Sources of Data

Mortality

1. Analyses of vital statistics data from death certificates
   1. LIMITATION: Mortality rates and life expectancy from national data are usually available only for the largest federally designated ethnic/racial categories, primarily black and white.
   2. LIMITATION: Death certificates have been found to be marginally accurate as to cause of death, and in some cases for ethnic and racial identification as well.
2. Local or regional longitudinal data
   1. LIMITATION: Only for specific ethnic populations included in the studies.
   2. LIMITATION: Different results from different studies.

Morbidity, Functional Status, and Social Support

1. National data sets such as Health Interview Surveys, HANES, Medicare
   1. LIMITATION: Smaller populations have too few subjects in the samples to be reported.
   2. LIMITATION: Ethnic groups (e.g., Mexican American) within federally designated categories (e.g., Hispanic) are frequently not identified.
2. Regional, state and local data from surveys, longitudinal studies, epidemiological catchment area studies, hospital discharge data, and Medicare records; dissemination through scientific publications and academic centers.
   1. LIMITATION: Different study designs, different definitions of ethnic populations, different indicators of health status, different exclusion criteria, and different results.
3. LIMITATION: Statistical differences are not always meaningful differences. In very large national data sets, such as Medicare or Health Interview Survey, a difference of one or two percentage points can be statistically significant, but they may not be clinically relevant.
4. LIMITATION: Variations within ethnic categories. Within each ethnic category and group, health status and mortality rates vary by education and income level, access to care, lifestyle, and sometimes by level of acculturation to the American culture.