--­

--­

--­

2.1

--­

- - ­

--­

- - ­

--­

4.6

- - ­

c origin.

--­--­

3.11.7

--­

--­

--­--­--­

8.9

--­

 

--­--­

1.61.9

--­

--­

--­--­--­

7.7

--­

 

--­--­

1.71.6

--­

--­

--­--­--­

7.0

--­

 

--­--­

1.51.5

--­

--­

--­--­--­

5.6

--­

 

--­

34.8

1.41.9

--­

--­

--­--­--­

5.6

--­

 

--­

18.9

1.31.1

--­

--­

--­--­--­

5.29.9

 

--­

13.9

1.21.0

--­

--­

--­--­--­

4.8

12.0

 

--­

13.1

1.11.0

--­

--­

--­--­--­

4.6

12.5

 

--­

11.0

1.10.9

--­

--­

1.5

--­--­

3.0

13.1

 

0.11.2

1.00.1

11.6

28.5

0.2

1.20.0

0.33.0 

0.1

1.1

0.80.2

6.5

3.00.10.10.00.11.0 

0.2

1.0

0.50.1

6.2

2.20.10.10.00.00.7 

0.1

0.6

0.50.2

6.7

1.20.30.10.00.20.3 

0.1

0.4

0.40.1

0.6

0.70.30.00.00.00.3 

0.1

0.1

0.40.1

0.2

0.40.30.00.00.10.1 

0.1

0.2

0.40.2

0.1

0.40.20.00.00.10.0 

0.1

0.1

0.40.1

0.0

0.50.10.10.00.10.1 

0.1

0.1

0.20.1

0.0

0.50.10.10.00.10.1 

0.1

0.1

0.20.1

0.1

0.60.10.10.00.00.6 

Page 18 [ Series 2, Number 148
Series 2, Number 148 [ Page 19

Appendix II

Tables 1–3 Study Sample Sizes by Selected Variables

Table I. Appendix for Table 1, Number of deaths from the Current Population Survey

period. National Longitudinal Mortality Study for deaths occurring in 1979–1989 and

and death

1990–1998

certificate by race, Hispanic origin, and

Race and Hispanic origin

Number of deaths1

1979–1989 1990–1998

White

CPS2 ...................

Death certificate. . . . . . . . . . . . .

Black

CPS ..................

Death certificate . . . . . . . . . . .

AIAN3

CPS ..................

Death certificate . . . . . . . . . . .

API4

CPS ..................

Death certificate . . . . . . . . . . .

Hispanic

CPS ..................

Death certificate . . . . . . . . . . .

Mexican

CPS ..................

Death certificate . . . . . . . . . . .

Puerto Rican

CPS ..................

Death certificate . . . . . . . . . . .

Cuban

CPS ..................

Death certificate . . . . . . . . . . .

Central and South American

CPS ..................

Death certificate . . . . . . . . . . .

Other Hispanic

CPS ..................

Death certificate . . . . . . . . . . .

Non-Hispanic white

CPS ..................

Death certificate . . . . . . . . . . .

Non-hispanic black

CPS ..................

Death certificate . . . . . . . . . . .

Non-Hispanic AIAN

CPS ..................

Death certificate . . . . . . . . . . .

Non-Hispanic API

CPS ..................

Death certificate . . . . . . . . . . .

52,390

52,519

5,993

5,994

419

332

516

473

1,516

1,465

1,018

864

150

144

84

80

67

28

197

349

12,786

12,860

1,960

1,960

94

77

100

74

90,065

90,272

10,010

9,941

754

651

1,155

1,120

5,140

4,855

2,887

2,622

527

496

532

505

250

235

944

997

81,797

82,146

9,687

9,651

663

588

1,126

1,092

1

Number of deaths based on unweighted data.

2

Current Population Survey.

3

American Indian or Alaska Native.

4

Asian or Pacific Islander.
Page 20 [ Series 2, Number 148

Table II. Appendix for Table 2, number of deaths from

sex: National Longitudinal Mortality Study for deaths

the Current

occurring in

Population

1990–1998

Survey and death certificate by race, Hispanic origin, age, and

Race, sex, and source of data Total

0–24

years

25–44

years

45–54

years

55–64

years

65–74

years

75 years

and over

White

CPS1 ..................

Death certificate . . . . . . . . . . .

Male

CPS ..................

Death certificate . . . . . . . . . . .

Female

CPS ..................

Death certificate . . . . . . . . . . .

Black

CPS ..................

Death certificate . . . . . . . . . . .

Male

CPS ..................

Death certificate . . . . . . . . . . .

Female

CPS ..................

Death certificate . . . . . . . . . . .

AIAN2

CPS ..................

Death certificate . . . . . . . . . . .

Male

CPS ..................

Death certificate . . . . . . . . . . .

Female

CPS ..................

Death certificate . . . . . . . . . . .

API3

CPS ..................

Death certificate . . . . . . . . . . .

Male

CPS ..................

Death certificate . . . . . . . . . . .

Female

CPS ..................

Death certificate . . . . . . . . . . .

Hispanic

CPS ..................

Death certificate . . . . . . . . . . .

Male

CPS ..................

Death certificate . . . . . . . . . . .

Female

CPS ..................

Death certificate . . . . . . . . . . .

Mexican

CPS ..................

Death certificate . . . . . . . . . . .

Male

CPS ..................

Death certificate . . . . . . . . . . .

Female

CPS ..................

Death certificate . . . . . . . . . . .

See footnotes at end of table.

90,065

90,272

45,861

45,982

44,204

44,290

10,010

9,941

4,970

4,925

5,040

5,016

754

651

420

358

334

293

1,155

1,120

654

640

501

480

5,140

4,855

2,892

2,750

2,248

2,105

2,887

2,622

1,663

1,492

1,224

1,130

892

895

654

654

238

241

256

253

211

209

45

44

22

23

20

21

2

2

32

31

18

19

14

12

125

125

97

94

28

31

84

82

65

60

19

22

3,967

3,988

2,640

2,658

1,327

1,330

1,089

1,079

637

629

452

450

117

109

82

72

35

37

84

81

54

54

30

27

527

496

374

350

153

146

308

264

224

184

84

80

Number of deaths

4,718

4,738

2,926

2,937

1,792

1,801

922

919

486

480

436

439

83

70

43

39

40

31

91

87

53

52

38

35

474

451

302

290

172

161

296

249

185

151

111

98

9,254

9,283

5,465

5,491

3,789

3,792

1,459

1,443

768

759

691

684

119

109

69

54

50

55

137

134

81

79

56

55

728

700

434

421

294

279

415

377

254

231

161

146

20,096

20,161

11,636

11,665

8,460

8,496

2,340

2,325

1,164

1,159

1,176

1,166

137

104

70

56

67

48

289

272

162

152

127

120

1,151

1,081

658

628

493

453

676

609

389

347

287

262

51,138

51,207

22,540

22,577

28,598

28,630

3,944

3,922

1,704

1,689

2,240

2,233

276

236

136

116

140

120

522

515

286

284

236

231

2,135

2,002

1,027

967

1,108

1,035

1,108

1,041

546

519

562

522
Series 2, Number 148 [ Page 21

Table II. Appendix

and sex: National

for Table 2, number of deaths from the

Longitudinal Mortality Study for deaths

Current Population Survey and

occurring in 1990–1998—Con.

death certificate by race, Hispanic origin, age,

Race, sex, and source of data Total

0–24

years

25–44

years

45–54

years

55–64

years

65–74

years

75 years

and over

Puerto Rican

CPS ..................

Death certificate . . . . . . . . . . .

Male

CPS ..................

Death certificate . . . . . . . . . . .

Female

CPS ..................

Death certificate . . . . . . . . . . .

Cuban

CPS ..................

Death certificate . . . . . . . . . . .

Male

CPS ..................

Death certificate . . . . . . . . . . .

Female

CPS ..................

Death certificate . . . . . . . . . . .

Central and South American

CPS ..................

Death certificate . . . . . . . . . . .

Male

CPS ..................

Death certificate . . . . . . . . . . .

Female

CPS ..................

Death certificate . . . . . . . . . . .

Other Hispanic

CPS ..................

Death certificate . . . . . . . . . . .

Male

CPS ..................

Death certificate . . . . . . . . . . .

Female

CPS ..................

Death certificate . . . . . . . . . . .

Non-Hispanic white

CPS ..................

Death certificate . . . . . . . . . . .

Male

CPS ..................

Death certificate . . . . . . . . . . .

Female

CPS ..................

Death certificate . . . . . . . . . . .

Non-Hispanic black

CPS ..................

Death certificate . . . . . . . . . . .

Male

CPS ..................

Death certificate . . . . . . . . . . .

Female

CPS ..................

Death certificate . . . . . . . . . . .

See footnotes at end of table.

527

496

306

291

221

205

532

505

298

274

234

231

250

235

119

107

131

128

944

997

506

586

438

411

81,797

82,146

41,394

41,588

40,403

40,558

9,687

9,651

4,786

4,766

4,901

4,885

20

18

15

14

5

4

1

1

1

1

0

0

6

6

4

4

2

2

14

18

12

15

2

3

707

708

507

507

200

201

234

233

193

193

41

40

100

90

67

63

33

27

27

26

18

15

9

11

28

33

20

23

8

10

64

83

45

65

19

18

3,351

3,376

2,202

2,227

1,149

1,149

1,039

1,035

603

600

436

435

68

65

45

42

23

23

19

17

16

15

3

2

31

34

17

21

14

13

60

86

39

61

21

25

4,100

4,132

2,528

2,549

1,572

1,583

900

897

467

460

433

437

85

84

52

53

33

31

69

63

45

39

24

24

44

37

23

19

21

18

115

139

60

79

55

60

8,212

8,258

4,826

4,857

3,386

3,401

1,413

1,401

743

737

670

664

122

108

69

61

53

47

118

104

77

68

41

36

43

40

19

16

24

24

192

220

104

136

88

84

18,289

18,377

10,594

10,631

7,695

7,746

2,270

2,265

1,128

1,130

1,142

1,135

132

131

58

58

74

73

298

294

141

136

157

158

98

85

36

24

62

61

499

451

246

230

253

221

47,138

47,295

20,737

20,817

26,401

26,478

3,831

3,820

1,652

1,646

2,179

2,174
Page 22 [ Series 2, Number 148

Table II. Appendix

and sex: National

for Table 2, number of deaths from the

Longitudinal Mortality Study for deaths

Current Population Survey and

occurring in 1990–1998—Con.

death certificate by race, Hispanic origin, age,

Race, sex, and source of data Total

0–24

years

25–44

years

45–54

years

55–64

years

65–74

years

75 years

and over

Non-Hispanic AIAN

CPS ..................

Death certificate ...........

Male

CPS ..................

Death certificate ...........

Female

CPS ..................

Death certificate ...........

Non-Hispanic API

CPS ..................

Death certificate ...........

Male

CPS ..................

Death certificate ...........

Female

CPS ..................

Death certificate ...........

663

588

371

321

292

267

1,126

1,092

637

617

489

475

20

20

18

19

2

1

31

30

17

18

14

12

104

99

73

65

31

34

81

78

53

52

28

26

72

65

37

36

35

29

88

84

51

49

37

35

104

97

62

50

42

47

135

129

79

75

56

54

120

98

61

52

59

46

280

266

157

147

123

119

243

209

120

99

123

110

511

505

280

276

231

229

1

Current Population Survey.

2

American Indian or Alaska

3

Asian or Pacific Islander.

Native.
Series 2, Number 148 [ Page 23

Table III. Appendix

urban-rural status,

for Table 3,

geographic

number of deaths from the Current Population Survey and

concentration, and nativity: National Longitudinal Mortality

death certificate by race, Hispanic origin,

Study for deaths occurring in 1990–1998

region,

Race Hispanic Non-Hispanic

Region, nativity, and area White Black AIAN1 API2 Total Mexican

Puerto

Rican Cuban

Central and

South American

Other

Hispanic White Black AIAN API

Region Number of deaths

Northeast

CPS3 ...................

Death certificate. . . . . . . . . . . . .

Midwest

CPS ....................

Death certificate. . . . . . . . . . . . .

South

CPS ....................

Death certificate. . . . . . . . . . . . .

West

CPS ....................

Death certificate. . . . . . . . . . . . .

Urban-rural status

Urban

CPS ....................

Death certificate. . . . . . . . . . . . .

Rural

CPS ....................

Death certificate. . . . . . . . . . . . .

Coethnic concentration

Yes

CPS ....................

Death certificate. . . . . . . . . . . . .

No

CPS ....................

Death certificate. . . . . . . . . . . . .

Nativity

U.S. born

CPS ....................

Death certificate. . . . . . . . . . . . .

Foreign born

CPS ....................

Death certificate. . . . . . . . . . . . .

19,423

19,483

24,135

24,173

27,629

27,713

18,825

18,852

62,171

62,348

27,885

27,915

. . .

. . .

. . .

. . .

83,007

83,163

6,790

6,839

1,369

1,331

1,937

1,924

6,007

5,995

695

687

8,032

7,978

1,978

1,963

. . .

. . .

. . .

. . .

9,756

9,701

205

190

21

12

189

174

167

110

377

355

244

162

510

489

474

469

280

182

738

638

11

10

76

63

56

46

76

61

946

949

982

941

172

178

. . .

. . .

. . .

. . .

553

552

600

567

617

563

293

278

1,911

1,793

2,315

2,217

4,406

4,161

731

691

2,507

2,459

2,633

2,396

2,902

2,698

2,221

2,141

19

14

203

190

1,158

1,127

1,504

1,288

2,430

2,246

454

373

1,348

1,321

1,539

1,301

1,948

1,704

928

912

339 71

304 70

32 10

35 7

93 415

88 392

62 36

68 36

514 525

473 497

13 7

23 8

256 343

246 334

271 189

250 171

122 27

112 15

402 505

383 490

94

91

11

6

64

60

81

78

243

229

7

6

391

386

131

114

22

17

228

217

94

84

37

40

181

126

632

747

694

716

250

281

361

508

583

489

783

850

158

139

18,243

18,322

23,122

23,166

23,808

23,952

16,618

16,700

56,395

56,699

25,396

25,441

. . .

. . .

. . .

. . .

76,724

76,988

4,847

4,930

1,304

1,289

1,907

1,895

5,794

5,790

681

676

7,792

7,771

1,895

1,880

. . .

. . .

. . .

. . .

9,492

9,451

152

155

20

11

185

173

99

60

359

344

201

141

462

447

. . .

. . .

. . .

. . .

651

578

8

8

70

62

52

72

56

931

930

958

917

167

174

. . .

. . .

. . .

. . .

543

538

581

553

. . . Category not applicable. 

1

American Indian or Alaska Native. 

2

Asian or Pacific Islander. 

3

Current Population Survey. 
Page 24 [ Series 2, Number 148

Appendix III

Listing of County and State of Death During the 1990–1998 Period for Hispanic Origin

Subgroups

County and state Percent of deaths

Mexican

Los Angeles, Calif. ......................................... 14.17 

Bexar, Tex. .............................................. 9.63 

El Paso, Tex.............................................. 4.50 

Cameron, Tex. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.69 

Webb, Tex. .............................................. 2.58 

Harris, Tex. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.44 

San Bernadino, Calif......................................... 2.40 

Frio, Tex. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.33 

Hidalgo, Tex. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.25 

San Diego, Calif. .......................................... 2.18 

Cook, Ill. ............................................... 1.88 

Nueces, Tex. ............................................. 1.81 

Dallas, Tex.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.73 

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50.59 

Remainder of country ....................................... 49.41 

Cuban

Dade, Fla. .............................................. 66.60 

Remainder of country ....................................... 33.40 

Puerto Rican

New York City, N.Y. ......................................... 34.94 

Cook, Ill. ............................................... 3.41 

Honolulu, Hawaii .......................................... 3.21 

Dade, Fla. .............................................. 3.21 

Hudson, N.J. ............................................. 3.01 

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47.78 

Remainder of country ....................................... 52.22 

Central and South American

New York City, N.Y. ......................................... 23.89 

Los Angeles, Calif. ......................................... 15.79 

Dade, Fla. .............................................. 13.77 

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53.45 

Remainder of country ....................................... 46.55 
Vital and Health Statistics

series descriptions

SERIES 1.	 Programs and Collection Procedures—These reports

describe the data collection programs of the National Center

for Health Statistics. They include descriptions of the methods

used to collect and process the data, definitions, and other

material necessary for understanding the data.

SERIES 2.	 Data Evaluation and Methods Research—These reports

are studies of new statistical methods and include analytical

techniques, objective evaluations of reliability of collected

data, and contributions to statistical theory. These studies

also include experimental tests of new survey methods and

comparisons of U.S. methodology with those of other

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SERIES 3.	 Analytical and Epidemiological Studies—These reports

present analytical or interpretive studies based on vital and

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the expository types of reports in the other series.

SERIES 4.	 Documents and Committee Reports—These are final

reports of major committees concerned with vital and health

statistics and documents such as recommended model vital

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reports contain statistics on illness; unintentional injuries;

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and a wide range of special current health topics covering

many aspects of health behaviors, health status, and health

care utilization. They are based on data collected in a

continuing national household interview survey.

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

National Health and Nutrition Examination Surveys, and

the Hispanic Health and Nutrition Examination Survey—

Data from direct examination, testing, and measurement on

representative samples of the civilian noninstitutionalized

population provide the basis for (1) medically defined total

prevalence of specific diseases or conditions in the United

States and the distributions of the population with respect to

physical, physiological, and psychological characteristics, and

(2) analyses of trends and relationships among various

measurements and between survey periods.

SERIES 12.	 Data From the Institutionalized Population Surveys—

Discontinued in 1975. Reports from these surveys are

included in Series 13.

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reports contain statistics on health resources and the public’s

use of health care resources including ambulatory, hospital,

and long-term care services based on data collected directly

from health care providers and provider records.

SERIES 14.	 Data on Health Resources: Manpower and Facilities—

Discontinued in 1990. Reports on the numbers, geographic

distribution, and characteristics of health resources are now

included in Series 13.

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statistics on health and health-related topics collected in

special surveys that are not part of the continuing data

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Statistics—Advance Data Reports provide early release of

information from the National Center for Health Statistics’

health and demographic surveys. They are compiled in the

order in which they are published. Some of these releases

may be followed by detailed reports in Series 10–13.

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reports. Special analyses by cause of death, age, other

demographic variables, and geographic and trend analyses

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Discontinued in 1975. Reports from these sample surveys,

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reports contain statistics on factors that affect birth rates,

including contraception, infertility, cohabitation, marriage,

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Vital Statistics System that were published as National Vital

Statistics Reports (NVSR), formerly Monthly Vital Statistics

Report. These reports provide highlights and summaries of

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DHHS Publication No. (PHS) 2009–1348, Series 2, No. 148