All ETDs from UAB

Advisory Committee Chair

Nevbahar Ertas

Advisory Committee Members

Akhlaque Haque

Gregory G Davis

Document Type

Thesis

Date of Award

2013

Degree Name by School

Master of Public Administration (MPA) College of Arts and Sciences

Abstract

A coroner and a medical examiner are legal certifiers of death. A coroner is an elected official who often lacks formal medical training. A medical examiner is usually an appointed official who has formal medical training in forensic pathology. Each state within the U.S. can be comprised of a coroner system, a medical examiner system, or a blended statewide system. The coroner or the medical examiner documents the cause and manner of death of a person both on a report and on a death certificate. Deaths are classi-fied as natural, accidental, suicide, homicide, or undetermined. In 1978, Jefferson County, Alabama switched from an elected coroner system to an appointed medical examiner system. In this thesis, a systematic review and coding of all death reports within Jefferson County, Alabama excluding Bessemer, Alabama during the years of 1970, 1971, 1976, and 1977 was performed and combined with the Jefferson County Coroner/Medical Examiner's database for 1978 through 2008 to create a data set of mortality aggregated at Jefferson County, AL per month for 1970-1971 and 1976-2008. An initial bivariate analysis of the data set was performed using an independent-samples t-test followed by a discontinuity regression analysis of the data set. The output generated from both analyses was used to answer the following question: When a system changes from a coroner system to a medical examiner system, is there an effect on how the manner of death is reported? I hypothesize that there would be systematic variations in reporting death across elected coroner and appointed medical examiner systems. Specifically, I hypothesize that elected coroners would have higher official justifiable homicide rates than medical examiners. Conversely, appointed medical examiners would have higher official autopsy, overall homicide, natural death, suicide, undetermined death, and work related death rates than elected coroners. The reasons for and implications of the differences are discussed in detail in the following chapters.

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