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National Healthcare Disparities Report, 2006

Data Sources
Centers for Disease Control and Prevention

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Behavioral Risk Factor Surveillance System (BRFSS)

Sponsor

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

Mode of Administration

Telephone interview. Interviews for 2004 were conducted through computer-assisted telephone interviewing (CATI).

Survey Sample Design

Data collection is conducted separately by each State. Sample design uses State-level, random-digit-dialed probability samples of the adult (age 18 years and over) population. Most States currently use disproportionate random sampling methods. The BRFSS was initiated in 1984, with 15 States collecting surveillance data on risk behaviors through monthly telephone interviews. The number of States participating in the survey has increased. Since 2001, 50 States, the District of Columbia, Puerto Rico, Guam, and the Virgin Islands have participated in the BRFSS.

Primary Survey Content

The survey consists of a core of questions asked in all States, standardized optional questions on selected topics that are administered at the State's discretion, a rotating core of questions asked every other year in all States, and State-added questions developed to address State-specific needs. Questions cover behavioral risk factors (for example, alcohol and tobacco use), preventive health measures, HIV/AIDS, health status, limitation of activity, and health care access and utilization.

The objective of the BRFSS is to collect uniform, State-specific data on preventive health practices and risk behaviors that are linked to chronic diseases, injuries, and preventable infectious diseases in the adult population.

Population Targeted

U.S. civilian noninstitutionalized population 18 years of age and older who reside in households with telephones.

Demographic Data

Gender, age, educational attainment, race/ethnicity, household income, employment status, and marital status.

Years Collected

Since 1984.

Schedule

Annual.

Geographic Estimates

National; State; smaller area estimates possible in some States.

Contact Information

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

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

Reference

Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Operational and User's Guide, Version 3.0, Atlanta, GA: U.S. Department of Health and Human Services, March 4, 2005.

See http://www.cdc.gov/brfss/technical_infodata/index.htm for a collection of documents and survey data providing technical and statistical information regarding the BRFSS, such as comparability, sample information, etc.


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 office-based physicians and instruct them in survey data collection methods. Physicians are asked to complete a one-page questionnaire (Patient Record Form) on a sample of their office visits during their assigned reporting period.

Survey Sample Design

NAMCS is a national probability sample survey of visits to office-based physicians in the United States. 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, using a visit sampling rate that varies by the size of the practice, with the intention of obtaining 30 survey forms per physician. In 2004, 25,286 survey forms were collected.

Primary Survey Content

Information is obtained on various aspects of office visits, including physician practice characteristics, patient characteristics, and other visit characteristics. Only visits to the offices of nonfederal physicians classified by the American Medical Association or the American Osteopathic Association as "office-based, patient care" are included. The survey form is redesigned every 2 to 4 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; 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 patient visit. Included in the survey are in-person visits made to the offices of non-federally 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. Also 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. Sample data are weighted to produce national estimates of office visits.

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 Bureau 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, MD: National Center for Health Statistics. 2002.

Woodwell DA, Cherry DK. National Ambulatory Medical Care Survey: 2002 Summary. Advance data from vital and health statistics; No. 346. Hyattsville, MD: National Center for Health Statistics. 2004.


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 Phase I or II of data collection (1988-1994). 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 oversampling of African Americans, Mexican Americans, adolescents, older persons, and low-income Whites.

The current NHANES are released in 2-year datasets; NHANES 2001-2002 and earlier were used for the 2005 NHQR and NHDR. 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. NHANES 2003-2004, the most recent data release, will be incorporated into future editions of the National Healthcare Quality Report and National Healthcare Disparities Report.

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.

In NHANES 2001-2002: Household interview response rate is 84 percent and the medical examination response rate is 80 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 age 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 (NHANES III).

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.

NHANES 1999-2000 Addendum to the NHANES III Analytic Guidelines (updated August 2002) and NHANES Analytic Guidelines (June 2004 Version), both available at http://www.cdc.gov/nchs/nhanes.htm.


National Health Interview Survey (NHIS)

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

Personal interview in households using computer-assisted personal interviewing (CAPI), administered by professional interviewers and conducted in English and Spanish (for CAPI, Spanish version was initiated in mid-1998). A new NHIS instrument, which utilizes Blaise® computer-assisted interviewing software, was implemented for the 2004 survey year.

Survey Sample Design

The NHIS uses a stratified multistage probability design that permits a continuous sampling of 358 primary sampling units (PSUs), with oversampling of African Americans and Hispanics. A typical NHIS sample for the data collection years 1995-2005 consists of approximately 7,000 second-stage units (segments) within a PSU. The expected sample of 43,000 occupied respondent households yields a probability sample of about 111,000 persons. The survey is designed so that the sample scheduled for each week is representative of the target population and the weekly samples are additive over time. In 2004, the survey instrument and data production process were reengineered.

Primary Survey Content

Information is obtained on demographic characteristics, illnesses, injuries, impairments, chronic conditions, utilization of health resources, health insurance, and other health topics. The core household interview asks about everyone in the household. Additional questions are asked of one sample adult and one sample child (under 18 years) per family in the household. The sample adult questionnaire includes chronic health conditions and limitations in activity, health behaviors, health care access, health care provider contacts, immunizations, and AIDS knowledge and attitudes. The sample child questionnaire includes questions about chronic health conditions, limitation of activities, health status, behavior problems, health care access and utilization, and immunizations. Child data are proxy-reported by a parent or other knowledgeable adult respondent. Adult sample person data are all self-reported. Special modules are fielded periodically and cover areas such as cancer, prevention, disability, and use of complementary and alternative medicine.

Population Targeted

Civilian noninstitutionalized population residing in the United States, all ages.

Demographic Data

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

Years Collected

Continuously since 1957. Current sample design began in 1995; current questionnaire design began in 1997.

Schedule

Annual.

Geographic Estimates

National; four U.S. Census Bureau regions; some of the 10 U.S. Department of Health and Human Services regions, some States; metropolitan and nonmetropolitan areas.

Contact Information

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

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

References

For more details, see the NHIS survey description documents available from the datasets and documentation section at http://www.cdc.gov/nchs/nhis.htm.

National Center for Health Statistics (2006). Data File Documentation, National Health Interview Survey, 2004 (machine readable data file and documentation). National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD.

National Center for Health Statistics (2004). Data File Documentation, National Health Interview Survey, 2003 (machine readable data file and documentation). National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD.


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

HIV/AIDS Surveillance Report is published annually. Supplemental reports are published on an ad hoc basis and available online at http://www.cdc.gov/hiv/dhap.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 is prohibited.

Contact Information

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

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

References

All referenced documents are available at http://www.cdc.gov/hiv/topics/surveillance/resources/reports/index.htm.

Centers for Disease Control and Prevention. Cases of HIV infection and AIDS in the United States, 2003. HIV/AIDS Surveillance Report, vol. 15. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2004.

Centers for Disease Control and Prevention. Cases of HIV infection and AIDS in the United States, 2002. HIV/AIDS Surveillance Report, vol. 14. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2003.

Centers for Disease Control and Prevention. Cases of HIV infection and AIDS in the United States, 2001. HIV/AIDS Surveillance Report, vol. 13, No. 2. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2002.


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 were 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 is a national probability sample survey of visits to emergency departments (EDs) and outpatient departments (OPDs) of non-Federal, short-stay, and general hospitals in the United States. 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 and/or emergency service areas. Hospital staff are 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 EDs and 225 OPDs participate each year. In 2004, 36,589 ED forms and 31,783 OPD forms were completed.

Primary Survey Content

The NHAMCS includes two files: ED visits and OPD visits. Information is obtained on various aspects of patient visits, including patient, hospital, and visit characteristics. The survey form is redesigned every 2 to 4 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; intentionality of injury, if any; physician's diagnoses; diagnostic services ordered or provided; procedures provided; medications; providers seen; visit disposition; immediacy with which patient should be seen; and expected source of payment. Items collected that are specific to the ED include mode of arrival, waiting time, duration of time in the ED. initial vital signs, and cause of injury.

Population Targeted

The basic sampling unit is the patient visit. Included in the survey are in-person visits made to EDs and OPDs of non-Federal, short-stay, and general hospitals (exclusive of Federal, military, and Department of Veterans Affairs hospitals) located in the 50 States and the District of Columbia. Telephone contacts and visits for administrative purposes are excluded. NHAMCS is weighted to give national estimates of ED and hospital OPD visits.

Demographic Data

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

Years Collected

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

McCaig LF, Burt CW. National Hospital Ambulatory Medical Care Survey: 2001 Emergency Department Summary. Advance data from vital and health statistics; No. 335. Hyattsville, MD: National Center for Health Statistics. June 4, 2003.

McCaig LF, Burt CW. National Hospital Ambulatory Medical Care Survey: 2002 Emergency Department Summary. Advance data from vital and health statistics; No. 340. Hyattsville, MD: National Center for Health Statistics. 2004.

Hing E, Middleton K. National Hospital Ambulatory Medical Care Survey: 2002 Outpatient Department Summary. Advance data from vital and health statistics; No. 345. Hyattsville, MD: National Center for Health Statistics. 2004.


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 U.S. Census Bureau field personnel or automated data collection through the purchase of electronic files from commercial sources, States, or hospitals.

Survey Sample Design

The NHDS utilizes a three-stage national probability design that includes primary sampling units (PSUs) used for the 1985-94 National Health Interview Survey (NHIS), hospitals within the PSUs, and discharges within the hospitals. Approximately 300,000 discharges are sampled each year from about 500 hospitals.

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 one to seven diagnoses coded using the ICD-9-CM; and, from zero to four procedures using the ICD-9-CM.

Population Targeted

The NHDS contains a sample of discharges from non-Federal, noninstitutional hospitals located in the 50 States and the District of Columbia. Only hospitals with an average length of stay for all patients of less than 30 days or with a general (medical/surgical) or children's specialty are included in the survey.

NHDS data are weighted to give national and regional estimates of hospital discharges from non-Federal, noninstitutional hospitals.

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 from some hospitals because the hospitals provide data from billing forms that do not include race as a required item. In general, nonresponse for race in the NHDS is about 22-25 percent. Nonresponse for Hispanic origin is greater and is about 60-63 percent annually.

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. 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.

Dennison CF, Pokras R. Design and operation of the National Hospital Discharge Survey: 1988 redesign. National Center for Health Statistics. Vital and Health Statistics 1(39). 2000.


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), 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 (IAP) areas (which together make up the U.S.), the NIS draws independent quarterly samples of telephone numbers and then uses random digit dialing 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 IAP areas, consisting of the 50 States, the District of Columbia, and 28 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.


National Nosocomial Infections Surveillance (NNIS) System

Sponsor

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

Mode of Administration

Participation in the NNIS System is voluntary and involves only acute care general hospitals in the United States. As of June, 2004 nearly 300 hospitals were participating in the NNIS System. Participation is limited to hospitals with 100 or more beds that meet minimum requirements for infection-control staffing.

The data are collected uniformly by trained infection-control personnel using surveillance protocols that target inpatients at high risk of infection and are reported routinely to CDC where they are aggregated into the database.

The standardized protocols, called "surveillance components," include adult and pediatric intensive care unit (ICU), high-risk nursery (HRN), and surgical patient. The components may be used singly or simultaneously, but once selected, they must be used for a minimum of 1 calendar month. All infections are categorized into major and specific infection sites using standard CDC definitions that include laboratory and clinical criteria.

Primary Content

Adult and pediatric intensive care units: all sites of nosocomial infection in patients located in ICUs.

High-risk nurseries: all sites of nosocomial infection in patients located in HRNs.

Surgical patients: all infections or surgical-site infections of patients undergoing operative procedures on the NNIS list.

Demographic Data

Age, gender.

Years Collected

Since 1970.

Schedule

Data reported monthly; aggregate report published annually.

Contact Information

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

Data system homepage: http://www.cdc.gov/ncidod/dhqp/nnis_pubs.html.

Reference

National Nosocomial Infections Surveillance System. National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004. American Journal of Infection Control 2004; 32:470-85. Also available at http://www.cdc.gov/ncidod/dhqp/nnis_pubs.html.


National Program of Cancer Registries (NPCR)

Sponsor

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

Description

NPCR provides funds and guidance to States and U.S. territories to implement and enhance their cancer registries. As of 2006, NPCR supported central registries and promoted the use of registry data in 45 States, the District of Columbia, and 3 territories. Cancer registry data collected through the NPCR are used to identify and monitor trends in cancer incidence and mortality; guide planning and evaluation of cancer control programs; help allocate health resources; contribute to clinical, epidemiologic, and health services research; and respond to concerns from citizens over the presence of cancer in their communities.

Population Targeted

NPCR registries collect data about cancer cases occurring among about 96 percent of the U.S. population.

Demographic Data

Gender, age, race.

Years Collected

Since 1994.

Schedule

Data collection is ongoing. Reports are published periodically. Since 2001, State registries have been reporting data annually.

Geographic Estimates

National, participating States.

Contact Information

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

Data system homepage: http://www.cdc.gov/cancer/npcr/index.htm.

References

U.S. Cancer Statistics Working Group. United States Cancer Statistics: 2002 Incidence and Mortality. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute; 2005. Available at: http://www.cdc.gov/cancer/npcr/uscs/

U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999-2001 Incidence and Mortality Web-based Report Version. Atlanta,GA: Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute; 2004. Available at: http://www.cdc.gov/cancer/npcr/uscs.


National Tuberculosis 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 (DTBE).

Mode of Administration

Currently, individual tuberculosis (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 TB trends.

Currently 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 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/nchstp/tb.

Reference:

Available at http://www.cdc.gov/nchstp/tb/surv/surv.htm.

Centers for Disease Control and Prevention. Reported Tuberculosis in the United States, 1999. Atlanta, GA: U.S. Department of Health and Human Services, CDC, August 2000.

Centers for Disease Control and Prevention. Reported Tuberculosis in the United States, 2002. Atlanta, GA: U.S. Department of Health and Human Services, CDC, September 2003.

Centers for Disease Control and Prevention. Reported Tuberculosis in the United States, 2003. Atlanta, GA: U.S. Department of Health and Human Services, CDC, September 2004.


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 are 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 2.3 to 2.4 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).

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 of the parents.

Years Collected

Linked data are available for the data years 1983-1991 and 1995-2003.

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. The public use file identifies counties of 250,000 population or more.

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 2001 period linked birth/infant death data set. National Vital Statistics Reports vol. 52, No. 2. Hyattsville, MD: National Center for Health Statistics. 2003.


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 funeral directors, physicians, medical examiners, and coroners 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 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 a 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 2.3 to 2.4 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, and educational attainment (beginning in 1989) for selected States.

Population Targeted

The U.S. population.

Demographic Data

Sex, race, Hispanic origin (beginning in 1984), age at death, place of decedent's residence, educational attainment (beginning in 1989) for selected States, and marital status. 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. Beginning with data for 2003, multiple race data will be available for selected States.

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, is 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

Arias E, Anderson RN, Hsiang-Ching K, Murphy SL, Kochanek KD. Deaths: final data for 2001. National Vital Statistics Reports, vol. 52, No. 3. Hyattsville, MD: National Center for Health Statistics. 2003.

Kochanek KD, Smith BL. Deaths: preliminary data for 2002. National Vital Statistics Reports, vol. 52, No. 13. Hyattsville, MD: National Center for Health Statistics. 2004.


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, 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) (education of father not currently collected), 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, is 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, Sutton PD, Ventura SJ, Menacker F, Munson ML. Births: Final data for 2002. National Vital Statistics Reports, vol. 52, No. 10. Hyattsville, MD: 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, MD: National Center for Health Statistics. 2003.

Sutton PD and Mathews TJ. Trends in characteristics of births by State: United States, 1990, 1995, and 2000-2002. National Vital Statistics Reports, vol. 52, No. 19. Hyattsville, MD: National Center for Health Statistics. 2004.


 

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