Online Program

Leveraging Electronic Death Registration Systems for Disaster-related Mortality Surveillance

Tuesday, November 3, 2015 : 1:30 p.m. - 1:50 p.m.

Margaret Warner, Ph.D., National Center for Health Statistics, Centers for Disease Control, Hyattsville, MD

Background: Public health agencies must have the capability to rapidly analyze mortality data after disasters. Death certificates are used to collect national mortality data; deaths registered in state-based Electronic Death Registration Systems (EDRS) are electronically transferred to CDC. These systems can be leveraged for “near-real time” mortality surveillance.

Methods: We collated from the literature and state experiences the effectiveness of state-based mortality surveillance systems after recent natural disasters. We compared the number of deaths reported by various response agencies.

Results: Seventy-four Hurricane Ike deaths were captured in Texas’ active surveillance system whereas only four (5%) were retrospectively identified in their EDRS using key word search. Red Cross and National Weather Service reported 38 and 20 Ike deaths, respectfully. NYC rapidly reported 44 deaths associated with Sandy using their EDRS; Red Cross captured 93% of these deaths and among the 41 cases present in both systems, high agreement existed across variables. During the Moore tornadoes, response agencies and media reported 91 deaths but using their EDRS public health officials determined the number of deaths was 25.

Conclusion: We found the number of disaster-related deaths reported vary by agencies within states and the federal government. Enhanced EDRS could aid in gathering rapid and accurate preliminary death counts for immediate public health action.  A working group, comprised of local, state, federal agencies, has been established to address findings and develop a framework for adapting EDRS for disasters. Priorities are to define disaster-relatedness and prepare guidance documents for EDRS developers and death certifiers.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Public health or related laws, regulations, standards, or guidelines

Learning Objectives:
Identify barriers to timely and accurate death reporting during disasters. Describe the potential benefits from applying the proposed framework for enhancing the Electronic Death Registration System. Discuss how the emerging framework to enhance guidance for death certifiers on documenting disaster-relatedness on death certificates.

Keyword(s): Mortality, Surveillance

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am epidemiologist and subject matter expert on mortality surveillance at the Centers for Disease Control and Prevention. My scientific research focuses on fatal injury and poisoning surveillance. Currently working to improve national mortality surveillance using multiple cause of death data from the National Vital Statistics System, free text from death certificates, and death investigation data from medical examiners and coroners.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.