Discrepancies in the reported frequency of cocaine-related deaths, United States, 1983 through 1988

Article Abstract:

During the last decade, ''crack'' cocaine use increased the problems already associated with drug abuse. The effectiveness of national programs to combat drug abuse can only be gauged if accurate measures of the adverse consequences of drug abuse are available. Federal information on mortality associated with drug abuse is available through the vital statistics system, which is maintained by the Centers for Disease Control's National Center for Health Statistics (NCHS), and the Drug Abuse Warning Network (DAWN). DAWN collects data on illnesses and deaths caused by drug abuse in 27 metropolitan areas. However, the validity of the mortality data provided by these two systems has never been evaluated. The two systems were compared with each other and with cocaine-related death data in published forensic case series. During the study period, from 1983 through 1988, 75 percent more deaths were reported to DAWN than to national vital statistics. In 1987, the number of cocaine-related deaths reported by DAWN was more than twice that for vital statistics. In Detroit and Washington, D.C., the number of deaths reported to DAWN was more than six times the number reported to vital statistics, but in other cities the numbers were more nearly equal. Although large discrepancies occurred in the magnitude of the statistics, the trends were essentially the same. The reasons for the discrepancies are discussed, as well as the strengths and weaknesses of each of the reporting systems. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Patient outcomes, Cocaine abuse, United States. National Center for Health Statistics, Drug Abuse Warning Network

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Temporal and geographic trends in the autopsy frequency of blunt and penetrating trauma deaths in the United States

Article Abstract:

Autopsies of blunt and penetrating trauma deaths increased in the 1980s, but better reporting of autopsy findings is needed for them to be of use in improving medical care and public health. The frequency of autopsies of blunt and penetrating deaths increased from 51.5% in 1980 to 58.9% in 1989, while the overall frequency of autopsies dropped 23.6%. Among all deaths due to blunt and penetrating traumas, 96.9% of homicides were autopsied compared with 50.2% of non-homicides. Across the US, autopsy frequency of homicidal deaths due to blunt and penetrating traumas ranged from 79.6% to 100%, with 44 states having a rate of 90% or better. Autopsy frequency of non-homicidal deaths due to blunt or penetrating traumas ranged from 10.3% to 94.5%. The frequency of non-homicidal blunt and penetrating trauma deaths autopsied in metropolitan areas was 38.3% higher than in non-metropolitan areas. Better incorporation of autopsy findings - what are the causes and consequences of trauma and which deaths are preventable - could improve medical care.

Autopsy

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Geographic distribution of heat-related deaths among elderly persons; use of county-level dot maps for injury surveillance and epidemiologic research

Article Abstract:

Data obtained from the Compressed Mortality File of the National Center for Health Statistics were analyzed on a county wide basis for deaths between 1968 and 1985. Computer techniques were used to assign the number of deaths by county, year of death, race, sex, age at death, and cause of death. The data are presented in tables and in geographic maps. In this study individuals aged 65 and older dying during the years of study from excessive heat were mapped. The greatest number of deaths occurred in urban, poor areas which were largely populated by nonwhites. Specific counties where heat-related death represents a public health threat are identified. It is hoped that identification of these areas will allow local public officials to prepare more adequately for this and related problems. Particular effort should be made in these high risk areas to acquaint all physicians with the manifestation, diagnosis and treatment of heat-related illnesses.

Aged, Elderly, Research, Physiological aspects, Demographic aspects, Diseases, Heat, Heatstroke

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