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Volume
2: No. 1, January 2005
LETTER TO THE EDITOR
Reengineering Vital
Registration and Statistics Systems [Response to Letter]
Suggested citation for this article: Rothwell
CJ. Reengineering vital registration and statistics systems [response to
letter]. Prev Chronic Dis [serial online] 2005 Jan [date cited].
Available from: URL:
http://www.cdc.gov/pcd/issues/2005/
jan/04_0116.htm.
In Reply:
Dr Nasseri has registered valid concerns (1) about reengineering vital
registration and statistics systems for the United States (2), many of which I
share. Certainly the move to state-of-the-art information technology will not
be the only key to rejuvenating the vital statistics system. We must not miss
this opportunity to improve both the quality and the content of the information
provided by these reengineered systems. The expanded data set derived from the
new standard certificates, once implemented by the new systems, will improve
data content extensively. These certificates are available on the Internet (3).
Considerable work lies ahead in finding innovative ways to improve data quality
for both new and old data items.
Dr Nasseri also suggests a number of demographic indicators for the death
certificate that would have analytic and research value, including the place
(country) of birth of the decedents’ parents and occupation. Some of these
items are of great potential value. The panel of experts (4) that recommended
to the Secretary of the Department of Health and Human Services the new and revised data items to be included in the new standard certificates consisted of a
broad range of data providers and users as well as state vital registrars and
statisticians. Three questions guided the panel’s decisions on maintaining or
revising old items and adding new items: 1) Is the item needed for legal,
research, statistical, or public health programs? 2) Is the item collectable
with reasonable completeness and accuracy? 3) Is the vital statistics system the
best source for this information? The panel worked exceedingly hard and
successfully to balance important public health needs with the most appropriate
mechanism to collect information with the concern that the collection of this
information not be an unreasonable burden for respondents. As Dr Nasseri notes,
state registration and health officials are free to add items to their own vital
records systems when they believe these additional questions are needed for
state purposes. With an advanced and flexible information technology
infrastructure in place, such additions become more practical at the state level
and could in the future serve as a method to effectively pilot test items for
inclusion in new national standards. State data users and providers need to be
very involved in implementing and updating these systems in their own state.
Information on place of birth of the decedent is requested on the death
certificate, and information on place of birth of parents is requested on the
birth certificate. Specifications developed for coding and editing data from the
2003 revisions of the U.S. Standard Certificates include detailed information on
country of birth, with an extended appendix of possible entries included in the
electronic systems (5,6). The National Center for Health Statistics has every
expectation that the detailed information on country of birth will be available
in the national data sets based on the 2003 revisions of the standard
certificates.
Information on educational attainment has changed in vital
records. For many years, standard birth and death certificates have included items
asking for number of years of schooling completed. Information from these items
was used in combination with census population estimates based on similar
questions to compute population-based fertility and mortality rates by
educational attainment. However, the 2000 census modified the educational
attainment question to collect information on the highest degree attained (e.g.,
high school diploma, associate’s degree, master’s degree). The change from years
of school completed to degree attained was made because years of schooling
completed are less synchronized than they used to be with degree attained,
especially for college years. The focus on highest degree attained provides more
consistent and uniform information. Because of the change by the U.S. Census
Bureau, the expert panel recommended a similar change for the U.S. Standard
Certificates so that the numerators for fertility and mortality rates (births
and deaths) would be compatible with the denominators (4); the 2003 revisions of
the standard certificates reflect this change.
Charles J. Rothwell
National Center for Health Statistics
Centers for Disease Control and Prevention
Hyattsville, Md
Read the original letter
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References
- Nasseri K. Reengineering vital registration and statistics systems [letter to the editor].
Prev Chronic Dis [serial online] 2005 Jan [Accessed 2004 Dec 15].
- Rothwell CJ.
Reengineering vital registration and statistics system for
the United States. Prev Chronic Dis [serial online] 2004 Oct [Accessed 2004
Sep 15].
- National Center for Health Statistics.
2003
revisions of the U.S. standard
certificates of live birth and death and report of fetal death.
Atlanta (GA): Centers for Disease Control and Prevention; 2004.
- National Center for Health Statistics, Division of Vital Statistics. Report of the
panel to evaluate the U.S. standard certificates. Atlanta (GA):
Centers for Disease Control and Prevention; 2001.
- National Center for Health Statistics. Birth
edit specifications for the
2003 proposed revision of the U.S. certificate of birth. Atlanta (GA):
Centers for Disease Control and Prevention; 2002.
- National Center for Health Statistics. Death
edit specifications for the
2003 proposed revision of the U.S. certificate of death. Atlanta (GA):
Centers for Disease Control and Prevention; 2002.
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