Blurred lines: racial misclassification in death certificates in Brazil

Hellen Geremias Santos (), Carla Ferreira Nascimento, Yeda Aparecida Duarte, Ichiro Kawachi and Alexandre Dias Porto Chiavegatto Filho
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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

International Journal of Public Health, 2020, vol. 65, issue 1, No 5, 29-36

Abstract: 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.

Keywords: Heath indicators; Numerator/denominator bias; Racial inequalities; Death certificate; Self-reported race; Racial classification (search for similar items in EconPapers)
Date: 2020
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DOI: 10.1007/s00038-019-01321-1

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