Ascertainment of Hispanic ethnicity on California death certificates: implications for the explanation of the Hispanic mortality advantage.
OBJECTIVE
We determined the size and correlates of underascertainment of Hispanic ethnicity on California death certificates.


METHODS
We used 1999 to 2000 vital registration data. We compared Hispanic ethnicity reported on the death certificate to Hispanic ethnicity derived from birthplace for the foreign-born and an algorithm that used first and last name and percentage of Hispanics in the county of residence for the US-born. We validated death certificate nativity by comparing data with that in linked Social Security Administration records.


RESULTS
Ethnicity and birthplace information was concordant for foreign-born Hispanics, who have mortality rates that are 25% to 30% lower than those of non-Hispanic Whites. Death certificates likely underascertain deaths of US-born Hispanics, particularly at older ages, for persons with more education, and in census tracts with lower percentages of Hispanics. Conservative correction for under-ascertainment eliminates the Hispanic mortality advantage for US-born men.


CONCLUSIONS
Hispanic ethnicity is accurately ascertained on the California death certificate for immigrants. Immigrant Hispanics have lower age-adjusted mortality rates than do non-Hispanic Whites. For US-born Hispanics, the mortality advantage compared with non-Hispanic Whites is smaller and may be explained by underreporting of Hispanic ethnicity on the death certificate.
Eschbach
Karl
K
Department of Internal Medicine, Division of Geriatrics, and the Sealy Center on Aging at the University of Texas Medical Branch, Galveston, Tex 77555-0460, USA. kaeschba@utmb.edu
Kuo
Yong-Fang
YF
Goodwin
James S
JS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002140:California / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003644:Death Certificates; D004641:Emigration and Immigration; D005260:Female; D005568:Forms and Records Control / Q000592:standards / Q000706:statistics & numerical data; D006630:Hispanic or Latino / Q000145:classification / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007843:Latin America / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D009026:Mortality; D040442:Public Health Informatics; D011786:Quality Control; D012042:Registries / Q000592:standards*; D012680:Sensitivity and Specificity; D012943:Social Security / Q000706:statistics & numerical data*; D013219:State Government