Completing the Revised Death Certificate,

The Iowa Office of the State Medical Examiner (IOSME) has received many questions regarding completion of the revised death certificate. This article addresses these common issues

Certificate of Death:

State of Florida death certificate for Infant of Isham Polke and Olivia (Bartley) Polke , age 11 days. Handwritten notes on the back

Death certificate

Rev. 11/20032003Other813

Certificate of Death:

State of Florida death certificate for infant of Alexander Lewis, age 1 day. Handwritten notes on the back

Consistency between education reported in health survey and recorded in death certificate

Background: Education level is one indicator of socioeconomic position which, in several countries including South Korea, is provided though death certificate data. Its validity determines the usefulness of death certificate data for exploring the association between socioeconomic position and mortality. This study was to compare education recorded on the death certificate with that reported before death in a nationally representative cohort of participants in the National Health and Nutrition Examination Survey (NHANES). Methods: The 1998/2001 NHANES data contained unique 13-digit personal identification numbers that were individually linked to death certificate data from the Korean National Statistical Office. Duration of mortality follow-up was 7.1 years. The data from 513 deaths were used to determine sensitivity and specificity of education in death certificate and estimate agreement rates of education level between NHANES data and death certificate data. Odds ratios for agreement in education were also estimated. Covariates considered in the analyses were gender, age, duration between NHANES and death, and cause of death. Results: The proportion of deaths without recorded education in death certificate was very low (0.2%). A total of 29.4% discordant pairs were found. Sensitivity and specificity for college or higher education were 0.84 (95% confidence interval 0.71–0.97) and 0.99 (0.98–1.00). However, sensitivity was poor for middle school education. The overall agreement rate was 70.7% (66.8%–74.6%) when education was categorized into five groups and increased up to 88.9% (86.2%–91.6%) when three education categories were used. The magnitude of validity and reliability for education did not generally vary with age, duration between health survey and death, and cause of death. However, a significantly smaller likelihood of agreement was found for middle and elementary school education after adjusting for covariates. Conclusion: Low percentage of missing information on education in South Korean death certificate data could provide a great potential to monitor mortality inequalities. A more collapsed categorization in education would be recommended when a more definitive conclusion on educational mortality inequality is required.Young-Ho Khang, Hye Ryun Kim and John W Lync

Correlates of undefined cause of injury coded mortality data in Australia

The objective of this research was to identify the level of detail regarding the external causes of death in Australia and ascertain problematic areas where data quality improvement efforts may be focused. The 2003 national mortality dataset of 12591 deaths with an external cause of injury as the underlying cause of death (UCOD) or multiple cause of death (MCOD) based on ICD-10 code assignment from death certificate information was obtained. Logistic regression models were used to examine the precision of coded external cause of injury data.---- It was found that overall, accidents were the most poorly defined of all intent code blocks with over 30% of accidents being undefined, representing 2314 deaths in 2003. More undefined codes were identified in MCOD data than for UCOD data. Deaths certified by doctors were more likely to use undefined codes than deaths certified by a coroner or government medical office.---- To improve the quality of external cause of injuries leading to or associated with death, certifiers need to be made aware of the importance of documenting all information pertaining to the cause of the injury and the intent behind the incident, either through education or more explicit instructions on the death certificate and accompanying instructional materials. It is important that researchers are aware of the validity of the data when they make interpretations as to the underlying causes of fatal injuries and causes of injury associated with deaths

Mauthausen Camp Death Certificate

Tan paper titled, Konzentrationslager Mauthausen Kommandantur with purple signature. Information Provided by Michael D. Bulmash: A pair of certificates (2012.1.3, 2012.1.4) certifying the death of an inmate. The first, dated march 1940, states that John Metz, a forty-one year-old prisoner, died of chronic illness and a heart attack. The second document, dated January 20, 1943, notified Alexandra Rutkiewski that her husband perished of a lung infection and that his body was cremated. Even more insultingly, it states as well that a death certificate is available for 72 pfennigs. Of course, many of the inmates at Mauthausen were worked to death in the granite quarry while receiving only starvation rations. Prisoners were divided into two groups: one that hacked the granite and the other that carried the 100 pound slabs up the 186 steep steps to the top of the quarry. Regardless of the real cause of death, for SS doctors, the official version was always euphemized to conceal the reality of life in this category three camp where prisoners were subject to vernichtung durch arbeit (extermination through work). For all prisoners life in Mauthausen meant ruckkehr unerwunscht (return not desired).https://digital.kenyon.edu/bulmash/1668/thumbnail.jp

Certificate of Death: Stillborn

State of Florida death certificate for Stillborn, age 6 mt. Father: McKinley. Mother: [Mianora] Carr. Informant: Viola King

Mauthausen Camp Death Certificate

Off-white paper with bold German title, including printed and typewritten information, with a black signature at the bottom. Information Provided by Michael D. Bulmash: A pair of certificates (2012.1.3, 2012.1.4) certifying the death of an inmate. The first, dated march 1940, states that John Metz, a forty-one year-old prisoner, died of chronic illness and a heart attack. The second document, dated January 20, 1943, notified Alexandra Rutkiewski that her husband perished of a lung infection and that his body was cremated. Even more insultingly, it states as well that a death certificate is available for 72 pfennigs. Of course, many of the inmates at Mauthausen were worked to death in the granite quarry while receiving only starvation rations. Prisoners were divided into two groups: one that hacked the granite and the other that carried the 100 pound slabs up the 186 steep steps to the top of the quarry. Regardless of the real cause of death, for SS doctors, the official version was always euphemized to conceal the reality of life in this category three camp where prisoners were subject to vernichtung durch arbeit (extermination through work). For all prisoners life in Mauthausen meant ruckkehr unerwunscht (return not desired).https://digital.kenyon.edu/bulmash/1669/thumbnail.jp