Racial and ethnic differences in place of death: United States, 1993

OBJECTIVES: To examine racial and ethnic differences in place of death, adjusting for likely confounders. DESIGN: A retrospective cohort analyzed using multinomial logistic regression. SETTING: United States in 1993. PARTICIPANTS: A nationally representative sample of 22,658 deaths in 1993 from the National Mortality Followback Survey. MEASUREMENTS: Place of death as determined on the death certificate, with controls for age, sex, income, education, and cause of death. The outcomes of interest were death in a hospital during an inpatient stay, death in a nursing home, death in a private residence, or death in some other place. RESULTS: After adjustment, 43% of whites die after an inpatient hospital stay, as do 50% of blacks and 56% of Mexican Americans. Twenty percent of whites, 22% of Mexican Americans, and 14% of blacks die in nursing homes. Twenty-two percent of whites, 18% of blacks, and 9% of Mexicans die in a private residence. CONCLUSIONS: There are substantial differences between whites, blacks, and Mexican Americans in place of death that cannot be explained by differences in age, sex, income, education, and causes of death between the groups.