Comparing underlying and multiple causes of death in analysing mortality among the elderly: United States, 1986-1997

Isaac W. Eberstein, Florida State University
Charles B. Nam, Florida State University
Kathleen M. Heyman, Florida State University

This paper compares actual and age-adjusted mortality rates by underlying and multiple causes of death for adults ages 55 and over in the USA, according to age, sex, and race/ ethnicity. Data include approximately 40,000 death records taken from a linked file combining the US National Health Interview Survey (1986-1994) and the Multiple Cause of Death file of the National Death Index (1986-1997). Seven leading medical causes of death are specifically considered: heart disease, malignant neoplasms, cerebrovascular diseases, chronic obstructive pulmonary diseases, diabetes mellitus, pneumonia and influenza, and hypertension. Combinations of these conditions are examined with and without taking the recorded underlying cause of death into account, and the results are compared with each other and with analysis based solely on underlying cause of death. Findings indicate mortality patterns from combinations of these causes and illustrate the additional insights provided by consideration of multiple causes of death.