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Mortality data analysis using a multiple-cause approach
Insights
Analyzing all listed conditions on death certificates reveals significantly more deaths from infectious diseases than officially reported. This highlights the importance of comprehensive mortality data analysis for accurate public health insights.
Area of Science:
- Public Health
- Epidemiology
- Biostatistics
Background:
- Death certificates are the primary source for US mortality data.
- Standard analysis often focuses only on the underlying cause of death.
- This approach may underestimate the full impact of certain diseases.
Purpose of the Study:
- To evaluate the utility of multiple-cause mortality tapes.
- To assess the completeness of reported infectious disease deaths.
- To examine associations between specific diseases and recorded complications.
Main Methods:
- Reviewed principles of mortality data analysis.
- Utilized "multiple-cause tapes" listing all conditions on death certificates.
- Analyzed data from 1968-1970 for seven infectious diseases.
Main Results:
- Multiple-cause tapes identified 24%-81% more deaths for seven infectious diseases compared to official reports.
- Confirmed associations between measles/varicella and their known complications.
- Demonstrated higher mortality figures for diphtheria, rubella, and other infectious diseases.
Conclusions:
- Multiple-cause mortality tapes provide a more comprehensive view of disease-related deaths.
- Examining all listed conditions on death certificates is crucial for accurate mortality analysis.
- Underestimation of infectious disease mortality is a significant public health concern.
Abstract:
Death certificates are the primary source for information used to define general mortality patterns in the United States. Analyses of mortality data generally are restricted to one of the conditions listed on the certificate--the underlying cause of dealth. We review principles related to the use of mortality data and describe a study using mortality tapes ("multiple-cause tapes") that list all conditions recorded on dealth certificates. Using multiple-cause tapes, we found that the number of deaths associated with seven infectious diseases in 1968, 1969, and 1970 was from 24% (diphtheria) to 81% (rubella) greater than that officially reported. Multiple-cause tapes also permitted a review of the association of deaths attributed to measles and varicella and known complications of these diseases. these observations confirm the usefulness of multiple-cause tapes in analyzing mortality data and emphasize the importance of examining all conditions listed on the death certificate.