Cause of Death? -- It's Probably Not What's Reported on the Death Certificate

Authors

Lauren R. Roth, Touro University

First Page

121

Abstract

In the age of big data, this country has a data problem—inaccurate and incomplete information in death certificates. The problem has long been hidden by the numbers reported—as have the people whose deaths go uncounted, but the COVID-19 pandemic unveiled the scope of the issue. Since the beginning of the pandemic, “excess deaths” (i.e., any deaths above the number predicted by existing mortality models) have increased significantly. Most of these excess deaths are likely attributable to COVID-19 because the decedent was never tested for COVID-19 or it was one of multiple factors contributing to their death. Other deaths are uncounted because of a lack of resources and training for death investigations and a focus on a linear chain of medical conditions leading to death in the death certificate.

Given difficulties in determining a cause of death, particularly where there may be multiple or unknown factors, the determination can result in uncertainty or incorrect decisions by public health authorities and legislators. Implications for this failure to properly attribute deaths may include harm to vulnerable populations, a lack of political will due to the underestimation of deaths from a particular cause, and resource misallocation because of the absence of supporting statistical data.

Recommended Citation

Lauren R. Roth, Cause of Death? -- It's Probably Not What's Reported on the Death Certificate, 1 Lewis & Clark L. Rev. 121 (2025).
Available at: https://lawcommons.lclark.edu/lclr/vol29/iss1/4