The Hispanic mortality advantage and ethnic misclassification on US death certificates.
OBJECTIVE
We tested the data artifact hypothesis regarding the Hispanic mortality advantage by investigating whether and to what degree this advantage is explained by Hispanic origin misclassification on US death certificates.


METHODS
We used the National Longitudinal Mortality Study, which links Current Population Survey records to death certificates for 1979 through 1998, to estimate the sensitivity, specificity, and net ascertainment of Hispanic ethnicity on death certificates compared with survey classifications. Using national vital statistics mortality data, we estimated Hispanic age-specific and age-adjusted death rates, which were uncorrected and corrected for death certificate misclassification, and produced death rate ratios comparing the Hispanic with the non-Hispanic White population.


RESULTS
Hispanic origin reporting on death certificates in the United States is reasonably good. The net ascertainment of Hispanic origin is just 5% higher on survey records than on death certificates. Corrected age-adjusted death rates for Hispanics are lower than those for the non-Hispanic White population by close to 20%.


CONCLUSIONS
The Hispanic mortality paradox is not explained by an incongruence between ethnic classification in vital registration and population data systems.
Arias
Elizabeth
E
Mortality Statistics Branch, Division of Vital Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Road, Room 7330, Hyattsville, MD 20782, USA. earias@cdc.gov
Eschbach
Karl
K
Schauman
William S
WS
Backlund
Eric L
EL
Sorlie
Paul D
PD
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003644:Death Certificates; D005006:Ethnicity / Q000145:classification*; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000208:ethnology*; D012680:Sensitivity and Specificity; D014481:United States / Q000453:epidemiology; D055815:Young Adult