Minority Health Archive

Lower Stroke Mortality Among Hispanics: an exploration of potential methodological confounders

Howrey, Bret and Goodwin, James S. and Eschbach, Karl and Freeman, Jean (2010) Lower Stroke Mortality Among Hispanics: an exploration of potential methodological confounders. Medical Care, 48 (6). pp. 534-539. ISSN 0025-7079

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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 1989-1991 and 1999-2002, 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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Item Type: Article
Additional Information: This article is available at the publisher’s Web site. Access to the full text is subject to the publisher’s access restrictions.
Uncontrolled Keywords: disparity, mortality, stroke
Subjects: Health > Public Health > Chronic Illness & Diseases > Cardiovascular Disease
Research > studies
Research > methodologies
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Depositing User: Users 141 not found.
Date Deposited: 24 Jul 2011 21:10
Last Modified: 24 Jul 2011 21:10
Link to this item (URI): http://health-equity.pitt.edu/id/eprint/2835

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