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

NCHS Fact Sheet, May 2018

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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 in order 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 (WHO) Collaborating Center for the Family of International Classifications for North America

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

• The 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 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 considers potential updates to the current ICD version to improve the international comparability of mortality data.
• The ICF is a classification of functioning, disability, and health. The 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 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 the improvement of 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 from that meeting led to the creation of the Mortality Reference Group, designed to consider possible updates to ICD–10 that now operates under the WHO Collaborating Centers. 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 the Core Group members: France, Germany, Italy, Hungary and the United States.

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 (OCED)

NCHS works with 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.

For more information about NCHS, visit https://www.cdc.gov/nchs/.

For more information about ISP, visit https://www.cdc.gov/nchs/isp.htm.