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At least 19 recordsLinked to original sources

The autopsy and vital statistics.

Vital statistics in the United States are collected through a decentralized, cooperative system of various levels of government administrated by the National Center for Health Statistics. Although registration of all deaths is virtually complete and demographic items are accurate, the reliability of cause of death data is hampered by the current state of medical knowledge, the incompleteness of information available at the time of death, the way in which physicians complete death certificates, and the system of classification of underlying cause. The need for quality assurance in national cause of death statistics can be met in large part by connecting the autopsy to the mainstream of vital statistics. Through case by case individual linkage of death certificates and autopsies in designated demographic and/or geographic areas, a representative, continuously collected, population-based system of aggregated autopsy data would be created. Demographic and clinical selection bias should be checked and adjusted through traditional methods of epidemiologic standardization. Such a use of autopsy information could further pathology's goals of understanding disease and improving the public health.

Autopsy↗

Survey of cause-of-death query criteria used by state vital statistics programs in the US and the efficacy of the criteria used by the Oregon Vital Statistics Program.

A survey of the 52 vital statistics registration areas in the United States revealed that at least 23 did not fulfill the minimum cause-of-death query guidelines recommended by the National Center for Health Statistics. The Oregon Center for Health Statistics is one of only a few that query certifying physicians at a comprehensive level. During August 1986-July 1987, a total of 2,453 of 23,238 death certificates were returned to the certifiers for additional information, not including those returned in a tobacco use study. More than one-half (56.1 per cent) resulted in new and more specific underlying cause-of-death data. Only 5.2 per cent of the queries were unanswered. One probable result of Oregon's program is that the state has the highest percentage of liver cirrhosis and disease deaths attributed to alcohol abuse in the United States. Nationally, 41.7 per cent of all liver disease and cirrhosis deaths in 1984 were listed as due to alcohol compared to 82.4 per cent in Oregon. The state's total liver cirrhosis and disease death rate (12.0 per 100,000 population) is only marginally higher than the United States rate (11.6). The query program also serves to locate maternal deaths that would otherwise not be reported, as well as to provide more accurate cause-of-death statistics in general.

Cause of Death↗

[Vital statistics: mechanisms of improvement].

Within the realm of basic statistics, information on vital facts represents a main tool for the study of the movement and dynamics of a population. Despite their importance, vital statistics in developing countries have had a limited development due to financial, cultural, geographical and coordination factors among the different institutions involved in recording vital statistics. Since 1982, Mexico has experienced a radical change in its system of vital statistics, which remained almost untouched for close to a century. Now (1988), the Mexican system of vital statistics has a completely modified and updated structure. This new structure permits interinstitutional actions which are necessary in order to achieve the consolidation of the system of vital statistics in Mexico.

Humans↗

Assessing the burden of cancer in Texas using vital statistics data.

BACKGROUND: Vital statistics data were used to describe the burden of cancer in Texas. METHODS: Average annual age-adjusted mortality data in Texas (1986 to 1990) for 17 cancer types were compared with the US data for whites and blacks and with California data for Hispanics. Trends were examined from 1980 to 1990 for the entire state and from 1976 to 1989 for 24 geographic regions within the state. RESULTS: Mortality excesses were detected for lung and liver cancer, and deficits for colorectal, breast, and prostate cancers. Rates were generally stable from 1980 to 1990 with several exceptions (lung, liver, colon). Six areas of Texas, including four areas along the Gulf Coast, had relatively more excesses of various cancers, without a discernible pattern by cancer type. CONCLUSIONS: Overall, Texas has fared favorably in cancer mortality when compared with the United States. Enhanced evaluation of the frequency of cancer, as well as the conduct of etiologic research, must await the availability of statewide long-term cancer incidence data.

Black or African American↗

Annual summary of vital statistics--1998.

Most vital statistics indicators of the health of Americans were stable or showed modest improvements between 1997 and 1998. The preliminary birth rate in 1998 was 14.6 births per 1000 population, up slightly from the record low reported for 1997 (14.5). The fertility rate, births per 1000 women aged 15 to 44 years, increased 1% to 65.6 in 1998, compared with 65.0 in 1997. The 1998 increases, although modest, were the first since 1990, halting the steady decline in the number of births and birth and fertility rates in the 1990s. Fertility rates for total white, non-Hispanic white, and Native American women each increased from 1% to 2% in 1998. The fertility rate for black women declined 19% from 1990 to 1996, but has changed little since 1996. The rate for Hispanic women, which dropped 2%, was lower than in any year for which national data have been available. Birth rates for women 30 years or older continued to increase. The proportion of births to unmarried women remained about the same at one third. The birth rate for teen mothers declined again for the seventh consecutive year, and the use of timely prenatal care (82.8%) improved for the ninth consecutive year, especially for black (73.3%) and Hispanic (74.3%) mothers. The number and rate of multiple births continued their dramatic rise; the number of triplet and higher-order multiple births jumped 16% between 1996 and 1997, accounting, in part, for the slight increase in the percentage of low birth weight (LBW) births. LBW continued to increase from 1997 to 1998 to 7.6%. The infant mortality rate (IMR) was unchanged from 1997 to 1998 (7.2 per 1000 live births). The ratio of the IMR among black infants to that for white infants (2.4) remained the same in 1998 as in 1997. Racial differences in infant mortality remain a major public health concern. In 1997, 65% of all infant deaths occurred to the 7.5% of infants born LBW. Among all of the states, Maine, Massachusetts, and New Hampshire had the lowest IMRs. State-by-state differences in IMR reflect racial composition, the percentage LBW, and birth weight-specific neonatal mortality rate for each state. The United States continues to rank poorly in international comparisons of infant mortality. Expectation of life at birth increased slightly to 76.7 years for all gender and race groups combined. Death rates in the United States continue to decline, including a drop in mortality from human immunodeficiency virus. The age-adjusted death rate for suicide declined 6% in 1998; homicide declined 14%. Death rates for children from all major causes declined again in 1998. A large proportion of childhood deaths, however, continue to occur as a result of preventable injuries.

Adolescent↗

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↗

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↗

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↗