Texas still has a lot of work to do to improve how it tracks deaths in the state, public health experts say.
Death certificates "give us snapshots of the health of the community and really helps us with our public health and health care priorities,” Dr. Umair Shah, executive director of Harris County Public Health, said.
Health officials have been working on improving data collection since public health experts raised concerns over the past few years about the state’s maternal mortality data. Experts said the state didn’t have reliable information regarding what was leading to maternal deaths.
On Jan. 1, Texas launched a vital statistics database, which houses information from birth and death certificates. The primary goal was to help the state keep better track of maternal deaths.
But Shah said the state still needs a uniform system for what gets put into those death certificates. The reports are handled by different people in different parts of the state – medical examiners, coroners or justices of the peace, who each have varying degrees of expertise.
“We really need to invest in these important – oftentimes maybe not so sexy – part of health, which is data systems – systems that help us count, enumerate,” Shah said. “These are things that we really have to invest in.”
Many areas of the state can't afford to have a medical examiner, who are trained to do autopsies, on staff.
“The only way to know how a patient died is through autopsy,” Frank Papa, associate dean for curricular design and faculty development at Texas College of Osteopathic Medicine in Fort Worth, said in a statement.
Justices of the peace can order autopsies, but they can be fairly expensive, which is a disincentive in rural areas.
Shah said that’s why Texas needs to make funding for better death reporting a priority.
“If we invest well, we get good results,” he said. “And when we don’t invest well, then what happens is you have inconsistent, outdated, unreliable – and frankly oftentimes confusing – systems.”