Last methodological note

Summary

The first classification of deaths according to cause of death goes back to the decade 1861-1870. This first classification only had five diseases. Subsequently, the cause of death was classified according to the list of 99 diagnoses by Dr. Bertillón which made up the origin of the International Classification of Diseases (ICD) from the World Health Organisation (WHO) which is currently used to code the causes of death. Today this classification consists of more than 12.000 diseases.

Nevertheless, to be able to speak of the modern statistic on the cause of death, we have to jump forward in time to 1951 as it was then when apart from using the ICD, international regulations were established for the selection of the basic cause of death.

Currently the statistic which reflects natural population movement is the deaths statistic according to cause of death. This statistic is carried out according to criteria established by the WHO in the ICD.

In this classification it is recommended that the cause of death that must be investigated and tabulated is the basic cause of death. This is defined as the disease or lesion which started the chain of pathological events. When the cause is trauma, the events surrounding the accident or act of violence leading to the fatal injury are regarded as the basic cause.

Specifically, this set or chain of diseases is what the death certifying doctor should supply in the statistical bulletin. Based on these causes, denominated by the WHO immediate, intermediate, fundamental and other processes, and following international guidelines for the selection of the basic cause the latter will be arrived at.

The data on the cause of death are covered in two models of statistical questionnaires: Statistical Death Bulletin (SDB) and Statistical Birth Bulletin (SBB). In the former data on the deceased who lived more than 24 hours are covered and in the latter relatives of the deceased before 24 hours of life. The latter, although for statistical purposes are considered deceased, for legal purposes they are not counted as deceased but rather as aborted children.

The sections of the bulletins which cover the cause of death are different in both models. While in the SDB 4 causes are described which conform with the chain of diseases which led to the death, in the SBB only two feature, a relative of the mother and another of the fetus.

In the cases of deaths when the court intervenes, apart from the SDB another questionnaire must be filled in by the courts of instruction where external circumstances which produced the lesions feature.

This statistic supplies information on the mortality dealing with the basic cause of death, its distribution by sex, age, residence and month of death. It also offers indicators which facilitate carrying out geographical comparisons and measuring premature mortality: standardised rates of mortality and potential years of lost life, on an Autonomous Community level and large groups of causes of death.