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Blurred lines: racial misclassification in death certificates in Brazil

Author

Listed:
  • Hellen Geremias Santos

    (Carlos Chagas Institute, Oswaldo Cruz Foundation)

  • Carla Ferreira Nascimento

    (University of São Paulo)

  • Yeda Aparecida Duarte

    (University of São Paulo)

  • Ichiro Kawachi

    (Harvard T.H. Chan School of Public Health)

  • Alexandre Dias Porto Chiavegatto Filho

    (University of São Paulo)

Abstract

Objectives To analyze the agreement between self-reported race and race reported on death certificates for older (≥ 60 years) residents of São Paulo, Brazil (from 2000 to 2016) and to estimate weights to correct mortality data by race. Methods We used data from the Health, Well-Being and Aging Study (SABE) and from Brazil’s Mortality Information System. Misclassification was identified by comparing individual self-reported race with the corresponding race on the death certificate (n = 1012). Racial agreement was analyzed by performing sensitivity and Cohen’s Kappa tests. Multinomial logistic regressions were adjusted to identify characteristics associated with misclassification. Correction weights were applied to race-specific mortality rates. Results Total racial misclassification was 17.3% (13.1% corresponded to whitening, and 4.2% to blackening). Racial misclassification was higher for self-reported pardos/mixed (63.5%), followed by blacks (42.6%). Official vital statistics suggest highest elderly mortality rates for whites, but after applying correction weights, black individuals had the highest rate (45.85/1000 population), followed by pardos/mixed (42.30/1000 population) and whites (37.91/1000 population). Conclusions Official Brazilian data on race-specific mortality rates may be severely misclassified, resulting in biased estimates of racial inequalities.

Suggested Citation

  • Hellen Geremias Santos & Carla Ferreira Nascimento & Yeda Aparecida Duarte & Ichiro Kawachi & Alexandre Dias Porto Chiavegatto Filho, 2020. "Blurred lines: racial misclassification in death certificates in Brazil," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 65(1), pages 29-36, January.
    • Handle: RePEc:spr:ijphth:v:65:y:2020:i:1:d:10.1007_s00038-019-01321-1
    DOI: 10.1007/s00038-019-01321-1
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    References listed on IDEAS

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    1. Chiavegatto Filho, A.D.P. & Beltrań-Sánchez, H. & Kawachi, I., 2014. "Racial disparities in life expectancy in Brazil: Challenges from a multiracial society," American Journal of Public Health, American Public Health Association, vol. 104(11), pages 2156-2162.
    2. Arias, E. & Eschbach, K. & Schauman, W.S. & Backlund, E.L. & Sorlie, P.D., 2010. "The hispanic mortality advantage and ethnic misclassification on US death certificates," American Journal of Public Health, American Public Health Association, vol. 100(S1), pages 171-177.
    3. Abraído-Lanza, A.F. & Dohrenwend, B.P. & Ng-Mak, D.S. & Turner, J.B., 1999. "The Latino mortality paradox: A test of the 'salmon bias' and healthy migrant hypotheses," American Journal of Public Health, American Public Health Association, vol. 89(10), pages 1543-1548.
    4. Cassio Turra & Irma Elo, 2008. "The Impact of Salmon Bias on the Hispanic Mortality Advantage: New Evidence from Social Security Data," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 27(5), pages 515-530, October.
    5. Ruiz, J.M. & Steffen, P. & Smith, T.B., 2013. "Hispanic mortality paradox: A systematic review and meta-analysis of the longitudinal literature," American Journal of Public Health, American Public Health Association, vol. 103(3), pages 52-60.
    6. Ann Morning, 2008. "Ethnic Classification in Global Perspective: A Cross-National Survey of the 2000 Census Round," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 27(2), pages 239-272, April.
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