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

Simple item page
dc.contributor.authorHowrey, Bret
dc.contributor.authorGoodwin, James S.
dc.contributor.authorEschbach, Karl
dc.contributor.authorFreeman, Jean
dc.date.accessioned2019-08-14T15:03:29Z
dc.date.available2019-08-14T15:03:29Z
dc.date.issued2010
dc.description.abstractOBJECTIVES: 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.
dc.description.urihttp://dx.doi.org/10.1097/MLR.0b013e3181d686cf
dc.identifierhttps://doi.org/10.13016/ys73-09xq
dc.identifier.citationHowrey, 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.
dc.identifier.issn0025-7079
dc.identifier.otherEprint ID 2835
dc.identifier.urihttp://hdl.handle.net/1903/23475
dc.subjectCardiovascular Disease
dc.subjectstudies
dc.subjectmethodologies
dc.subjectdisparity
dc.subjectmortality
dc.subjectstroke
dc.titleLower Stroke Mortality Among Hispanics: an exploration of potential methodological confounders
dc.typeArticle

Files

Collections

Minority Health and Health Equity Archive