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National Vital Statistics System - Mortality. Arialdi M. Miniño, MPH National Center for Health Statistics Presented at the 134th Annual Meeting & Exposition of the American Public Health Association Continuing Education Institutes November 4, 2006 Boston, MA.
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National Vital Statistics System - Mortality Arialdi M. Miniño, MPH National Center for Health Statistics Presented at the 134th Annual Meeting & Exposition of the American Public Health AssociationContinuing Education Institutes November 4, 2006Boston, MA
Staff – Mortality Statistics Branch • Robert N. Anderson (chief) • Elizabeth Arias • Melonie P. Heron • Donna L. Hoyert • Kenneth D. Kochanek • Hsiang Kung • Arialdi M. Miniño • Sherry L. Murphy • Chester Scott • Jiaquan Xu
National Vital Statistics System • Registration of births and deaths is not a Federal activity – responsibility lies with the States • Currently, there are 57 registration areas • 50 States • District of Columbia • New York City • 5 Territories (Puerto Rico, U.S. Virgin Islands, Guam, American Samoa, and Northern Marianas)
National Vital Statistics System, cont. • Vital Statistics Cooperative Program (VSCP) • Includes all 57 registration areas • Standardization of data collection and data processing • Comparability among States • Compilation of national vital statistics data sets
Sample of Major Users of National Mortality Data • Centers for Disease Control and Prevention (CDC) • National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) • National Center for Injury Prevention and Control (NCIPC) • National Center for Infectious Diseases (NCID) • Office of the Surgeon General • Bureau of the Census • Social Security Administration (SSA) • National Institutes of Health (NIH) • National Cancer Institute (NCI) • National Institute on Aging (NIA) • National Institute on Drug Abuse (NIDA) • National Highway Traffic Safety Administration (NHTSA) • Substance Abuse and Mental Health Services Administration (SAMHSA)
Sample of Major Users of National Mortality Data • Other Non-Government Organizations and Firms: • World Health Organization (WHO) • Pan American Health Organization (PAHO) • American Cancer Society • American Heart Association • American College of Surgeons • National Bureau of Economic Research (NBER) • Max Planck Institute for Demographic Research • North American Association of Central Cancer Registries (NAACCR) • Population Reference Bureau • State and Local Departments of Health • Various Marketing, Investment, Insurance, Pharmaceutical, Healthcare and Law Firms • March of Dimes
Two Data Series for Mortality • Preliminary Data • Consists of large proportion of deaths occurring in calendar year • Data are weighted up to independent counts • Data files not released to public • Final Data • Tied to release of public use file
California Idaho Michigan Montana New Hampshire New Jersey New York (city) New York (state) Oklahoma South Dakota Washington Wyoming Most still use old (1989) Standard Certificate Some combine old certificate with certain items reported as per new standard certificate Hawaii, Maine, Minnesota and Wisconsin provide multi-race data. Minnesota provides multi-Hispanic data. Massachusetts, Missouri and Texas provide FIPS geo. codes. States Using New (Revised 2003) Standard Certificate for 2004 Data Year Balance of States & Registration Offices New Standard
Issues Affecting Interpretation, Analysis & Handling of NVSS Mortality Data • Changes to data items due to variability of certificate (change of revision, or interstate) • Multiple race selection for decedent • Checkboxes for specific causes of death • Availability of specific items on certificate • Periodic revision of the system for International Classification of Diseases (ICD) • Last revision change occurred between 1998-1999 for U.S. • Affects the way that causes of death and medical entities are coded, classified and selected
Age-adjusted death rates for Nephritis, nephrosis & nephrotic syndrome: United States, 1950-2002 Age-adjusted Death Rate per 100,000 U.S. Standard Population ICD-6 ICD-9 ICDA-8 ICD-7 ICD-10 Year Source: National Vital Statistics System Trend Discontinuities Across ICD Revisions in the U.S.
Analysis of Time Series Across Revisions ln(rate)=a+b1(year) R2=.7372 APC=3.9% Age-adjusted Death Rate per 100,000 U.S. Standard Population Year Source: National Vital Statistics System
Analysis of Time Series Across Revisions 1=ICD-10 ln(rate)=a+b1(year)+b2 0=ICD-9 R2=.9898 APC=0.8% Age-adjusted Death Rate per 100,000 U.S. Standard Population Year Source: National Vital Statistics System