Manner and Cause of Deaths

Medical examiners use five different categories to classify manner of death. Each manner of death includes many possible causes of death. Manner is more general and cause is more specific.

1. Natural
2. Accidental
3. Homicide
4. Suicide
5. Undetermined

Natural Death, Including SIDS

Often, deaths classified as natural are not considered to be preventable. They include cancer, heart conditions and other diseases. Sudden Infant Death Syndrome (SIDS) is also classified on death certificates as "natural." Many other natural deaths have contributing risk factors, that if reduced, could decrease the number of child fatalities. These deaths, including premature births, deaths due to infectious diseases, and various perinatal conditions can also be examined by Child Death Review Teams to identify risk factors and implement prevention programs.

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Accidental

Accidental fatalities occur as a result of unintentional injuries. The major causes of unintentional injury deaths studied in detail include motor vehicle accidents, house fires, drowning, suffocation, and firearms.

Fires, Drowning, Falls and Other Accidents

These deaths are particularly tragic due to the high degree of preventability. For example, fire deaths to children aged one to four years most often result when a child who is not closely supervised sets fire to the house accidentally by playing with matches or other flammable materials. Additionally, since most young children tend to hide within the house once a fire starts, the absence of a family fire escape plan is a clear risk factor for this kind of accidental death. Drownings often result when unsupervised children enter unlocked swimming pool gates or swim unattended in lakes or ponds. Other accidental child deaths include such things as falls, farming accidents, electrocution, asphyxiation, and accidental firearm discharge. Infants make up the greatest portion of the victims in these types of deaths, primarily due to the incidence of asphyxiation. Central issues in these accidental deaths include product safety, including firearm safety, as well as the education of caregivers as to proper sleeping equipment and bedding for infants.

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Homicide

Child abuse and neglect deaths include those which result from apparent lack of care, abusive head injury/trauma, and other forms of physical violence. Child abuse education and training for parents, educators, and caregivers is aimed at decreasing the number of deaths due to abuse and neglect. Violence perpetrated by peers occurs most often in the 15-17 year-old range. The majority of child deaths in this category involve firearms. Violence prevention initiatives in schools is one way in which communities have sought to decrease teen homicides.

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Suicide

Suicides are the third leading manner of death for 10-17 year-olds. In most of these cases, firearms are the method used. Arguably the most tragic cause of child death, preventability in this category is often elusive. However, a social autopsy of these deaths is very important in our attempt to understand these deaths. Sufficient access to community mental health services, including active and involved referrals from school counselors and prevention programs in schools are important initiatives in the struggle to reduce this category of death.

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Undetermined

A case that is categorized as undetermined may be re-designated after further investigation. Others remain questionable as to manner or cause. Current research and better understanding of infant sleep-related deaths now demonstrate that many or most deaths historically classified as SIDS would have been more accurately classified as undetermined for both manner and cause of death.

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