Undetermined manner of death. A comparison with unintentional injury, suicide, and homicide death

Injury deaths can be grouped into four general categories: accident, homicide, suicide, and undetermined. The present study investigates the use of the "undetermined" category. External cause of death, as well as demographic and other variables, were abstracted from death certificates of the 386,936 Californians who died of an injury between 1969 and 1991. Differences among the four manner-of-death groups were examined, and characteristics of the decedent and the injury event were used to predict a classification of undetermined. Coroners classified 1.9% of the deaths as undetermined in manner. Deaths of women, Blacks, Asians, and Native Americans; the very young and the middle aged; or those involving poisoning or submersion were most likely to be classified as undetermined. Acknowledging that individual coroner judgment may not be free of bias, these findings can help provide a better estimate of the frequency and the epidemiologic features of injury deaths that are assigned to the category of undetermined.