Evaluating the Use of an Electronic Death Registration System for Mortality Surveillance During and After Hurricane Sandy: New York City, 2012

• Published in: American journal of public health (1971) Vol. 105; no. 11; pp. e55 - e62
• Main Authors: Howland, Renata E, Li, Wenhui, Madsen, Ann M, Wong, Howard, Das, Tara, Betancourt, Flor M, Nicaj, Leze, Stayton, Catherine, Matte, Thomas, Begier, Elizabeth M
• Format: Journal Article
• Language: English
• Published: United States American Public Health Association 01.11.2015
• Subjects: Cyclonic Storms - mortality; Death Certificates; Disasters; Disease control; Epidemiology; Evacuations & rescues; Fatalities; Female; Flexibility; Health facilities; Health surveillance; Humans; Hurricanes; Information Systems - organization & administration; Information Systems - standards; Injury/Emergency Care/Violence; Male; Medical examiners; Mortality; New York City - epidemiology; Other Environment; Population Surveillance - methods; Public health; Registration; Research and Practice; Retrospective Studies; Software; Storm damage; Studies; Surveillance; Time Factors; Vital statistics; New York City; United States > US; New York City New York
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2015.302784

We evaluated the use of New York City's (NYC's) electronic death registration system (EDRS) to conduct mortality surveillance during and after Hurricane Sandy. We used Centers for Disease Control and Prevention guidelines for surveillance system evaluation to gather evidence on usefulness, flexibility, stability, timeliness, and quality. We assessed system components, interviewed NYC Health Department staff, and analyzed 2010 to 2012 death records. Despite widespread disruptions, NYC's EDRS was stable and collected timely mortality data that were adapted to provide storm surveillance with minimal additional resources. Direct-injury fatalities and trends in excess all-cause mortality were rapidly identified, providing useful information for response; however, the time and burden of establishing reports, adapting the system, and identifying indirect deaths limited surveillance. The NYC Health Department successfully adapted its EDRS for near real-time disaster-related mortality surveillance. Retrospective assessment of deaths, advanced methods for case identification and analysis, standardized reports, and system enhancements will further improve surveillance. Local, state, and federal partners would benefit from partnering with vital records to develop EDRSs for surveillance and to promote ongoing evaluation.