More than 1,500 counties in America elect their coroners, and that voting may play a role in their decisions on whether to classify deaths as suicides.

Elected coroners report 12% fewer suicides among females and 6% fewer among males than appointed medical examiners, even after controlling for other factors that affect suicide rates, according to a study presented in August at the American Sociological Assn.’s annual meeting.

Because people who commit suicide usually do not leave notes or other explanations for their actions, it is often left to coroners to determine based on the evidence available whether a death is due to suicide, accident or some other cause. A lot rides on the decision, as many families and survivors fear the stigma associated with suicide or may lose out on insurance benefits if the death is ruled a suicide.

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