Understanding deep disadvantage at the end of life: A nationwide analysis of unclaimed deaths

To describe unclaimed deaths nationwide and to examine contextual factors associated with higher rates of these types of interments.

Unclaimed death records from 2009 to 2021 were collected by a combination of direct outreach and obtaining data from publicly available websites. Data were summarized by county-year and linked to American Community Survey demographic variables, as well as markers of social isolation and economic disadvantage.

The underlying individual-level dataset included 42,942 decedents. Unclaimed deaths in the United States from 2009 to 2021, based on data from more than 248 counties that provided records, are increasing over time. This population appears to be younger at death, more male, and more likely to be of Black race than decedents in the general population. Several county-level markers of social isolation and economic deprivation were correlates of unclaimed deaths.

This is the first systematic examination of unclaimed deaths at the county level and offers a novel way to understand marginalized populations, such as the unhoused and others living in extreme social or economic deprivation. Unclaimed death rates may also provide an objective measure of social support that can be measured over time.