Classification of Causes of Death

Prior to 1898 there was no standard classification of cause of death throughout the United States. But, as of the first of that year Michigan blazed a trail by becoming the first state in the country to adopt the Bertillon classification scheme. [1] One reason Michigan adopted this system so early was because the chief of the division of vital statistics for Michigan, Cressy Wilbur, was one of three commissioners appointed to implement the change in the U.S. [2]

The American Public Heath Association, at their meeting in October 1897, recommended that the Bertillon system be adopted by all registrars in North America. [2] At that time “no two states in this country, hardly any two cities and no two nations (except such as had already put the Bertillon system in force), used identical classification of causes of death.” [3] This may not be a big deal to genealogists, but it certainly was to state and federal bean counters who wished to compare death rates from certain diseases across jurisdictions. Ultimately, this type of analysis could result in public health benefits by identifying disease trends and promoting systems for containment and prevention, like showing the advantages of public sewer systems. However, before this could happen, the causes of death from region to region needed to be comparable.

The Bertillon classification scheme was based on the anatomical origin of the disease. This meant that diseases of the respiratory system, for instance, were listed together, with a further breakdown within each category rather than simply including all diseases alphabetically. [4] This was a rather radical change from previous methods that grouped causes of death by the nature of the fatal disease. [6] While not a perfect system it did eliminate the necessity of searching the entire list to find a disease that could be described by numerous terms (for example, typhoid fever was also called dothinenteritis, mucous fever or continued fever). [4] Diseases affecting the entire organism were listed separately under the term general diseases, which was further broken down into epidemic diseases such as measles or influenza and other general diseases such as cancer or diabetes. Some other causes of death were listed separately: malformations, diseases of infancy, diseases of old age, violence (suicide, accidents, homicide) and a final catch-all category “causes ill-defined.” [5]

Jacques Bertillon, who devised the scheme was one of its foremost proponents, by virtue of his work with the International Statistical Institute (ISI). The system was to be revised every ten years to keep up with progress in medical science [6] By 1909, Bertillon reported to the ISI meeting in Paris that the first revision of the system “was in use throughout the world, in the Americas, Australia, and Japan.” [7] It was also in use in several countries in Europe, but adoption there lagged because countries wanted to maintain the ability to compare statistics with those collected in the past. [7] The tenth revision of the system was published in 1989 and is still in use, including by the World Health Organization. [8]

1. Secretary of State of Michigan. Thirty-Second Annual Report of the Secretary of State on the Registration of Births And Deaths Marriages And Divorces in Michigan For The Year 1898. (Lansing, Michigan: Robert Smith Printing Co, 1900), ix-x.
2. Secretary of State of Michigan. Thirty-Second Annual Report . . . 1898., appendix, p. 5.
3. Secretary of State of Michigan. Thirty-Second Annual Report . . . 1898., x.
4. Secretary of State of Michigan. Thirty-Second Annual Report . . . 1898., appendix, p. 9.
5. Secretary of State of Michigan. Thirty-Second Annual Report . . . 1898., lxxiv-lxxv.
6. Iwao M. Moriyama, Ruth M. Loy and Alastair H.T. Robb-Smith, History of the Statistical Classification of Diseases and Causes of Disease, (Hyattsville, Maryland: National Center for Health Statistics, Centers of Disease Control and Prevention, U.S. Government Printing Office, 2011), 12.
7. Moriyama, Loy and Robb-Smith, History of the Statistical Classification, 13.
8. Moriyama, Loy and Robb-Smith, History of the Statistical Classification, 21.