Literature DB >> 11942513

Unlocking the numerator-denominator bias. I: Adjustments ratios by ethnicity for 1991-94 mortality data. The New Zealand Census-Mortality Study.

Tony Blakely1, Bridget Robson, June Atkinson, Andrew Sporle, Cindy Kiro.   

Abstract

AIM: To determine the extent of the under-reporting of Mäori and Pacific mortality among 0-74 year olds for the period 1991-94.
METHODS: A subset (n=22,578) of highly probable linked 1991 census and 1991-94 mortality records were selected from the 31,635 census-mortality links in the New Zealand Census-Mortality Study. The numbers of decedents assigned as Mäori, Pacific, and non-Mäori non-Pacific were compared between mortality and census data.
RESULTS: Compared to the death registration form, 29% more 0-74 year old decedents during 1991-94 had self-identified as sole-Mäori on the 1991 census (46% for prioritised-Mäori). This numerator-denominator bias was greater among the young and those living in central and southern New Zealand. Among 0-14, 15-24, 25-44, 45-64, and 65-74 year old decedents, respectively, 91%, 50%, 41%, 26% and 15% more decedents had self-identified as sole-Mäori on the 1991 census. For Northern, Midland, Central and Southern regional health authority areas, respectively, 14%, 17%, 81% and 102% more decedents had self-identified as sole-Mäori. Among Pacific decedents 68% more 0-74 year old decedents had self-identified as sole-Pacific on the 1991 census (78% for prioritised-Pacific group). This bias for Pacific decedents did not notably vary by age and region.
CONCLUSIONS: This study confirms substantial underestimation of Mäori and Pacific mortality rates for the period 1991-94, even using the recommended sole-ethnic group denominator. The results from this study should be used to adjust ethnic-specific mortality rates for the early 1990s. Population-based funding formulas that included region-specific Mäori mortality rates would have particularly disadvantaged central and southern regions.

Mesh:

Year:  2002        PMID: 11942513

Source DB:  PubMed          Journal:  N Z Med J        ISSN: 0028-8446


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