Stephanie J. Ventura, M.A. National Center for Health Statistics

1. 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 AssociationContinuing Education Institutes November 4, 2006Boston, MA

2. 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. 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

4. 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

5. U.S. Standard Certificate of Live Birth: 1989 Revision

6. U.S. Standard Certificate of Live Birth: 2003 Revision

7. WA ME MT ND MN VT OR NH MA ID WI NY SD CT WY MI RI PA IA NJ NE NV OH DE IN IL UT MD CO WV VA KS MO CA KY NC TN DC OK AZ AR SC NM GA AL MS TX LA FL AK HI Implementation of the2003 Revised Birth Certificate 2003 or 2004 2005 Mid-year reviser 2006 2007 or later NOTE: New York State but not New York city implemented for 2004.

8. 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

9. 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

10. Birth Data Web Pagewww.cdc.gov/nchs/births.htm SOURCE: CDC/NCHS National Vital Statistics System

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

12. Preliminary Data • Based on substantial sample of records – 99% of all births for 2004 • 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

13. 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

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

15. Selected Findings from Reports

16. From: Births: Final Data for 2004 Total and primary cesarean rate and VBAC rate: US, 1989-2004 1/ Number of vaginal births after cesarean (VBAC) per 100 live births to women with a previous cesarean delivery. 2/ Percentage of all live births by cesarean delivery. 3/ Number of primary cesarean deliveries per 100 live births to women who have not had a previous cesarean. NOTE: Due to changes in data collection from implementation of the 2003 revision of the U.S. Standard Certificate of Live Birth, there may be small discontinuities in rates of primary cesarean delivery and VBAC in 2003 and 2004. See “Births: Final Data for 2004.” SOURCE: CDC/NCHS National Vital Statistics System

17. From:Infant Mortality Statistics from the 2003 Period Linked Birth/Infant Death Data Set Percentage of live births and infant deaths by birthweight in grams, 2003 SOURCE: CDC/NCHS National Vital Statistics System

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

19. From:Births: Final Data for 2004 Percent distribution of births by gestational age: US, 1990 and 2004 NOTE: Percent distribution based on gestational ages of 17-47 completed weeks. SOURCE: CDC/NCHS National Vital Statistics System

20. Upcoming Reports • Births: Preliminary Data for 2005 • Characteristics of Births to Single-Race and Multiple-Race Women: 2003 • Fetal and Perinatal Mortality: United States, 2003 • Report on new items from the 2003 revised birth certificate • Estimated Pregnancy Rates: United States, 1990-2002 • Teenage Birth Rates for the United States, 1940-2005 • Births: Final Data for 2005

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

22. Types of Data Dissemination: CD-ROMs (ASCII and SETS versions) Unit Record Data SOURCE: CDC/NCHS National Vital Statistics System

23. Web based interactive data system • CDC WONDER: http://wonder.cdc.gov/ • CDC Interactive Atlas of Reproductive Health: http://www.cdc.gov/reproductivehealth/gisatlas/index.htm • NCHS/DVS system to access vital statistics data (available later in the Fall, 2006)

24. 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

25. 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