NCHS International Statistics Programs
Collaborations with the United Nations and Other International Organizations


NCHS Fact Sheet, August 2020


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About NCHS

The National Center for Health Statistics (NCHS) is the nation’s principal health statistics agency, providing data to identify and address health issues. NCHS compiles statistical information to help guide public health and health policy decisions.

Collaborating with other public and private health partners, NCHS uses a variety of data collection mechanisms to obtain accurate information from multiple sources. This process provides a broad perspective on the population’s health, influences on health, and health outcomes.

International activities at NCHS

NCHS collaborates with countries around the world and participates in a wide range of international initiatives. These programs consist of cooperative ventures on analytical and methodological issues, technical assistance, consultation, training, information exchange, and liaison with multinational agencies. Additionally, NCHS sponsors and hosts international meetings and symposia to foster the sharing of scientific information. Through these efforts, NCHS seeks to improve the availability and advance the quality and comparability of health data in the United States and other countries.

Three fact sheets describe international statistics activities at NCHS. In addition to this fact sheet on collaborations with the United Nations, fact sheets on “Bilateral and Multilateral Collaborations” and “Washington Group on Disability Statistics” are available from the NCHS website.

World Health Organization Collaborating Centre for the Family of International Classifications

The World Health Organization (WHO) produces international classifications of health and functioning and disability to provide a consensual, meaningful, and useful framework that governments, providers, and consumers can use as a common language. The WHO Collaborating Centre for the WHO Family of International Classifications (FIC) was established to represent the United States and Canada in international activities related to the development, revision, and implementation of WHO-FIC classifications (International Classification of Diseases and Health Problems [ICD] and International Classification of Functioning, Disability, and Health [ICF]). The WHO Collaborating Centre for WHO-FIC is located at NCHS. In this capacity, NCHS is responsible for coordinating all official disease classification activities in the United States relating to ICD and ICF, including their use, interpretation, and periodic revision.

  • ICD is the standard diagnostic tool for epidemiology, health management, and clinical purposes. The most recent version, ICD–10, is designed to promote international comparability in the collection, processing, classification, and presentation of mortality statistics, including providing a format for reporting causes of death on the death certificate. The ICD coding rules standardize and improve the usefulness of mortality statistics by giving preference to certain categories, consolidating conditions, and systematically selecting a single cause of death from a reported sequence of conditions. A Mortality Reference Group (MRG) considers potential updates to the current ICD version to improve the international comparability of mortality data.
  • ICF is a classification of functioning, disability, and health. ICF is structured around the following broad components: body structure and function, activities (related to tasks and actions by an individual) and participation in society, and additional information on personal and environmental factors.
  • The International Classification of Health Interventions covers interventions implemented by a broad range of providers across the full scope of health systems and includes interventions for diagnostic, medical, and surgical purposes, as well as for mental health, primary care, allied health, functioning support, rehabilitation, traditional medicine, and public health.

Iris Institute and International Collaborative Effort on Automating Mortality Statistics

The NCHS-sponsored International Collaborative Effort (ICE) on Automating Mortality Statistics ended in 2016 after 20 successful years of promoting the use of automated systems for coding mortality information. The first ICE on Automation Symposium in 1996 produced a number of key recommendations for improving mortality coding globally. The first of these recommendations was to create a global online reference system for mortality coders, which became the Mortality Forum; it is still active. Another recommendation led to the creation of the MRG, designed to consider possible updates to ICD–10 that now operates under the WHO Collaborating Centres.

“Iris,” now the global standard for automated coding of causes of death, grew out of the collaboration and exchanges that were an integral part of the ICE on Automation. Discussions among European and U.S. members of the ICE on Automation led to the development of Iris, a language-independent automated coding system essential for mortality coding in non-English-speaking countries. The Iris Institute, based in Cologne, Germany, maintains the Iris software and offers training courses as part of annual Iris Institute meetings. Iris is supported via financial and in-kind contributions from core group members: France, Germany, Italy, Hungary, and the United States.

United Nations Statistics Division

The United Nations Statistics Division compiles and distributes global statistical information, develops standards and norms for statistical activities, and supports countries’ efforts to strengthen their national statistical systems. NCHS provides the division with U.S. vital statistics data for a yearly demographic report, and it is an active partner in improving health statistics worldwide.

Organisation for Economic Co-operation and Development

NCHS works with the Organisation for Economic Co-operation and Development (OECD) on projects that facilitate international comparison of health data across a variety of measures. NCHS provides OECD with data for OECD Health Statistics, an annual comprehensive source of comparable statistics on health and health systems across OECD member countries. Data on topics such as health status, determinants of health, health care activities, and health expenditure and financing are featured in the OECD publication, Health at a Glance. NCHS also serves as the U.S. representative to OECD’s Health Care Quality Indicator, a project aimed at comparing the quality of health care across OECD member countries.

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