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Abstract
It is traditional when investigating risk factors for mortality to use data on the underlying cause of death on death certificates. Multiple causes of death are often given on death certificates, the underlying cause and contributory causes, but little is known about the usefulness of using data based on combined underlying or contributory cause of death when investigating associations with risk factors. We examined associations between three known risk factors (smoking, low educational attainment, and hypertension) and death outcomes, based on whether cause of death is listed as underlying or appears anywhere on the certificate, using data from two cohort studies, UK Biobank and the Health Survey for England and Scottish Health Surveys. We found that associations with known risk factors were essentially the same regardless of where cause of death was given on the death certificate. This finding has implications when studying risk factors for rare causes of death or using small samples.