title: A case study of the impact of inaccurate cause-of-death reporting on health disparity tracking: New York City premature cardiovascular mortality.
abstract: OBJECTIVE
  Heart disease death overreporting is problematic in New York City (NYC) and other US jurisdictions. We examined whether overreporting affects the premature (< 65 years) heart disease death rate disparity between non-Hispanic Blacks and non-Hispanic Whites in NYC.
  
  
  METHODS
  We identified overreporting hospitals and used counts of premature heart disease deaths at reference hospitals to estimate corrected counts. We then corrected citywide, age-adjusted premature heart disease death rates among Blacks and Whites and a White-Black premature heart disease death disparity.
  
  
  RESULTS
  At overreporting hospitals, 51% of the decedents were White compared with 25% at reference hospitals. Correcting the heart disease death counts at overreporting hospitals decreased the age-adjusted premature heart disease death rate 10.1% (from 41.5 to 37.3 per 100,000) among Whites compared with 4.2% (from 66.2 to 63.4 per 100,000) among Blacks. Correction increased the White-Black disparity 6.1% (from 24.6 to 26.1 per 100,000).
  
  
  CONCLUSIONS
  In 2008, NYC's White-Black premature heart disease death disparity was underestimated because of overreporting by hospitals serving larger proportions of Whites. Efforts to reduce overreporting may increase the observed disparity, potentially obscuring any programmatic or policy-driven advances.
authors.affiliation: University of Michigan School of Public Health, USA.
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Johns
authors.forename: Ann M
authors.initials: AM
authors.lastname: Madsen
authors.forename: Gil
authors.initials: G
authors.lastname: Maduro
authors.forename: Regina
authors.initials: R
authors.lastname: Zimmerman
authors.forename: Kevin
authors.initials: K
authors.lastname: Konty
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Begier
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D002318:Cardiovascular Diseases / Q000208:ethnology* / Q000401:mortality*; D002423:Cause of Death; D059019:Clinical Coding; D016001:Confidence Intervals; D003644:Death Certificates; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D016012:Poisson Distribution; D044465:White People / Q000706:statistics & numerical data*