Understanding the Role of Work in Mortality: Making the Best Use of Available US Death Certificate Occupation Data and Opportunities for Improvements

Occupational disparities in mortality are a concern in public health. Understanding these disparities is important for identifying high-risk occupations for intervention and occupational factors that may be contributing to high risk for primary prevention. Using data from death certificates is a useful strategy for tracking occupational disparities in mortality. There are a number of challenges associated with working with this data. This paper describes how to access death certificate data, code occupational information from these death certificates, calculate mortality rates by occupation, and combine death certificate data with data from other sources. Limitations of existing death certificate occupation data are described along with recommendations about how to improve the collection of occupation information for death certificates. Finally, a proposal for the development of a national occupational mortality surveillance system is presented.