Recording the Cause of Death

Dana Flanders in 1992 article wrote an article on the misclassification of causes of death. Her focus was on the comparison of smokers and non-smokers. She explores results from studies from the 1960s and the 1990s.

She discusses how for smokers, if lung cancer was found at the time of their death, it is listed as the underlying cause of death. For non-smokers, however, it would be listed as a contributory cause of death. Furthermore, for these non-smokers with lung cancer, they were often found with another type of cancer at the time of their death as well. She explains that some of this issue might be due to the fact that if non-smokers have died of cancer, the supposed ‘lung cancer’ might be another type of misdiagnosed lung issue. ¹

While this is a very specific example, it is a window into how a medical practitioner may make the wrong judgement in classifying the cause of death. Since smoking was a common habit of many people of the 20th century, this problem may have been more widespread than we think. We, as the public, should be careful not to assume all death records will have these inaccuracies. We can, however, be cautious about thinking about recorded deaths are always done responsibly.

1926-7- Births and Deaths Registration Act

In 1926, the UK government passed a law called the Births and Deaths Registration Act in 1926. It covered some of the legal issues with recording deaths prior to the disposal of the bodies, including stillborn babies. ² This act, however, states that this does not apply to cremation. ³ In 1927, an article from the British Medical Journal published a column urging medical practitioners to follow the regulations in this Act, particularly when recording details. They even state this effort to record information is ‘an important piece of research work for the public advantage’. ⁴

It is interesting to see that the British Medical Journal recognised that the public would need this information this early on. They seemed to have understood, even in the 1920s, that families would want to have the best details possible recorded for their sake. While the issues discussed by Flanders are important to note, there is a sense in which the 20th century may have brought with it a high standard of accuracy overall.

Cremation Practice

You may or may not be aware already that cremation by the 1920s was still relatively unpopular. The British Medical Journal once again commented on this in 1929, arguing while many people agreed in theory, few would think about their own death by cremation in practice. The article did state, however, that the practice was slowly growing. The article states that there were 20 crematoriums existing on the British Islands at the time of publication. ⁵

Remember cremation was not included in the 1926 Act mentioned above. The fact that it was growing slowly meant that the moral implications of how to handle cremation was not being done particularly well. A person who was keen to find out about their deceased loved one’s death or burial may have found it harder if the deceased were cremated. I will be writing further articles on the topic of cremation in particular since the implications for burials and finding ancestors is significant.

Conclusion

I have pointed out three key points for you to consider regarding death records. Those three points are:

• poor medical research can lead to poor reporting
• The 1920s is a key moment in changing the thoughts and approach to caring for the deceased
• Cremation affects how much information is available to families at certain points in history

There is much more to explore on all of these points, but these are simply to get you started. I will be building upon these topics in future blog posts, but you can treat this as a signpost for where to get a good overview.

Sources

‘Births and Deaths Registration Act 1926’, Section 3. Accessed 16th May 2025. https://www.legislation.gov.uk/ukpga/Geo5/16-17/48/section/3 .

‘Births and Death Registration Act 1926’, Section 10, Accessed 16th May 2025. https://www.legislation.gov.uk/ukpga/Geo5/16-17/48/section/10 .

‘Cremation in England’, British Medical Journal, 1 (1929): 652

Flanders, Dana. ‘Inaccuracies in Death Certificate Information’. Epidemiology 3 (1992): 3-5.

‘The New Death Certificate’. British Medical Journal 1 (1927): 1152