The recording of demographic information on death certificates: A national survey of funeral directors

Objective. The authors sought to ascertain the methods used by funeral directors to determine the demographic information recorded on death certificates. Methods. Standardized questionnaires were administered to funeral directors in five urban locations in the U.S. In addition, personnel on four Indian reservations were interviewed. Study sites were selected for diverse racial/ethnic populations and variability in recording practices; funeral homes were selected by stratified random sampling. Results. Fifty-two percent of responding funeral directors reported receiving no formal training in death certification. Seventy-nine percent of respondents reported finding certain demographic items difficult to complete-26% first specified race as the problematic item, and 25% first specified education. The decedent's race was sometimes or often determined through personal knowledge of the family by 58% of respondents; 43% reported sometimes or often determining race by observation. Only three respondents reported that occupation was a problematic item. Conclusions. The authors recommend that the importance of demographic data and the instructions for data collection be clarified for funeral directors, that standard data collection worksheets be developed, and that training videos be developed.