This was the first year that all the American states included Hispanic origin on death certificates.
Cirrhosis death rates were found to be highest among white Hispanic males, followed by black non-Hispanic males, white non-Hispanic males, white Hispanic females, black non-Hispanic females, and white non-Hispanic females.
Most of the 1997 white Hispanic decedents were of Mexican ancestry. Many were born outside the United States and had low education levels.
Reported in Alcoholism: Clinical and Experimental Research, the findings have immediate implications for research and health practice, and potential impact on health policy directions.
"The new Hispanic ethnicity distinction on certificates of death corrects the decades-old belief that black males are at greatest risk of cirrhosis death. Clinicians should be newly alert to the risk for white Hispanic males," said NIAAA Deputy Director Mary Dufour, one of the study authors.
"This dramatic finding from 1997 warrants close re-examination as data for subsequent years become available," said Dr Dufour.
"In addition, NIAAA will examine cirrhosis mortality by state to identify any possible influences of environment and point up implications for health services delivery."
|Increased liver cirrhosis deaths may be due to drinking patterns among Hispanics.
|Alcoholism: Clinical and Experimental Research|
In 1989, the US Standard Certificate of Death was revised to include Hispanic origin of the decedent. This allowed for the study of racial/ethnic groups, such as white Hispanic, white non-Hispanic, black Hispanic, and black non-Hispanic. These designations accounted for 96% of the US population during the 1990s, according to lead study author Frederick S. Stinson.
"Rates of cirrhosis death remain high among black non-Hispanic men and women, but are considerably higher among white Hispanic men and women.
"Our results demonstrate the importance of the Hispanic designation in epidemiologic research, but complicate the search to explain the observed differences among racial and ethnic groups," Dr. Stinson said.
Increased risk for liver cirrhosis deaths among white Hispanic males may be explained by different drinking patterns among population subgroups or other factors.
Some Hispanic groups, especially those of Mexican and Central American heritage, have a drinking style marked by the periodic consumption of large amounts of alcohol. Other candidate factors include socioeconomic status and its component dimensions of income, occupation, and poverty status, all of which directly affect the use of medical care services.
"Doctors and other health care workers need to be aware of the increased risk of cirrhosis death in white Hispanic males in order to advise them of risks that seem to be associated with specific drinking patterns," comments Bridget F. Grant, NIAAA Biometry Branch Chief.