ABSTRACT
There is a fourth type of death investigation that differs somewhat from the three basic types described in the Chapter 3 (Figure 4.1). Public health death investigations are performed by public health agencies, such as local or state health departments, researchers, and federal agencies such as the Centers for Disease Control and Prevention (CDC). Generally, public health death investigations involve
retrospective
(afterward) study of groups (a
series)
of deaths to analyze the characteristics of the deaths with the goal of planning prevention, intervention, or response programs. The other forms of death investigation involve investigation of individual deaths
as they occur
to answer questions that have arisen about the specific death in question. Two aspects of public health death investigation are
surveillance
and
epidemiologic research
. Surveillance has to do with monitoring the occurrence of certain types of death, such as identifying when and where they are occurring. Epidemiologic research has to do with analyzing the data from a group of similar deaths in an attempt to quantify the
incidence
(the number of new cases occurring) and
prevalence
(the number of cases that exist at any given time), and to identify possible causes and risk factors that place people at risk (
risk factors
) for the particular type of death. Thus, surveillance and epidemiologic research are aimed at prevention, control, and monitoring of a problem over time. For example, surveillance techniques detected the fact that there were excessive numbers of Native Americans dying in the southwestern U.S. a few years ago. Epidemiologists studied the deaths by reviewing medical records, conducting in-depth analyses of the lifestyles of the people involved as well as their habitats, and discovered that the problem was due to a virus (hantavirus) that was carried by rodents in areas with sanitation problems. This lead to elucidation of a new disease (hantavirus pulmonary syndrome) as well as the development of prevention and control measures. Because the cause of the illness was discovered and the typical features of the disease were clarified, greater awareness of the disease and improvement in diagnostic and treatment measures occurred. Thus, analysis of the dead ultimately benefited the living. There are numerous examples of how surveillance and epidemiologic research have identified and helped to control diseases, injuries, and other problems that may lead to human morbidity (illness) and mortality (death) (Figure 4.2).
