Bidulescu Aurelian, Rose Kathryn M, Wolf Susanne H, Rosamond Wayne D
Cardiovascular Research Institute and Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA, USA.
BMC Public Health. 2007 Aug 31;7:229. doi: 10.1186/1471-2458-7-229.
Death certificates are a potential source of sociodemographic data for decedents in epidemiologic research. However, because this information is provided by the next-of-kin or other proxies, there are concerns about validity. Our objective was to assess the agreement of job titles and occupational categories derived from death certificates with that self-reported in mid and later life.
Occupation was abstracted from 431 death certificates from North Carolina Atherosclerosis Risk in Communities Study participants who died between 1987 and 2001. Occupations were coded according to 1980 Bureau of Census job titles and then grouped into six 1980 census occupational categories. This information was compared with the self-reported occupation at midlife as reported at the baseline examination (1987-89). We calculated percent agreement using standard methods. Chance-adjusted agreement was assessed by kappa coefficients, with 95% confidence intervals.
Agreement between death certificate and self-reported job titles was poor (32%), while 67% of occupational categories matched the two sources. Kappa coefficients ranged from 0.53 for technical/sales/administrative jobs to 0.68 for homemakers. Agreement was lower, albeit nonsignificant, for women (kappa = 0.54, 95% Confidence Interval, CI = 0.44-0.63) than men (kappa = 0.62, 95% CI = 0.54-0.69) and for African-Americans (kappa = 0.47, 95% CI = 0.34-0.61) than whites (kappa = 0.63, 95% CI = 0.57-0.69) but varied only slightly by educational attainment.
While agreement between self- and death certificate reported job titles was poor, agreement between occupational categories was good. This suggests that while death certificates may not be a suitable source of occupational data where classification into specific job titles is essential, in the absence of other data, it is a reasonable source for constructing measures such as occupational SES that are based on grouped occupational data.
在流行病学研究中，死亡证明是死者社会人口统计学数据的一个潜在来源。然而，由于这些信息是由近亲或其他代理人提供的，因此存在有效性方面的担忧。我们的目的是评估从死亡证明中得出的职业头衔和职业类别与中年及晚年自我报告的职业之间的一致性。
从参与北卡罗来纳州社区动脉粥样硬化风险研究且于1987年至2001年期间死亡的431份死亡证明中提取职业信息。职业按照1980年人口普查局的职业头衔进行编码，然后被归入六个1980年人口普查职业类别。将此信息与基线检查（1987 - 1989年）时报告的中年自我报告职业进行比较。我们使用标准方法计算百分比一致性。通过kappa系数评估机会校正一致性，并给出95%置信区间。
死亡证明和自我报告的职业头衔之间的一致性较差（32%），而职业类别在两个来源之间的匹配度为67%。kappa系数范围从技术/销售/行政工作的0.53到家庭主妇的0.68。女性（kappa = 0.54，95%置信区间，CI = 0.44 - 0.63）的一致性低于男性（kappa = 0.62，95% CI = 0.54 - 0.69），非裔美国人（kappa = 0.47，95% CI = 0.34 - 0.61）的一致性低于白人（kappa = 0.63，95% CI = 0.57 - 0.69），但受教育程度的差异仅略有不同。
虽然自我报告和死亡证明报告的职业头衔之间的一致性较差，但职业类别之间的一致性较好。这表明，虽然在将职业分类为特定职业头衔至关重要时，死亡证明可能不是职业数据的合适来源，但在没有其他数据的情况下，它是构建基于分组职业数据的职业社会经济地位等指标的合理来源。
