Unequal burials: Medicolegal death investigation system variation as a determinant of FEMA's disaster funeral assistance allocation

Abstract

Federal Emergency Management Agency (FEMA) disaster funeral assistance is available to cover funeral expenses for the relatives of disaster victims in the United States. However, funds are dependent on death certificate proof of a disaster‐related cause of death. Previous research has shown that the medicolegal death investigation (MDI) system may impact the quality of death certificate data. This research examines the relationship between MDI systems and FEMA disaster funeral assistance distribution. The results of the study indicate that centralized medical examiner systems have higher funeral assistance acceptance rates than other MDI system types. Democratic states and counties with fewer minority residents also have higher acceptance rates. Furthermore, acceptance rates varied significantly by FEMA regional office. These findings suggest that the distribution of funeral assistance may be influenced by administrative and political differences between states.