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UKnowledge > College of Public Health > Journal of Appalachian Health > Vol. 6 (2024) > Iss. 3

 

Corresponding Author

Allen Archer

archera1@etsu.edu

Author Affiliations

  1. Allen Archer, BSHA: Research assistant, College of Public Health, East Tennessee State University (Johnson City TN); E-mail: ArcherA1@etsu.edu; ORCiD: https://orcid.org/0000-0003-0469-9173
  2. Melissa White, DrPH, MPH, MS: Research associate, College of Public Health, East Tennessee State University; ORCiD: https://orcid.org/0000-0002-6479-2268
  3. Megan Quinn, DrPH, MSc: Associate professor, Biostatistics and Epidemiology, College of Public Health, East Tennessee State University; ORCiD: https://orcid.org/0000-0003-1032-4052
  4. Randy Wykoff, MD, MPH, TM: Professor and Dean, Health Services Management and Policy, College of Public Health, East Tennessee State University; ORCiD: https://orcid.org/0000-0003-3018-9767

Author Area of Expertise

Allen Archer: Health Administration; Quality Improvement; Public Health; Medicine

Melissa White: Maternal and Child Health Epidemiology; Contraceptive Access and Provision; Health Disparities; Rural Health

Megan Quinn: Epidemiology; Public Health; Rural Health; Infectious Disease

Randy Wykoff: Rural Health; Appalachian Health; Preventive Medicine; Pediatrics

Abstract

Introduction: Delays (10-22 months) in availability of official state and county-level mortality data could have significant public health consequences. The COVID-19 pandemic illuminated the need for health officials to access timely death data to identify unexpected increases in mortality in their communities.

Purpose: The purpose of this study is to determine if funeral home listings and/or newspaper obituaries could help identify excess mortality on the local level, prior to the availability of official death records.

Methods: To calculate excess mortality, four years (2017–2020) of data were collected from three sources: the state health department, online funeral home listings, and newspaper obituaries, all from Washington County, Tennessee. Simple linear regression was used to predict number of expected deaths by month for 2020 using 2017, 2018, and 2019 reported deaths, by data source. The percent difference of actual 2020 deaths from the expected deaths was then calculated by month and compared for each data source.

Results: Official COVID-19 state-reported death data accounted for only 50% of excess mortality estimated in 2020. Nearly 100 excess deaths occurred before the first reported death due to COVID-19. Trends in the percent difference between actual and expected funeral home listings and newspaper obituaries followed similar patterns as percent differences in actual v. expected state-reported mortality data.

Implications: Had funeral home listings and newspaper obituaries been used to identify excess mortality, health officials would have seen increases in mortality nearly five months prior to the first identified COVID-19 death. These publicly available tools could prove valuable to local health officials as an “early warning” sign of excess mortality.

DOI

https://doi.org/10.13023/jah.0603.03

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

Recommended Citation

Archer A, White M, Quinn M, Wykoff R. Using public funeral and obituary listings to identify spikes in excess mortality in one Appalachian county. J Appalach Health 2024;6(3): 10-26. DOI: https://doi.org/10.13023/jah.0603.03

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