Assessment of the “real” causes of death in a rapidly developing high-income country in the Middle East

Peter Barss, United Arab Emirates University
Michal Grivna, United Arab Emirates University
Sakina Al Belooshi, United Arab Emirates University
Salama Al Hosani, United Arab Emirates University
AR Al Yamahi, United Arab Emirates University
MR Al Zaabi, United Arab Emirates University

Cardiovascular disease is often cited as a main cause of death in United Arab Emirates, and indeed in many countries. Deaths are frequently reported as cardiovascular based solely upon incomplete death reports where a physician has written cardiac arrest or cardio-respiratory death, which occurs in all deaths, as the underlying cause. Unfortunately this leads to underreporting of other leading causes and insufficient attention and inappropriate resource allocation to prevention of main causes. We decided to review a random sample of death certificates in conjunction with review of the hospital records to verify the real causes of death. This led to a reordering of main health priorities, with injury the leading cause of loss of economic life years, followed by cancer; cardiovascular diseases were almost negligible by this indicator, and ranked third as a cause of mortality after injury and cancer once the 9% of deaths classified as “cardiac arrest” had been reassigned to the real cause of death. The research led to development of a greatly improved new research-based death notification form, which piloted with excellent results and is now in use throughout the Abu Dhabi Emirate.