Date Published: October 10, 2017
Publisher: Public Library of Science
Author(s): Justin M. Feldman, Sofia Gruskin, Brent A. Coull, Nancy Krieger, Alexander C. Tsai
Abstract: BackgroundPrior research suggests that United States governmental sources documenting the number of law-enforcement-related deaths (i.e., fatalities due to injuries inflicted by law enforcement officers) undercount these incidents. The National Vital Statistics System (NVSS), administered by the federal government and based on state death certificate data, identifies such deaths by assigning them diagnostic codes corresponding to “legal intervention” in accordance with the International Classification of Diseases–10th Revision (ICD-10). Newer, nongovernmental databases track law-enforcement-related deaths by compiling news media reports and provide an opportunity to assess the magnitude and determinants of suspected NVSS underreporting. Our a priori hypotheses were that underreporting by the NVSS would exceed that by the news media sources, and that underreporting rates would be higher for decedents of color versus white, decedents in lower versus higher income counties, decedents killed by non-firearm (e.g., Taser) versus firearm mechanisms, and deaths recorded by a medical examiner versus coroner.Methods and findingsWe created a new US-wide dataset by matching cases reported in a nongovernmental, news-media-based dataset produced by the newspaper The Guardian, The Counted, to identifiable NVSS mortality records for 2015. We conducted 2 main analyses for this cross-sectional study: (1) an estimate of the total number of deaths and the proportion unreported by each source using capture–recapture analysis and (2) an assessment of correlates of underreporting of law-enforcement-related deaths (demographic characteristics of the decedent, mechanism of death, death investigator type [medical examiner versus coroner], county median income, and county urbanicity) in the NVSS using multilevel logistic regression. We estimated that the total number of law-enforcement-related deaths in 2015 was 1,166 (95% CI: 1,153, 1,184). There were 599 deaths reported in The Counted only, 36 reported in the NVSS only, 487 reported in both lists, and an estimated 44 (95% CI: 31, 62) not reported in either source. The NVSS documented 44.9% (95% CI: 44.2%, 45.4%) of the total number of deaths, and The Counted documented 93.1% (95% CI: 91.7%, 94.2%). In a multivariable mixed-effects logistic model that controlled for all individual- and county-level covariates, decedents injured by non-firearm mechanisms had higher odds of underreporting in the NVSS than those injured by firearms (odds ratio [OR]: 68.2; 95% CI: 15.7, 297.5; p < 0.01), and underreporting was also more likely outside of the highest-income-quintile counties (OR for the lowest versus highest income quintile: 10.1; 95% CI: 2.4, 42.8; p < 0.01). There was no statistically significant difference in the odds of underreporting in the NVSS for deaths certified by coroners compared to medical examiners, and the odds of underreporting did not vary by race/ethnicity. One limitation of our analyses is that we were unable to examine the characteristics of cases that were unreported in The Counted.ConclusionsThe media-based source, The Counted, reported a considerably higher proportion of law-enforcement-related deaths than the NVSS, which failed to report a majority of these incidents. For the NVSS, rates of underreporting were higher in lower income counties and for decedents killed by non-firearm mechanisms. There was no evidence suggesting that underreporting varied by death investigator type (medical examiner versus coroner) or race/ethnicity.
Partial Text: The National Vital Statistics System (NVSS), administered by the US government and based on state death certificates, is the longest-running national data source on law-enforcement-related deaths (i.e., those involving fatal injuries inflicted by law enforcement), but has long been suspected of underreporting a large number of such deaths [1–3]. Other databases run by the US Department of Justice similarly undercount law-enforcement-related deaths . In recent years, a new type of data source on legal intervention mortality has emerged: national databases maintained by newspapers, nongovernmental organizations, and the US Bureau of Justice Statistics (BJS; a governmental organization) that identify incidents via web searches of news media reports [3,5–8].
We created a dataset of law-enforcement-related deaths in 2015 by matching 2 sources: The Counted, a news-media-based dataset created by the newspaper The Guardian , and the NVSS, from which we obtained individually identifiable mortality data for cases that were reported by The Guardian. Our study was deemed exempt from review by the Harvard T.H. Chan School of Public Health institutional review board (IRB16-1146) because it did not involve living persons. We were not able to publish death counts for all US states and counties due to privacy restrictions for NVSS data. We did not have a written prospective analysis plan; we agreed on an analytic plan at an October 2016 meeting and conducted all analyses in January 2017. Our cross-sectional study involved 2 main analyses: (1) a capture–recapture analysis to estimate the total number of law-enforcement-related deaths in the US during 2015, as well as the proportions captured by The Counted and the NVSS, and (2) a multilevel logistic regression analysis investigating the correlates of misclassification for law-enforcement-related deaths in NVSS data. This report has been prepared according to STROBE guidelines, as suggested by the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) network (S1 STROBE checklist).
The Counted identified 1,146 law-enforcement-related deaths in the US during 2015. Applying our exclusion criteria, we eliminated 60 cases that did not conform to the ICD definition of legal intervention, such that the initial dataset included 1,086 observed deaths (Table 2).
We estimated the total number of law-enforcement-related deaths in the US in 2015–1,166 deaths (95% CI: 1,153, 1,184)—and found that, as hypothesized, a much higher proportion of such deaths were captured by The Guardian’s The Counted (93.1%; 95% CI: 91.7%, 94.2%) than by US vital statistics data (44.9%; 95% CI: 44.2%, 45.4%). We also found that misclassification rates in NVSS data for law-enforcement-related deaths varied widely both within and between states, and that misclassification was more likely for non-firearm deaths than firearm deaths and for deaths that occurred outside of the highest income counties. These findings together affirm that major shortcomings exist in official counts of law-enforcement-related deaths based on US vital statistics. The results additionally suggest these shortcomings could potentially be corrected by simultaneously (1) improving the extent and accuracy of the information recorded in death certificates and (2) expanding the types of data employed (such as media-based reports) utilized to generate official counts of these cases.