Levin's attributable risk statistic for analytic studies and vital statistics.
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Epidemiology↗
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The development of national vital statistics in Canada: Part 1--From 1605 to 1945.
This article describes the key events in the development of the national vital statistics system in Canada. Particular emphasis is placed on the role played by Statistics Canada, known as the Dominion Bureau of Statistics from 1918 to 1971. There were many obstacles to uniform national compilations, including differences in provincial legislation, the incomplete registration of vital events, a lack of uniform standards in classification and methods of presentation, the omission of important data, the use of fiscal instead of calendar years, and periodic breaks in the annual publications prepared by the provinces and territories. To overcome these obstacles, collaboration among federal and provincial/territorial governments was necessary. This two-part article chronicles the evolution of this collaboration, which led to the production of national vital statistics in Canada. Part 1 covers the years 1605 to 1945, from the time explorers, the Catholic Church and census takers first recorded details about the European population in New France, to the establishment of a system of national vital statistics. It ends by noting the important role national vital statistics played in launching Family Allowances in 1945. Part 2, scheduled to appear in a future issue of Health Reports, will cover the years 1945 to the present. It will focus on the creation of the National Vital Statistics Index, the Vital Statistics Council, computerization, record linkage, and occupational and environmental health statistics.
Canada↗
Vital statistics in the United States: preparing for the next century.
"This paper outlines the development of U.S. national vital statistics based on the local registration of vital events in the United States during the twentieth century, including the organization of the National Vital Statistics System. Current data developments and selected publications of the National Center for Health Statistics are presented as they relate to vital statistics. The paper concludes with an overview of ongoing efforts at the local, state, and federal levels to improve the timeliness and quality of vital statistics through the redesign and automation of data collection, processing, and dissemination systems."
Americas↗
Underestimates of unintentional firearm fatalities: comparing Supplementary Homicide Report data with the National Vital Statistics System.
OBJECTIVE: A growing body of evidence suggests that the nation's vital statistics system undercounts unintentional firearm deaths that are not self inflicted. This issue was examined by comparing how unintentional firearm injuries identified in police Supplementary Homicide Report (SHR) data were coded in the National Vital Statistics System. METHODS: National Vital Statistics System data are based on death certificates and divide firearm fatalities into six subcategories: homicide, suicide, accident, legal intervention, war operations, and undetermined. SHRs are completed by local police departments as part of the FBI's Uniform Crime Reports program. The SHR divides homicides into two categories: "murder and non-negligent manslaughter" (type A) and "negligent manslaughter" (type B). Type B shooting deaths are those that are inflicted by another person and that a police investigation determined were inflicted unintentionally, as in a child killing a playmate after mistaking a gun for a toy. In 1997, the SHR classified 168 shooting victims this way. Using probabilistic matching, 140 of these victims were linked to their death certificate records. RESULTS: Among the 140 linked cases, 75% were recorded on the death certificate as homicides and only 23% as accidents. CONCLUSION: Official data from the National Vital Statistics System almost certainly undercount firearm accidents when the victim is shot by another person.
Adolescent↗
Assessment of surveillance and vital statistics data for monitoring abortion mortality, United States, 1972-1975.
To assess the usefulness of vital statistics and surveillance for monitoring abortion mortality, the authors compared data from two systems of classification: 1) deaths classified according to the underlying cause by the National Center for Health Statistics (NCHS) under the International Classification of Disease, Adapted (ICDA) code numbers 640-645 (abortion) for 1972-1975; and 2) abortion-related deaths reported to the Center for Disease Control (CDC) through its epidemiologic surveillance of abortion mortality for the same years. Vital statistics classifications dealing with the underlying cause of death are based on criteria defined by ICDA guidelines applied to all available information listed on death certificates, and exclude some deaths classified as abortion-related by CDC. Surveillance classifications are based on broader criteria developed by CDC for expanded data gathered by individual case investigation. Results showed that the surveillance techniques had identified more deaths as abortion-related and had resolved more cases into the specific abortion categories of legal, illegal, and spontaneous than vital statistics tabulations based on death certificates. The authors estimate that the surveillance system alone reported 88% of all abortion-related deaths, the vital statistics system 52%, and the two systems combined a total of 94%. Inadequate physician documentation on the death certificate was the primary reason vital statistics data contained a smaller number of reported abortion deaths than surveillance data.
Abortion, Illegal↗
The participant effect: mortality in a community-based study compared to vital statistics.
The 20-year mortality experience of the community-based Evans County Heart Study population is compared to local, regional and national vital statistics. Deficit mortality occurred in the study population at younger ages while at older ages mortality was similar to or greater than vital statistics. This was particularly true for white and nonwhite males, whose mortality patterns were statistically significantly different from Evans Co. vital statistics (P less than 0.005). Nonwhite/white mortality ratios in the study were close to those observed in local vital statistics, particularly for males. Sex mortality ratios in the study population were lower than in vital statistics due to a stronger participant effect (lower mortality) in males. Evans Co. was an area of particularly high mortality for whites in the period 1960-1980 compared to other parts of Georgia and the U.S. Results of this study are similar to other reports of participant effects in epidemiologic follow-up studies; implications for bias in estimates of population levels of disease and of disease/exposure relationships are discussed.
Adult↗
The use of sampling for vital registration and vital statistics.
In this paper, the author does not so much try to give a blueprint for the application of sampling methods to vital registration and vital statistics as to show the opportunities for their use and the advantages to be derived from them. In the less developed areas of the world, modern sampling methods make it possible to obtain very accurate national statistics in the early stages of the establishment of a vital registration and vital statistics system and will lead to its more orderly and efficient development. In areas where more or less complete registration exists, the use of sampling may result in a reduction of costs and an improvement in the quality and currency of the data obtained.The sample vital statistics system proposed by the author should comprise complete primary registration units or combinations of them, representative of the entire universe for which statistics are wanted. The selection of these, however, must be made at random; but, in order to avoid bias, the units should be taken with probabilities proportionate to their size.After discussing the ways of carrying out his proposal and the relation of a sample vital statistics system to health programmes, the author considers the use of the sample system as a supplement to a complete system and the advantages of sampling for quality control, checking the completeness of registration, preparing advance tabulations, and conducting supplemental surveys and research.
Data Collection↗
INFECTIOUS diseases and vital statistics.
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Communicable Diseases↗
INFECTIOUS diseases and vital statistics.
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Communicable Diseases↗
Vital statistics linked birth/infant death and hospital discharge record linkage for epidemiological studies.
A methodology for linking vital statistics linked birth/death data and hospital discharge data is described. The resulting data set combines information on a neonate's sociodemographic characteristics, prenatal care, and mortality aspects and connects it to detailed health outcome and resource utilization data, thus establishing an extensive database for epidemiological studies. In the absence of a universal identifier common to both databases, our linkage strategy relied on using a virtual identifier based on variables common to both data sets. In the case of multiple incidences of the same virtual identifier we used secondary health status information to optimize the likelihood of linking low birth weight or premature infants in one database to infants of similar health status in the other while randomizing cases in which no secondary information was present. Applying our method to the 1992 California birth cohort, we could link 563,114 out of 571,189 eligible births (98.59%). Of these links, 91.2% were established on the basis of unique virtual identifiers. The link was internally consistent and no bias was evident when comparing variable distributions for all single live births in the vital statistics linked birth/death file and linked births in the linked vital statistics linked birth/death and hospital discharge file. Multiple imputation techniques showed that the prediction error incurred by randomization was negligible. Even though computationally intensive, our method for linking the vital statistics linked birth/death file and the hospital discharge file appeared to be effective. However, it is important to be aware of the limitations of the resulting data set, in particular the fact that it cannot be used for tracking individual cases. The method provides a database suitable for a variety of perinatal epidemiological analyses, such as descriptive studies of disease distribution in neonates, studies of the geographic distribution of disease, and studies of the relationship between risk and outcome.
Algorithms↗
TYPES of vital statistics available in different countries: Demographic and Social Statistics Branch, Statistical Office of the United Nations.
This article analyses the types of vital statistical data available in the 58 major statistical areas of the world, covering about half the world population. The information for the rest of the world can be assumed to be even less complete.Tables are given showing the number of areas supplying information for the various tabulations in the vital statistics section of the United Nations Demographic Yearbook, and the availability of each tabulation for each area. Other tables indicate which items of substantive interest are given on national statistical-report forms in the same areas, and with what frequency.
Birth Rate↗
Reinventing vital statistics. The impact of changes in information technology, welfare policy, and health care.
Vital statistics offers a case study in the potential of new information technology and reengineering to achieve better public sector performance. New technology--notably the shift from a paper to an electronic process for recording vital events and transmitting the data to public agencies--is creating opportunities to produce more timely, accurate, and useful information. The furthest advanced innovation is the electronic birth certificate. At the same time, changes in welfare policy and health care--including efforts to establish paternity at the time of birth and to improve health care outcomes--are creating pressures for more policy-relevant data about vital events. In addition, the rise of integrated health plans and health information networks is radically altering the organizational context of vital statistics. On the basis of a State-by-State survey of vital statistics officials, the authors estimate that at the end of 1994, 58 percent of all births in the United States were being recorded on an electronic birth certificate and communicated to a public agency electronically. Nearly all respondents reported that the electronic birth certificate brought improvements in both timeliness and accuracy of data. Achieving the full promise of the new technology, however, will require more fundamental changes in institutions and policies and a reconceptualization of the birth certificate as part of a broader perinatal information system.
Birth Certificates↗
Systematic bedside statistics used as a substitute for vital statistics at present in Ethiopia.
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Adult↗
Annual summary of vital statistics-1994.
Recent trends in the vital statistics of the United States continued in 1994, including decreases in the number of births, the birth rate, the age-adjusted death rate, and the infant mortality rate. Life expectancy increased slightly to 75.7 years. Only marriages reversed the recent trend with a slight increase in 1994. An estimated 3,979,000 infants were born during 1994, a decline of < 1% from 1993. The birth rate was 15.3 live births per 1000 population, a 1% decline. These decreasing rates reflect a decline in the fertility rate to 67.1 live births per 1000 women aged 15 to 44 years. Final figures for 1993 indicate that fertility rates declined for all racial groups, by 1% for white women (to 65.4) and 3% for black women (to 80.5). The fertility rate for Hispanic women (106.9) was 84% higher than that for non-Hispanic white women and 31% higher than for non-Hispanic black women. Between 1991 and 1993, birth rates for teenage mothers remained virtually unchanged, and abortion rates have steadily declined, suggesting that teenage pregnancy rates are levelling off. The number and proportion of births to women over age 30, however, continued to rise. The rate of births to all unmarried women (45.3 per 1000 in 1993) has been stable for 3 years. Prenatal care utilization improved in 1993; 79% of women initiated care in the first trimester and < 5% had delayed care or no care. Improvements occurred among nearly all racial and ethnic groups. Reported smoking during pregnancy declined to 15.8% in 1993 from 16.9% in 1992. The proportion of babies delivered by cesarean section was 21.8% in 1993, a 2% decrease from 1992. Between 1992 and 1993, the rate of low birth weight (LBW) rose slightly to 7.2%, while very low birth weight (VLBW) remained stable at 1.3%. Most of the increase in LBW occurred among white infants and reflected, primarily, an increase in the proportion of multiple births. The black/white ratio in LBW continued to increase to more than two-fold with the largest difference recorded among term and postterm infants. Age-adjusted death rates in 1994 were lower for heart disease, malignant neoplasm, pulmonary diseases, other accidents, and homicides. The age-adjusted death rate for human immunodeficiency virus disease continued to rise to 15.1 in 1994. The infant mortality rate declined 4% in 1994, to 7.9 per 1000, the lowest rate ever recorded in the United States. The decline was primarily in neonatal mortality.(ABSTRACT TRUNCATED AT 400 WORDS)
Adolescent↗
Annual summary of vital statistics--1995.
Recent trends in the vital statistics of the United States continued in 1995, including decreases in the number of births, the birth rate, the age-adjusted death rate, and the infant mortality rate; life expectancy at birth increased to a level equal to the record high of 75.8 years in 1992. Marriages and divorces both decreased. An estimated 3,900,089 infants were born during 1995, a decline of 1% from 1994. The preliminary birth rate for 1995 was 14.8 live births per 1000 total population, a 3% decline, and the lowest recorded in nearly two decades. The fertility rate, which relates births to women in the childbearing ages, declined to 65.6 live births per 1000 women 15 to 44 years old, the lowest rate since 1986. According to preliminary data for 1995, fertility rates declined for all racial groups with the gap narrowing between black and white rates. The fertility rate for black women declined 7% to a historic low level (71.7); the preliminary rate for white women (64.5) dropped just 1%. Fertility rates continue to be highest for Hispanic, especially Mexican-American, women. Preliminary data for 1995 suggest a 2% decline in the rate for Hispanic women to 103.7. The birth rate for teenagers has now decreased for four consecutive years, from a high of 62.1 per 1000 women 15 to 19 years old in 1991 to 56.9 in 1995, an overall decline of 8%. The rate of childbearing by unmarried mothers dropped 4% from 1994 to 1995, from 46.9 births per 1000 unmarried women 15 to 44 years old to 44.9, the first decline in the rate in nearly two decades. The proportion of all births occurring to unmarried women dropped as well in 1995, to 32.0% from 32.6% in 1994. Smoking during pregnancy dropped steadily from 1989 (19.5%) to 1994 (14.6%), a decline of about 25%. Prenatal care utilization continued to improve in 1995 with 81.2% of all mothers receiving care in the first trimester compared with 78.9% in 1993. Preliminary data for 1995 suggests continued improvement to 81.2%. The percent of infants delivered by cesarean delivery declined slightly to 20.8% in 1995. The percent of low birth weight (LBW) infants continued to climb in 1994 rising to 7.3%, from 7.2% in 1993. The proportion of LBW improved slightly among black infants, declining from 13.3% to 13.2% between 1993 and 1994. Preliminary figures for 1995 suggest continued decline in LBW for black infants (13.0%). The multiple birth ratio rose to 25.7 per 1000 births for 1994, an increase of 2% over 1993 and 33% since 1980. Age-adjusted death rates in 1995 were lower for heart disease, malignant neoplasms, accidents, and homicide. Although the total number of human immunodeficiency virus (HIV) infection deaths increased slightly from 42,114 in 1994 to an estimated 42,506 in 1995, the age-adjusted death rate for HIV infection did not increase, which may indicate a leveling off of the steep upward trend in mortality from HIV infection since 1987. Nearly 15,000 children between the ages of 1-14 years died in the United States (US) in 1995. The death rate for children 1 to 4 years old in 1995 was 40.4 per 100,000 population aged 1 to 4 years, 6% lower than the rate of 42.9 in 1994. The 1995 death rate for 5- to 14-year-olds was 22.1, 2% lower than the rate of 22.5 in 1994. Since 1979, death rates have declined by 37% for children 1 to 4 years old, and by 30% for children 5 to 14 years old. For children 1 to 4 years old, the leading cause of death was injuries, which accounted for for an estimated 2277 deaths in 1995, 36% of all deaths in this age group. Injuries were the leading cause of death for 5- to 14-year-olds as well, accounting for an ever higher percentage (41%) of all deaths. In 1995, the preliminary infant mortality rate was 7.5 per 1000live births, 6% lower than 1994, and the lowest ever recorded in the US. The decline occurred for neonatal as well as postneonatal mortality rates, and among white and black infants alike.
Global Health↗
National vital statistics needs. A report of the United States National Committee on Vital and Health Statistics.
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Humans↗
[Suicide deaths among psychiatric patients--a study based on vital statistics].
Utilizing data from the Vital Statistics in 1987 of the Ministry of Health and Welfare, a study was performed to estimate suicide mortality rates among psychiatric in and out-patients. Mental disorder was recorded as being present on 1,755 certifications of suicide deaths (984 men and 771 women). Suicide rate per 100,000 person-years in psychiatric in-patients was 167.3 for males, 116.0 for females. Compared with the general population, this represented an age-standardized mortality ratio (SMR) of 4.5 for males and 5.3 for females. For out-patients the suicide rate was 135.7 for males and 103.7 for females, and the SMR was 4.6 and 5.9 respectively. Considering that the possibility of omission of mental disorders in a death certificate is greater for an out-patient than that for an in-patient, it is concluded that the suicide rate of psychiatric out-patients is greater than that of in-patients.
Adolescent↗
Vital statistics as a data source.
A focus group convened at a National Institutes of Health (NIH) Stillbirth Conference discussed issues related to vital statistics as a data source on fetal mortality. Fetal death is a tragic occurence and part of the continuum of pregnancy outcomes. A primary source of data is the National Vital Statistics System fetal death component, which is routinely used to track mortality trends and to provide the context for nonrepresentative investigations. The data are also used to examine differentials in mortality by characteristics and to evaluate data quality. Issues concerning how to improve the vital statistics data include culture and context; data instrument; persons providing information; what information is available to the information provider; processing issues; and use of data. Perhaps most important is to enhance recognition of fetal death both for the individual confronting a loss and to promote research. Other studies are needed to augment the information obtainable through vital records.
Culture↗