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Title: Lower Stroke Mortality Among Hispanics: An Exploration of Potential Methodological Confounders

Citation Type: Journal Article

Publication Year: 2010

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Abstract: Objectives: Stroke mortality rates are reported to be lower for Hispanics than non-Hispanic Whites. We investigate the degree to which this lower reported mortality is explained by inaccuracies introduced through omission of nativity, imprecise measurement of cause of death, and under-ascertainment of Hispanic ethnicity on death certificates. We used national vital registration data for the years 19891991 and 19992002, including foreign- and US-born Hispanics and non-Hispanic Whites. Hispanic deaths were adjusted for misclassification of ethnicity on the death certificate. Denominators for the rates were derived from census estimates.Results: Adjustment for nativity and death certificate misclassification removes the stroke mortality advantage for US-born Hispanic men, but not women. After adjustment, US-born Hispanic men and women have higher rates of mortality from subarachnoid hemorrhage than non-Hispanic Whites (RR: 1.23 and 1.23, respectively), but lower rates of mortality from Ischemic (RR: 0.76 and 0.73, respectively) and chronic effects of stroke (RR: 0.87 and 0.73, respectively).Conclusions: When adjusted for misclassification the lower stroke mortality remains for Hispanic men and women at older ages. Part of the previously reported advantage is a combination of imprecise measurement and data quality.

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Authors: Goodwin, James; Howrey, Bret; Eschbach, Karl; Freeman, Jean

Periodical (Full): Medical care

Issue: 6

Volume: 48

Pages: 534-539

Data Collections: IPUMS USA

Topics: Health, Race and Ethnicity

Countries: United States