The validity of race and Hispanic origin reporting on death certificates in the United States.

OBJECTIVES: This report presents the results of an evaluation study of the validity of race and Hispanic origin reporting on death certificates in the United States and its impact on race- and Hispanic origin-specific mortality estimates. METHODS: The National Longitudinal Mortality Study (NLMS) was used to evaluate death certificate classification of race and Hispanic origin by comparing death certificate with survey race-ethnicity classifications for a sample of decedents identified in NLMS. NLMS consists of a series of annual Current Population Survey files (1973 and 1978-1998) linked to death certificates for years 1979-1998. To identify and measure the effect of race-ethnicity misclassification on death certificates on mortality estimates, pooled 1999-2001 vital statistics mortality data and population data from the 2000 census were used to estimate and compare observed and corrected (for death certificate misclassification) race-ethnicity specific death rates. RESULTS: Race and ethnicity reporting on the death certificate continues to be excellent for the white and black populations. It remains poor for the American Indian or Alaska Native (AIAN) population but is reasonably good for the Hispanic and Asian or Pacific Islander (API) populations. Decedent characteristics such as place of residence and nativity have an important effect on the quality of reporting on the death certificate. The effects of misclassification on mortality estimates were most pronounced for the AIAN population, where correcting for misclassification reverses a large AIAN over white mortality advantage to a large disadvantage. Among the Hispanic and API populations, adjustment for death certificate misclassification did not significantly affect minority-majority mortality differentials.