title: Increased gallbladder-related mortality among Hispanics: does education play a role?
abstract: OBJECTIVE
  Hispanics, particularly Mexican Americans, are known to have a higher incidence of mortalities whose underlying cause is a gallbladder-related disorder. These analyses evaluate the role of educational attainment in the differential mortality experiences of these populations.
  
  
  METHODS
  US mortality data for 1989-1991 were examined to determine ethnically-specific death rates using 'any mention' of the disease on the death certificate.
  
  
  RESULTS
  Age-adjusted multiple cause mortality was found to be higher for all gallbladder-related disorders among Hispanics, particularly Mexican Americans. Mortality due to gallbladder cancer, gallstones and 'other gallbladder diseases' were found to be inversely proportional to educational attainment in all ethnic groups. When both age and education were used to adjust mortality, the gallstone and other gallbladder disease mortality among Hispanics was non-significantly higher than white, non-Hispanics. However, mortality due to gallbladder cancer remained significantly higher among Hispanics.
  
  
  CONCLUSIONS
  Gallbladder cancer mortality is elevated in Hispanic populations, especially Mexican Americans, independent of educational attainment. However, increased mortality associated with gallstones or other gallbladder diseases among Hispanics may be partially due to differences in factors associated with educational attainment. Research and public health efforts to address these educational-related factors may improve this mortality pattern among Hispanics.
authors.affiliation: Office of Analysis, Epidemiology and Health Promotion, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782, USA.
authors.forename: D K
authors.initials: DK
authors.lastname: Wagener
authors.forename: M
authors.initials: M
authors.lastname: McDonald
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D002423:Cause of Death / Q000639:trends; D003644:Death Certificates; D004522:Educational Status; D005260:Female; D005705:Gallbladder Diseases / Q000208:ethnology* / Q000401:mortality* / Q000517:prevention & control; D007722:Health Knowledge, Attitudes, Practice; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D016018:Least-Squares Analysis; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology