The underreporting of deaths of American Indian children in California, 1979 through 1993

Objectives. This study linked birth and death certificates to determine misclassification of deaths of American Indian children in California. Methods. Birth records for 1979 to 1993 were matched with mortality records through a computerized system. Results. The number of deaths to American Indians was estimated to be three to four times greater than that reported on death certificates. Children in urban counties and those who died before 1987 were more likely to be misclassified. Conclusions. California death certificates identify less than one third of the deaths among American Indian children. Adjusting for racial misclassification provides a more accurate accounting of child mortality among American Indians.