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National Mortality Followback Survey (NMFS) Public-Use Data Files

Survey description
Data file description
List of data file variables at a glance
Data file technical characteristics
Geographic coverage
Data availability
Ordering information
Documentation contents
Related reports
Contact
NMFS Web page 

Survey description
The National Mortality Followback Survey (NMFS) includes a number of surveys, the two most recent relating to 1986 and 1993, designed to supplement information from death certificates in the vital statistics file with information on important characteristics of the decedent. These include the use of health services prior to death, socioeconomic status, aspects of life style, health care utilization prior to death, and other factors that may affect when and how death occurs. Supplemental information is obtained from a variety of sources. Information is collected from proxy next-of-kin informants identified on the death certificate filed in State and independent vital registration areas in each survey.

In the 1986 NMFS, additional information is collected from hospital and other health care facilities used in the last year of life. The 1993 NMFS collects additional information from medical examiner/coroner offices if death is due to homicide, suicide, or accidental injury, is certified by a medical examiner or coroner, and permission to release the records is given by the proxy respondent. The foci of the each survey reflects current research interests and needs of the Public Health Service, other Federal agencies, and private health researchers in addressing salient issues related to health and mortality.

The foci of the 1986 NMFS are: (1) socioeconomic status and mortality; (2) associations between risk factors and mortality; and (3) health care sought and provided in the last year of life. Foci of the 1993 NMFS include: (1) socioeconomic differentials in mortality; (2) prevention of premature death by inquiring into the association between risk factors and the cause of death; (3) health care services provided in the last year of life; and (4) disability in the last year of life. A major objective of both the 1986 and 1993 NMFS is to examine the reliability of items reported on the death certificate by comparing these items with the same items reported by the survey proxy respondent. This includes age, race, gender, veteran status, education, occupation, and industry.

NCHS does not distribute certificates, files, or indexes with indentifying information for deaths. Please refer to the section of the home page on "How to obtain birth, death, marriage, and divorce certificates."

Data file description
The 1986 NMFS file consists of four types of linked records for 18,733 decedents: (1) data from death certificates; (2) the 24-page proxy respondent survey questionnaire; (3) the 16-page nursing home, hospital, and hospice questionnaire; and (4) the facility abstract record. The 1986 NMFS is a nationally representative sample of adults 25 years of age and over who died in 1986.

The 1993 NMFS file consists of three types of linked records for 22,957 decedents: (1) data from death certificates; (2) the 75-page proxy respondent survey questionnaire; and (3) the medical examiner/coroner abstract record for deaths due to homicide, suicide, and accidental injury. The 1993 NMFS is a nationally representative sample of persons 15 years of age and over who died in 1993.

List of data file variables at a glance (1993 and 1986 files)

Death certificate file (1993)
Race
Age (decedent and respondent in years)
Hispanic origin
Year of birth
Place of birth
Educational attainment
Usual occupation
Kind of business/industry
Veteran status
Marital status
Month of death
Manner of death
Underlying cause of death
Multiple cause of death

Proxy respondent file (1993)
Race
Age (in years)
Hispanic origin
Place of birth
Educational attainment (decedent and respondent)
Usual occupation (decedent and spouse)
Kind of business/industry (decedent and spouse)
Veteran status
Marital status
Place of death
Manner of death
Firearm related injury
Circumstances of injury
Use of alcoholic beverages
Drug use
Tobacco use
Co-morbid condition
Utilization of services (in last year of life)
Payment sources
Access to care
Cognitive functioning
Activities of daily living (ADL) and instrumental ADL's
Assistive devices used
Medical devices used/implanted
Health indicators
Motor vehicle/driving behavior
Firearm ownership/access
Organ donorship
Participation in social activities (in last year of life)
Life events
Problem behaviors
Income and assets
Authorizations

Medical examiner/coroner abstract record file (1993)
Race
Age (estimated, in years)
Month of death
Place of death
Manner of death
Firearm related injury
Circumstances of injury (transport/nontransport
related injury, homicide, suicide, undetermined
manner of death)
Examination/autopsy of body
Toxicological findings
Co-morbid conditions
Activities and impairments
Medical devices implanted
Organ donorship

Death Certificate file (1986)
Race
Sex
Age (in years)
Birth date
Education level
Date of death
Place of death
Birthplace
Usual occupation
Type of business/ industry
Veteran status
Marital status
Informant

Informant questionnaire file (1986)
Race
Sex
Age (in years)
Education of decedent and spouse
Total family income
Inventory of all facilities used in last year of life
Time in facility
Medical history (for example, cancer, heart,
cerebrovascular, lung disease,
gynecological history)
Medical care (in last year)
Problems getting care
Activities in daily living
Costs of care
Source of payment for care
Out-of-pocket cost
Main source of payment
Life style and health (exercise, medicines, health
history, alcohol and smoking history)
Social support (provider, type)
Kind of work done longest
Number of years doing work
Activity on job
Spouse's occupational history
Marital status at time of death
Marriage length
Number of spouses (ever had)
Family medical history (for example, heart disease)
Relationship to decedent
Time lived with decedent

Facility abstract record file¹ (1986)
Birth date
Date of death
Discharge/admission dates
Diagnoses (ICD-9-CM)
Principal/other
Surgical/diagnostic procedures in each admission
(ICD-9-CM)
Type of facility
Other facility used (identifier not on tape)
Names/addresses of facilities (used for mailing facility
abstract records/hospital/nursing home
questionnaires)
_____________________________________________________
¹Similar to hospital discharge summary. ICD-9-CM is International Classification of Diseases, Ninth Revision, Clinical Modification.

Staff person questionnaire file (nursing home, hospice) (1986)
Race
Sex
Age
Education of decedent
Inventory of all facilities used in last year of life
Time in facility
Other facility used (identifier not on tape)
Names/addresses of facilities (used for mailing facility
abstract records/hospital/nursing home
questionnaires)
Medical history (for example, cancer, heart,
cerebrovascular, lung disease,
gynecological history)
Medical care (in last year)
Activities in daily living
Costs of care
Source of payment for care
Main source of payment
Health (medicines, health history)
Kind of work done longest
Number of years doing
Activity on job
Veteran status
Marital status at time of death
Marriage length

For each survey, death certificates are sampled from the Current Mortality Sample (CMS) for the respective calendar years. The CMS is a systematic 10-percent sample of the States' death certificates, which NCHS, CDC, receives about 3 to 4 months after the deaths occur. Approximately 2,500 of the 18,733 sample death certificates from the 1986 CMS were selected with certainty to meet certain specific research needs. A little over 45 percent of the 22,957 sample death certificates from the 1993 CMS were selected with certainty.

Data availability
Data from the NMFS are available on CD-ROM.   Survey data are currently available for 1986.  Public-use data files containing underlying and multiple cause-of-death data can be purchased as well.

Ordering information
The NMFS  can only be purchased through the National Technical Information Service (NTIS). Contact NTIS for current pricing and availability. 

Documentation contents
The 1986 NMFS documentation includes a list of data elements; ICD-9 codes; occupation codes; and a technical appendix including sources of data, history, and classification of data schema.

Documentation for the 1993 NMFS provisional  file can be downloaded from the CDC/FTP server.  The documentation include sections on general NCHS, CDC, guidelines for file use, overview of file structure, introduction to the survey, data preparation and processing, sample weights, methodological notes for users, sample SAS and SUDAAN procedures, variable lists, and file format and response frequencies. The latter section includes tape location, field size, unweighted and weighted response frequencies, and the item and response categories. 

Related reports
Publications using the 1986 NMFS include: Advance Data Nos. 172, 173, and 180. Vital and Health Statistics Series 1, No. 29, Series 2, No. 118, and Series 20, No. 19.

Contact
Mortality Statistics Branch
Division of Vital Statistics
National Center for Health Statistics
Centers for Disease Control and Prevention
3311 Toledo Road, Room 7318
Hyattsville, Maryland 20782
(301) 458-4666

This page last reviewed September 09, 2008