Opinion ID: 2740291
Heading Depth: 2
Heading Rank: 1

Heading: The Creation of Indiana’s Death Record System

Text: In 1881, preventable diseases caused 25% of deaths in Indiana. 19 Brevier Legis. Rep. 200 (1881). In addition to the obvious human cost, those deaths created an adverse economic impact on the state estimated at over $15 million dollars each year. Id. In an effort to ameliorate this condition, Senator Flavius J. Van Vorhis of Marion, Indiana proposed legislation to create a State Board of Health.1 Id. at 83. Senator Van Vorhis drafted his bill “upon the experience of twenty- 1 Senator Van Vorhis (1840–1913) served in the General Assembly during the 1881 and 1883 sessions. “Van Vorhis, Flavius Josephus,” in 10 The National Cyclopaedia of American Biography 393, 393 (New York, James T. White & Co. 1900). As a Civil War veteran trained in both medicine and law, he was uniquely suited to understand Indiana’s public health problems and address them through legislation. Id. Despite Senator Van Vorhis’s expertise, this bill got off to a rocky start; it failed on third reading in a close vote (19–26) but upon reconsideration, was returned to committee. 19 Brevier Legis. Rep. 111 (1881). When it came back to the floor, Senator Van Vorhis spoke at length in its favor, decrying the dearth of existing legislation to protect and promote the public health and citing statistics to demonstrate the prevalence and impact of preventable disease. He concluded his remarks by saying: 2 two States having similar laws,” id. at 84, and charged the Board to “endeavor to make intelligent and profitable use of the collected records of deaths and of sickness among the people” and recommend legislation to promote Hoosiers’ health and well-being. 1881 Ind. Acts ch. 19, § 2. To that end, the new law empowered the Board to create and supervise a “system of registration of births, deaths and marriages.” Id. at § 7. It also established county boards of health designed to work in partnership with the State Board: “The Board of Health of each county shall act in conjunction with the State Board of Health, and it shall be the duty of the Secretary of such County Boards . . . to report such facts and statistics as may be required under instructions from, and according to, forms and blanks furnished by said Board.” Id. at § 9. When a death occurred, the attending physician or caregiver was required to report the fact and cause of death to the board of the applicable locality. Id. at § 10. A physician making such a report was required to submit “a certificate of the cause of death, and such correlative facts as may be required in the blank forms furnished.” Id. And these death certificates were public records: It shall be the duty of the Board of Health of each county to keep a complete record, according to the form prescribed by the State Board, of all marriages, births and deaths reported to them under the But does it speak well for the intelligence and business sense of the Legislative Department of the State that she is so far behind in all those efforts to protect life and health, and prevent the occurrence of those calamities that increase each year the number required to be cared for by the public charities of the State, and of the Counties of the State? . . . I can not bring myself to believe that any Senator upon this floor, when he comes to consider the subject in the light of the knowledge of the year 1881, will require argument to convince him that the necessity exists for the enactment of some such law as that proposed by this bill for the protection of life and health. Id. at 201. In the vote immediately following these remarks, the bill passed 36–3. Id. 3 provisions of this act, and such record shall be open to the inspection of any citizen without fee. Id. at § 12. Over the decades, the General Assembly amended this statutory scheme many times, but the county boards of health remained responsible for collecting, retaining, and producing individual death certificates, while the State Board compiled and analyzed the records and recommended appropriate public policy.