The proportion of reported causes of death which are not considered to be underlying causes of disease can impact how mortality statistics are used for public health planning purposes. In burden of disease studies, these codes are routinely redistributed to underlying causes of death on the basis of evidenced-based algorithms.

The Italian Global Burden of Disease Initiative have recently published a paper in the European Journal of Public Health. The paper focuses on the case of Italy, at national and regional level, compared to nine other Western European countries, by exploring the impact of the redistribution of garbage coded deaths on final mortality estimates from the Global Burden of Disease (GBD) 2019 study.

The findings indicate a potential reason for why mortality estimates, derived from vital registration systems, can differ from GBD mortality estimates. Across countries, there were high levels of garbage code reported deaths (>20%) which implie there is wide potential for improvements in death registration processes to remove the reliance on algorithm-based approaches.

The journal paper, published in the European Journal of Public Health, can be access at the following link: https://doi.org/10.1093/eurpub/ckab194