1. U.S. Department of Health and Human Services Centers for Disease Control and Prevention National Center for Health Statistics Division of Vital Statistics U.S. Department of Health and Human Services Centers for Disease Control and Prevention National Center for Health Statistics Division of Vital Statistics T.J. Mathews The Linked Birth/Infant Death Data Set

2. SOURCE: CDC/NCHS National Vital Statistics System

3. Only Cities and Counties with populations over 250,000 are identified in the data set. Only Cities and Counties with populations over 250,000 are identified in the data set. Geographic suppression is used to protect confidentiality

4. SOURCE: CDC/NCHS National Vital Statistics System The Linked file has more accurate reporting of Race and Ethnicity than the main Mortality file. The Linked file has more accurate reporting of Race and Ethnicity than the main Mortality file. Race and Ethnicity reporting

5. SOURCE: CDC/NCHS National Vital Statistics System Birth Certificate checkbox items add many variables to the Linked file Medical Risk Factors Medical Risk Factors Obstetric Procedures Obstetric Procedures Complications of Labor Complications of Labor

6. SOURCE: CDC/NCHS National Vital Statistics System 2000 Cohort File = 2000 births, 2000 and 2001 deaths Cohort File – data based on all deaths to infants born in a given year

7. SOURCE: CDC/NCHS National Vital Statistics System 2001 Period File = 2001 deaths, 2000 and 2001 births Period File – data based on all infant deaths in a given year

8. SOURCE: CDC/NCHS National Vital Statistics System Creating the Linked file at NCHS Birth Certificate -> Hospital* -> State Vital Statistics Office -> NCHS -> File and NCHS -> File and Publication Production Publication Production *99% of US births

9. SOURCE: CDC/NCHS National Vital Statistics System Timing and Dissemination of data No files for 1992-1994 No files for 1992-1994 2002 Period file now in process 2002 Period file now in process

10. SOURCE: CDC/NCHS National Vital Statistics System Linked file data available on CD ROM Cohort file – 1985-91 and 1995-2000 Cohort file – 1985-91 and 1995-2000 Period file available on the Perinatal CD ROM – 1995-2001 Period file available on the Perinatal CD ROM – 1995-2001

11. SOURCE: CDC/NCHS National Vital Statistics System Infant mortality rate by race and ethnicity, 2001 Note: Rates are per 1,000 lives births. Total U.S.

12. SOURCE: CDC/NCHS National Vital Statistics System Infant mortality rates by State, 1999- 2001 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 6.0-6.9 Less than 6.0 7.0-7.9 8.0-8.9 DC Note: Rate is per 1,000 live births 9.0 or more US rate = 6.9

13. SOURCE: CDC/NCHS National Vital Statistics System +3% Infant mortality rate: United States, 1990-2002 * Preliminary data

14. SOURCE: CDC/NCHS National Vital Statistics System BEFORE Is the increase the result of changes in risk BEFORE birth:   Maternal characteristics (age, hypertension)   Infant characteristics (multiple births),   Characteristics of labor & delivery (induction) AFTER OR risk of death AFTER birth:   Birthweight/gestation-specific mortality   Obstetric and neonatal care Stay tuned: Research from the 2002 Linked Birth/Infant Death File