Disparities in the recording of Parkinson's disease on death certificates

Authors

  • Joyce C. Pressley PhD, MPH,

    Corresponding author
    1. Department of Epidemiology, The Mailman School of Public Health, New York, New York, USA
    2. Department of Health Policy and Management, The Mailman School of Public Health, New York, New York, USA
    • Columbia University, College of Physicians and Surgeons, 722 West 168th Street, Room 1712, New York, NY 10032
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  • Ming-Xin Tang PhD,

    1. Department of Biostatistics, The Mailman School of Public Health, New York, New York, USA
    2. The Gertrude H. Sergievsky Center, New York, New York, USA
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  • Karen Marder MD, MPH,

    1. The Gertrude H. Sergievsky Center, New York, New York, USA
    2. Department of Neurology, College of Physicians and Surgeons, New York, New York, USA
    3. Department of Psychiatry, College of Physicians and Surgeons, New York, New York, USA
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  • Lucien J. Cote MD,

    1. The Gertrude H. Sergievsky Center, New York, New York, USA
    2. Department of Neurology, College of Physicians and Surgeons, New York, New York, USA
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  • Richard Mayeux MD, MSc

    1. Department of Epidemiology, The Mailman School of Public Health, New York, New York, USA
    2. The Gertrude H. Sergievsky Center, New York, New York, USA
    3. Department of Neurology, College of Physicians and Surgeons, New York, New York, USA
    4. Department of Psychiatry, College of Physicians and Surgeons, New York, New York, USA
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Abstract

Although little is known regarding potential socioeconomic or racial bias in the recording of Parkinson's disease (PD) on death certificates, studies of incidence, prevalence, and the etiology of PD frequently rely on this type of data. A national population-based survey was linked to death certificate data to investigate the concordance of PD reported on death certificates for persons reporting PD during life. Logistic regression was used to identify independent factors associated with differential reporting of PD at death. Among decedents with PD reported during life, 54.8% had PD recorded on the death certificate. Nearly 70% of persons in higher income categories had PD recorded at death compared to 35.4% for those earning $10,000 or less. Age and gender adjusted odds of having PD recorded at death was 2.3 (1.1–3.9), for those with an annual income of $35,000 or more. Income differences remain significant in multivariable models after controlling for age, gender, race, census region, family size, rural residence, and number of chronic medical conditions. In conclusion, this study found socioeconomic bias in the reporting of PD at death. This bias is large enough to confound death certificate–based investigations of incidence, prevalence, and risk factors that differ across socioeconomic strata. © 2004 Movement Disorder Society

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