The role of medicolegal systems in producing geographic variation in suicide rates. Soc Sci Q 2013; 94

Objectives. In this analysis, we ask whether there is systematic variation in the reporting of suicide by medicolegal system and if so whether this biases estimated effects of social correlates on suicide. Methods. With cause of death records (1999– 2002) and 2000Census data, we use negative binomial regression to analyze the effects of medicolegal system on suicide and nonsuicide mortality aggregated at county of occurrence. Results. We find that elected coroners have slightly lower official suicide rates than medical examiners (MEs; all of whom are appointed) and appointed coroners. In addition, we find that omittingmedicolegal systemdoes not bias estimates of the social determinants of suicide. Conclusion. Contrary to arguments that MEs’ greater scientific trainingmakes themmore likely to underreport suicides, we conclude that appointed death investigators (MEs and appointed coroners) underreport suicide to a lesser degree than elected coroners, who are subject to greater public pressures that result in the misclassification of suicides. Suicide is typically understood as an intensely private and personal act. Those seeking to explain it inevitably focus on themental and emotional healt