Changing effect of the numerator-denominator bias in unlinked data on mortality differentials by education: evidence from Estonia, 2000-2015.

BACKGROUND: This study highlights changing disagreement between census and death record information in the reporting of the education of the deceased and shows how these reporting differences influence a range of mortality inequality estimates.
METHODS: This study uses a census-linked mortality data set for Estonia for the periods 2000-2003 and 2012-2015. The information on the education of the deceased was drawn from both the censuses and death records. Range-type, Gini-type and regression-based measures were applied to measure absolute and relative mortality inequality according to the two types of data on the education of the deceased.
RESULTS: The study found a small effect of the numerator-denominator bias on unlinked mortality estimates for the period 2000-2003. The effect of this bias became sizeable in the period 2012-2015: in high education group, mortality was overestimated by 23-28%, whereas the middle education group showed notable underestimation of mortality. The same effect was small for the lowest education group. These biases led to substantial distortions in range-type inequality measures, whereas unlinked and linked Gini-type measures showed somewhat closer agreement.
CONCLUSIONS: The changing distortions in the unlinked estimates reported in this study warn that this type of evidence cannot be readily used for monitoring changes in mortality inequalities. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.