Citation

dos Santos HG, do Nascimento CF, de Oliveira Duarte YA, Kawachi I, Chiavegatto Filho ADP. Int. J. Public Health 2019; ePub(ePub): ePub.

Affiliation

Department of Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil.

Copyright

(Copyright © 2019, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s00038-019-01321-1

PMID

31848636

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.

Language: en

Keywords

Death certificate; Heath indicators; Numerator/denominator bias; Racial classification; Racial inequalities; Self-reported race