1. U.S. Department of Health and Human Services Centers for Disease Control and Prevention National Center for Health Statistics Division of Vital Statistics The National Natality Data Set Paul D. Sutton, Ph.D.

2. SOURCE: CDC/NCHS National Vital Statistics System 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)

3. SOURCE: CDC/NCHS National Vital Statistics System Vital Statistics Cooperative Program (VSCP) Goals Goals Standardize definitions Standardize definitions Standardize measures for quality Standardize measures for quality Standardize methods for collecting, processing and analyzing vital statistics Standardize methods for collecting, processing and analyzing vital statistics

4. SOURCE: CDC/NCHS National Vital Statistics System 1989 U.S. Standard Certificate of Live Birth

5. SOURCE: CDC/NCHS National Vital Statistics System Confidentiality Public Use Data files do NOT include Names Names Addresses Addresses Geographic identifiers for cities or counties with population under 100,000 Geographic identifiers for cities or counties with population under 100,000 Dates of birth for infants, mothers, fathers Dates of birth for infants, mothers, fathers Birth certificate numbers Birth certificate numbers

6. SOURCE: CDC/NCHS National Vital Statistics System Items on the 1989 Standard Birth Certificate Maternal demographics (i.e. Hispanic origin, race, age, education) Maternal demographics (i.e. Hispanic origin, race, age, education) Maternal and infant health characteristics Maternal and infant health characteristics

7. SOURCE: CDC/NCHS National Vital Statistics System Hispanic Origin and subgroups Mexican Mexican Puerto Rican Puerto Rican Cuban Cuban Central or South American Central or South American

8. SOURCE: CDC/NCHS National Vital Statistics System Asian of Pacific Islander (API) subgroups Coded prior to 1992 Chinese Chinese Japanese Japanese Hawaiian Hawaiian Filipino Filipino Other API Other API Expanded coding beginning with 1992* Vietnamese Vietnamese Asian Indian Asian Indian Korean Korean Samoan Samoan Guamanian Guamanian Remaining API Remaining API *detail reported by 11 states

9. SOURCE: CDC/NCHS National Vital Statistics System Some Health Items on the 1989 Standard Birth Certificate Maternal medical risk factors- e.g. hypertension, diabetes Maternal medical risk factors- e.g. hypertension, diabetes Induction, stimulation of labor Induction, stimulation of labor Cesarean rates/VBAC rates Cesarean rates/VBAC rates Preterm delivery, low birthweight Preterm delivery, low birthweight Tobacco use Tobacco use Multiple births Multiple births

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

11. SOURCE: CDC/NCHS National Vital Statistics System Provisional Data Most timely data release of counts and rates Most timely data release of counts and rates Short “fact sheet” released monthly on the Internet in the NVSR series Short “fact sheet” released monthly on the Internet in the NVSR series Includes counts of births, deaths, infant deaths, marriages & divorces Includes counts of births, deaths, infant deaths, marriages & divorces Estimates based on counts of certificates received during a one- month period, regardless of month of occurrence Estimates based on counts of certificates received during a one- month period, regardless of month of occurrence

12. SOURCE: CDC/NCHS National Vital Statistics System Preliminary Data Based on substantial sample of records – 98% of all births for 2002 Based on substantial sample of records – 98% of all births for 2002 More detailed inclusive annual report More detailed inclusive annual report Provides preview of data in final report Provides preview of data in final report Data track very well with those from 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 Sample of all records received and processed by cut-off date – 4-5 months after end of data year Published 6-8 months after end of year Published 6-8 months after end of year

13. SOURCE: CDC/NCHS National Vital Statistics System Final Data Annual report – based on all US births in a given year Annual report – based on all US births in a given year Discussion and detailed data on almost all items in the data set Discussion and detailed data on almost all items in the data set Released 12-14 months after end of year Released 12-14 months after end of year

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

15. SOURCE: CDC/NCHS National Vital Statistics System Upcoming Reports Births to 10-14 year old mothers, 1990-2002: Trends and Health Outcomes (available early fall) Births to 10-14 year old mothers, 1990-2002: Trends and Health Outcomes (available early fall) Analysis of Rise in infant Mortality for 2002 (available late summer) Analysis of Rise in infant Mortality for 2002 (available late summer)

16. SOURCE: CDC/NCHS National Vital Statistics System Types of Data Dissemination: Vital Statistics of the United States Tabulated Data

17. SOURCE: CDC/NCHS National Vital Statistics System Types of Data Dissemination: CD-ROMs Unit Record Data

18. SOURCE: CDC/NCHS National Vital Statistics System Statistical Export and Tabulation System (SETS)

19. SOURCE: CDC/NCHS National Vital Statistics System Birth Data Web Page www.cdc.gov/nchs/births.htm

20. SOURCE: CDC/NCHS National Vital Statistics System The 2003 U.S. Standard Certificate of Live Birth Improved data quality Improved data quality Standardized worksheets (Tested prior to implementation) Standardized worksheets (Tested prior to implementation) Standardized electronic systems Standardized electronic systems Changes to existing items Changes to existing items New items New items

21. SOURCE: CDC/NCHS National Vital Statistics System Standardized Worksheets To encourage collection from the best sources, two worksheets have been developed and tested Mother’s Worksheet Mother’s Worksheet Facility Worksheet Facility Worksheet

22. SOURCE: CDC/NCHS National Vital Statistics System Mother’s Worksheet Data directly from the mother (e.g., race, education, cigarette smoking, WIC) Tested on women with a recent live birth Tested on women with a recent live birth Slight modifications made Slight modifications made Overall, mother’s worksheet worked well Overall, mother’s worksheet worked well Companion brochure Companion brochure

23. SOURCE: CDC/NCHS National Vital Statistics System Facility Worksheet Data directly from the medical records (e.g., pregnancy risk factors, method of delivery) Tested in hospitals Tested in hospitals Hospital staff completed the worksheet using medical records Hospital staff completed the worksheet using medical records Outside expert reviewed responses for accuracy Outside expert reviewed responses for accuracy Several items modified or deleted Several items modified or deleted Testing generally showed that the facility worksheet could be completed efficiently and accurately Testing generally showed that the facility worksheet could be completed efficiently and accurately

24. SOURCE: CDC/NCHS National Vital Statistics System Guide to Completing Facility Worksheet To assist hospital staff in completing the facility worksheet a comprehensive instruction manual has been developed. It includes: Definitions Definitions Preferred sources within the records Preferred sources within the records Key words/common abbreviations Key words/common abbreviations

25. SOURCE: CDC/NCHS National Vital Statistics System Detailed Specification for Electronic Systems Detailed specifications for each data item on the birth certificate have been developed Automatic edits/cross edits Automatic edits/cross edits Ability to edit and query at data entry Ability to edit and query at data entry Suggested screens Suggested screens On-line help On-line help Drop-down menus Drop-down menus Test decks for vendors/States Test decks for vendors/States

26. SOURCE: CDC/NCHS National Vital Statistics System New Birth Certificate: Modified Items Cigarette smoking before and during pregnancy Cigarette smoking before and during pregnancy Method of delivery Method of delivery Pre-pregnancy weight, weight at delivery and height Pre-pregnancy weight, weight at delivery and height Congenital anomalies Congenital anomalies

27. SOURCE: CDC/NCHS National Vital Statistics System New Birth Certificate: New Items Fertility therapy Fertility therapy WIC WIC Infections during pregnancy Infections during pregnancy Maternal morbidity Maternal morbidity Breast feeding Breast feeding Principal source of payment for the delivery Principal source of payment for the delivery

28. SOURCE: CDC/NCHS National Vital Statistics System 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 Expected to Implement in 2005 Implementing in 2006 or later Implemented New Certificate DC Transition to the New Birth Certificate Continues…

29. SOURCE: CDC/NCHS National Vital Statistics System Data Dissemination Public Use data file for 2003, will include data from new and modified items for States that have implemented the new certificate Public Use data file for 2003, will include data from new and modified items for States that have implemented the new certificate

30. SOURCE: CDC/NCHS National Vital Statistics System For more information contact a member of the Natality Team at 301-458-4111