Age-adjusted mortality indexes for small areas: applications to health planning

This study compares four age-adjusted mortality indexes and their standard errors among United States counties using 1969-1971 mortality data. It is shown that the direct and indirect methods of age adjustment give nearly identical results (correlation coefficients over .97). Two other indexes which indirectly adjust for age are then compared with the usual indirect method: one is the relative mortality index and the other an index of productive years of life lost. The three indirect indexes are substantially different in the are groups emphasized. This results in substantial differences in those counties identified as having "excess" mortality. Implications of the results for health planning applications are discussed.