[National committees of vital and health statistics].
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Biometry↗
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The 1989 revisions of the US Standard Certificates of Live Birth and Death and the US Standard Report of Fetal Death.
The US Standard Certificates and Reports are models used by state vital statistics offices to develop documents for the collection of data about vital events. The 1989 revisions incorporate some major modifications to previous versions. Both the Standard Certificate of Live Birth and the Standard Report of Fetal Death utilize a checkbox format to elicit information on medical and other risk factors affecting the pregnancy, complications of labor and/or delivery, obstetric procedures, method of delivery, congenital anomalies, and abnormal conditions of the newborn. Revisions to the Standard Certificate of Death include modifications to the medical certification section and the addition of decedent's educational attainment. Items requesting information about Hispanic origin are added to all of these documents. The rationale behind these changes and their intended use are discussed.
Birth Certificates↗
Medical and life-style risk factors affecting fetal mortality, 1989-90.
OBJECTIVES: This report presents fetal mortality data by medical and life-style risk factors of the mother and the fetus. METHODS: Deaths and fetal mortality rates are presented in this descriptive report. Data sources used are vital statistics data for fetal deaths and live births. RESULTS: The data that became available with the revision of the U.S. Standard Report of Fetal Death in 1989 expanded the medical and health data available on mothers and fetuses. Reporting of medical conditions is probably incomplete for fetal deaths as well as for live births. Therefore, caution should be exercised in using this data. Reported occurrences of medical and life-style risk factors of mother and fetus for fetal deaths and live births and fetal mortality rates are presented. Maternal medical conditions most often associated with having a fetal death were problems with amniotic fluid levels and blood disorders. Fetal mortality was 35 percent greater when tobacco was used during pregnancy and 77 percent higher when alcohol was consumed during pregnancy. The complication of labor most often associated with fetal mortality was abruptio placenta. Although a very small proportion of all deliveries have specific congenital anomalies reported, fetal mortality was close to 50 percent for anencephalus, about 25 percent for renal agenesis, and slightly more than 20 percent for hydrocephalus.
Adult↗
Maternal age and birth outcomes: data from New Jersey.
The effects of maternal age on low birth weight, newborns' hospital costs and infant mortality were estimated based on individual 1989 and 1990 vital statistics records from New Jersey that were linked with uniform billing hospital discharge records. Results of multivariate analyses show a U-shaped relationship between maternal age and low birth weight among whites, with the youngest (younger than 15) and oldest (aged 40 and older) mothers being at higher risk than 25-29-year-olds; older teenagers were not at any significantly increased risk. Among blacks, however, 15-19-year-olds faced significantly lower risks of delivering low-birth-weight babies than did black women aged 25-29. Both black and white mothers in their 30s were significantly more likely to deliver a low-birth-weight baby than women aged 25-29 of the same race. The multivariate analysis also showed that newborn hospitalization costs increased with maternal age among both blacks and whites. The seemingly poorer birth outcomes of teenage mothers appear to result largely from their adverse socioeconomic circumstances, not from young maternal age per se.
Adolescent↗
Outmigrant ascertainment for bias assessment in environmental epidemiology.
BACKGROUND: In the summer of 1985, the McGill Epidemiology Rapid Response Unit undertook a study comparing two areas exposed to emissions of 'sour gas' refineries to an unexposed area. One operational objective of the project was the identification and survey of all the people who had lived in the study area but had since moved (outmigrants). METHODS: We estimated the number of outmigrants (people who had ever lived in the area during the period 1957 to 1985) to be 3363 by using information obtained from our cross-sectional survey and from population statistics for the area of interest. Ten different methods combined lead to the identification of approximately 87% of all the outmigrants who left the study area during that period. We used vital statistics to identify the outmigrants who had died and mailed questionnaires to obtain the necessary information from the others. RESULTS: We confirmed the vital status of approximately 46% of them (1532/3363). The results from the outmigrant survey showed that they were younger than area residents, that they experienced lower rates of heart disease and hypertension and that they had moved for health reasons in only 1.3% of the cases. These findings were similar across comparison areas. CONCLUSION: We concluded that there was no effect due to migration bias on the cross-sectional study results. This evidence considerably strengthened the conclusions regarding the effects of exposure, a benefit that largely justified the cost of identifying and surveying the outmigrants.
Adolescent↗
The state of federal health statistics on racial and ethnic groups.
OBJECTIVE: To examine assumptions underlying federal health statistics on racial and ethnic groups in the United States. DATA SOURCES: Studies conducted by federal agencies and other investigators, and technical appendices of published vital statistics and census reports. DATA SYNTHESIS: Several assumptions underlying federal health statistics on racial and ethnic groups are not well supported. Conceptual (as opposed to operational) definitions of race and ethnicity are not available, and scientific grounds for definition are not considered. Procedures for the ascertainment of race and ethnicity vary within and among data-collection agencies. Miscounting and misclassification may vary by an order of magnitude between whites and other races. The responses of individuals to questions of racial and ethnic identity differ for different indicators, in different surveys, and at different times. As a result, counts, rates, and rate ratios may not be meaningful or accurate. Particularly for Hispanics and for races other than whites or blacks, there are inconsistencies in statistical information that may hinder health research and program development. CONCLUSIONS: Improvement of federal health statistics for racial and ethnic groups requires (1) clarification of goals for classification, (2) adoption of scientific principles for the validation and definition of the categories "race" and "ethnicity," (3) assessment of perceived social identity in the population, and (4) periodic evaluation.
Data Collection↗
An international comparison of mortality in middle-aged men from cardiovascular diseases during 1970--1974.
An international comparison of mortality rates in middle-aged men (35--54 years) from cardiovascular diseases (CVD) during the period 1970--1974 was made. The material for this study was obtained from the statistics of the WHO (World Health Statist. Ann. 1970--1974, Vol. I, Vital Statistics of Causes of Death. WHO, Geneva, 1973--1976). The mean death rate of middle-aged men from all CVD and ischaemic heart diseases was clearly higher in Finland than in any other country in the world during the 5-year period. The mortality rates according to all ICD (International Classification of Diseases) main groups of diseases were determined for a selected group of countries containing all the Scandinavian countries, the United States, Canada, Hungary, Australia, Scotland, and Czechoslovakia. The death rates of all natural (ICSI-XVI) and unnatural causes (ICDXVII) were higher in Finland than in the other selected countries. Also the proportion of cardiovascular deaths as a percentage of all natural deaths was clearly higher in Finland than in any of the above countries, whereas in these countries proportionally more deaths were due to neoplasms than in Finland, especially in men aged 35--44. Only in Hungary did infectious diseases account for about 4.5% of all natural deaths; in the other countries they accounted for only about 1--2%. In the United States, Sweden, Czechoslovakia and Canada a clearly higher relative number of deaths (about 9--13%) were due to diseases of the digestive system than in the other countries (about 3--9%), whereas the relative numbers of deaths from respiratory and genitourinary diseases were uniform among all selected countries. Only in Denmark and Norway was a prominent proportion of the deceased (3.5--9.5%) certified as having died due to some symptom or ill-defined condition. About 90% of all middle-aged men died in each country from various diseases of the above six main ICD categories. As a whole, the above single deviations from the general trend were so small that the present results do not support the view that the differences in certifying and coding practices could explain the significant differences found in cardiovascular mortality of middle-aged men between various countries.
Adult↗
Trends in early and late deaths due to motor vehicle accidents in Japan.
To clarify trends and urban-rural differences in the early death rate (deaths within 24 h divided by the deaths within 1 year after motor vehicle accident x100 [%]) due to motor vehicle accidents (MVAs) in Japan. Mortality data were collected from the annual statistics of traffic accident research and vital statistics in Japan from 1980 through 1998 and analyzed. Early death rates were nearly constant (73.9-78.0%) from 1980 through 1998. Early death rates were lower in younger and elderly groups. As regards to geographic variations, early death rates and 1-year death rates per 100,000 vehicles were significantly higher in rural areas (population density <1000/km(2)) than in urban areas. To investigate MVA deaths, both early and late deaths should be examined. Decreasing the early death rate, a new index for MVA death, which reflects the reduction of injury severity is important for preventing MVA deaths.
Journal Article↗
Discrepancies between published data on racial classification and self-reported race: evidence from the 2002 North Carolina live birth records.
OBJECTIVES: We compared data on race as reported by the mother on North Carolina birth certificates with data on race in officially reported statistics. We also determined to what extent differences in the classification of race affect measures of racial disparity in maternal and child health indicators. METHODS: We examined how data on race are collected, coded, and tabulated in North Carolina via live birth certificates, death certificates, the Behavioral Risk Factor Surveillance System (BRFSS) telephone survey, and the Central Cancer Registry case records. We showed how the data on race collected through North Carolina birth and death certificates are translated into 10 fixed racial categories designated by the National Center for Health Statistics (NCHS) for use in official vital statistics. We compared race as reported by the mother on birth certificates to racial tabulations used in the official published birth statistics. We also examined to what extent differences in the determination of race affect measures of racial disparity in maternal and child health indicators. RESULTS: Out of nearly 118,000 live births in North Carolina in 2002, mothers reported more than 600 different versions of race on birth certificates. These entries were collapsed into the 10 standard racial categories outlined in federal coding rules. Approximately two-thirds of mothers of Hispanic ethnicity report their race with a label that can be categorized as "Other" race, but nearly all of these births are re-coded to "white" for the official birth statistics. Measures of racial disparity vary depending on whether self-reported or officially coded race is used. CONCLUSIONS: This study shows that, given the opportunity to report their own race, North Carolinians describe their race using a wide variety of terms and concepts. In contrast, health statistics are usually reported using a few standardized racial categories defined by federal policy. The NCHS rules for coding race should be reexamined. As the ethnic and racial diversity of the United States continues to increase, these rules will become increasingly antiquated.
Birth Certificates↗
Objectives underlying future patterns of work of national committees on vital and health statistics.
As a basis for considering the forms and patterns of national committees on vital and health statistics in the future, the author first discusses the six main objectives of national systems of those statistics. Turning then to the aims of the national committees themselves, he observes that such is the variety of statistcal needs in different countries in view of their different stages of economic development that the work of the national committees at present inevitably differs greatly from country to country and must continue to do so as development continues. However, the common purpose of the committees is to help in developing, or in strengthening, the statistical structure of each country. Any activity or objective of a national committee that furthers one or more of the country's objectives can be regarded as worthwhile and legitimate.
Health Services Needs and Demand↗
Federal monitoring of the nation's nutritional status. Contributions of the National Center for Health Statistics.
The National Center for Health Statistics conducts a broad program of record-based systems and population surveys providing information on the health and nutritional status of the US population. The record-based systems include vital statistics and health-care surveys. Population surveys include the National Health and Nutrition Examination Survey (NHANES), the National Health Interview Survey, the National Survey of Family Growth, and epidemiologic follow-back surveys. Although all of these data systems provide nutrition-related information, the NHANES collects the most directly relevant nutritional status data through interview and examination of a national probability sample of children and adults. The third NHANES is scheduled to begin in September 1988 and is designed to provide cross-sectional estimates of dietary intake and nutritional status for nutrition-monitoring purposes and to serve as the baseline for longitudinal studies of diet and health.
Anthropometry↗
[Cause of death statistics (I). Resources for risk evaluation in life insurance?].
Vital statistics as they are generally used are of no help for evaluation of risks in life insurance since they are biased by the high number of the elderly population beyond age 70. Therefore the causes of death were compiled for the age groups from 15 to 70 that are of importance in life insurance. Tumors are the number one cause of death and not cardiovascular diseases which so far have been considered to be the number one. They take second place. Even in the male population cardiovascular diseases are the number one cause of death only from age 60 on upwards. Further cross-sectioning according to decades of age shows the typical causes of death for any particular age group. Below age 30 non-natural causes s. a. accident and suicide take with over 50 per cent first place. Females have a much lower mortality as is generally known; they contribute only one third to the overall mortality of the age group under consideration.
Adolescent↗
Methodological issues for vital rates and population estimates: 1997 OMB standards for data on race and ethnicity.
A workshop in July 2000 explored research needed to address methodological challenges for population estimates and vital rates arising from the revision of the standards for Federal data on race and ethnicity; the use of different standards for Census 2000 and vital records during the implementation of the revised standards; and underlying differences in the collection of race and ethnicity data in censuses and surveys and in vital records. Matching studies were proposed to compare race and ethnicity reports in vital records and in Census 2000 or survey responses. Work on vital records might include exploring enhanced collection of race and ethnicity data and documenting State vital statistics reporting mandates and practices. Key work on sources of error includes identifying, quantifying, and reporting on bias and random errors related to race and ethnicity in population estimates and vital rates. Also needed are comparisons of Census Bureau and State population estimates and more frequent tests of the accuracy of population estimates and projections. Studies on racial and ethnic identity were proposed to examine changes in reporting over time and to explore origins of racial and ethnic identities. More information on these issues should be developed for technical and nontechnical audiences.
Data Collection↗
Alberta Congenital Anomalies Surveillance System.
The Alberta Congenital Anomalies Surveillance System was started in 1966 in response to the thalidomide tragedy earlier in the decade. It was one of four provincial surveillance systems on which the federal government relied for baseline statistics of congenital anomalies. The government now collects data from six provinces and one territory. The Alberta Congenital Anomaly Surveillance System originally depended on three types of notification to the Division of Vital Statistics, Department of Health, Government of Alberta: birth notice and certificates of death and stillbirth; increased sources of ascertainment have greatly improved data quality. We present the data for 1980-86 and compare the prevalence rates of selected anomalies with the rates from three other surveillance systems. Surveillance systems do not guarantee that a new teratogen will be detected, but they are extremely valuable for testing hypotheses regarding causation. At the very least they provide baseline data with which to compare any deviation or trend. For many, if not most, congenital anomalies total prevention is not possible; however, surveillance systems can be used to measure progress in prevention.
Alberta↗
Births and deaths: preliminary data for July 1997-June 1998.
OBJECTIVES: This report presents preliminary data on births and deaths in the United States from the National Center for Health Statistics (NCHS) for the 12 months ending June 1998. U.S. data on births are shown by age, race, and Hispanic origin of mother. Natality data on marital status, prenatal care, cesarean delivery, and low birthweight are also presented. Mortality data presented include leading causes of death and infant mortality. METHODS: Data in this report are based on more than a 99-percent sample of births and on more than an 89-percent sample of deaths in the United States for the 12 months ending June 1998. The records are weighted to independent control counts of births, infant deaths, and deaths 1 year and over received in State vital statistics offices from July 1997 to June 1998. Unless otherwise indicated, comparisons are made with final data for the 12-month period ending June 1997. RESULTS: For the period July 1997-June 1998, the birth rate for teenagers dropped 4 percent to 51.5 births per 1,000 women aged 15-19 years, the lowest level since 1987. Birth rates for teenagers have been declining since 1991. Birth rates for women aged 20-29 years changed very little, whereas rates for women in their thirties and forties rose 2 to 4 percent. The birth rate for unmarried women declined slightly, but the number of births to unmarried women was up about 1 percent because of an increase in the number of unmarried women. The rate of prenatal care utilization continued to improve. The percent of births delivered by cesarean section rose from 20.7 percent to 20.9 percent as the result of a slight increase in the primary cesarean rate and a substantial decline in the rate of vaginal births after previous cesarean (VBAC). The overall low birthweight rate was unchanged at 7.5 percent. Age-adjusted death rates reached a record low, 2 percent below the rate for the previous 12-month period. The largest declines in estimated age-adjusted death rates among the leading causes of death were for Human immunodeficiency virus (HIV) infection (37 percent) and homicide (9 percent). Smaller declines were noted for most of the other leading causes of death, but no increases occurred. Mortality also decreased for firearm injuries and alcohol-induced deaths. The infant mortality rates for all races and white and black infants were about the same as the corresponding rates for the previous 12-month period.
Adolescent↗
[The development of demographic surveys and censuses in Indonesia].
"The development of statistical activities in Indonesia since the 1960s is outlined with special reference to demographic surveys and population censuses." The author notes the substantial improvements that have been made in the design, organization, and execution of censuses and surveys and expresses the hope that similar improvements can be made in the vital statistics system. (summary in ENG)
Asia↗
The use of sentinel injury deaths to evaluate the quality of multiple source reporting for occupational injuries.
PURPOSE: This study sought to develop an efficient method for evaluating the validity and completeness of routinely available sources of occupational injury fatality data. METHODS: Deaths due to falls from elevations, machinery, and electrocutions were selected as sentinel injuries likely to have occurred at work. Deaths from these injuries were identified from Maryland vital statistics over 7 years. The work-relatedness of these injuries and sensitivity of reporting were determined from death certificates, medical examiner reports, the National Traumatic Occupational Fatality System (NTOF), the Maryland Occupational Safety and Health Administration (MOSH), and Workers' Compensation (WC) data. RESULTS: A total of 527 deaths were identified for ages 16 and above, of which, 45% were work-related. Identification of work-related deaths varied by source: medical examiner (100%), death certificates (89%), NTOF (68%), MOSH (59%), and WC (44%). Reporting differed by age, cause of injury, year, occupation, and industry. CONCLUSIONS: Examination of work-relatedness for deaths from certain causes is an efficient means of evaluating the quality of occupational injury reporting source data. These sentinel injuries uncovered significant underreporting in sources used by national surveillance systems, resulted in improved NTOF reporting, and suggest the need to make more use of medical examiner data when available.
Accidents, Occupational↗
Rainbow reviews. VII: Recent publications of the National Center for Health Statistics.
In this article, selected recent publications of the National Center for Health Statistics (NCHS) are reviewed. In particular, data from a recent NCHS report on hearing loss were found to be consistent with a prediction made in a preview article in this series that there would be an increase in high-tone hearing loss among persons who were exposed to loud music as teenagers and young adults, beginning in the late 1960s, although the data were not specific enough to be considered proof. In addition, the article discusses: (1) recent data on home health care, (2) new insights on how people remember and report on preventive examinations and tests, (3) a comparison of vital statistics in the United States and the Russian Federation, and (4) trends in births to unmarried women.
Adolescent↗