UHS resurrects two decades of missing student death data

For the past 20 years, University Health Services at UW-Madison recorded the total number of students that died each year. This amounts to 192 total students from April 1998 to 2017, 56 of whom died in the last five years.

Many of these students were victims of motor vehicle accidents or took their own lives by suicide. In some cases, the cause of death was not reported but pieced together by UHS staff, who dug up scraps of information using “informal sources,” like news media outlets and obituaries..

However, for one-third of all deceased students, the cause of death remains a mystery.

UHS Director of Quality and Informatics Nancy Ranum, along with the staff epidemiologist Agustina Marconi, are working to obtain formal documents in order to record the causes of death for the last 20 years of deceased UW-Madison students. They said having confirmed causes will provide UHS with adequate data to report trends and determine if actions can be taken to prevent numbers of certain causes from rising.

“Mortality is not very prevalent in this age group, but we need to check on trends,” Marconi said. “We need to know why these students are dying. If we get to know the official information, we might be able to do some prevention or some actions to minimize those deaths.”

In the last 20 years, suicide was one of the most common fates among recorded student deaths that had known causes. According to UHS Suicide Prevention Coordinator Valerie Donovan, it is the second leading cause of death among college students nationwide.

She said suicide prevention and mental health promotion are campus priorities — there are trainings in place, like UHS’s At-Risk program, that teaches students how to recognize and respond when others are experiencing suicidal thoughts. This is in addition to other efforts to raise awareness and offer services for students.

According to Marconi, accurate data about student deaths can also help inform prevention strategies. If staff can notice trends of causes, they could enhance prevention and awareness programs to combat those issues. Donovan gave the example of alcohol connected to student deaths: If they notice a trend where alcohol was involved somehow in students’ deaths, alcohol prevention leaders will “leverage resources” to fight that trend.

“Communicating [about suicide data] carefully and strategically can reduce stigma, encourage help seeking, and prevent suicide,” Donovan said in an email. “Our goals with suicide prevention communications (e.g. raising awareness) are to: reduce stigma around mental health, normalize help-seeking, educate about resources, offer messages of hope and healing, and encourage all members of our campus community to look out for one another.”

According to Ranum, UHS is notified by the Dean of Students Office when an enrolled student dies. They also receive messages from informal sources, such as the student’s family, a medical examiner or law enforcement. Representatives from the office, as well as from other campus departments including UHS, form a Crisis Response Team following the notification. The group is responsible identifying individuals on campus who may be impacted by the death, including the student’s teachers and house fellows, and creating a plan to support these people.

The information UHS receives is basic — Ranum said “sometimes … we just knew that a student died and that was it” — and does not list the cause of death, which is when UHS turns to other sources for answers.

Ranum and Marconi will apply to acquire formal sources from the Center for Disease Control National Center for Health Statistics National Death Index. These documents are what Marconi labeled “the gold standard” — the students’ death certificates. Ranum said application process to obtain CDC data is “rigorous,” as they have to ensure they will not reveal any information about students’ identities when sharing their findings.

Along with looking into causes of death trends, they will also analyze secondary causes, which are additional factors that may have influenced a student’s death — for example, maybe a student died of pneumonia, but they also poorly controlled their diabetes. The data will reveal trends among demographics of the deceased and include whether students were off campus or abroad.

“All the demographics that we can get will be matched with the cause of death to see if there’s any difference,” Marconi said. “If there is any significant difference that we could afterwards work with the students and with the rest of the university to minimize those potential causes of death and potential hazards for students. We need to know [not only] how they are dying but who is dying.”

Ranum and Marconi said they are hoping, if all goes well with the CDC application, to have the information by the end of this spring semester.

They said collecting all data points explaining each enrolled student’s death will not be a “one time thing” — once they have all the information for the past 20 years of missing causes of death, they will apply to receive the official death certificates of deceased UW-Madison students at the end of every year and update the data.

Ranum and Marconi said they hope more accurate information from death certificates, Marconi said they can set constants to compare rates of certain causes of death and notice patterns in numbers, which could draw necessary attention to where additional preventative action could be taken.

“A bigger goal is to have more power with greater numbers,” Ranum said. “If there were a standardized way that all universities collected and looked at the data with a strategy that verified the cause of death in the same way so that they were comparable there’d be more power in that kind of analysis.”