Alcohol involvement in motor vehicle fatalities often not listed on death certificates
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* Kim Krisberg

While alcohol often plays a role in motor vehicle related fatalities, that fact does not always show up on death certificates, according to a study published in the March issue of *Journal of Studies on Alcohol and Drugs.*

To gain a clearer picture of how often alcohol involvement is officially recorded on death certificates, researchers turned to an area rich with data: motor vehicle crash fatalities. Specifically, researchers compared blood-alcohol level data from the National Highway Traffic Safety Administration’s Fatality Analysis Reporting System to death certificate data from all U.S. states.

From 1999 to 2009, the study found that about 3 percent of death certificates listed alcohol as a contributing cause in a traffic death. But during that same time period in the NHTSA database, 21 percent of people who died were considered legally drunk. Overall, alcohol involvement was 84 percent less likely to be reported on death certificates than in the Fatality Analysis Reporting System.

Between 1999 and 2009, more than 450,000 Americans were killed in traffic crashes. Injuries, including motor vehicles crashes, are the leading cause of death among Americans younger than 45 years old, according to the Centers for Disease Control and Prevention.

“We need to have a handle on what’s contributing to the leading cause of death among young people,” said study author Ralph Hingson, ScD, director of the Division of Epidemiology and Prevention Research at the National Institute on Alcohol Abuse and Alcoholism. “You want to know how big the problem is and if we can track it. Is it going up or going down? And what policy measures are working?”

The study also found that whether alcohol is listed on a death certificate varies widely by state. In some states, such as Maryland and Nevada, alcohol involvement in a traffic death is rarely listed on the death certificate; however, death certificates in other states, such as Iowa and Kansas, more frequently documented alcohol involvement. Interestingly, the study found that state policies requiring blood alcohol concentration testing for drivers killed in motor vehicle crashes are not necessarily associated with better death certificate reporting.

“Laws help, but they are not a silver bullet,” Hingson told *The Nation’s Health*.

Hingson said the study is an indication that alcohol involvement is likely under-reported on death certificates for other preventable injuries as well. In other words, researchers, policymakers and public health workers can not rely on death certificates to provide an accurate picture of alcohol-related injury deaths and whether such deaths are going up or down, he said. In fact, the study noted that despite growing acknowledgement of alcohol use as a critical risk factor, “reporting of alcohol involvement on death certificates does not seem to have improved much over the years.” Overall, Hingson said the study demonstrates the importance of data collection and reporting.

“Part of the reason we’ve made progress (on drunk driving) is not only that we have good testing, but we have good data,” he said. “If we can measure it, we know if we’re improving or getting worse and what works to make it better.”

For more information, view the study abstract at [www.jsad.com/jsad/article/State\_Variation\_in\_Underreporting\_of\_Alcohol\_Involvement\_on\_Death\_Certifica/4934.html](http://www.jsad.com/jsad/article/State\_Variation\_in\_Underreporting\_of\_Alcohol\_Involvement_on_Death_Certifica/4934.html).

*   Copyright The Nation’s Health, American Public Health Association