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A New Model Law for Vital Statistics

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A New Model Law for Vital Statistics National Center for Health Statistics Division of Vital Statistics * * Vital statistics data are among the most valuable tools ... – PowerPoint PPT presentation

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Title: A New Model Law for Vital Statistics


1
A New Model Law for Vital Statistics
National Center for Health Statistics
Division of Vital Statistics
2
Model law revision
  • Model State Vital Statistics Act and Regulations
  • Provides detailed guidance to States that are
    considering revision of their own State vital
    statistics laws and regulations.
  • Promotes uniformity among states in definitions,
    registration practices, disclosure and issuance
    procedures, and in the many other functions that
    comprise a state system of vital statistics.
  • Initially established in 1907, has been revised
    in 1941, 1959, 1977, 1992
  • http//www.cdc.gov/nchs/nvss/model_law_revision.ht
    m

3
Why update?
  • Security
  • Electronic environment
  • Assisted reproduction
  • Confidentiality and disclosure
  • Establishing new records of live birth
  • Same-sex marriage
  • COOP (Continuity of Operations Planning)

4
Model law revision work group
  • Chairperson
  • Alvin T. Onaka, Ph.D., Hawaii Department of
    Health
  • Members
  • Catherine Molchan Donald, Alabama Department of
    Public Health
  • Karen R. Hampton, J.D., Oregon Department of
    Human Services
  • Ronald Hyman, Colorado Department of Public
    Health and Environment
  • Wilfredo Lopez, J.D., General Counsel Emeritus,
    New York City Department of Health and Mental
    Hygiene
  • Patricia W. Potrzebowski, Ph.D., Formerly,
    Pennsylvania Department of Health Executive
    Director, NAPHSIS
  • Steven Schwartz, Ph.D., New York City Department
    of Health and Mental Hygiene
  • Linette T. Scott, M.D., M.P.H., California
    Department of Public Health

5
Model law revision work group
  • Centers for Disease Control and Prevention
    National Center for Health Statistics, Division
    of Vital Statistics, Registration Methods Staff
  • Judy M. Barnes
  • Julia L. Kowaleski
  • George C. Tolson
  • Dewey LaRochelle
  • Centers for Disease Control and Prevention
  • Deborah Tress, J.D.Office of General Counsel

6
Functional focus areas
The Model Act and Regulations were divided by
functional focus areas with a Work Group member
assigned as lead for each area
  • Registration
  • Issuance
  • Preservation
  • Dissemination
  • Security
  • Authorities
  • Fees
  • Penalties
  • Cathy Molchan Donald
  • Karen Hampton
  • Ron Hyman
  • Trish Potrzebowski
  • Linette Scott
  • Alvin Onaka
  • Steve Schwartz
  • Wilfredo Lopez

7
Objectives
  • Implementation of revised Model Law and
    Regulations in jurisdictions
  • Improved uniformity of process
  • Use as a resource to support justifications for
    actions in the jurisdictions regarding the vital
    records system

8
Legislative research
  • Assisted reproductive technology
  • Adoption laws
  • Electronic records and signatures
  • Aspect of breach of confidentiality
  • Same-sex parentage

9
Accomplishments
  • Surveys of NAPHSIS Membership developed by the
    Workgroup
  • Model Law Survey 32 states responded
  • Issuance Survey 35 states responded
  • Other Surveys of NAPHSIS Membership used by the
    Workgroup
  • Fees Charged
  • Fee Retention
  • Levying Fines
  • Verification Charges

10
Accomplishments
  • Solicitation of Comments on NCHS web site
  • Received feedback from NAPHSIS Members
  • National Archives and Records Administration
  • CSTE Subcommittee on Tribal Epidemiology
  • US Department of Justice, Witness Security
    Division
  • Vermont Notary Public
  • West VA Funeral Directors Association
  • American College of Nurse Midwives
  • National Funeral Directors Association
  • Lambda Legal
  • ACLU LGBT Rights Project
  • National Center for Lesbian Rights
  • Gay and Lesbian Advocates and Defenders
  • Others

11
Accomplishments
  • 2009/2010 NAPHSIS/VSCP Joint Meetings
  • Presentations
  • Roundtables
  • Town Hall
  • Workgroup Meetings began in 2009
  • April, July, September, November 2009
  • January, April , July, September, November 2010
  • March, May 2011

12
Accomplishments
  • October/November 2010 Workgroup Webinars
  • Total of 8
  • December 23, 2010 Draft Model Law sent to
    NAPHSIS Membership

13
Accomplishments
  • January Webinars with NAPHSISPurpose
  • Provided background on development process for
    Draft Model Law Regulations
  • Provided overview of changes
  • Answered clarifying questions
  • Comments on draft were due from NAPHSIS Members
    February 11, 2011

14
Statistical Uses of Vital Records Data

15
Statistical uses of the data
  • Identifying and measuring public health problems
  • Planning and evaluating programs at local, State,
    national, and international levels
  • Providing baseline data for city, county, state,
    and U.S. comparisons

16
Uses of natality data
  • Population composition and growth
  • Estimate size of population and project increases
    and decreases
  • Influence on economic and social institutions
    (schools, labor market, commercial uses)

17
Uses of natality data
  • Life expectancy
  • Teenage birth rates
  • Births to unmarried mothers

18
Uses of natality data
  • Adverse birth outcomes
  • Low birth weight babies
  • Racial differentials
  • Multiple births

19
Natality data used to
  • Determine need for birthing centers and
    hospitals
  • Target prenatal care to certain populations
  • Develop educational programs
  • Add warning labels to certain products

20
Uses of mortality data
  • Infant mortality
  • Teenage suicide
  • Deaths due to violence
  • Motor vehicle mortality
  • Maternal mortality

21
Mortality data used for
  • Allocation of health facilities
  • Epidemiological research
  • Discovery of emerging problems

22
Latest available NCHS data
  • Final Birth2008
  • Preliminary Birth2009
  • Final Death2008
  • Preliminary Death-2009

23


Life expectancy and age-adjusted death rates
U.S., 1900-2008
Deaths per 100,000 standard population


Life expectancy
Age-adjusted death rates
2008
NOTE Prior to 1933, data are for
death-registration States only.
24
Live births and fertility rates United States,
1930-2008
Number
Rate
2008
NOTES Beginning with 1959, trend lines are based
on registered live births trend lines for
1930-59 are based on live births adjusted for
underregistration. SOURCE CDC/NCHS, National
Vital Statistics System.
25
Fertility rates by race and Hispanic origin
United States, 19202006
200
150
Black
Hispanic
Births per 1,000 women aged 15-44 in specified
group (plotted on a log scale)
American Indian
100
White, total
Asian/PI
Non-Hispanic White
50
1920
1930
1940
1950
1960
1970
1980
1990
2000
2006
NOTE Data for black women for years prior to
1960 are for women of all races other than white.
In 1960, 92 of "all other" births were to black
women. Data for 2006 are preliminary.
26
Number of births, birth rate, and percent of
births to unmarried women
Births in 1000s
Births per 1,000 unmarried women 15-44
Birth rate
Percent
Number of births
SOURCE National Vital Statistics System,
National Center for Health Statistics, CDC.
27
Percent of births to unmarried women, US,
selected years, 19802008
40.6
36.9
33.2
32.2
28.0
Percent
18.4
1980
1990
2000
2005
2008
1995
SOURCE Division of Vital Statistics, National
Center for Health Statistics, Centers for Disease
Control and Prevention
28
Birth rate for unmarried women, selected years,
19802008
Rates per 1,000 unmarried women aged 1544
52.5
47.5
44.3
44.1
43.8
29.4
1980
1990
2000
2005
2008
1995
SOURCE Division of Vital Statistics, National
Center for Health Statistics, Centers for Disease
Control and Prevention
29
Triplet/ birth rates
NOTE Triplet/ births are births in triplet and
higher order multiple deliveries. SOURCE
CDC/NCHS, National Vital Statistics System.
30
Cesarean delivery by race and Hispanic origin of
mother
Non-Hispanic black
Percent
Non-Hispanic white
Hispanic
0
SOURCE CDC/NCHS, National Vital Statistics
System.
31
Cesarean delivery rates by race and Hispanic
origin of mother
Per 100 births
0
Non-Hispanic black
Hispanic
American Indian or Alaska Native
Asian or Pacific Islander
Non-Hispanic white
Race and Hispanic origin
NOTE Data for 2009 are preliminary. SOURCE
CDC/NCHS, National Vital Statistics System.
32
Twin birth rates by age of mother United
States, 1990, 2000, and 2008
200
160
120
Per 1,000
80
40
0
1519
2024
2529
3034
3539
4044
4549
Years of age
NOTE The twin birth rate is per 1,000 live
births. The birth rate for women 45-49 for 1990
is not shown because of the small number of
births.
33
Birth rates for teenagers 15-19 years
Rates per 1,000 women aged 15-19 years
SOURCE National Vital Statistics System,
National Center for Health Statistics, CDC
34
Teenage birth rates for 15-19 year olds by State,
2009
DC
35
Birth rate for teenagers by age
18-19 years
Rate per 1,000 women in specified age
15-19 years
15-17 years
2009
NOTE Data for 2009 are preliminary. SOURCE
CDC/NCHS, National Vital Statistics System.
36
Teen birth rates by race and Hispanic origin,
final 1991, 2005, 2007, and 2009
Non-Hispanic
SOURCE CDC/NCHS, National Vital Statistics
System.
37
Number of births and birth rate for teenagers
15-19 years
Birth rate
Number of births
NOTE Data for 2009 are preliminary.
SOURCE CDC/NCHS, National Vital Statistics
System.
38
Birth rates for teenagers 15-17 years by race
and Hispanic origin
Non-Hispanic
NOTE Data for 2009 are preliminary. SOURCE
CDC/NCHS, National Vital Statistics System
39
Change in birth rate for women aged 15-17 years
by State, 2007 and 2009
U.S. teen birth rate for ages 15-17 was 22.1 per
1,000 in 2007 and 20.1 in 2009
NOTE Data for 2009 are preliminary. SOURCE
CDC/NCHS, National Vital Statistics System.
40
Change in birth rate for women aged 18-19 years
by State, 2007 and 2009
U.S. teen birth rate for ages 18-19 was 73.9 per
1,000 in 2007 and 66.2 in 2009
NOTE Data for 2009 are preliminary. SOURCE
CDC/NCHS, National Vital Statistics System.
41
Preterm and low birthweight rates
Preterm
Low birthweight
0
42
Age-adjusted death rates for heart disease and
influenza and pneumonia
Heart disease
Influenza Pneumonia
Note Data prior to 1933 contain
death-registration States only.
43
Leading causes for U.S.
  • 1900
  • Influenza Pneumonia
  • Tuberculosis
  • Diarrhea
  • Heart disease
  • Stroke
  • 2008
  • Heart disease
  • Cancer
  • Stroke
  • Chronic lower respiratory diseases
  • Accidents (unintentional injuries)

NOTE Prior to 1933, data are for
death-registration States only.
44
Trends in leading causes of death, United States,
2003-2008
Deaths per 100,000 standard population
1- Diseasesof heart
2- Malignant neoplasms
4- Chronic lower respiratory diseases
5- Accidents (unintentional injuries)
3- Cerebro-vascular diseases
45

Childhood death rates by age at death
Deaths per 100,000 population
1-4 years
15-19 years
10-14 years
5-9 years
2008
SOURCE CDC/NCHS National Vital Statistics
System, 1900-2008
46
Maternal mortality rates, 1915-2007
2007
NOTE Prior to 1933, data are for
birth-registration States only.
47

Infant, neonatal, and postneonatal mortality rates

Infant
Neonatal
Postneonatal
NOTES Death registration area complete for
1933-2002.
48
www.cdc.gov/nchs/nvss.htm
49
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

50
Need for complete and accurate information
Every certificate is important!
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