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November 21, 1966

Truth Behind Death Certificates

JAMA. 1966;198(8):41-42. doi:10.1001/jama.1966.03110210015004

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Cardiovascular disease has become a "garbage bin category" for many physicians who do not know or aren't willing to record the true cause of sudden death.

Over-reporting of this cause of death is diluting the value of death certificates for public health, according to Ellis D. Sox, MD.

Separate Studies  His complaint, supported by separate studies from San Francisco and New York, was voiced at the recent American Public Health Association's 94th annual meeting. Preliminary findings from a 10-nation cooperative study suggests this shortcoming is not confined to the US.Although the "underlying cause of death" is not always easy to pick out, it is critical for epidemiological purposes, said Dr. Sox. He is director of public health, City and County of San Francisco.The Bay City study, headed by Dr. Sox, was part of a cooperative World Health Organization-Pan American Health Organization project. Participants included 12 cities in England,