Differential Adult Mortality by Underlying and Associated Causes of Death

Isaac W. Eberstein, Florida State University
Bryan M. Giblin, Florida State University
Charles Nam, Florida State University
Amy Walsh, Florida State University
Kyle Reese-Cassal, Florida State University

We explore whether information on multiple causes of death gives a different indication of the magnitude and/ or direction of important cause specific mortality differentials according to selected demographic, socioeconomic, and health characteristics. Data are from the National Health Interview Survey years 1986-1994 linked to the National Death Index through December 1997. Sample size is 704502 adults, of whom 54534 were statistically matched to a death certificate. We distinguish underlying and all other ("associated") causes of death, and focus on fourteen leading medical causes. Two conclusions are suggested. First, the information on multiple causes more accurately represents the prevalence and complexity of medical conditions reported at death than does a single underlying cause. Second, we have found variability in the degree or extent of cause of death specific mortality differentials according to demographic, socioeconomic and health characteristics, but few instances where extant differentials are reversed.