Medical Examiners, Coroners, and Public Health: A Review and Update

2006 ◽  
Vol 130 (9) ◽  
pp. 1274-1282 ◽  
Author(s):  
Randy Hanzlick

Abstract Context.—Traditionally, the emphasis of work done by medical examiners, coroners, and the death investigation community has been viewed as serving the criminal justice system. During the last several decades, however, an important role for these 3 groups has emerged within public health. Objective.—To provide important background information on death investigation systems, the evolution and framework of public health entities that rely on information gathered by medical examiners and coroners, and the role of medical examiners and coroners in epidemiologic research, surveillance, and existing public health programs and activities. Data Sources.—Previous articles on epidemiologic aspects of forensic pathology and the role of medical examiners and coroners in epidemiologic research and surveillance; a review of the Web sites of public health and safety agencies, organizations, and programs that rely on medical examiner and coroner data collected during medicolegal investigations; and a review of recent public health reports and other publications of relevance to medical examiner and coroner activities. Conclusions.—The role of medical examiners and coroners has evolved from a criminal justice service focus to a broader involvement that now significantly benefits the public safety, medical, and public health communities. It is foreseeable that the public health role of medical examiners and coroners may continue to grow and that, perhaps in the not-too-distant future, public health impact will surpass criminal justice as the major focus of medicolegal death investigation in the United States.

PEDIATRICS ◽  
1993 ◽  
Vol 92 (5) ◽  
pp. 734-735
Author(s):  

A significant proportion of infant and child deaths are preventable. Of the 55 861 deaths of children aged 14 and younger in the United States in 1989, more than three fourths occurred in children under the age of 2 years.1 Approximately one third of the latter were unexpected, including those due to sudden infant death syndrome (SIDS) or trauma, or deaths that were otherwise unexplained. Child abuse deaths occur in greatest numbers among infants, followed by those in toddlers and preschool children.2 Children younger than 6 years of age are most vulnerable to abuse because of their small size, incomplete verbal skills, and often limited contact with adults other than their primary caretakers.3 With few exceptions, throughout the United States there is no uniform system for the investigation of infant and child deaths. Many jurisdictions lack appropriately trained pathologists, interagency collaboration hat would facilitate sharing of information about the family, and a surveillance system to evaluate data regarding infant deaths. As a result, progress in the understanding of SIDS is inhibited, cases of child abuse and neglect may be missed, familial genetic diseases go undiagnosed, public health threats may be unrecognized, and inadequate medical care may be undetected. Lack of adequate infant and child death investigation is an impediment to preventing illness, injury and death of other children at risk. Adequate death investigation requires the participation of numerous individuals including medical examiner/coroner, public health officials, the patient's physician, the pathologist, and personnel from agencies involved with child welfare and social services and law enforcement.


2015 ◽  
Vol 60 (4) ◽  
pp. 914-918 ◽  
Author(s):  
Stacy A. Drake ◽  
Stanley G. Cron ◽  
Angelo Giardino ◽  
Vanessa Trevino ◽  
Kurt B. Nolte

Author(s):  
Wang ◽  
Xia ◽  
Li ◽  
Wang

With the characteristics of low cost and open call, crowdsourcing has been widely adopted in many fields, particularly to support the use of surveys, data processing, and the monitoring of public health. The objective of the current study is to analyze the applications, hotspots, and emerging trends of crowdsourcing in the field of public health. Using CiteSpace for the visualization of scientific maps, this study explores the analysis of time-scope, countries and institutions, authors, published journals, keywords, co-references, and citation clusters. The results show that the United States is the country with the most publications regarding crowdsourcing applications for public health. Howe and Brabham are the two leading authors in this field. Further, most of the articles published in this field are found in medical and comprehensive journals. Crowdsourcing in public health is increasing and diversifying. The results of this study will enable and support the analysis of the specific role of crowdsourcing in the public health ecosystem.


2015 ◽  
Vol 43 (S1) ◽  
pp. 64-68 ◽  
Author(s):  
Shannon Frattaroli ◽  
Keshia M. Pollack ◽  
Jessica L. Young ◽  
Jon S. Vernick

State health departments are at the core of the United States (U.S.) public health infrastructure. Surveillance to monitor trends in disease and injury; the development, coordination, and delivery of services; and public education are some of the core functions health department employees oversee every day. As such, agencies and their employees are well positioned to inform policy decisions that affect the public’s health. However, little is known about the role of health department staff — a sizeable proportion of the public health workforce — as advocates for public health policies, independent of their agency roles. Anecdotally, some health department employees with whom we have spoken expressed reluctance to engage in policy advocacy for fear of violating little known or understood agency or state rules.


2016 ◽  
Vol 141 (1) ◽  
pp. 82-84 ◽  
Author(s):  
Veena D. Singh ◽  
Sarah L. Lathrop

Context.—Medical examiners and coroners have long been an integral component of public health, often being the first to recognize and describe emerging infectious diseases. Given their experience and access, medical examiners and coroners will provide valuable contributions to better understanding Zika virus infection and its sequelae. Objective.—To review past examples of medical examiner/coroner involvement in recognition of emerging infectious diseases and describe how medical examiners and coroners will be critical in understanding the pathophysiology of Zika infections. Design.—Review of the existing literature on the role of medical examiners and coroners in the identification of emergent infections and the available literature on Zika virus. Results.—Medical examiners and coroners have played a crucial role in identifying numerous emerging infectious diseases such as hantavirus pulmonary syndrome and West Nile virus, and have the expertise and experience to aid in elucidating the pathophysiologic effects of Zika virus and tracking its distribution and risk factors. Conclusions.—Medical examiners and coroners will be a significant factor in the unified public health approach needed to mitigate the effects of Zika virus and other, heretofore unrecognized, infectious diseases.


Author(s):  
Michael C. Kovac

Prosecutors in the United States play multifaceted roles in their criminal justice system. They provide guidance during the investigative stages of cases, lead the prosecution of cases in the country’s adversarial proceedings, police their own profession, and lead legislative efforts aimed at making the system more just for all involved. There are separate prosecuting offices for the separate sovereignties located within the countries. Statutes, constitutions, and case law establish the rights and duties of those separate offices. All prosecuting offices in the United States share the pursuit of justice as their common goal.


Author(s):  
Scott Burris ◽  
Micah L. Berman ◽  
Matthew Penn, and ◽  
Tara Ramanathan Holiday

This chapter explores the public health system as a whole, including the organizations, activities, and people who promote public health in the United States. It describes the agencies at the federal, state, tribal, local, and territorial levels that have been granted legal authority to act on behalf of public health, including the functions of each agency in promoting public health. The chapter examines the role of the healthcare system within public health and concludes with a short discussion of the evolving effort to improve the public health system through accreditation, governance, and evaluation.


2017 ◽  
Vol 7 (1) ◽  
pp. 7-18 ◽  
Author(s):  
Thomas A. Andrew ◽  
Jennie V. Duval

The dramatic increase in drug-related deaths in the last decade has presented fiduciary and logistical difficulties to medicolegal jurisdictions of all types and sizes. New Hampshire, with a centralized state medical examiner system of death investigation, has been confronted with the task of investigating these drug-related deaths against the backdrop of statutory hurdles inhibiting a nimble response to the situation. This has led to a collaborative approach with law enforcement and the state Department of Justice in terms of triaging drug deaths to full autopsy versus external examination with toxicology testing. Preliminary data suggest that between 11 and 13% of suspected drug deaths have an alternative cause of death revealed by autopsy. Positive toxicological findings were documented in 97.5% of cases in which only an external examination was performed; however, some of these cases may have had undetected, significant internal findings that could have accounted for an alternative cause of death if an autopsy had been performed. While the case triage system described has temporarily addressed the acute problem, the issue of the medical examiner's appropriate role in the adequate evaluation of public health and safety remains extant. Furthermore, noncompliance with the National Association of Medical Examiners inspection and accreditation standards puts this agency, and others facing the same issues, at risk of losing full accreditation status until such resource issues are addressed by legislators and other stakeholders in the quality of medicolegal death investigation in the United States.


Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Saeed Khan ◽  
Tusha Sharma ◽  
Basu Dev Banerjee ◽  
Scotty Branch ◽  
Shea Harrelson

: Currently, Coronavirus disease 2019 (COVID-19) has transformed into a severe public health crisis and wreaking havoc worldwide. The ongoing pandemic has exposed the public healthcare system's weaknesses and highlighted the urgent need for investments in scientific programs and policies. A comprehensive program utilizing the science and technologydriven strategies combined with well-resourced healthcare organizations appears to be essential for current and future outbreak management.


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