Why Do Elected Coroners Underreport Suicide?

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The WSJ reports on a new study that finds that elected coroners report 15% fewer suicides than do appointed medical examiners. The researchers looked at 1,578 counties with elected coroners, and 1,036 with appointed medical examiners, adjusting for poverty, marriage, household income, education levels and gun ownership.

Their reasoning for the difference in reporting? Stigma and politics:

“Elected coroners would feel pressure because they are elected by the public at large and would be worried about antagonizing local community stakeholders who might badmouth them,” said Joshua Klugman, PhD, first author of the study and assistant professor of sociology at Temple University in Philadelphia. “For medical examiners, we think the pressure is still there, but it’s to a lesser degree. They feel insulated from that.”

In addition, the researchers looked at 174 appointed coroners and found that their reporting rate matched the medical examiners, instead of the elected coroners.

In general, suicide is a taboo subject. But not too taboo for us — if you haven’t already downloaded our latest podcast, do so and find out about  “The Suicide Paradox.”

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  1. TelliameD says:

    By not reporting a suicide, an elected coroner is helping a family (and hence a community) financially to collect on a life insurance policy. This in turn ensures their re-election.

    By reporting a suicide, a professional coroner is only helping an insurance company.

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  2. AMC says:

    My only expreience with the term of an elected coroner was living in a small town in the southern US (until then, I had never heard of an elected coroner; I’d always lived in metro areas in the US where there is an appointed medical examiner) The notion seemed odd to me (it was my understanding that a person running for/elected coroner need not have any medical training or background). I suspect that most areas with elected coroners are smaller jurisdictions, and possibly in areas that could be considered more religious (I know that was the case in my expreience; small town in the so-called bible-belt). Since suicide is not only a [secular] cultural taboo- but also a religious one, there might be less reporting of suicide because of cultural/religious reasons in smaller jurisdictions (which also happen to have elected coroners). Or it could be there are fewer actual suicides in these smaller, more religious areas (so it might not be underreporting, but cultural difference).

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  3. Longtime Lurker says:

    Just have to clarify something about life insurance benefits. In the past, yes, if it were a suicide life insurance would not pay out, no matter how old the policy was. Today, all states have what is called a “contestability period” of no more than two years (some are shorter) after policy issue. After that time, even if you kill yourself, your policy will pay out as long as there wasn’t egregious and blatant fraud that rendered the contract invalid from the start (and sometimes even if there IS egregious and blatant fraud the court favors the family over the insurance company anyway). So unless it is a new policy, your family will collect even if you kill yourself.

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  4. Drumm says:

    While I agree some Coroners may feel some pressure to adjust the death rates where possible, consider the large city with an extremely high murder rate and very low conviction rate. Classifying murders as accidential deaths or Suicides decreases both and gains them the political support of the elected politicians for making the city look safer. The problem is they give murders a free pass, but with the low conviction rate, not really.

    If I remember correctly this happened in Washington DC, probably under the control of Marion Berry. However, I don’t doubt it has happened elsewhere.

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