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National Healthcare Disparities Report, 2003

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Data Sources: Centers for Disease Control and Prevention


National Ambulatory Medical Care Survey (NAMCS)

Sponsor

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Mode of Administration

Field personnel meet with participating physicians and instruct them in survey data collection methods. Physicians are asked to complete 1-page questionnaires on a sample of their office visits during an assigned reporting period.

Survey Sample Design

The NAMCS utilizes a three-stage survey design that involves probability samples of primary sampling units (PSUs), physician practices within PSUs, and patient visits within physician practices. Participating physicians are randomly assigned to a 1-week reporting period during the survey year, and a systematic random sample of patient visits during that period is selected by the physician, using a visit sampling rate that varies by the size of the practice. Sample data are weighted to produce national estimates of office visits.

Primary Survey Content

Information is obtained on various aspects of office visits, including physician practice characteristics, patient characteristics, and other visit characteristics. The survey form is redesigned every 2 years to address changing health data needs. Among the items collected are patient's age, gender, race, and ethnicity; patient's expressed reason for visiting the physician; place, cause, and intentionality of injury, if any; physician's diagnoses; diagnostic services ordered or provided; therapeutic services; ambulatory surgical procedures performed; medications; providers seen; visit disposition; time spent with physician; and expected source of payment.

Population Targeted

The basic sampling unit is the physician-patient encounter or visit. Visits made to the offices of nonfederally employed, office-based physicians who are classified by the American Medical Association or the American Osteopathic Association as being primarily engaged in direct patient care. The specialties of anesthesiology, pathology, or radiology are not included. Not included are contacts by telephone, visits made outside the physician's office, visits in hospitals or institutional settings, and visits made for administrative purposes only.

Demographic Data

Patient's age, gender, race, and ethnicity.

Years Collected

Annual from 1973–81; again in 1985; resumed an annual schedule in 1989.

Schedule

Annual.

Geographic Estimates

National, four census regions.

Notes

The NAMCS is a visit-based survey rather than a population-based survey. Therefore, estimates of incidence and prevalence of disease cannot be computed. The survey is cross-sectional in nature. Multiple visits may be made by the same person within the sample.

Contact Information

Agency homepage: http://www.cdc.gov/nchs.

Data system homepage: http://www.cdc.gov/nchs/about/major/ahcd/ahcd1.htm.

References

Cherry DK, Woodwell DA. National Ambulatory Medical Care survey: 2000 summary. Advance data from vital and health statistics; No. 328. Hyattsville, Maryland: National Center for Health Statistics. 2002.

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National Health and Nutrition Examination Survey (NHANES)

Sponsor

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Mode of Administration

In-person interview in the household and in a private setting in the mobile examination center. Standardized physical examinations and medical tests in mobile examination centers.

Survey Sample Design

The NHANES uses a stratified multistage probability sample, nationally representative of the U.S. civilian noninstitutionalized population. The NHANES III survey is designed to be nationally representative for either 3 or 6 years of data collection. The NHANES 1999-2004 survey is designed to give an annual sample that is nationally representative, and approximately 5,000 people are examined at 15 locations each year, with over sampling of African Americans, Mexican Americans, adolescents, and older persons.

The current NHANES are released in 2 year datasets, and NHANES 1999-2000 is the most recent data release. The sample size is smaller than NHANES III and the number of geographic units in the sample is more limited. The sample design, weighting, and variance estimation methodology also differ from NHANES III.

Response Rates

In NHANES III (1984-1994): Household interview response rate is 86 percent; and the medical examination response rate is 78 percent.

In NHANES 1999-2000: Household interview response rate is 82 percent; and the medical examination response rate is 76 percent.

Primary Survey Content

Chronic disease prevalence and conditions (including undiagnosed conditions), risk factors, diet and nutritional status, immunization status, infectious disease prevalence, health insurance, and measures of environmental exposures. Other topics addressed include hearing, vision, mental health, anemia, diabetes, cardiovascular disease, osteoporosis, obesity, oral health, mental health, and physical fitness.

Population Targeted

For NHANES III, the civilian noninstitutionalized population residing in the United States aged 2 months and over. Beginning in 1999, people of all ages are included.

Demographic Data

Gender, age, education, race/ethnicity, place of birth, income, occupation, and industry.

Years Collected

From 1960 to 1994, a total of seven national examination surveys have been conducted. Beginning in 1999, the survey has been conducted continuously.

Schedule

Fielded periodically (1960–94); continuously beginning in 1999, with data releases occurring in 2 year increments.

Geographic Estimates

National; four U.S. Census Bureau regions.

Contact Information

Agency homepage: http://www.cdc.gov/nchs.

Data system homepage: http://www.cdc.gov/nchs/nhanes.htm.

References

National Center for Health Statistics. Plan and operation of the third National Health and Nutrition Examination Survey, 1988–94. National Center for Health Statistics (NCHS). Vital and Health Statistics 1(32), 1994.

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National HIV/AIDS Surveillance System

Sponsor

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Center for HIV, STD, and TB Prevention (NCHSTP).

Mode of Administration

Reports from health care providers are sent to the local, State, or territorial health departments. States and territories share, on a voluntary basis, de-identified data with CDC.

Survey Sample Design

All 50 States, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and other U.S. territories report AIDS cases.

Primary Survey Content

The AIDS case definition was modified in 1985, 1987, 1993 (for adults and adolescents), and 1994 (for pediatric cases). Data include mode of exposure to HIV, case definition category, and other clinical and demographic information.

Population Targeted

Entire population of all 50 States, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and other U.S. territories. AIDS data are nationally representative.

Demographic Data

Age, gender, race, ethnicity, State and county of residence, country of birth, and living status.

Years Collected

CDC first received reports of persons with AIDS in 1981.

Schedule

Biannual. HIV/AIDS Surveillance Report is published twice a year. Supplemental reports are published on an ad hoc basis and available on the Web at http://www.cdc.gov/hiv/topics/surveillance/resources/reports/index.htm#supplemental and at http://www.cdc.gov/hiv/resources/reports/mmwr/index.htm.

Geographic Estimates

National, State, and Metropolitan Statistical Area. Data release policies dictate that no data that could be used to identify a person reported to the system may be released, thus, release of data in cell sizes less than or equal to three in a given category are prohibited.

Contact Information

Agency homepage: http://www.cdc.gov.

Data system homepage: http://www.cdc.gov/hiv/topics/surveillance/index.htm.

References

Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, 2001; 13(No. 2).


National Home and Hospice Care Survey (NHHCS)

Sponsor

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Mode of Administration

Data are collected through personal interviews with administrators and staff. No patient was interviewed directly.

Survey Sample Design

The sample design was a stratified two stage probability design. The first stage consisted of the selection of a stratified sample of agencies. Each agency was placed into 1 of 24 strata based on type of agency, Metropolitan Statistical Area (MSA) status, and region.

The second stage of sample selection, sampling of six current patients and six discharges within each agency, was done using a sample selection table to obtain systematic probability samples of current patients and of discharges.

Primary Survey Content

Data are collected on referral and length of service, diagnoses, number of visits, patient charges, health status, reason for discharge, and types of services provided.

Population Targeted

Patients of U.S. home health and hospice care agencies.

Demographic Data

Gender, age, educational attainment, race/ethnicity, marital status and health status.

Years Collected

For individual years from 1992-94, 1996, 1998, and 2000.

Schedule

Periodically.

Geographic Estimates

The NHHCS covers all types of home health and hospice care agencies in the United States. Geographic identifiers are available by the U.S. Bureau of Census regions and metropolitan statistical area (MSA) indicators.

Contact information

Agency homepage: http://www.cdc.gov/nchs.

Data system homepage: http://www.cdc.gov/nchs/nhhcs.htm.

References

Haupt BJ. Characteristics of hospice care users: Data from the 1996 National Home and Hospice Care Survey. Advance data from vital and health statistics; no. 299. Hyattsville, Maryland, National Center for Health Statistics. 1998.

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National Hospital Ambulatory Medical Care Survey (NHAMCS)

Sponsor

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Mode of Administration

Hospital staff are asked to complete one-page questionnaires (Patient Record forms) on a sample of their patient visits during an assigned reporting period.

Survey Sample Design

The NHAMCS utilizes a four-stage probability design that involves samples of primary sampling units (PSUs), hospitals within PSUs, clinics within hospitals, and patient visits within clinics. Hospital staff were asked to complete Patient Record forms for a systematic random sample of patient visits occurring during a randomly assigned 4-week reporting period during the survey year. Sample data are weighted to produce national estimates of patient visits. About 400 emergency departments participated in 1998 and more than 24,000 Patient Record forms were completed. About 230 outpatient departments (OPD) participated in 1998 and about 30,000 Patient Record forms were completed.

Primary Survey Content

NHAMCS includes two files: ED visits and OPD visits. Information is obtained on various aspects of patient visits, including patient characteristics, physician characteristics, and other visit characteristics. The survey form is redesigned every 2 years to address changing health data needs. Among the items collected are: patient's age, gender, race, and ethnicity; patient's expressed reason for visit; place, cause, work-relatedness, and intentionality of injury, if any; physician's diagnoses; diagnostic services ordered or provided; procedures provided; medications ordered, supplied, administered or continued; providers seen; visit disposition; immediacy with which patient should be seen; time spent with physician; and, expected source of payment.

Population Targeted

The basic sampling unit is the patient visit. Included in the survey are in-person visits by patients to EDs and OPDs of noninstitutional general and short-stay hospitals, exclusive of Federal, military, and Veterans Administration hospitals, located in the 50 States and the District of Columbia. Telephone contacts are excluded.

Demographic Data

Patient's age, gender, race, and ethnicity.

Years Collected

Annual since 1992.

Schedule

Annual.

Geographic Estimates

National, four U.S. Census Bureau regions.

Contact Information

Agency homepage: http://www.cdc.gov/nchs.

Data system homepage: http://www.cdc.gov/nchs/about/major/ahcd/ahcd1.htm.

References

Ly N, McCaig LF, National Hospital Ambulatory Medical Care Survey: 2000 Outpatient Data Summary. Advance data from vital and health statistics; No. 327. Hyattsville, MD: National Center for Health Statistics. 2002.

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National Hospital Discharge Survey (NHDS)

Sponsor

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Mode of Administration

Manual sample selection and abstraction of inpatient medical records by field personnel or automated data collection through the purchase of electronic files from commercial abstracting sources, States, or hospitals.

Survey Sample Design

The NHDS utilizes a three-stage probability design that includes primary sampling units (PSUs) used for the 1985-94 NHIS, hospitals within PSUs, and discharges within hospitals. The largest hospitals were selected with certainty. The annual number of records included in the survey is approximately 300,000.

Primary Survey Content

Variables collected include: age; gender; race; ethnicity; admission and discharge dates (length of stay); discharge status; source of payment; hospital size, ownership, and region; from 1-7 diagnoses coded using the ICD-9-CM; and, from 0-4 procedures using the ICD-9-CM.

Population Targeted

Hospital discharges from short-stay noninstitutional hospitals and general and children's general hospitals regardless of length of stay, exclusive of military and U.S. Department of Veteran Affairs hospitals, located within the 50 States and the District of Columbia.

Demographic Data

Patient's age, gender, race, and ethnicity.

Years Collected

1965 to present.

Schedule

Annual.

Geographic Estimates

National, four U.S. Census Bureau regions.

Notes

Data on race are not available for some hospitals because the hospitals provide data from billing forms that do not include race as a required item. A comparison of NHDS data with data for those who reported being hospitalized in the NHIS indicated that under reporting for whites was about 30 percent in 1992; the difference for African Americans was not statistically significant. Hispanic origin is not reported for 75 percent of the NHDS records in 1992. (Kozak, L.J. Under reporting of race in the National Hospital Discharge Survey. Advance Data from Vital and Health Statistics, No. 265. Hyattsville, MD: National Center for Health Statistics, 1995.)

Contact Information

Agency homepage: http://www.cdc.gov/nchs.

Data system homepage: http://www.cdc.gov/nchs/about/major/hdasd/nhds.htm.

References

Kozak LJ, Hall MJ, Owings MF, National Hospital Discharge Survey: 2000 Annual Summary with detailed diagnosis and procedure data. National Center for Health Statistics. Vital Health Stat 13(153). 2002.

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National Immunization Survey (NIS)

Sponsor

U. S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), The National Immunization Program (NIP).

Mode of Administration

The NIS is a list-assisted random-digit-dialing telephone survey.

Survey Sample Design

In each of 78 Immunization Action Plan areas (which together make up the U.S.) the NIS draws independent quarterly samples of telephone numbers and then uses random-digit dialing (RDD) to identify households that have one or more children 19 to 35 months of age. The telephone interview continues by collecting vaccination information for each such child and requesting consent to contact the providers of the child's vaccinations. In a second phase, a mail survey, the NIS asks the providers to report vaccination information from the child's medical record, which is generally more accurate and complete than the household's information.

Primary Survey Content

Vaccination coverage rates for each of six recommended vaccines for the nation and for each of 78 Immunization Action Plan (IAP) areas, consisting of the 50 states, the District of Columbia, and 27 large urban areas.

Population Targeted

Children between the ages of 19 and 35 months living in the United States at the time of the interview.

Demographic Data

Gender, age, region.

Years Collected

Since 1994

Schedule

Quarterly.

Geographic Estimates

National, state, and local area levels.

Contact information

Agency homepage: http://www.cdc.gov/nchs.

Data system homepage: http://www.cdc.gov/nis.

References

Zell ER, Ezzate-Rice TM, Battaglia MP, Wright RA. National Immunization Survey: The methodology of a vaccination surveillance system. Public Health Reports, 115(1), 65-77. 2000.

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National Nursing Home Survey (NNHS)

Sponsor

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Mode of Administration

Data for the survey has been obtained through personal interviews with administrators and staff and occasionally with self-administered questionnaires in a sample of about 1,500 facilities.

Survey Sample Design

The sampling was basically a stratified two-stage probability design. The first stage was the selection of facilities and the second stage was the selection of residents and discharges.

The primary sampling strata of facilities were defined by bed size and certification status. The strata of certified facilities consist of facilities certified by either Medicare or Medicaid as a skilled nursing or intermediate care facility. The second-stage sampling of current residents and discharges was carried out by the interviewers at the time of their visits to the facilities in accordance with specific instructions given for each sample facility.

Primary Survey Content

The National Nursing Home Survey provides information on nursing homes from two perspectives--that of the provider of services and that of the recipient. Data about the facilities include characteristics such as size, ownership, Medicare/Medicaid certification, occupancy rate, number of days of care provided, and expenses. For recipients, data are obtained on demographic characteristics, health status, and services received.

Population Targeted

Population residing in long-term care facilities or nursing home.

Demographic Data

Gender, age, educational attainment, race/ethnicity, marital status and health status.

Years Collected

1973-1974, 1977, 1985, 1995, 1997, 1999.

Geographic Estimates

The data represent nursing homes, their residents, and their staff in the conterminous United States. Geographic identifiers are also available by the U.S. Bureau of the Census region, metropolitan statistical area (MSA) indicator.

Contact information

Agency homepage: http://www.cdc.gov/nchs.

Data system homepage: http://www.cdc.gov/nchs/nnhs.htm.

References

Jones, A. The National Nursing Home Survey: 1999 summary. National Center for Health Statistics. Vital Health Stat 13(152). 2002.

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National TB Surveillance System (NTBSS)

Sponsor

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Center for HIV, STD, and TB Prevention (NCHSTP), Division of Tuberculosis Elimination.

Mode of Administration

Currently, individual TB case reports (Report of Verified Case of Tuberculosis, or RVCT) are submitted electronically via the Tuberculosis Information Management System (TIMS), a comprehensive CDC software system for TB surveillance, patient management, and program evaluation.

Survey Sample Design

Since 1953, through the cooperation of state and local health departments, CDC has collected information on the numbers of reported TB cases in the United States.

In January 1993, DTBE, implemented an expanded TB surveillance system, which collects additional information for each reported TB case in order to better monitor trends in TB.

For 1999, data are collected from 60 reporting areas (the 50 states, the District of Columbia, New York City, Puerto Rico, and other jurisdictions in the Pacific and Caribbean).

Primary Survey Content

Number of new tuberculosis (TB) cases, patient management, and program evaluation.

The expanded surveillance system started in 1993 collects additional data to better monitor and target groups at risk for TB disease, to estimate and follow the extent of drug-resistant TB, and to evaluate outcomes of TB cases. The RVCT form for reporting TB cases was revised to collect information on occupation, the initial drug regimen, human immunodeficiency virus (HIV) test results, history of substance abuse and homelessness, and residence in correctional or long-term care facilities at the time of diagnosis. RVCT Follow Up Report-1 was added to collect drug susceptibility results for the initial M. tuberculosis isolate from patients with culture-positive disease. To evaluate the outcomes of TB therapy, RVCT Follow Up Report-2 was added to collect information on the reason and date therapy was stopped, the type of health care provider, sputum culture conversion, the use of directly observed therapy, and the results of drug susceptibility testing for the final M. tuberculosis isolate from patients with culture-positive disease.

Population Targeted

U.S. civilian, noninstitutionalized population.

Demographic Data

Age, gender, race, country of origin, metropolitan.

Years Collected

Since 1953.

Schedule

Annually.

Geographic Estimates

National, and states.

Contact information

Agency homepage: http://www.cdc.gov.

Data source homepage: http://www.cdc.gov/tb/default.htm.

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National Vital Statistics System 'Linked Birth and Infant Death Data (NVSS-I)

Sponsor

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Mode of Administration

Linked Birth and Infant Death Data is part of the Nation's vital and health statistics.

Vital statistics are provided through State-operated registration systems. Administrative records (death certificates) completed by physicians, coroners, medical examiners, and funeral directors, and administrative records (birth certificates) completed by physicians and midwives, are filed with State vital statistics offices; selected statistical information is forwarded to NCHS to be merged into a national statistical file.

Survey Sample Design

NVSS mortality files include data for the 50 States, the District of Columbia, and the territories of Puerto Rico, Virgin Islands, Guam, American Samoa, and the Commonwealth of the Northern Marianas. All deaths (all ages) occurring in those areas are included (approximately 2.2 to 2.3 million annually).

Standard forms for the collection of the data and model procedures for the uniform registration of the events are developed and recommended for State use through cooperative activities of the States and NCHS.

Software is available to automate coding of medical information on the death certificate, following World Health Organization rules specified in the International Classification of Diseases (ICD).

http://www.cdc.gov/nchs/linked.htm

In the linked birth and infant death data set the information from the death certificate is linked to the information from the birth certificate for each infant under 1 year of age who dies in the United States, Puerto Rico, The Virgin Islands, and Guam.

Primary Survey Content

The linked files include information from the death and birth certificates. The vital statistics general mortality data are a fundamental source of geographic and cause-of-death information, and some demographic information. The birth certificate is the primary source of demographic information, such as age, race, and Hispanic origin of the parents, maternal education, live birth order, and mother's marital status, and of maternal and infant health information, such as birthweight, period of gestation, plurality, prenatal care usage, and maternal smoking, etc.

Population Targeted

National.

Demographic Data

Age, race, gender, Hispanic origin.

Years Collected

Linked files are available for the data years 1983-91 and 1995-2001. Future data years will be available annually.

Schedule

Data are collected / produced annually.

Geographic Estimates

National, by states

Place of death is classified by State and county. In residence classification, all deaths are allocated to the usual place of residence as reported on the death certificate and are classified by State, county, and city.

Contact Information

Agency homepage: http://www.cdc.gov/nchs

Data system homepage: http://www.cdc.gov/nchs/linked.htm

Reference

Mathews TJ, Menacker F, MacDorman MF. Infant mortality statistics for the 2000 period linked birth/infant death data set. National vital statistics reports; vol. 50 no. 12. Hyattsville, Maryland: National Center for Health Statistics.

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National Vital Statistics System, Mortality (NVSS-M)

Sponsor

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Mode of Administration

Administrative records (death certificates) completed by physicians, coroners, medical examiners, and funeral directors are filed with State vital statistics offices; selected statistical information is forwarded to NCHS to be merged into a national statistical file. Beginning with 1989, revised standard certificates replaced the 1978 versions; implementation of the next scheduled revision, for 2003, is being phased in by the States. Demographic information on the death certificate is provided by the funeral director and is based on information supplied by an informant. Medical certification of cause of death is provided by the physician, medical examiner, or coroner.

Survey Sample Design

NVSS mortality files include data for the 50 States, the District of Columbia, and the territories of Puerto Rico, Virgin Islands, Guam, American Samoa, and the Commonwealth of the Northern Marianas. All deaths occurring in those areas are included (approximately 2.2 to 2.3 million annually).

Primary Survey Content

Year of death, place of decedent's residence, place death occurred, age at death, day of week and month of death, Hispanic origin, race, marital status (beginning in 1979), place of birth, gender, underlying and multiple causes of death for all States, injury at work (beginning in 1993), hospital and patient status, educational attainment (beginning in 1989) for selected States, and occupation and industry (beginning in 1985) for selected States.

Population Targeted

The U.S. population.

Demographic Data

Gender, race, Hispanic origin (beginning in 1984), age at death, place of decedent's residence, educational attainment (beginning in 1989) for selected States, marital status, and industry and occupation for selected States. Race and ethnic origin are separate items on the death certificate. Beginning with 1992 data, California, Hawaii, Illinois, New Jersey, New York, Texas, and Washington reported expanded Asian and Pacific Islander categories of Asian Indian, Korean, Vietnamese, Samoan, and Guamanian. The rest of the States reported a combined Other Asian and Pacific Islander category in addition to the categories of white, black, American Indian, Chinese, Hawaiian, Japanese, and Filipino that all States report. As of 1997, all States report Hispanic origin. The categories reported include Mexican, Puerto Rican, Cuban, Central and South American, and Other Hispanic. Previously published mortality rates for 2000 have been revised using populations from the 2000 census; revised rates for the 1990s will be available in early fall, 2003.

Years Collected

The data system began in 1880 but not all States participated before 1933. Coverage for deaths has been complete since 1933.

Schedule

Annual.

Geographic Estimates

National, regional, State, and county. Beginning with 1989 data, some changes were initiated to increase confidentiality protection. Identifying information including date of death and geographic identifiers for counties of less than 100,000 persons are not available for public use.

Contact Information

Agency homepage: http://www.cdc.gov/nchs

Data system homepage: http://www.cdc.gov/nchs/deaths.htm.

References

Miniño AM, Arias E, Kochanek KD, Murphy SL, Smith BL. Deaths: Final Data for 2000. National vital statistics reports; vol. 50 no. 15. Hyattsville, Maryland: National Center for Health Statistics. 2002.

Arias E and Smith BL. Deaths: Preliminary Data for 2001. National vital statistics reports; vol 51 no 6. Hyattsville, Maryland: National Center for Health Statistics. 2003.

Anderson RN and Arias E. The Effect of Revised Populations on Mortality Statistics for the United States, 2000. National vital statistics reports; vol 51 no 9. Hyattsville, Maryland: National Center for Health Statistics. 2003.

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National Vital Statistics System, Natality (NVSS-N)

Sponsor

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS).

Mode of Administration

Administrative records (birth certificates) completed by physicians and midwives are filed with State vital statistics offices; selected statistical information is forwarded to NCHS to be merged into a national statistical file. Beginning with 1989, revised standard certificates replaced the 1978 versions; implementation of the next scheduled revision, for 2003, is being phased in by the States. Demographic information on the birth certificate is provided by the informant, usually the mother; maternal and infant health information is provided by the physician.

Survey Sample Design

NVSS natality files include data for the 50 States, the District of Columbia, and the territories of Puerto Rico, Virgin Islands, Guam, American Samoa, and the Commonwealth of the Northern Marianas. All births occurring in those areas are included (approximately 4 million annually).

Primary Survey Content

Demographic items collected include year of birth, place of mother's residence, place birth occurred, age of mother and of father, day of week and month of birth, Hispanic origin and race of mother and of father, marital status of mother, place of birth (i.e., State or country) of mother and of father, educational attainment of mother and of father, sex of child, and live-birth order. Maternal and infant health information is collected, including month prenatal care began, number of prenatal visits, medical risk factors, tobacco use, alcohol use, maternal weight gain, obstetric procedures, attendant at birth, method of delivery, place of delivery, complications of labor and/or delivery, period of gestation, birthweight, Apgar score, abnormal conditions of newborn, congenital anomalies, and plurality.

Population Targeted

The U.S. population.

Demographic Data

Sex of child, race of mother and of father, Hispanic origin (beginning in 1978) of mother and of father, age of mother and of father, place of mother's residence, educational attainment of mother and of father (beginning in 1978), and marital status of mother. Race and Hispanic origin are separate items on the birth certificate. Beginning with 1992 data, California, Hawaii, Illinois, New Jersey, New York, Texas, and Washington reported expanded Asian and Pacific Islander (API) categories of Asian Indian, Korean, Vietnamese, Samoan, and Guamanian. Eleven States currently collect expanded API categories. The rest of the States report a combined Other Asian and Pacific Islander category in addition to the categories of white, black, American Indian, Chinese, Hawaiian, Japanese, and Filipino that all States report. As of 1993, all States report Hispanic origin. The categories reported include Mexican, Puerto Rican, Cuban, Central and South American, and Other Hispanic. Birth and fertility rates by race and Hispanic origin for the 1990s through 2001 have been revised and published, using populations consistent with the 2000 census.

Years Collected

The national birth registration system was established in 1915. Not all States participated before 1933. Coverage for births has been complete since 1933.

Schedule

Annual.

Geographic Estimates

National, regional, State, and county; also cities of 100,000 population or more. Beginning with 1989 data, some changes were initiated to increase confidentiality protection. Identifying information including geographic identifiers for counties of less than 100,000 persons are not available for public use.

Contact Information

Agency homepage: http://www.cdc.gov/nchs

Data system homepage: http://www.cdc.gov/nchs/births.htm

References

Martin JA, Hamilton BE, Ventura SJ, Menacker F, Park MM, and Sutton PD. Births: Final Data for 2001. National vital statistics reports; vol. 51 no. 2. Hyattsville, Maryland: National Center for Health Statistics. 2002.

Hamilton BE, Martin JA, Sutton PD. Births: Preliminary Data for 2002. National vital statistics reports; vol 51 no 11. Hyattsville, Maryland: National Center for Health Statistics. 2003.

Hamilton BE, Sutton PD, Ventura SJ. Revised Birth and Fertility Rates for the 1990s and New Rates for Hispanic Populations, 2000 and 2001: United States. National vital statistics reports; vol 51 no 12. Hyattsville, Maryland: National Center for Health Statistics. 2003.

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