By Lee Bowman and Thomas Hargrove Scripps Howard News ServiceA first-of-its-kind study has found that younger, well-educated and wealthy people are more likely to be autopsied when they die.
More men than women are autopsied. And blacks, Hispanics, Asians and Native Americans are more likely to be autopsied than whites.
The disparity has a profound effect on how people understand the diseases that run in their families and how medical research is conducted.
The findings from Scripps Howard News Service's seven-month review of the 4.9 million deaths in the United States in 2005 and 2006 surprised medical experts.
"Wow," said veteran coroner Michael Doberson of Colorado, the state with the nation's highest rate of autopsies. "This could have something to do with a greater educational level among these families, families that may want to have more information about the death. Less-educated people may not be aware of the benefits of an autopsy."
There are few laws that dictate when an autopsy must be conducted, and it depends largely on the age of the deceased and on the preference of local authorities.
For example, excluding cases of homicide and suicide that are routinely autopsied, the study found that nearly 10 percent of people who died between ages 45 and 54 received an autopsy compared to less than 4 percent of people 65 to 74. The rate drops to less than 2 percent for older Americans.
"The population is aging and we're not researching how different diseases affect people," said Dr. Elizabeth Burton of Baylor Medical Center in Dallas. "When you get a 113-year-old woman into the pathology lab, the question shouldn't be so much why did she die, but how did she manage to live so long. What was different about her."
The study found that racial and ethnic minorities were more likely to be autopsied than whites. When looking at all 4.9 million deaths, whites were autopsied less than 6 percent of the time compared to 11 percent for blacks, 14 percent for Hispanics, 8 percent for Asians and 13 percent for American Indians.
Blacks and Hispanics are much more likely than whites to die before reaching 60 years of age, and therefore would be expected to receive more autopsies. These groups are also more likely to be the victims of homicides and therefore be autopsied as part of a criminal investigation.
But even looking at only deceased persons who are 60 or older and who were not victims of homicide or suicide, the autopsy rate for blacks and Hispanics was about twice as high as that for whites.
"This may have something to do with higher rates of unattended death," said Robert Anderson, chief of mortality statistics for the National Center for Health Statistics. "People who have less access to health care can have conditions like hypertension that can lead to sudden death," which are more likely to trigger an autopsy.
Black families also may be more likely than whites to question the official cause of death for a family member.
