Vital Statistics Summary of a Workshop (2009) / Chapter Skim
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2 Uses of Vital Statistics Data
2 Uses of Vital Statistics Data
Pages 9-34
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From page 9... ...
In Section 2–B, we summarize workshop presentations and discussion on the development of population projections and estimates by the Census Bureau and the Social Security Administration; in the latter case, the decades-long projections of population composition based on vital statistics play a key role in the major policy debates on the long-run viability of Social Security entitlements. In terms of future directions, Section 2–C summarizes the workshop's session that focused on the emerging field of biosurveillance -- monitoring of disease and mortality with fine spatial and temporal precision in order to rapidly detect major disease outbreaks or, perhaps, terrorist attacks using biological agents.
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state health department or health researcher for public health monitoring and for studying any health outcome from birth to death for any age, gender, or racial or ethnic group. The project started in 1998, making use of data from the Massachusetts Department of Public Health and the Rhode Island Department of Health; the data were for a set of years centered around the 1990 census, and the socioeconomic data in the ABSMs made use of information from that census.
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From page 11... ...
Krieger presented socioeconomic gradients for several health outcome measures to illustrate that the technique provides a way for routine documentation and monitoring of trends using existing vital statistics and public health surveillance data. Specifically, her graphic displays divided census tracts into categories based on percentage of the population below the poverty level (e.g., less than 5 percent, 20 percent or greater)
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From page 12... ...
However, stratifying by census-tract poverty level shows more complex gradients: the poorest census tracts have consistently higher risk levels than the least poor, with particularly pronounced gaps for white and black men living in the poorer census tracts. Similar findings follow from an analysis using 2004–2005 Massachusetts birth outcome data involving low birth weight and smoking during pregnancy.
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were linked to county-level population and median family income data from the Census Bureau. These data were used to calculate and compare premature mortality and infant death rates by county income quintile for the entire study period.
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The data used in his research include mortality data from the vital statistics, particularly a linked mortality file combining records from the National Death Index with survey data from NCHS's National Health and Nutrition Examination Survey (NHANES)
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The differential life expectancy by sex still shows up when mortality rates are disaggregated by age. The biggest age gap between males and females manifests itself in late teens and early adolescence, what Rogers said has been described as the "accident peak" or "testosterone spike." Cigarette smoking patterns are one variable that seems to be a central contributor to sex differences in mortality, but those patterns have changed over time.
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Period effects are important -- researchers get different results in explaining sex differences in longevity and mortality in the 2000s than were estimated in the 1970s and 1980s. Still, it is important to think about other covariates and, specifically, what other covariates might be important that are not regularly collected in current national surveys and national data sets.
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The block grant funds are allocated using a formula based on a state's percentage of children living in poverty as a share of the national total; the funds support the operation of state-level maternal and child health offices and programs. Van Dyck said that the states are required to provide matching funds (at least $3 in state funds for every $4 in federal funds)
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Perinatal mortality rate per 1,000 live births plus fetal deaths 6. Child death rate per 100,000 children ages 1–14 NOTE: Italics indicate that the measure is derived from vital statistics data.
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(Van Dyck added that the MCHB's website, which posts these indicators for all grant recipients, is the only ongoing data site that provides the rate of infant deaths for Medicaid clients compared with the infant deaths for non-Medicaid clients.) • HSCI #09A and B: Self-scores by the states on their data capacity for implementing four types of data linkages: – annual linkage of infant birth and infant death certificates – annual linkage of birth certificates and Medicaid eligibility or paid claims files – annual linkage of birth certificates and WIC eligibility files – annual linkage of birth certificates and newborn screening files • HSI #01A: Percent of live births weighing less than 2,500 grams • HSI #01B: Percent of live singleton births weighing less than 2,500 grams • HSI #02A: Percent of live births weighing less than 1,500 grams • HSI #02B: Percent of live singleton births weighing less than 1,500 grams • HSI #03A: Death rate per 100,000 due to unintentional injuries among children ages 14 years and younger • HSI #03B: Death rate per 100,000 for unintentional injuries among children ages 14 years and younger due to motor vehicle crashes • HSI #03C: Death rate per 100,000 for unintentional injuries for youth ages 15 through 24 years due to motor vehicle crashes MCHB also administers the $100+ million, county-based Healthy Start program, which is intended to reduce infant mortality rates in vulnerable or poor communities.
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statistics data as inputs. The performance measures for the Title V block grant program include such entries as decreasing the incidence of low-birthweight births and increasing the percentage of pregnant women who receive prenatal care in the first trimester.
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Van Dyck said that Indiana has also linked this system with the Indiana Health Information Exchange, with the additional benefit of providing a comprehensive electronic medical record on Indiana children to their medical providers. 2–B POPULATION PROJECTIONS AND ESTIMATES Samuel Preston (University of Pennsylvania)
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In addition to summarizing the projections program of the Social Security Administration, this section also consolidates material from two presentations by Census Bureau staff. The issues and challenges faced by the Census Bureau in producing current population estimates (between decennial censuses)
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Goss further demonstrated that the basic shape and implications of the curve in Figure 2-1 is evident in other formulations: a modified version of the aged dependency ratio that also reflects some economic parameters, the ratio of the estimated number of beneficiaries per 100 workers, and the cost of Social Security as a percentage of taxable earnings. Goss commented on OCA's use of and reliance on data on five different components of demographic change: (1)
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Hence, Goss said that OCA has never assumed birth rates lower than 1.9 for the total fertility rate. Though some European countries do project a continued decline in fertility rates, OCA generally assumes a steady, average fertility rate of 2.0 for the U.S.
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OCA's new calculations are based on analysis of 2000 census data, combined with estimates generated by DHS in 2006; the age distribution at entry (and exit) is based on unpublished Census Bureau tabulations for the net "other immigrant" count for 1975–1980.
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Deaths For data on deaths, OCA augments NCHS-compiled vital statistics with Medicare data. For deaths of persons under age 65, the vital statistics of death by cause are the exclusive source, with Census Bureau population estimates as the denominator.
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Census Bureau) addressed the workshop on the use of vital statistics data in the Census Bureau's intercensal population estimates and its projections of U.S.
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The NCHS vital statistics data are the basis for the estimates of births and deaths used in the cohort method. The Census Bureau also periodically releases long-term population projections to describe the demographic character of the future U.S.
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Velkoff and Hollmann both commented on the experience of using the vital statistics data and analyses: • Velkoff noted that the time lag in the availability of final vital statistics raises some concerns for the Census Bureau's work. Given the Bu reau's internal timeline of producing some national estimates by the end of the target year, the Census Bureau typically finds itself in the position of "projecting" vital events for about a year and a half.
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commented that lower mortality rates among Hispanics are evident in Social Security Administration data, which may be less immune to data reporting effects in the vital statistics data (i.e., without birth and death certificates playing such a major role in both the numerator and denominator of calculated rates)
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From page 31... ...
Although originally focused on the detection of terrorist attacks using biological agents, Stoto argued that biosurveillance has come to be interpreted more broadly, as a means for situational awareness for public health emergencies. In either event, Stoto noted that the data systems he was discussing have a much more exacting standard for timeliness than the current vital statistics collections -- timeliness measured in weeks and days, and sometimes hours, rather than years.
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From page 32... ...
Given the emphasis on timeliness that is central to biosurveillance systems, Stoto asked what kind of contributions vital statistics -- and the principles and practices of vital statistics systems -- can bring to bear. Mortality due to pneumonia and influenza is an instructive example to consider for a number of reasons, among them a lengthy history of analysis of such data, experience with the challenge of distinguishing between routine seasonal influenza and wider pandemic outbreaks, and the fact that exposure to many biological agents that could be used in a terrorist attack would initially cause flu-like symptoms.
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From page 33... ...
The example of influenza monitoring raises the question of how modern information technology -- such as electronic vital records collection and electronic death records -- might make mortality data more useful for near-realtime monitoring. Vital statistics may never achieve the near-hourly temporal resolution that is needed for outbreak detection, but Stoto suggested that there is still a great deal of value in being able to frame assessments based on what is going on in cause-specific mortality data on a monthly or weekly basis.
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From page 34... ...
34 VITAL STATISTICS situational awareness and surveillance, including rapid availability of vital records data and, ideally, marked decreases in the time lags to issuance of birth and death data. This development would also have a variety of beneficial spillover effects for the general study of health information.
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