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Hawaii-IBIS Death Data Release Notes

General Release Notes

2019 Death

New Primary Care Service Area Dimension

We have added a new geographic dimension to the Birth Module to cover primary care service areas. Primary care service areas were created to describe the delivery of primary health services in the State of Hawai'i through participation of multiple stakeholders in the early 1990's. The rural health associations of the Hawai'i, Maui and Kauai Counties delineated rational service areas under their respective jurisdictions. Neighborhoods were clustered into primary care service areas to provide information below the county or island level with demarcation between adjacent neighborhoods. Census tracts were used in defining these areas due to their availability in census and vital statistic data.

Here is a link to a document containing the Hawaii-IBIS Census Tract to Primary Care Service Area Crosswalk:

All Years

Population Estimates for Population-based Rates

Annual population estimates are extracted each year from the U.S. Census, Population Division, Annual County Resident Population Estimates. These estimates change each year and provide the denominator for the crude birth rates, fertility rates and teen birth rates, by age, sex and census race, for the years 2000-2019.

However, population estimates for Hawai'i-specific race/ethnicities (DOH Race/Ethnicity) are not reportable for individual years, so a special 5 year aggregate population estimate file was created for Hawai'i, by the Data Products Development Branch, American Community Survey Office, U.S. Census Bureau. This 5 year aggregate (2010-2014) file was used to create a single average annual population estimate, which does not change and is used for all population-based rates by DOH Race/Ethnicity for the years 2010-2019.

Because HHDW uses two different population estimate files, birth rates may vary slightly depending on which category you select your birth rate indicator from - Rates by Census Race vs Rates by DOH Race/Ethnicity. Census Race and DOH Race/Ethnicity rates should not be compared directly.


Data can be analyzed geographically by decendent's residence or occurence of death. Decedent's residence is based on the address provided on the death certificate as the place where the decedent resided at the time of death. Military members and dependents who live in Hawai'i at the time are classified as residents.

There are two measures for capturing geography in the Death Record - zip code and census tract. School complex and community are based on zip code and primary care service area is based on census tract.

Cell Suppression Criteria

Cell suppression criteria have changed. In accordance with data use restrictions set forth by Hawai'i State Department of Health (DOH) and the National Center for Health Statistics (NCHS), cell counts of fewer than 9 events and rates based on counts of 9 or fewer will be suppressed, and rates based on counts of less than 20 will be regarded as unreliable and will also be suppressed. Suppressed data is denoted with a double asterisk (**).

Additional information on national standards for the collection and analysis of mortality statistics from the NCHS, National Vital Statistics System can be accessed here.

Causes of Death

While more than one cause of death can be listed on the death certificate, this system is based on the underlying cause-of-death which is defined by the World Health Organization (WHO) as "the disease or injury which initiated the train of events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury." Underlying cause-of-death is selected from the conditions entered by the physician on the cause of death section of the death certificate. When more than one cause or condition is entered by the physician, the underlying cause is determined by the sequence of conditions on the certificate, provisions of the ICD-10 code, and associated selection rules and modifications.
If you are interested in underlying and contributing causes of death, please contact us or visit CDC WONDER to access the Multiple Cause of Death data file.

Beginning with data for 2006, the valid ICD-10 codes used to classify causes of death changed. Effective with the 2006 data year, 18 codes were introduced as valid causes of death, and 4 codes were discontinued. Effective with the 2007 data year, 4 codes were introduced as valid causes of death, and 2 codes were discontinued. See ICD-10 Changes for more information.

Race/Ethnicity Data

The Death certificate allows for up to 4 race/ethnicities to be captured for the decedent. The DOH Office of Health Status Monitoring (OHSM) uses the following algorithm to code a single race/ethnicity for each individual.

Only one ethnicity is coded from the actual certificates. If more than one ethnicity is listed on the certificate, the following rules apply:
    1. If Hawaiian is one of the multiple ethnicities listed, Part-Hawaiian is coded.
    2. If a non-Caucasian ethnicity is listed with a Caucasian ethnicity, the non-Caucasian ethnicity is coded.
    3. If there is more than one non-Caucasian ethnicity listed, the first one is coded.
    4. If there is more than one Caucasian ethnicity listed, the first one is coded.

In IBIS, the most granular level is the program race/ethnicity (PRG) which rolls up into the DOH standard race/ethnicity (DOH), which rolls up into Census race reporting categories (Census). The table below illustrates how the data is aggregated.

Race/Ethnicity Classifications
Source Race/Ethnicity Program Race/Ethnicity (PRG) DOH Race/Ethnicity (DOH) Census Race (Census)
Asian Indian Asian Indian Other Asian Asian
Black Black Black Black or African American
Caucasian Caucasian Caucasian Caucasian
Chinese Chinese Chinese Asian
Cuban Cuban Other Other
Filipino Filipino Filipino Asian
Guamanian Guamanian Other Pacific Islander Native Hawaiian and Other Pacific Islander
Hawaiian Hawaiian Native Hawaiian Native Hawaiian and Other Pacific Islander
Part Hawaiian Part Hawaiian Native Hawaiian Native Hawaiian and Other Pacific Islander
Indian Indian Native Alaskan/American Indian Native Alaskan/American Indian
Japanese Japanese Japanese Asian
Korean Korean Other Asian Asian
Mexican Mexican Other Other
Portuguese Portuguese Caucasian Caucasian
Puerto Rican Puerto Rican Other Other
Samoan Samoan Other Pacific Islander Native Hawaiian and Other Pacific Islander
Vietnamese Vietnamese Other Asian Asian
Other Asian Other Asian Other Asian Asian

The information provided above is from the Hawaii Health Data Warehouse and the Hawaii State Department of Health's Hawaii-IBIS web site ( The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Sat, 22 January 2022 1:39:04 from Hawaii State Department of Health, Hawaii Health Data Warehouse, Indicator-Based Information System for Public Health Web site: ".

Content updated: Tue, 30 Nov 2021 14:26:18 HST