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

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.

Socioeconomic status in relation to Parkinson's disease risk and mortality

“…Most of these studies used a surrogate (e.g., a specific occupation) for SES, or included the surrogate as a covariate in the analyses, reporting conflicting results. [27–31] A previous Swedish nationwide study used education as a marker for SES and reported that individuals with higher educational level had increased risk of PD among men, [29] corroborating our results. Another study showed that some occupational groups such as construction and extractive workers (e.g., miners, oil well drillers) and production workers (e.g., machine operators, fabricators), which were similar to low-manual workers in our study, were associated with a decreased PD risk.…”

Socioeconomic variations in the prevalence and incidence of Parkinson's disease: a population-based analysis

“…Li et al 9 found a weak positive association between hospitalisation rates for PD and level of education—one indicator of SES. In an investigation of vital statistics data, Pressley et al 10 found that higher-income individuals were more likely to have PD recorded on the death certificate than lower-income individuals.…”

Mortalidad por enfermedad de Parkinson en Chile

“…En particular, en la enfermedad de Parkinson diferentes trabajos han mostrados reportes entre 60 y 75% de esta enfermedad en los certificados de defunción de pacientes con diagnóstico establecido adecuadamente y en conocimiento de la familia, lo que demuestra un índice de sub-reporte importante 15,16 . No obstante, la información contenida en los certificados de defunción ha sido utilizada ampliamente para establecer el comportamiento de distintas enfer- …”