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Health Research Restricted By Colorado’s Records Laws

Mountain west states – including Colorado – have higher suicide rates compared to the rest of the country. In January, Weld County reported 49 suicide deaths in 2013, marking a 10 year high.

Crafting a local suicide prevention campaign can be very difficult though, if you don’t know who is the most at risk.

In Weld County, Health Department Director Dr. Mark Wallace only knows that men, between the ages 45 and 64 are statistically the most likely to commit suicide, a little over half the time using a fire arm. Wallace said having ready access to the information on the death certificates that are housed just down the hall from his office could help.

There are 35 data points on a death certificate, but even county health professionals only have ready access to four.

“We would be able to be more responsive I think in understanding some of the issues around suicide if we were able to go in and take a look at those suicides and maybe contribute back some of that information,” Wallace said.

If you haven’t seen a death certificate, they contain a gold mine of information, from a research perspective. They have a person’s ethnicity, their occupation, if the deceased had significant health conditions, like cancer or depression. But Colorado is a closed records state, meaning death certificates are confidential, even to public health officials like Wallace.

Jeff Boles, a law professor at Temple University's Fox School of Business, has studied how different states treat death certificates nationwide. He said Colorado is fairly restrictive, compared to other states.

"Colorado gives it's state registrar broad power to allow or deny access to records data for research purposes," said Boles. "The state registrar is essentially able to impose whatever conditions or restrictions of its choosing for attaining research access."

This becomes a big problem if part of your job is to create campaigns to try to decrease negative public health trends, like suicide rates. Those campaigns are usually based on analyzing data in order to figure out who is most at risk and trying to reach them.

Credit Weld County Department of Public Health
Suicide rates continue to increase in Weld County, especially in men.

Dayna Matthew, a health law professor at the Wolf Law School at the University of Colorado in Boulder, said it would take a change in the law by the Colorado general assembly to loosen the restrictions.

“That happens when a committee or a commission holds hearings, gathers evidence, and reaches a consensus about the need to change language in existing laws,” said Matthew.

Credit Jackie Fortier / KUNC
These binders within the vault at the Weld County Health Department contain a gold mine of research information, but it's up to the State Registrar in Denver if county health departments can access them.

Colorado lawmakers did create a statewide suicide prevention commission during the 2014 legislative session. While members have yet to be named and meet, the commission must make annual recommendations to the state legislature.

Even if Wallace did have ready access, the deceased’s privacy would still be protected. Another Colorado law states data on death certificates must be kept confidential and nothing can be released that could identify the deceased.

Wallace said more accessibility by health departments would help them inform the community and maybe help more people.

“My hope would be that it would be a very streamlined process where if we as a deputy site for maintaining the integrity of these records and abiding by the law, had a process that allowed up more flexibility in going in and looking at these death certificates ourselves,” said Wallace. “But right now we don’t have that permission to do that directly.”

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