Mortality data analysis using a multiple-cause approach
R. A. Goodman, K. G. Manton, T. F. Nolan Jr, D. J. Bregman and A. R. Hinman
Death certificates are the primary source for information used to define
general mortality patterns in the United States. Analyses of mortality data
generally are restricted to one of the conditions listed on the
certificate--the underlying cause of dealth. We review principles related
to the use of mortality data and describe a study using mortality tapes
("multiple-cause tapes") that list all conditions recorded on dealth
certificates. Using multiple-cause tapes, we found that the number of
deaths associated with seven infectious diseases in 1968, 1969, and 1970
was from 24% (diphtheria) to 81% (rubella) greater than that officially
reported. Multiple-cause tapes also permitted a review of the association
of deaths attributed to measles and varicella and known complications of
these diseases. these observations confirm the usefulness of multiple-cause
tapes in analyzing mortality data and emphasize the importance of examining
all conditions listed on the death certificate.
