Abstract
BackgroundThere is analytical potential for multiple cause of death data collected from death certificates. This study examines relationships of multiple causes of death as a function of factors available on the death certificate (demographics of decedent, place of death, type of certifier, disposal method, whether an autopsy was performed, and year of death).MethodsData from 326,332 Minnesota death certificates from 1990–1998 are examined. Underlying and non-underlying causes of death are examined (based on record axis codes) as well as demographic and death-related covariates. Associations between covariates and prevalence of multiple causes of death and conditional probability of underlying compared to non-underlying causes of death are examined. The occurrence of ischemic heart disease or diabetes as underlying causes are specifically examined.ResultsBoth the probability of multiple causes of death and the proportion of underlying cause compared to non-underlying cause of death are associated with demographic characteristics of the deceased and other non-medical conditions related to filing death certificate such as place of death.ConclusionsMultiple cause of death data provide a potentially useful way of looking for inaccuracies in reporting of causes of death. Differences across demographics in the proportion of time a cause is selected as underlying compared to non-underlying exist and can potentially provide useful information about the overall impact of causes of death in different populations.
Highlights
There is analytical potential for multiple cause of death data collected from death certificates
Differences across demographics in the proportion of time a cause is selected as underlying compared to non-underlying exist and can potentially provide useful information about the overall impact of causes of death in different populations
When we focus on the population that has diabetes mentioned on the death certificate, as mentioned above 29.3% of the time diabetes is selected as the underlying, and the second most common underlying cause selected is ischemic hear disease at 25.4%, followed by cerebrovascular disease at 7.75% followed by Other diseases of the heart 2.9%
Summary
There is analytical potential for multiple cause of death data collected from death certificates. This study examines relationships of multiple causes of death as a function of factors available on the death certificate (demographics of decedent, place of death, type of certifier, disposal method, whether an autopsy was performed, and year of death). In their 1986 paper Israel, Rosenberg, and Curtin [1] gave a sort of rallying call for researchers to consider the analytical potential for multiple cause of death data collected by the United States National Center for Health Statistics (NCHS). The resulting multiple cause of death datasets by year are made publically available through the NCHS website
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