title: Socioeconomic differences in the use of ill-defined causes of death in 16 European countries.
abstract: BACKGROUND
  Cause-of-death data linked to information on socioeconomic position form one of the most important sources of information about health inequalities in many countries. The proportion of deaths from ill-defined conditions is one of the indicators of the quality of cause-of-death data. We investigated educational differences in the use of ill-defined causes of death in official mortality statistics.
  
  
  METHODS
  Using age-standardized mortality rates from 16 European countries, we calculated the proportion of all deaths in each educational group that were classified as due to "Symptoms, signs and ill-defined conditions". We tested if this proportion differed across educational groups using Chi-square tests.
  
  
  RESULTS
  The proportion of ill-defined causes of death was lower than 6.5% among men and 4.5% among women in all European countries, without any clear geographical pattern. This proportion statistically significantly differed by educational groups in several countries with in most cases a higher proportion among less than secondary educated people compared with tertiary educated people.
  
  
  CONCLUSIONS
  We found evidence for educational differences in the distribution of ill-defined causes of death. However, the differences between educational groups were small suggesting that socioeconomic inequalities in cause-specific mortality in Europe are not likely to be biased.
authors.affiliation: Department of Public Health, Erasmus Medical Center, P,O, Box 2040, 3000 CA Rotterdam, The Netherlands. i.kulhanova@erasmusmc.nl.
authors.forename: Ivana
authors.initials: I
authors.lastname: Kulhánová
authors.forename: Gwenn
authors.initials: G
authors.lastname: Menvielle
authors.forename: Matthias
authors.initials: M
authors.lastname: Bopp
authors.forename: Carme
authors.initials: C
authors.lastname: Borrell
authors.forename: Patrick
authors.initials: P
authors.lastname: Deboosere
authors.forename: Terje A
authors.initials: TA
authors.lastname: Eikemo
authors.forename: Rasmus
authors.initials: R
authors.lastname: Hoffmann
authors.forename: Mall
authors.initials: M
authors.lastname: Leinsalu
authors.forename: Pekka
authors.initials: P
authors.lastname: Martikainen
authors.forename: Enrique
authors.initials: E
authors.lastname: Regidor
authors.forename: Maica
authors.initials: M
authors.lastname: Rodríguez-Sanz
authors.forename: Jitka
authors.initials: J
authors.lastname: Rychtaříková
authors.forename: Bogdan
authors.initials: B
authors.lastname: Wojtyniak
authors.forename: Johan P
authors.initials: JP
authors.lastname: Mackenbach
mesh_terms: D000328:Adult; D015982:Bias; D002423:Cause of Death; D016009:Chi-Square Distribution; D004522:Educational Status; D005060:Europe / Q000453:epidemiology; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D009026:Mortality; D012107:Research Design; D012737:Sex Factors; D012959:Socioeconomic Factors