ArticleHealth services research2025
Are suicides underreported? The impact of coroners versus medical examiners on suicide reporting.
Article in Health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
8 citing papers in PubMed.
- Association between undetermined intent death classification and county death investigation system for drug poisoning deaths in nine US jurisdictions.Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention · 2026Article
- Mental Health Stressors and Barriers to Support Among Rural Farmers: A Qualitative Study of Agricultural Communities in the East South-Central United States.International journal of environmental research and public health · 2026Article
- Racial disparities in suicide rates across the united states: a comparative analysis of non-Hispanic Whites and non-Hispanic Blacks.Archives of public health = Archives belges de sante publique · 2026Article
- Defining suicidality phenotypes for genetic studies: perspectives of the Psychiatric Genomics Consortium Suicide Working Group.Molecular psychiatry · 2025Review
- Seasonal and Sociodemographic Factors Associated With Farmer Suicide: National Violent Death Reporting System 2014-2021.Rural mental health · 2025Article
- State-level suicide mortality insights: a comparative study of VHA veterans and the whole US population.Journal of public health (Oxford, England) · 2025Article
- Are suicides underreported? The impact of coroners versus medical examiners on suicide reporting.Health services research · 2025Article
- Examining contextual differences in suicide by rural-urban designation and military status, 2009-2019: a cross-sectional analysis of the National Violent Death Reporting System.Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention · 2025Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate if state death investigation systems affect the reporting of suicides, particularly when comparing medical examiners to coroners. DATA SOURCES AND STUDY
settingWe used restricted-access state mortality data from National Vital Statistics System between the years 1959 to 2016. These data were matched with state-level changes in death investigation systems reported by the Centers for Disease Control and Prevention database on the Public Health Law Program: Coroner/ME Laws. STUDY
designWe used difference-in-differences and event study methods for the analysis. We estimated the relative per capita changes in suicides, accidental deaths, and homicides when comparing coroner-only states with other death investigation types. Sub-analyses estimated differences by sex, race, and if coroners were required to receive training. DATA COLLECTION/EXTRACTION
methodsNot Applicable. PRINCIPAL
findingsCoroners-only states underreported suicides by 17.4% (p < 0.05) and performed 20.4% (p < 0.05) fewer autopsies compared to states with county coroners and a state medical examiner. This pattern is consistent by sex and race. Required coroner training did not affect death determination significantly.
conclusionCoroners-only states underreported suicides compared to states with county coroners and a state medical examiner. The disparity in the use of autopsies is a potential mechanism for underreporting of suicides by coroners. If all coroners-only states adopted a state medical examiner, suicide reporting would increase by 2243-3100 deaths in the United States annually.
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Registered trials
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