Vital Statistics Summary of a Workshop (2009) / Chapter Skim
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1 Introduction
1 Introduction
Pages 1-8
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The vital statistics themselves are a critical national information resource for understanding public health and examining such key indicators as fertility, mortality, and causes of death, and the factors associated with them. Vital statistics begin as individual, geographically focused vital events that are registered or certified after their occurrence.
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and state registrar State State vital registration office verifies information, State health department/registrar of vital statistics maintains official copies, and codes and keys electronic verifies information, maintains official copies Processing record National National Center for Health Statistics receives copies of electronic records from states, edits the data, and Processing compiles national vital statistics files for analysis Figure 1-1 Flow of vital records and statistics in the United States SOURCES: Adapted from Hetzel (1997:62; reproduction of 1950 original) and National Center for Health Statistics (Appendix B, this volume:note 1)
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by myriad physicians, new parents, and funeral directors; channeled through state and local information systems of widely varying levels of sophistication and automation; and coordinated and processed by a federal statistical agency that has experienced relatively flat funding for many years. The challenges facing the vital statistics system and the continuing importance of the resulting data make it an important topic for periodic examination, assessing both current and emerging uses of the data and considering the methodological and organizational features of compiling vital data.
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Prior to the workshop, the workshop's planning committee asked that two background papers on two basic perspectives on the vital statistics be prepared in order to inform the discussion. Steven Schwartz (New York City Department of Health and Mental Hygiene)
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in consistently completing vital record data items • Current Mortality Sample (discontinued) -- beginning in the 1940s, state registra tion areas directly forwarded a 10-percent sample of incoming death records to the national vital statistics office, thus enabling publication of national estimates of causes of death with only a 4-month lag after month of occurrence; discontin ued around 1995 because of resource constraints • Classifying Causes of Death According to International Standards -- World Health Organization's International Classification of Diseases (ICD)
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• Training -- training sessions on medical coding and specific methodological tech niques (e.g., using the Mortality Medical Data System) were conducted by NCHS beginning in 1983, but have been reduced greatly in number in recent years • Mortality Workshops -- wide-ranging practitioner workshops on improving cause of-death data convened by NCHS in 1989 and 1991 • Electronic Registration of Vital Events (see Appendixes A and B)
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• Discontinuation of national collection of some vital records and down grading of some quality assurance methods: There have been major ca sualties of data streams within the national vital statistics collections, which Rosenberg attributed principally to the inability to secure ade quate and sustained funding for the system. The most prominent of these casualties is data on marriage and divorce; marriage and divorce records do continue to be developed at the state and local level but national-level collection and compilation was discontinued almost 20 years ago because of budget concerns.
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The workshop featured selected case studies of analogous partnership systems in the federal statistical system, and those are briefly recounted in the chapter. Chapter 4 considers methodological issues and, in particular, those raised by the 2003 revision of the standard birth and death certificates, which includes a new format for race and Hispanic origin data and preliminary findings from new public health data items included on the certificates.
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