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Hundreds of thousands of death certificates filed every year in the United States are wrong, meaning we don’t really know what’s killing Americans.
The erroneous death certificates cause medical researchers to look at the wrong health threats, and mislead people to the real diseases that run in their families.
More than 2.4 million Americans die each year, and each one has an official cause of death on a death certificate. But medical experts think that about one-third of them are incorrect, fraudulent or even just guesses.
“I’ve been preaching for years to anyone who will listen that death certificates are worthless,” said Dr. Stephen Geller, former chief of pathology at New York’s Mount Sinai Medical Center.
The most common error is blaming some form of heart disease for other kinds of deaths. In several major cities, coronary disease is improperly blamed for nearly half of all deaths.
Some places have rates of fatal heart disease three times higher than others – not because of heart problems but because of bad reporting.
“Heart disease has become the default diagnosis of death in this country. There are a not-inconsequential number of deaths for which the cause is completely wrong,” said Robert Anderson, chief of mortality data for the National Center for Health Statistics.
Dan Rohling, a retired funeral home director in Southern California, said, “If you’re trying to get a doctor to sign a death certificate, but he’s uncertain or confused about what to write, all you have to do is say ‘ASHD.’ That stands for atherosclerotic heart disease.
“If the deceased is over 60, the doctor will probably say ‘Oh, yeah’ and then sign it. That happens, I know, because I’ve done it,” Rohling said.
Scripps Howard News Service’s seven-month review of the 4.9 million death records in the United States in 2005 and 2006 provided by the Centers for Disease Control and Prevention found that the state of New York has the nation’s highest rate of fatal heart disease – 32 percent of all deaths.
New York officials have doubted the accuracy of these numbers for many years, and in 2004 cited 40 funeral homes for illegally filling in the cause of death and signing a doctor’s name to death certificates.
But most death certificates are completed by hospital staff and not at funeral homes.
A joint New York City and federal investigation of deaths in 2003 found that coronary heart disease had been overstated by 51 percent among people aged 35 to 74 and by about 200 percent among people 75 or older.
The Scripps study found that some states are good at determining why people die.
One of the best states is Colorado where 13 percent of all deaths are autopsied, the nation’s highest statewide autopsy rate, and only 20 percent of deaths are attributed to heart disease.
Another example of wildly varying diagnosis is cancer, blamed for 28 percent of all deaths in urban Fairfax County, Va., near Washington, D.C. But cancer is blamed for just 19 percent of all deaths in Salt Lake City.
Among smaller communities nationwide, cancer rates range from more than 40 percent of all deaths to fewer than 7 percent.
Reports of death by stroke and other cerebral vascular diseases range from 9 percent in Orangeburg, S.C., to 3 percent in the Bronx, N.Y. In smaller communities, the rate of stroke deaths ranges from nearly 17 percent to less than 1 percent.
