Editorial Board

All Lives Count. So Should All Deaths.

Across the globe, millions of deaths go unrecorded every year. That's bad news for public health.

Points of light.

Photograph: Stocktrek Images

Across the world, tens of millions of deaths go unrecorded each year. This lack of information is a killer in its own right: Without an accurate measure of deaths and their causes, fighting disease in low- and middle-income countries is much harder. Investing in the means to keep track of lives and deaths would be money well spent.

Knowing how people die is essential to stemming epidemics of infectious illnesses and to steering people toward behaviors that protect them from lifestyle-related conditions including obesity, diabetes, heart disease, lung disease, certain cancers and even dementia. Such noncommunicable illnesses have become the world’s leading killers. Yet in most of the world, if deaths are officially reported at all, they are described in highly generalized ways. In Malaysia, for instance, almost a third of deaths are listed by family or police officers as “old age.”

Many countries still don’t have the basic bureaucracy and trained workforce needed to meticulously and systematically record how many people are born and die each year. Even those with the requisite computer capacity often lack the political will to gather the data.

Counting Deaths

Fewer than a quarter of global fatalities reported to the World Health Organization in 2015 carried useful cause-of-death data.

Source: World Health Organization's World Health Statistics 2017

The necessary work is fairly straightforward, and is helped along by the ubiquitous use of smartphones and tablet computers in even the poorest countries. A trained health worker’s description of a deceased person’s symptoms can readily be uploaded from such devices to a central repository, where the cause of death can be automatically estimated. (Bloomberg Philanthropies’ Data for Health initiative is helping establish such systems, for example in Papua New Guinea.)

Done promptly, this recording can alert public officials to early signs of an influenza outbreak or other epidemic. Peru’s health ministry, which recently switched to an electronic recordkeeping system, reduced the time it takes to report mortality data from two years to two weeks.

There are other ways to improve data collection. By prohibiting burials with no death certificate, Bahrain was able to expand its data-gathering to include every death in the country. In one sub-district of Bangladesh, a pilot project to have community health workers rather than family members report deaths expanded registration to about nine in 10 deaths, from less than one in 100.

These efforts require no technology. But when combined with electronic recordkeeping, they can ensure that the living benefit. It might seem unexciting, but counting deaths and their causes saves lives.  

    —Editors: Jason Gale, Mary Duenwald.

    To contact the senior editor responsible for Bloomberg View’s editorials: David Shipley at davidshipley@bloomberg.net .

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