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Comparing Race and Ethnicity as Reported on Infant Death and Matching Live Birth Certificates, North Carolina 2002-2006 Paul A. Buescher, Ph.D. State Center for Health Statistics NC Division of Public Health June 3, 2008

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Page 1: Comparing Race and Ethnicity as Reported on Infant Death and Matching Live Birth Certificates, North Carolina 2002-2006 Paul A. Buescher, Ph.D. State Center

Comparing Race and Ethnicity as Reported on Infant Death and

Matching Live Birth Certificates, North Carolina 2002-2006

Paul A. Buescher, Ph.D.State Center for Health Statistics

NC Division of Public HealthJune 3, 2008

Page 2: Comparing Race and Ethnicity as Reported on Infant Death and Matching Live Birth Certificates, North Carolina 2002-2006 Paul A. Buescher, Ph.D. State Center

2008 NAPHSIS Annual MeetingCelebrating 75 Years of ExcellenceOrlando, FL June 1st – 5th, 2008

Introduction During 2002-2006, 99% of NC

resident infant death certificates were successfully matched to a live birth certificate.

This matched file allows joint analysis of the variables from each file.

Page 3: Comparing Race and Ethnicity as Reported on Infant Death and Matching Live Birth Certificates, North Carolina 2002-2006 Paul A. Buescher, Ph.D. State Center

2008 NAPHSIS Annual MeetingCelebrating 75 Years of ExcellenceOrlando, FL June 1st – 5th, 2008

Introduction The purpose of this project is to

compare race and ethnicity as reported on infant death and matching birth certificates, and to compute infant death rates calculated using race/ethnicity at birth vs. race/ethnicity at death.

Page 4: Comparing Race and Ethnicity as Reported on Infant Death and Matching Live Birth Certificates, North Carolina 2002-2006 Paul A. Buescher, Ph.D. State Center

2008 NAPHSIS Annual MeetingCelebrating 75 Years of ExcellenceOrlando, FL June 1st – 5th, 2008

Introduction NC has not yet adopted the new national

model live birth or death certificates. NC certificates currently collect data on

race via open-ended, fill-in-the-blank boxes.

On the birth certificate, both mother’s and father’s race are collected; the data are usually tabulated by mother’s race.

Page 5: Comparing Race and Ethnicity as Reported on Infant Death and Matching Live Birth Certificates, North Carolina 2002-2006 Paul A. Buescher, Ph.D. State Center

2008 NAPHSIS Annual MeetingCelebrating 75 Years of ExcellenceOrlando, FL June 1st – 5th, 2008

Introduction In a study of 2002 NC birth

certificates, we found that mothers wrote in more than 600 different text versions of mother’s “race.”

Extreme examples of the race written in by the mother were “Son of God” and “Dominant White.” “Human Race” was a common entry.

Page 6: Comparing Race and Ethnicity as Reported on Infant Death and Matching Live Birth Certificates, North Carolina 2002-2006 Paul A. Buescher, Ph.D. State Center

2008 NAPHSIS Annual MeetingCelebrating 75 Years of ExcellenceOrlando, FL June 1st – 5th, 2008

Introduction These many open-ended responses to

race on birth and death certificates are coded by Vital Records staff into ten standard racial categories according to rules provided by the NCHS: white, black, American Indian, Chinese, Japanese, Hawaiian, Filipino, Other Asian or Pacific Islander, other race, and unknown race.

Page 7: Comparing Race and Ethnicity as Reported on Infant Death and Matching Live Birth Certificates, North Carolina 2002-2006 Paul A. Buescher, Ph.D. State Center

2008 NAPHSIS Annual MeetingCelebrating 75 Years of ExcellenceOrlando, FL June 1st – 5th, 2008

Introduction On both the NC birth and death

certificates, Hispanic origin is ascertained by a yes/no question.

The data on race and ethnicity were combined for this project into 11 categories: white, non-Hispanic; black, non-Hispanic; American Indian, non-Hispanic; etc. for the other 7 race groups; and Hispanic of any race.

Page 8: Comparing Race and Ethnicity as Reported on Infant Death and Matching Live Birth Certificates, North Carolina 2002-2006 Paul A. Buescher, Ph.D. State Center

2008 NAPHSIS Annual MeetingCelebrating 75 Years of ExcellenceOrlando, FL June 1st – 5th, 2008

Results There were 5,024 matched infant

deaths during 2002-2006 (defined by NC residence at birth) and for 4,627 (92%) of these infants deaths the detailed race/ethnicity category was the same on both the infant death and the live birth certificate.

Conversely, the rate of disagreement was 8%.

Page 9: Comparing Race and Ethnicity as Reported on Infant Death and Matching Live Birth Certificates, North Carolina 2002-2006 Paul A. Buescher, Ph.D. State Center

2008 NAPHSIS Annual MeetingCelebrating 75 Years of ExcellenceOrlando, FL June 1st – 5th, 2008

Results Race-specific infant death rates are often

published by states using race as recorded on the death certificate to specify the numerator.

The following chart compares infant death rates when race/ethnicity from the death certificate is used versus when mother’s race/ethnicity from the matching birth certificate is used.

Page 10: Comparing Race and Ethnicity as Reported on Infant Death and Matching Live Birth Certificates, North Carolina 2002-2006 Paul A. Buescher, Ph.D. State Center

2008 NAPHSIS Annual MeetingCelebrating 75 Years of ExcellenceOrlando, FL June 1st – 5th, 2008

Results Due to the small numbers of infant

deaths in some of the racial categories, the data for Chinese, Japanese, Hawaiian, Filipino, and Other Asian are combined into one “Asian” category in the chart.

Page 11: Comparing Race and Ethnicity as Reported on Infant Death and Matching Live Birth Certificates, North Carolina 2002-2006 Paul A. Buescher, Ph.D. State Center

2008 NAPHSIS Annual MeetingCelebrating 75 Years of ExcellenceOrlando, FL June 1st – 5th, 2008

Results

Page 12: Comparing Race and Ethnicity as Reported on Infant Death and Matching Live Birth Certificates, North Carolina 2002-2006 Paul A. Buescher, Ph.D. State Center

2008 NAPHSIS Annual MeetingCelebrating 75 Years of ExcellenceOrlando, FL June 1st – 5th, 2008

Results The infant death rates for Hispanics

and Asians are one-fifth and one-fourth larger, respectively, when using the mother’s race/ethnicity from the matching birth certificate rather than the infant’s race/ethnicity from the death certificate.

Page 13: Comparing Race and Ethnicity as Reported on Infant Death and Matching Live Birth Certificates, North Carolina 2002-2006 Paul A. Buescher, Ph.D. State Center

2008 NAPHSIS Annual MeetingCelebrating 75 Years of ExcellenceOrlando, FL June 1st – 5th, 2008

Conclusions Mother’s race/ethnicity from the birth

certificate is presumably more accurate because it is self-reported. Race/ethnicity on the death certificate is reported by a funeral director, ideally after asking the family.

Race as collected on vital records is imprecise and subject to the vagaries of reporting by many people.

Page 14: Comparing Race and Ethnicity as Reported on Infant Death and Matching Live Birth Certificates, North Carolina 2002-2006 Paul A. Buescher, Ph.D. State Center

2008 NAPHSIS Annual MeetingCelebrating 75 Years of ExcellenceOrlando, FL June 1st – 5th, 2008

Conclusions Tabulations of infant death rates by

race and ethnicity (especially for smaller racial/ethnic groups) should use the mother’s race and ethnicity from the matching birth certificate for the numerator, which are likely to be more accurate.

Page 15: Comparing Race and Ethnicity as Reported on Infant Death and Matching Live Birth Certificates, North Carolina 2002-2006 Paul A. Buescher, Ph.D. State Center

2008 NAPHSIS Annual MeetingCelebrating 75 Years of ExcellenceOrlando, FL June 1st – 5th, 2008

References Buescher PA. Congruence between

race and ethnicity reported on infant death and the matching live birth certificates: North Carolina, 2002-2006. SCHS Studies, No. 156. State Center for Health Statistics, February 2008. Available at: www.schs.state.nc.us/SCHS/pdf/SCHS156.pdf

Page 16: Comparing Race and Ethnicity as Reported on Infant Death and Matching Live Birth Certificates, North Carolina 2002-2006 Paul A. Buescher, Ph.D. State Center

2008 NAPHSIS Annual MeetingCelebrating 75 Years of ExcellenceOrlando, FL June 1st – 5th, 2008

References Buescher PA, Gizlice Z, Jones-Vessey

KA. Discrepancies between published data on racial classification and self-reported race: evidence from the 2002 North Carolina live birth records. Public Health Reports. 2005;120:393-398.

Page 17: Comparing Race and Ethnicity as Reported on Infant Death and Matching Live Birth Certificates, North Carolina 2002-2006 Paul A. Buescher, Ph.D. State Center

2008 NAPHSIS Annual MeetingCelebrating 75 Years of ExcellenceOrlando, FL June 1st – 5th, 2008

Contact InformationPaul A. Buescher, Ph.D.DirectorState Center for Health StatisticsNC Division of Public Health1908 Mail Service CenterRaleigh, NC 27699-1908(919) [email protected]/SCHS