Are suicides underreported? The impact of coroners versus medical examiners on suicide reporting.
Health Serv Res
; 2024 Sep 07.
Article
en En
| MEDLINE
| ID: mdl-39243207
ABSTRACT
OBJECTIVE:
To evaluate if state death investigation systems affect the reporting of suicides, particularly when comparing medical examiners to coroners. DATA SOURCES AND STUDYSETTING:
We used restricted-access state mortality data from National Vital Statistics System between the years 1959 to 2016. These data were matched with state-level changes in death investigation systems reported by the Centers for Disease Control and Prevention database on the Public Health Law Program Coroner/ME Laws. STUDYDESIGN:
We used difference-in-differences and event study methods for the analysis. We estimated the relative per capita changes in suicides, accidental deaths, and homicides when comparing coroner-only states with other death investigation types. Sub-analyses estimated differences by sex, race, and if coroners were required to receive training. DATA COLLECTION/EXTRACTIONMETHODS:
Not Applicable. PRINCIPALFINDINGS:
Coroners-only states underreported suicides by 17.4% (p < 0.05) and performed 20.4% (p < 0.05) fewer autopsies compared to states with county coroners and a state medical examiner. This pattern is consistent by sex and race. Required coroner training did not affect death determination significantly.CONCLUSION:
Coroners-only states underreported suicides compared to states with county coroners and a state medical examiner. The disparity in the use of autopsies is a potential mechanism for underreporting of suicides by coroners. If all coroners-only states adopted a state medical examiner, suicide reporting would increase by 2243-3100 deaths in the United States annually.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
Health Serv Res
Año:
2024
Tipo del documento:
Article
País de afiliación:
Estados Unidos
Pais de publicación:
Estados Unidos