Medical examiner/coroner records: uses and limitations in occupational injury epidemiologic research

Epidemiologic research often relies on existing data, collected for nonepidemiologic reasons, to support studies. Data are obtained from hospital records, police reports, labor reports, death certificates, or other sources. Medical examiner/coroner records are, however, not often used in epidemiologic studies. The National Institute for Occupational Safety and Health's Division of Safety Research has begun using these records in its research program on work-related trauma. Because medical examiners and coroners have the legal authority and responsibility to investigate all externally caused deaths, these records can be used in surveillance of these deaths. Another use of these records is to validate cases identified by other case ascertainment methods, such as death certificates. Using medical examiner/coroner records also allows rapid identification of work-related deaths without waiting several years for mortality data from state offices of vital statistics. Finally, the records are an invaluable data source since they contain detailed information on the nature of the injury, external cause of death, and results of toxicologic testing, which is often not available from other sources. This paper illustrates some of the ways that medical examiner/coroner records are a valuable source of information for epidemiologic studies and makes recommendations to improve their usefulness.     

Proposed: a comprehensive health care system for the poor.

More than half the poor are not covered by Medicaid, the program designed to serve them. Louise Russell outlines a program that would make health care available to all of the poor.     

Wife assault theory,research, and treatment: A literature review

Treatments for wife assaulters and their victims have been based on a variety of psychological and sociological theories. Tests of theory based on investigation of assailant and victim characteristics as well as evaluation of treatment effects based on empirical outcome studies have yielded diverse results. In reviewing the literature it appears that development of assailant typologies based on extent of psychopathology, severity of violence, and context of violence has potential utility in guiding future treatment decisions for assaulters. Further development of similar typologies for classifying responses of assaulted women could yield similar results. Population screening and matching programs to individual characteristics could be expected to improve clinical outcomes.