Racial disparities in risks of mortality in a sample of the US Medicare population
Racial disparities in risks of mortality adjusted for socio-economic status are not well understood. To add to the understanding of racial disparities, we construct and analyse a data set that links, at individual and zip code levels, three government databases: Medicare, the Medicare Current Beneficiary Survey and US census. Our study population includes more than 4 million Medicare enrollees residing in 2095 zip codes in the north-east region of the USA. We develop hierarchical models to estimate the black-white disparities in risk of death, adjusted for both individual level and zip code level income. We define the population level attributable risk AR, relative attributable risk RAR and odds ratio OR of death comparing blacks "versus" whites, and we estimate these parameters by using a Bayesian approach via Markov chain Monte Carlo sampling. By applying the multiple-imputation method to fill in missing data, our estimates account for the uncertainty from the missing individual level income data. Results show that, for the Medicare population being studied, there is a statistically and substantively significantly higher risk of death for blacks compared with whites, in terms of all three measures AR, RAR and OR, both adjusted and not adjusted for income. In addition, after adjusting for income we find a statistically significant reduction in AR but not in RAR and OR. Copyright (c) 2010 Royal Statistical Society.
If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Volume (Year): 59 (2010)
Issue (Month): 2 ()
|Contact details of provider:|| Postal: |
Web page: http://wileyonlinelibrary.com/journal/rssc
More information through EDIRC
|Order Information:||Web: http://ordering.onlinelibrary.wiley.com/subs.asp?ref=1467-9876&doi=10.1111/(ISSN)1467-9876|
When requesting a correction, please mention this item's handle: RePEc:bla:jorssc:v:59:y:2010:i:2:p:319-339. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Wiley-Blackwell Digital Licensing)or (Christopher F. Baum)
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.