Sunday Data: The Most Distinct Cause of Death in The States?

This map from The Centers for Disease Control shows in Alabama it is....the accidental discharge of firearms.

Note: there is an obvious difference between the most distinct and the most common or average causes of death. It appears that finding is true only in Alabama and Tennessee.
Another odd example: "water and space and other unexpected transport accidents" are the most distinct cause of death in Idaho.
The CDC suggests the data is a good conversation starter. I'm sure that's true. I can hear the comments now...but read the notes below first.

 

Main Findings

The resulting map depicts a variety of distinctive causes of death based on a wide range of number of deaths, from 15,000 deaths from HIV in Florida to 679 deaths from tuberculosis in Texas to 22 deaths from syphilis in Louisiana. The largest number of deaths mapped were the 37,292 deaths in Michigan from “atherosclerotic cardiovascular disease, so described”; the fewest, the 11 deaths in Montana from “acute and rapidly progressive nephritic and nephrotic syndrome.” The state-specific percentage of total deaths mapped ranged from 1.8% (Delaware; atherosclerotic cardiovascular disease, so described) to 0.0005% (Illinois, other disorders of kidney).
Some of the findings make intuitive sense (influenza in some northern states, pneumoconioses in coal-mining states, air and water accidents in Alaska and Idaho), while the explanations for others are less immediately apparent (septicemia in New Jersey, deaths by legal intervention in 3 Western states). The highly variable use of codes beginning with “other” between states is also apparent. For example, Oklahoma accounted for 24% of the deaths attributable to “other acute ischemic heart diseases” in the country despite having only slightly more than 1% of the population, resulting in a standardized mortality rate ratio of 19.4 for this cause of death, the highest on the map. The highest standardized mortality rate ratio after Oklahoma was 12.4 for pneumoconioses in West Virginia.
A limitation of this map is that it depicts only 1 distinctive cause of death for each state. All of these were significantly higher than the national rate, but there were many others also significantly higher than the national rate that were not mapped. The map is also predisposed to showing rare causes of death — for 22 of the states, the total number of deaths mapped was under 100. Using broader cause-of-death categories or requiring a higher threshold for the number of deaths would result in a different map. These limitations are characteristic of maps generally and are why these maps are best regarded as snapshots and not comprehensive statistical summaries (5).
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Action

This map has been a robust conversation starter among those who have seen it before publication, generating hypotheses and inviting further exploration of the underlying data set, something that an equivalent tabular representation does not accomplish as well. Although chronic disease prevention efforts should continue to emphasize the most common conditions, an outlier map such as this one should also be of interest to public health professionals, particularly insofar as it highlights nonstandard cause-of-death certification practices within and between states that can potentially be addressed through education and training. This is especially true considering that most death certificates are completed by community physicians who receive little or no formal training in this area. For example, a study found that nearly half of the death certificates certified by physicians in a suburban Florida county contained major errors, often reflecting confusion between the underlying cause of death and the terminal mechanism of death (6). It would not take many systematic miscodes involving an unusual cause of death for it to appear on this type of map.

                                                                                                                       From the CDC

The rest of the story is HERE. 

[Sunday Data is a regular feature of www.timlennox.com]