Tobacco and death certificate real estate

In 2006, the Commonwealth of Pennsylvania added a tobacco related question (Q28. Did Tobacco Use Contribute to Death? Yes, No, Probably, Unknown) to all certificates of death authorized by the Department of Health Vital Records. This addition offers an opportunity to collect specific data on the role of tobacco in a death supplementing ICD10 codes. Public Health Management Corporation (PHMC) with the support of the Department of Health, Division of Tobacco Prevention and Control, examined the 2006 final death file's reporting on the new death certificate variable. The purpose of this poster is to examine Q28 reporting differences and identify recommendations related to inconsistent or low Q28 completion. PHMC examined the full final file of de-identified 2006 deaths. Demographic, geographic and certifier variables were examined in relation to Q28. Of the 126,511 deaths to residents in 2006, a "yes," "probably," or "no" Q28 response was found for 54,930 (43.4%) deaths. The tobacco field was answered more for females (45.6%) than males (41.1%); more for whites (44.8%) than blacks (31.0%) and other (39.8%); and more for children 0-17 (55.2%) than for ages 18+ (44.3%), with little variation among adults. The most variation in completing Q28 was by geographic location. Among the six health districts and the two most populated counties (Allegheny and Philadelphia), Philadelphia was a far outlier with only 27.7% completion. No other region was below 40%. These and other findings can inform educational efforts for those completing and certifying death certificates, in Philadelphia and throughout the Commonwealth.