Purpose: This form may be used for collecting mortality data from Medical Examiner(s) and/or Justice of the Peace offices.
The purpose of the mortality surveillance is to:
a) identify the number of deaths related to the public health emergency and provide basic demographic information to public health and emergency management officers;
b) identify the cause of death to inform immediate public health interventions;
c) assess the direct and indirect impact; and d) provide information on deaths to inform future planning and mitigation efforts.
Information Flow: Local and regional health departments may work with the local medical examiner (if one exists locally) and Justice of the Peace offices to gather the information. Ideally the information should be gathered and the form completed within 24 hours of death. Daily submission to the regional health department office is optimal.
An access database is also available for demonstration purposes. Please contact David Zane if you would like more information.
Disaster-related Mortality Surveillance Form
Hurricane Ike (2008)
For information on the mortality surveillance that was conducted related to Hurricane Ike, see Tracking Deaths Related to Hurricane Ike, Texas, 2008, Disaster Medicine and Public Health Preparedness, American Medical Association.
Presentation made during the State and Territorial Injury Prevention Director's Association webcast on March 17, 2009.