National Vital Statistics System - Natality Stephanie J. Ventura, M.A. National Center for Health Statistics Presented at the 134th Annual Meeting & Exposition of the American Public Health Association Continuing Education Institutes November 4, 2007 Washington, DC

Joyce A. Martin (Team Leader) T. J. Mathews Fay Menacker The Natality Team Brady E. Hamilton Sharon Kirmeyer Marian F. MacDorman Joyce A. Martin (Team Leader) T. J. Mathews Fay Menacker Martha L. Munson Paul D. Sutton Stephanie J. Ventura (Branch Chief) Began with 12 registration areas in 1900 All States included beginning in 1933

Core of our health data system Vital Statistics Core of our health data system Base for public health, social science, economic planning and program development Monitor key indicators of health world-wide and at the local, state and national level Track progress to goals Identify disparities Alert to emerging problems Every now and then we need to even remind ourselves of the value of this data system. And why all of our efforts to re-engineer are so worthwhile. -- It’s the core of our health data system – the oldest, the leader, a pioneer -- Vital statistics provide the base for public health research, policies and programs but also in every phase of life, here and throughout the world -- Vital statistics track progress, identify disparities, alert us to new or emergency programs.

National Vital Statistics System Registration of births and deaths is not a Federal activity – responsibility lies with the states Vital Statistics Cooperative Program Includes all 57 registration areas (all states and territories, DC and NYC) Standardization of data collection and data processing Comparability among states Compilation of national vital statistics data sets Began with 12 registration areas in 1900 All States included beginning in 1933

U.S. Standard Certificate of Live Birth: 2003 Revision Legal information:

U.S. Standard Certificate of Live Birth: 2003 Revision LOCAL FILE NO. BIRTH NUMBER: U.S. Standard Certificate of Live Birth: 2003 Revision Parents’ Demographic Information and Birth Place Information: REV. 11/2003

U.S. Standard Certificate of Live Birth: 2003 Revision LOCAL FILE NO. BIRTH NUMBER: U.S. Standard Certificate of Live Birth: 2003 Revision Maternal Medical and Health Information: REV. 11/2003

U.S. Standard Certificate of Live Birth: 2003 Revision LOCAL FILE NO. BIRTH NUMBER: U.S. Standard Certificate of Live Birth: 2003 Revision Newborn Information: REV. 11/2003

Implementation of the 2003 Revised Birth Certificate MT WY ID WA OR NV UT CA AZ ND SD NE CO NM TX OK KS AR LA MO IA MN WI IL IN KY TN MS AL GA FL SC NC VA WV OH MI NY PA MD DE NJ CT RI MA ME VT NH AK HI DC 2003 or 2004 2005 Mid-year reviser 2006 2007 or later NOTE: New York State but not New York city implemented for 2004.

Challenges in Implementing the 2003 Revised Birth Certificate Delayed/Phased/Selective implementation of 2003 revised birth certificate Multiple-race and geographic coding Modified (improved) and new items Natality data files for 2003 and later years – larger and complex

Benefits in Implementing the 2003 Revised Birth Certificate Changes to existing items New items Improved data quality Worksheets Edit data at source Standardized edits for all items

Types of Data Dissemination: National Vital Statistics Reports Provisional Reports Counts of births, deaths, infant deaths Only source of information on marriages and divorces SOURCE: CDC/NCHS National Vital Statistics System

Preliminary Data Based on substantial sample of records – 99% of all births for 2005 More detailed inclusive annual report Provides preview of data in final report Data track very well with those from final report Sample of all records received and processed by cut-off date – 4-5 months after end of data year Published 6-10 months after end of year

Final Data Annual report – based on all US births in a given year Discussion and detailed data on almost all items in the data set Released 12-14 months after end of year Accompanies release of public use data file

Types of Data Dissemination: National Vital Statistics Reports SOURCE: CDC/NCHS National Vital Statistics System

Types of Data Dissemination: Topical Reports SOURCE: CDC/NCHS National Vital Statistics System

Selected Findings from Reports

From: Expanded Health Data from the New Birth Certificate, 2004 Rates of prepregnancy diabetes: 7 reporting states, 2004 SOURCE: CDC/NCHS National Vital Statistics System

From: Births: Preliminary Data for 2005 Cesarean delivery rates by age of mother: US, 1990-2005 SOURCE: CDC/NCHS National Vital Statistics System

From: Infant Mortality Statistics from the 2004 Period Linked Birth/Infant Death Data Set Total and preterm-related infant mortality rates by race and ethnicity of mother: United States, 2004 SOURCE: CDC/NCHS National Vital Statistics System

Population of Hispanic Origin and Subgroups, 2000 From: Birth and Fertility Rates for States by Hispanic Origin Subgroups: United States, 1990 and 2000 Population of Hispanic Origin and Subgroups, 2000

From: Births: Preliminary Data for 2005 Percentage of preterm births: United States, 1990, 2004, and 2005 SOURCE: CDC/NCHS National Vital Statistics System

Upcoming Reports Births: Preliminary Data for 2006 Expanded Health Data from the New Birth Certificate, 2005 Fetal and Perinatal Mortality: United States, 2005 Infant Mortality Statistics from the 2005 Period Linked Birth/Infant Death Data Set Estimated Pregnancy Rates: United States, 1990-2003 Teenage Birth Rates for the United States, 1940-2006 Births: Final Data for 2005

Types of Data Dissemination: Vital Statistics of the United States Tabulated Data

Types of Data Dissemination: Public Use Micro Data Files (ASCII and SETS versions) Unit Record Data SOURCE: CDC/NCHS National Vital Statistics System

Types of Data Dissemination: Online Data Access Tools SOURCE: CDC/NCHS National Vital Statistics System  

Interactive Table from VitalStats

Other Web based interactive data systems CDC WONDER: http://wonder.cdc.gov/ CDC Interactive Atlas of Reproductive Health: http://www.cdc.gov/reproductivehealth/gisatlas/index.htm

Website addresses National Center for Health Statistics Web Page: http://www.cdc.gov/nchs/ Birth Data Web Page: http://www.cdc.gov/nchs/births.htm Linked Birth/Infant Death Web Page: http://www.cdc.gov/nchs/linked.htm 2003 Revisions of the U.S. Standard Certificates of Live Birth and Death and the Fetal Death Report Web Page: http://www.cdc.gov/nchs/vital_certs_rev.htm U.S. Census Populations with Bridged Race Categories Web Page: http://www.cdc.gov/nchs/about/major/dvs/popbridge/popbridge.htm

For more information contact: Stephanie Ventura SVentura@cdc.gov Joyce Martin JAMartin@cdc.gov Brady Hamilton BHamilton@cdc.gov Paul Sutton PSutton@cdc.gov Or births@cdc.gov -- 301-458-4111