1 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 National Vital Statistics System - Mortality
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Arialdi M. Miniño, MPH National Center for Health Statistics
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. - PowerPoint PPT Presentation
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Arialdi M. Miniño, MPHNational Center for Health Statistics
Presented at the 134th Annual Meeting & Exposition of the American Public Health Association
Continuing Education Institutes
November 4, 2006Boston, MA
National Vital Statistics System - MortalityNational Vital Statistics System - Mortality
• 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
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National Vital Statistics System 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)
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• 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
National Vital Statistics System, cont.National Vital Statistics System, cont.
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U.S. Standard Certificate of Death, first third U.S. Standard Certificate of Death, first third
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U.S. Standard Certificate of Death, mid third U.S. Standard Certificate of Death, mid third
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U.S. Standard Certificate of Death, last third U.S. Standard Certificate of Death, last third
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• 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 DataSample of Major Users of National Mortality Data
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• 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
Sample of Major Users of National Mortality DataSample of Major Users of National Mortality Data
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• 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
Two Data Series for MortalityTwo Data Series for Mortality
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List of Variables and Locations on FileList of Variables and Locations on File
General Tape Locations
The Decedent Tape Locations
Record Type 19 Month of Death 55-56 Resident status 20 Sex 59 Place of death and decedent’s status 75 Race 60-63 Day of week of death 83 Age 64-74 Date of data receipt 110-114 Marital status 77 Data year 115-118 State of birth 78-79 Manner of death 139 Hispanic origin 80-81,82 Activity code 140 Education 52-53, 54 Place of injury 141
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List of Variables and Locations on File, cont.List of Variables and Locations on File, cont.
Residence Tape Locations
Occurrence Tape Locations
State 31-32,43 Reporting Area 3 Expanded State 44-45 State 21-22,28 County 33-35 Expanded State 29-30 County Population size 50 County 23-25 City 36-38 County Population size 49 City Population size 39 Region 26 Met/Nonmet county 40 Division 27 Region 41 FIPS State 119-120 Division 42 FIPS County 121-123 PMSA/MSA 46-48 PMSA/MSA Population size 51 FIPS State 124-125 FIPS County 126-128 FIPS Place 97-101 FIPS PMSA/MSA 129-132 FIPS CMSA 134-135
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List of Variables and Locations on File, cont.List of Variables and Locations on File, cont.
Underlying Cause of Death
Tape Locations
Tape Locations
ICD-10 code 142-145 Entity-Axis conditions 358 cause recode 146-148 Number of… 160-161 113 cause recode 151-153 Each condition 162-301 130 cause recode 154-156 39 cause recode 157-158 Number of… 338-339 Place of injury 141 Each condition 341-440 Injury at work 136
Multiple Causes of Death
Record-Axis conditions
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States Using New (Revised 2003) Standard Certificate for 2004 Data YearStates Using New (Revised 2003) Standard Certificate for 2004 Data Year
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.
New StandardBalance of States & Registration Offices
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NCHS Reports Using NVSS Mortality DataNCHS Reports Using NVSS Mortality Data
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NCHS Reports Using NVSS Mortality DataNCHS Reports Using NVSS Mortality Data
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NCHS Reports Using NVSS Mortality DataNCHS Reports Using NVSS Mortality Data
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NCHS Reports Using NVSS Mortality DataNCHS Reports Using NVSS Mortality Data
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NCHS Reports Using NVSS Mortality DataNCHS Reports Using NVSS Mortality Data
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Other Reports Using NVSS Mortality DataOther Reports Using NVSS Mortality Data
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Other Reports Using NVSS Mortality DataOther Reports Using NVSS Mortality Data
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Other Reports Using NVSS Mortality DataOther Reports Using NVSS Mortality Data
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Trend Data Using Multiple Years’ Mortality DataTrend Data Using Multiple Years’ Mortality Data
Age-adjusted Death Rates for HIV Disease: United States, 1987-2003
Issues Affecting Interpretation, Analysis & Handling of NVSS Mortality DataIssues 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 decedentCheckboxes for specific causes of deathAvailability 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
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Trend Discontinuities Across ICD Revisions in the U.S.Trend Discontinuities Across ICD Revisions in the U.S.
Source: National Vital Statistics SystemYear
0
5
10
15
20
25
30
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ICD-6 ICD-7 ICDA-8 ICD-9
Age-adjusted death rates for Nephritis, nephrosis & nephrotic syndrome: United States, 1950-2002
Age
-ad
just
ed D
eath
Rat
e p
er 1
00,0
00 U
.S. S
tan
dar
d P
opu
lati
on
ICD-10
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Analysis of Time Series Across RevisionsAnalysis of Time Series Across Revisions
Source: National Vital Statistics SystemYear
7
8
9
10
11
12
13
14
15
Age
-ad
just
ed D
eath
Rat
e p
er 1
00,0
00 U
.S. S
tan
dar
d P
opu
lati
on
R2=.7372APC=3.9%
ln(rate)=a+b1(year)
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Analysis of Time Series Across RevisionsAnalysis of Time Series Across Revisions
Source: National Vital Statistics SystemYear
7
8
9
10
11
12
13
14
15
Age
-ad
just
ed D
eath
Rat
e p
er 1
00,0
00 U
.S. S
tan
dar
d P
opu
lati
on
R2=.9898APC=0.8%
ln(rate)=a+b1(year)+b2
1=ICD-100=ICD-9
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Access to Public Use Data and Relevant DocumentationAccess to Public Use Data and Relevant Documentation