Quality of death rates by race and Hispanic origin: a summary of current research, 1999.

OBJECTIVES: This report provides a summary of current knowledge and research on the quality and reliability of death rates by race and Hispanic origin in official mortality statistics of the United States produced by the National Center for Health Statistics (NCHS). It also provides a quantitative assessment of bias in death rates by race and Hispanic origin. It identifies areas for targeted research. METHODS: Death rates are based on information on deaths (numerators of the rates) from death certificates filed in the states and compiled into a national database by NCHS, and on population data (denominators) from the Census Bureau. Selected studies of race/Hispanic-origin misclassification and under coverage are summarized on deaths and population. Estimates are made of the separate and the joint bias on death rates by race and Hispanic origin from the two sources. Simplifying assumptions are made about the stability of the biases over time and among age groups. Original results are presented using an expanded and updated database from the National Longitudinal Mortality Study. RESULTS: While biases in the numerator and denominator tend to offset each other somewhat, death rates for all groups show net effects of race misclassification and under coverage. For the white population and the black population, published death rates are overstated in official publications by an estimated 1.0 percent and 5.0 percent, respectively, resulting principally from undercounts of these population groups in the census. Death rates for the other minority groups are understated in official publications approximately as follows: American Indians, 21 percent; Asian or Pacific Islanders, 11 percent; and Hispanics, 2 percent. These estimates do not take into account differential misreporting of age among the race/ethnic groups.

Causes of death contributing to changes in life expectancy: United States, 1984-89.

During 1984-89, life expectancy increased for the total population (0.6 year), white males (0.9 year), and white females (0.5 year), while it decreased for black males (-0.8year) and black females (-0.2 year). These changes in life expectancy are the result of changes in mortality for specific age-ram-sex groups and identifiable causes of death. Using a technique developed by Eduardo E. Arriaga (1,2), this report identifies major causes of death contributing to the change in life expectancy between 1984 and 1989. Refer to Technical notes for a brief description of this methodology. The tectique partitions changes in life expectancy into positive contributions (which are those causes of death and age groups that contribute to an increase in life expectancy) and negative contributions (which are those that contribute to a decrease). The report includes separate analyses by age and causes of death. For the total population, positive contributions occurred for the age groups under 15 years and age groups 45 years and over while negative contributions occurred for the age groups 15-44 years. The report also examines the combined contributions of age and causes of death for the total population and the four race-sex groups. For the total population, positive contributions to the increase in life expectancy were due to changes in mortality for Diseases of heart under 1 and 35 years and over; Cerebrovascular diseases, 40 years and over; and Malignant neoplasms, including neoplasms of lymphatic and hematopoietic tissues, 30-59 years. Negative contributions were largely due to HIV infection, 20-59 years; Malignant neoplasma, including neoplasm of lymphatic and hematopoietic tissues, 65 years and oveq and Pneumonia and influenza, 75 years and over.

Mortality Trends for leading Causes of Death United States - 1950-69.

This is the second report in a series on mortality trends in the United States. The first report analyzed trends in death rates for 1950-69 by age,sex,and color. This report examines mortality trends for 1950-69 for the 15 leading causes of death by age,color,and sex. These 15 causes accounted for 89 percent of the 1,921,990 deaths that occurred in the United States in 1969.

Mortality trends: age,color, and sex United States - 1950-69.

The crude death rate for the United States experience d a clear downward trend throughout the first half of this century. It reached a low in 1954 (919.0 deaths per 100,000 population) and then began to level off (figure 1). The rate was relatively stable during 1954-69 with the exception of fluctuations associated for the most part with epidemics of influenza. For the severe influenza epidemic year of 196 8-with peaks of mortality at both the beginning and end of the year-a high point of 965.7 deaths per 100,000 population was reached. The rate then dropped back for 1969 (951.9 deaths per 100,000) to about the same level recorded for 1966.

Deaths of Hispanic origin, 15 reporting States, 1979-81.

This report describes the mortality of the Hispanic-origin population for a 15-State reporting area during the 3-year period of 1979-81. Death rates are centered on 1980, the year for which population counts are available from the decennial census enumeration for major Hispanic groups in the States that comprise the reporting area. A total of 21 States had a Hispanic origin or an ethnic origin item on their death certificates for 1979-81. For 15 of these States (Arizona, Colorado, Georgia, Hawaii, Illinois, Indiana, Kansas, Mississippi, Nebraska, New York, North Dakota, Ohio, Texas (1980-81 only), Utah, and Wyoming), reporting of Hispanic origin or ethnic origin was at least 90 percent complete by place of occurrence and the wording of the questions was comparable among the States. Reporting of Hispanic origin or ethnic origin was 94.7 percent complete (on a place-of-residence basis) for these 15 States. Mortality data in,this report are presented in tables 1-17. The analysis of mortality is limited to the 15-State reporting area (tables 2-13 and 15-17). Completeness of reporting Hispanic origin or ethnic origin on the death certificate has improved since 1978, when the death certificates of 18 States included one of the items. In 1978, decedent's origin was not reported for 22.7 percent of deaths occurring in these States; by 1980, for the 21 States then reporting this information, the percent had declined to 15.8. Reporting has continued to improve through 1987, when decedent's origin was not reported for only 5.2 percent of deaths occurring in the 22 reporting States and the District of Columbia.

Why did black life expectancy decline from 1984 through 1989 in the United States?

OBJECTIVES: The objective of this study was to partition the change in US life expectancy into those major causes of death and age groups that contributed most to the decline in life expectancy for Black males and females and to the increase in life expectancy for White males and females in the period from 1984 through 1989. METHODS: By means of a life table partitioning technique, the positive and negative contributions of age and cause of death to changes in life expectancy were estimated. RESULTS: Causes contributing most to the decrease in life expectancy for Black males included human immunodeficiency virus (HIV) infection (< 5 and 20-69 years of age) and homicide (1-4 and 10-34 years of age); for Black females the causes included HIV infection (< 5 and 20-59 years of age) and cancer (65-79 and > or = 85 years of age). CONCLUSIONS: Mortality trends between the two major race groups in the United States diverged sharply, and without precedent, during the late 1980s. A description of these trends in terms of contributions to change in life expectancy may help us better analyze and interpret changes in the health of these groups and may contribute to a better allocation of resources for research, education, and public health programs.

Births and deaths: United States, 1996.

OBJECTIVES: This report presents preliminary data on births and deaths in the United States from the National Center for Health Statistics for 1996. U.S. data are shown by age, race, and Hispanic origin. National and State data on births by marital status, prenatal care, cesarean delivery, and low birthweight are also presented. Mortality data presented include life expectancy, leading causes of death, and infant mortality. METHODS: This report, the third in a new statistical series, presents preliminary data for 1996 on births and deaths based on a substantial sample of vital records. The records are weighted to independent control counts of births, infant deaths, and total deaths received in State vital statistics offices during calendar year 1996. RESULTS: According to preliminary data for 1996, the birth rate for teenagers dropped 4 percent in 1996 to 54.7 births per 1,000 women aged 15-19 years. The teen birth rate has declined 12 percent since 1991 (62.1), with larger reductions for young teenagers 15-17 years and for black teenagers. Birth rates for women aged 20-34 years increased 1-2 percent, while rates for women aged 35-44 years rose 3 percent. The number and percent of births to unmarried women increased about 1 percent, while the birth rate for unmarried women declined 1 percent. The rate of prenatal care utilization improved and the cesarean delivery rate declined. The overall low birthweight rate increased to 7.4 percent. The 1996 preliminary infant mortality rate reached a record low of 7.2 infant deaths per 1,000 live births with all-time lows for white and black infants. Life expectancy reached a record high of 76.1 years with all-time highs for white and black males and black females. The largest declines in age-adjusted death rates among the leading causes of death were for Human immunodeficiency virus (HIV) (26 percent) and Homicide (11 percent), which dropped from the 12th to the 14th leading cause of death.