Why do we continue to use standardized mortality ratios for small area comparisons?

Journal of Public Health Medicine
Steven A JuliousS George

Abstract

Public health practitioners are often faced with the necessity to compare the mortality experience of different geographical areas. Indirect standardization, producing a 'standardized mortality ratio' (SMR) is the most commonly used technique for doing this. However, as we show, indirect standardization is inappropriate for such comparisons, as SMRs for different geographical areas have different denominators. The fact that indirect standardization is usually chosen for this type of comparison is probably based on two beliefs: (1) that direct standardization yields only a rate rather than a more easily interpreted ratio or index; (2) that direct standardization cannot be carried out in many cases because the sub-group specific mortality rates in the groups to be compared are not available or, in at least some age classes, are based upon such small numbers as to be completely unreliable. In this paper we show that a simple index (the comparative mortality figure) can be calculated from the directly standardized rate in most cases. Using a comparison of the overall mortality experience of electoral wards in Sheffield between 1980 and 1987 we demonstrate also that the advantage gained by the smaller standard error of the SMR is ou...Continue Reading

Citations

Dec 25, 2012·Social Psychiatry and Psychiatric Epidemiology·Stephanie BurrowsAmadou D Barry
Sep 6, 2003·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·L Jarup, N Best
Jul 12, 2003·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Richard J Q McNallyJillian M Birch
Oct 31, 2013·BMC Medical Research Methodology·Jon NichollMichael J Campbell
Jan 22, 2010·BMC Public Health·Ricardo Ocaña-Riola, José María Mayoral-Cortés
Aug 26, 2011·International Journal for Equity in Health·Martin Gächter, Engelbert Theurl
Jul 7, 2007·Environmental Health : a Global Access Science Source·Karen Y FungKevin M Gorey
Dec 19, 2008·International Journal of Health Geographics·Kevin A Borden, Susan L Cutter
Jul 27, 2002·BMJ : British Medical Journal·Andrew Rixom
Jun 17, 2004·Environmental Health Perspectives·Paul Elliott, Daniel Wartenberg
Nov 9, 2012·American Journal of Epidemiology·Marcel F JonkerJohan P Mackenbach
Apr 12, 2012·Clinical and Experimental Nephrology·Minako WakasugiIchiei Narita
Apr 20, 2012·Expert Review of Anti-infective Therapy·Omar M Ibrahim, Ron E Polk
Dec 24, 2015·International Journal of Environmental Research and Public Health·Siriwan HassarangseeMarc Souris
Jul 16, 2010·The Science of the Total Environment·Ori EitanDavid M Broday
Feb 23, 2008·Journal of Psychosomatic Research·Urara HiroehLouis Appleby
Sep 11, 2007·Public Health·Steven A Julious, Steve George
May 1, 2007·Health & Place·Mohsen RezaeianLouis Appleby
Apr 14, 2007·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·N CuendeM Alonso
Jan 18, 2012·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Minako WakasugiIchiei Narita
May 14, 2014·Movement Disorders : Official Journal of the Movement Disorder Society·Angus D MacleodCarl E Counsell
Oct 10, 2006·Public Health·Steve George, Steven Julious
Jan 26, 2010·Health & Place·Soumya MazumdarPeter Bearman
Apr 19, 2015·BMC Complementary and Alternative Medicine·Hee-Jeong JinSiwoo Lee
Aug 15, 2014·BMJ Quality & Safety·Perla J Marang-van de Mheen, Kaveh G Shojania
Apr 20, 2006·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Tracy L Gustafson
Jul 24, 2014·Journal of Epidemiology and Community Health·M F JonkerA Burdorf
Feb 8, 2005·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Miguel Delgado-Rodríguez, Javier Llorca
Jun 20, 2017·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Lyndsay M O'HaraAnthony D Harris
Mar 21, 2018·Zeitschrift für Rheumatologie·Y H Lee, G G Song
Mar 29, 2018·International Journal for Equity in Health·Patricia CarracedoFrancisco Montes
Dec 13, 2006·Journal of Occupational and Environmental Medicine·Peter MorfeldUNKNOWN International Carbon Black Association

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