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Paper short abstract

This paper explores the making of cause of death data, showing how certifying physicians and registering coders deal with tensions arising between the logic of medical practice and statistical classification systems and how standardization attempts involved in data production work in practice.

Paper long abstract

Official statistics is a form of knowledge production organized by and for the state, where specific statistical offices or other government agencies collect, register, disseminate and compare statistics for depicting and governing matters of public importance. The “cooking” of such data can be organized and take place in various ways (cf. Biruk 2018), and has received relatively limited attention within STS. Official cause of death statistics is part of public health work; used for understanding the prevalence and trends of causes of mortality and fatal diseases and for evaluating preventive measures and health care systems. The World Health Organization has promoted standardization for classification and reporting to make such data comparable, but the logic of this terminological and procedural standard contrast with how physicians’ approach death. By exploring how physicians certify causes of death and how their reports enter administrative systems, this paper presents what happens when the worldviews of clinical practice and statistical reasoning meet. Based on interviews with physicians reporting causes of death and coders at the National Board of Health and Welfare in Sweden, we show how these groups deal with tensions arising in relation to reporting and coding and how standardization attempts involved in production of cause of death data work in practice. We also reflect upon the relationship between data and reference, given these conditions of production.