Cause of Death Affects Racial Classification on Death Certificates

The title of this post is the name of a fascinating paper in PLoS One. I haven’t had time to read the entire article but here is the first couple of paragraphs:

The accuracy of official data on birth rates and death rates are often taken for granted. However, recent research has drawn attention to inconsistencies in the recording of race across data sources and the resulting variability in estimates of race-specific death rates in the United States [1], [2]. These analyses have sparked debate among researchers over which measure of race should be considered correct [3]. Rather than focus on identifying errors or inaccuracies in the data, we extend previous research by exploring how the discrepancies in race reporting arise and whether they provide insight into why racial disparities in vital statistics persist. In particular, we use a nationally representative sample of death certificates and matched data from a subsequent survey of the decedent’s next of kin to examine whether cause of death and other non-racial characteristics of decedents are related to their racial classification.

According to official statistics for the period under study, American Indians were 2.6 times more likely to die of cirrhosis or chronic liver disease than Whites, and Blacks were 6.6 times more likely than Whites to be victims of homicide in the United States [4]. Drawing from previous research on how medical examiners make decisions under conditions of uncertainty [5], as well as work demonstrating a relationship between social status and racial classification [6], we postulate that these well-known racial disparities in cause of death may unintentionally become self-fulfilling prophecies as medical examiners, funeral directors and others make decisions about how to complete an individual’s death certificate. In addition to calling into question the interpretation of race and cause-specific death rates in the United States, our results suggest that racial stereotypes are one mechanism shaping how people are perceived and classified by others.

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