Forensic Epidemiology in Injury Prevention: Translating Death Investigation Data into Evidence-based Public Health Action

Abstract Forensic epidemiology integrates medicolegal death investigation with public health methodology to reduce preventable mortality. This narrative review synthesizes evidence on how systematic analysis of death investigation data informs injury prevention strategies, with focus on applications relevant to preventive medicine practice. We searched PubMed, EMBASE, and Web of Science (2010–2025) using forensic epidemiology, death investigation, injury prevention, and medicolegal system terms, supplemented by the targeted searches for effectiveness evidence and Saudi Arabian forensic medicine literature. Gray literature sources included reports from the World Health Organization, Centers for Disease Control and Prevention, and Saudi Ministry of Health. High-quality medical examiner systems generate population-level surveillance data essential for identifying injury patterns, emerging threats, and prevention opportunities. Evidence from observational studies and program evaluations demonstrates substantial mortality reductions associated with forensic data-informed interventions: greater than 50% decline in sudden infant death syndrome following safe sleep campaigns derived from death scene investigations, 29%–38% of child deaths identified as preventable through fatality review programs, and 30%–50% suicide rate reductions through means restriction strategies informed by method-specific mortality analysis. Drug overdose surveillance through forensic toxicology enables rapid public health responses to novel synthetic opioids. In Saudi Arabia, road traffic crashes account for 4.7% of all deaths and represent the predominant injury category; however, systematic forensic epidemiology applications remain underdeveloped despite expanding medicolegal capacity. As of 2016, only 59% of Saudi medical schools taught forensic medicine, and child death review programs are limited or not systematically implemented in many Arab countries. Vision 2030 health transformation goals create opportunities for integrating forensic data into national injury surveillance systems. Preventive medicine specialists can leverage forensic epidemiology principles through establishing death review teams, collaborating with medical examiners on surveillance systems, and translating mortality pattern analysis into targeted interventions addressing modifiable risk factors.