Certification of obesity as a cause of death in England 1979--2006

Marie Duncan, Myfanwy Griffith, Harry Rutter, Michael J Goldacre

Research output: Contribution to journalArticle

  • 14 Citations

Abstract

Background: There is increasing recognition of the importance of obesity as a cause of death but it is uncommon for obesity to be certified on death certificates. We considered it useful to study what doctors actually do in respect of certification of obesity and to study trends, if any, in certification practice. Methods: Analysis of two datasets that include all certified causes of death (‘mentions’), not just the underlying cause—the Oxford record linkage study 1979–2006 and English national mortality data 1995–2006. Results: Underlying-cause mortality identified only a quarter (26% in Oxford, 25% in England) of all deaths with obesity as a certified cause. The longstanding Oxford dataset showed that there were significant changes over time in the percentage of certificates, with mention of obesity, that were coded with obesity as the underlying cause. Changes coincided with times of national change in selection and coding rules for underlying cause mortality. In the recent English dataset from 1995–2006, mention-based death rates rose by an average annual rate of 7.5% [95% confidence intervals (CI) 6.1–8.8] for men and by 4.0% (2.3–5.7) for women. Analysis of mortality based on underlying cause alone would have missed this rise. We report on diseases commonly certified alongside obesity on death certificates in England. Conclusion: There is an emerging trend of increased certification of obesity as a cause of death in England. The use of underlying-cause mortality statistics alone fails to capture the majority of obesity deaths.
LanguageEnglish
Pages671-675
Number of pages5
JournalEuropean Journal of Public Health
Volume20
Issue number6
Early online date2 Feb 2010
DOIs
StatusPublished - 1 Dec 2010

Fingerprint

Certification
England
Cause of Death
Obesity
Mortality
Death Certificates
Confidence Intervals

Cite this

Certification of obesity as a cause of death in England 1979--2006. / Duncan, Marie; Griffith, Myfanwy; Rutter, Harry; Goldacre, Michael J.

In: European Journal of Public Health, Vol. 20, No. 6, 01.12.2010, p. 671-675.

Research output: Contribution to journalArticle

Duncan, Marie ; Griffith, Myfanwy ; Rutter, Harry ; Goldacre, Michael J. / Certification of obesity as a cause of death in England 1979--2006. In: European Journal of Public Health. 2010 ; Vol. 20, No. 6. pp. 671-675.
@article{d1d394d388a3418fb45f2a316e98a187,
title = "Certification of obesity as a cause of death in England 1979--2006",
abstract = "Background: There is increasing recognition of the importance of obesity as a cause of death but it is uncommon for obesity to be certified on death certificates. We considered it useful to study what doctors actually do in respect of certification of obesity and to study trends, if any, in certification practice. Methods: Analysis of two datasets that include all certified causes of death (‘mentions’), not just the underlying cause—the Oxford record linkage study 1979–2006 and English national mortality data 1995–2006. Results: Underlying-cause mortality identified only a quarter (26{\%} in Oxford, 25{\%} in England) of all deaths with obesity as a certified cause. The longstanding Oxford dataset showed that there were significant changes over time in the percentage of certificates, with mention of obesity, that were coded with obesity as the underlying cause. Changes coincided with times of national change in selection and coding rules for underlying cause mortality. In the recent English dataset from 1995–2006, mention-based death rates rose by an average annual rate of 7.5{\%} [95{\%} confidence intervals (CI) 6.1–8.8] for men and by 4.0{\%} (2.3–5.7) for women. Analysis of mortality based on underlying cause alone would have missed this rise. We report on diseases commonly certified alongside obesity on death certificates in England. Conclusion: There is an emerging trend of increased certification of obesity as a cause of death in England. The use of underlying-cause mortality statistics alone fails to capture the majority of obesity deaths.",
author = "Marie Duncan and Myfanwy Griffith and Harry Rutter and Goldacre, {Michael J}",
year = "2010",
month = "12",
day = "1",
doi = "10.1093/eurpub/ckp230",
language = "English",
volume = "20",
pages = "671--675",
journal = "European Journal of Public Health",
issn = "1101-1262",
publisher = "Oxford University Press",
number = "6",

}

TY - JOUR

T1 - Certification of obesity as a cause of death in England 1979--2006

AU - Duncan, Marie

AU - Griffith, Myfanwy

AU - Rutter, Harry

AU - Goldacre, Michael J

PY - 2010/12/1

Y1 - 2010/12/1

N2 - Background: There is increasing recognition of the importance of obesity as a cause of death but it is uncommon for obesity to be certified on death certificates. We considered it useful to study what doctors actually do in respect of certification of obesity and to study trends, if any, in certification practice. Methods: Analysis of two datasets that include all certified causes of death (‘mentions’), not just the underlying cause—the Oxford record linkage study 1979–2006 and English national mortality data 1995–2006. Results: Underlying-cause mortality identified only a quarter (26% in Oxford, 25% in England) of all deaths with obesity as a certified cause. The longstanding Oxford dataset showed that there were significant changes over time in the percentage of certificates, with mention of obesity, that were coded with obesity as the underlying cause. Changes coincided with times of national change in selection and coding rules for underlying cause mortality. In the recent English dataset from 1995–2006, mention-based death rates rose by an average annual rate of 7.5% [95% confidence intervals (CI) 6.1–8.8] for men and by 4.0% (2.3–5.7) for women. Analysis of mortality based on underlying cause alone would have missed this rise. We report on diseases commonly certified alongside obesity on death certificates in England. Conclusion: There is an emerging trend of increased certification of obesity as a cause of death in England. The use of underlying-cause mortality statistics alone fails to capture the majority of obesity deaths.

AB - Background: There is increasing recognition of the importance of obesity as a cause of death but it is uncommon for obesity to be certified on death certificates. We considered it useful to study what doctors actually do in respect of certification of obesity and to study trends, if any, in certification practice. Methods: Analysis of two datasets that include all certified causes of death (‘mentions’), not just the underlying cause—the Oxford record linkage study 1979–2006 and English national mortality data 1995–2006. Results: Underlying-cause mortality identified only a quarter (26% in Oxford, 25% in England) of all deaths with obesity as a certified cause. The longstanding Oxford dataset showed that there were significant changes over time in the percentage of certificates, with mention of obesity, that were coded with obesity as the underlying cause. Changes coincided with times of national change in selection and coding rules for underlying cause mortality. In the recent English dataset from 1995–2006, mention-based death rates rose by an average annual rate of 7.5% [95% confidence intervals (CI) 6.1–8.8] for men and by 4.0% (2.3–5.7) for women. Analysis of mortality based on underlying cause alone would have missed this rise. We report on diseases commonly certified alongside obesity on death certificates in England. Conclusion: There is an emerging trend of increased certification of obesity as a cause of death in England. The use of underlying-cause mortality statistics alone fails to capture the majority of obesity deaths.

U2 - 10.1093/eurpub/ckp230

DO - 10.1093/eurpub/ckp230

M3 - Article

VL - 20

SP - 671

EP - 675

JO - European Journal of Public Health

T2 - European Journal of Public Health

JF - European Journal of Public Health

SN - 1101-1262

IS - 6

ER -