The Cause of Death Was...

Sometimes it can be difficult to decipher handwriting on a death certificate.

Have you ever had trouble reading the cause of death on a death certificate? If you have, you are not alone. Thankfully, there is another way to find the cause of death, and it's right there on the death certificate.

In the example above, do you see the number "59" bracketed by two diagonal lines? These numbers are International Classification of Diseases (ICD) codes. The ICD codes were a mechanism developed by the medical community for standardizing and classifying diseases. According to Encyclopedia Britannica, the ICD was a system first adopted by the International Statistical Institute in 1893 and recommended by the American Public Health Association in 1898.

Over the years it has been updated and revised to reflect advances in disease classification. As a result, many new codes have been added and the format of the codes have changed. For example, in 1900 there were just 191 codes (1 was “Small-pox: Vaccinated” and 191 was "Violent deaths: Execution"). Today there are over 70,000 codes in the 10th revision of the ICD.

How are these codes helpful for genealogists?

Deciphering the handwritten cause of death on a death certificate can be difficult at times. When this happens, look up the ICD codes online. This website is a good resource.

Be sure to look up the code in the ICD revision in use at the time of death. For example, if someone died in 1912, you’ll want to use the 1909 revision.

Using the example above, the individual died on 20 Sep 1935. That means we'll need to look at the ICD codes revised in 1929. Code 59 was "Diabetes." Now when we go back and read the cause of death, the word "diabetes" is more easily read.

ICD codes were typically assigned by medical coders, and like all people, they sometimes made mistakes when coding. Be aware of this when evaluating ICD codes.

Let’s look at some more examples (all are Ohio death certificates):

1915 Ohio death certificate. Code 28 in the 1909 ICD codebook was divided into 28A and 28B. 28A was "Pulmonary tuberculosis" and 28B was "Phthisis (not defined as tuberculous)."

1917 Ohio death certificate. Code 119 in the 1909 ICD codebook was "Acute nephritis."

1931 Ohio death certificate. Using the 1920 revision of the ICD codes, we find that code 11A is "Influenza with respiratory complications, with pneumonic complications."

1932 Ohio death certificate. In this example we can see that the cause of death was clearly heart related. There were additional contributing factors which may explain why code 54B was used. Code 54B in the ICD 1929 revision is "Non-malignant tumours of the other sites."

1940 Ohio death certificate. Sometimes the ICD code is difficult to read. The cause of death is clearly "cancer of liver." It appears the ICD code could be 46F. Looking at the 1938 ICD codes, we find that 46F is "cancer of the pancreas." But we can also see that 46E is "Cancer of the liver and biliary passages".

If you haven't done so already, go back and look up the ICD codes on the death certificates in your family files. Leave me a comment if you find anything unusual.

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