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2003 Revisions of the U.S. Standard Certificates of Live Birth and Death and the Fetal Death Report

This Web site is being updated to reflect final approval by the HHS Secretary of the 2003 Revised Standard Certificates and Reports.  Many of the documents on this Web site have been updated to incorporate changes made during the clearance process.  HHS Secretary's notice of approval [PDF - 59 KB] is on this Web site as well as a letter from CDC/NCHS Director, Edward J. Sondik [PDF - 87 KB], to the State registrars that documents the revision and approval process in detail. The Specifications for collecting and editing the U.S. Standard Certificates of live birth and death and the Report of Fetal Death -- 2003 revisions have now been updated to reflect the changes made during the HHS clearance process as well as changes recommended by the Data Analysis Committee.


The Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) has been collaborating with colleagues in the State vital statistics offices to revise the certificates of live birth and death and the report of fetal death. This process is generally carried out every 10 to 15 years. Prior to 2003, the most recent revisions in effect were implemented in 1989. The 2003 revisions have recently been approved by the HHS Secretary and are going into effect in the States. Some States began the revision process in 2003, but full implementation in all States will be phased in over several years. A critical component of the recommendations for this revision focuses on fundamental changes in the way that data are collected, especially for births. Partly as a consequence of these recommendations, States are engaged in re-engineering their vital statistics systems as they implement the revisions.

The complex process involved in revising the content of the standard certificates and reports is described in the "Executive Summary" of the Report of the Panel to Evaluate the U.S. Standard Certificates and Reports, which is now available at this Web site. The final 2003 certificates of live birth and death and the report of fetal death are now available at this Web site.

As part of the revision process, CDC/NCHS has developed sets of detailed specifications for collecting and reporting the items on the birth and death certificates and fetal death report, which are all available on this Web site. It is critical that all registration areas follow these standards as closely as possible to promote uniformity in data collection across registration areas. Included with the draft specifications is an "overview." The overview gives the rationale behind the approaches taken to develop the specifications, and is available at the above Web site.

We are strongly promoting the use of standard worksheets to enhance the collection of quality, reliable data. We have developed a guidebook/instruction manual for data collection from the facility worksheets for the birth certificate and the fetal death report. The guidebook is available on this Web site in WORD and also in print on request.

Also available at this site are two handbooks for the death certificate, "Physicians' Handbook on Medical Certification of Death," and "Medical Examiners' and Coroners' Handbook on Death Registration and Fetal Death Reporting." We expect that these handbooks will be published in final form in about a month.

The Division of Vital Statistics has developed a poster presentation, "The New Birth Certificate: Making Vital Statistics More Vital" [PPT - 5 MB], which is available on this Web site. The poster summarizes the revision process, including a description of the Panel membership and composition, and the Panel's recommendations. The Panel's recommendation of standardized worksheets for collecting the data and the development of detailed specifications for electronic systems are described in the poster. Also presented is information on the modified items and new items recommended for the certificate.

A companion poster presentation, " Making Vital Statistics More Vital Supplement: The New Death Certificate," [PPT - 615 KB] is also available.

A number of communications have been transmitted by the Division of Vital Statistics to State registration colleagues since late 2000 concerning the implementation of the revised certificates. These letters are also available on this Web site. Recent presentations by NCHS staff on "Geographic Coding" and "New Methodologies for Data Transmission to NCHS" are also available at this site. The specifications for editing the birth and death certificate items have been updated as of September 10, 2002; lists of the substantive changes are available on this website. Updates of the specifications reflecting changes made during the clearance process will be posted as soon as they are available. Also available are the file layouts that are consistent with the final approved certificates and the code lists for race and Hispanic origin. Most recently, two items with information about the 2003 mortality medical programs have been added. State-specific information on these programs will be provided to the States by the Division of Vital Statistics.