Operationalizing the structural vulnerability profile within the medical examiner context

Abstract

The medicolegal death investigation process in the United States, historically focused on personal identification and determination of cause and manner of death, has evolved in recent decades to include space for advocacy centered around public health. Particularly, in the domain of forensic anthropology, practitioners have begun to incorporate a structural vulnerability perspective on human anatomical variation, with the goals of articulating the social determinants of ill health and early death and ultimately influencing public policy. This perspective has explanatory power far beyond the anthropological sphere. In this piece, we argue that biological and contextual indicators of structural vulnerability can be incorporated into medicolegal reporting with potentially powerful impacts on policy. We apply theoretical frameworks from medical anthropology, public health, and social epidemiology to the context of medical examiner casework, highlighting the recently proposed Structural Vulnerability Profile developed and explored in other articles in this special issue. We argue that: 1. Medicolegal case reporting provides a valuable opportunity to record a faithful accounting of structural inequities in the annals of death investigation, and 2. Existing reporting infrastructure could, with limited modifications, provide a powerful opportunity to inform State and Federal policy with medicolegal data, presented within a structural vulnerability framework.