Factors associated with reporting multiple causes of death

BMC Med Res Methodol. 2005 Jan 17;5(1):4. doi: 10.1186/1471-2288-5-4.


Background: There is analytical potential for multiple cause of death data collected from death certificates. This study examines relationships of multiple causes of death as a function of factors available on the death certificate (demographics of decedent, place of death, type of certifier, disposal method, whether an autopsy was performed, and year of death).

Methods: Data from 326,332 Minnesota death certificates from 1990-1998 are examined. Underlying and non-underlying causes of death are examined (based on record axis codes) as well as demographic and death-related covariates. Associations between covariates and prevalence of multiple causes of death and conditional probability of underlying compared to non-underlying causes of death are examined. The occurrence of ischemic heart disease or diabetes as underlying causes are specifically examined.

Results: Both the probability of multiple causes of death and the proportion of underlying cause compared to non-underlying cause of death are associated with demographic characteristics of the deceased and other non-medical conditions related to filing death certificate such as place of death.

Conclusions: Multiple cause of death data provide a potentially useful way of looking for inaccuracies in reporting of causes of death. Differences across demographics in the proportion of time a cause is selected as underlying compared to non-underlying exist and can potentially provide useful information about the overall impact of causes of death in different populations.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cause of Death*
  • Child
  • Child, Preschool
  • Comorbidity
  • Death Certificates*
  • Diabetes Mellitus / mortality
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Logistic Models
  • Male
  • Middle Aged
  • Minnesota / epidemiology
  • Myocardial Ischemia / mortality
  • Public Health Informatics*
  • Research Design