The National Vital Statistics System is the oldest and most successful example of inter-governmental data sharing in Public Health and the shared relationships, standards, and procedures form the mechanism by which NCHS collects and disseminates the Nation's official vital statistics. These data are provided through contracts between NCHS and vital registration systems operated in the various jurisdictions legally responsible for the registration of vital events--births, deaths, marriages, divorces, and fetal deaths. Vital Statistics data are also available on line. In the United States, legal authority for the registration of these events resides individually with the 50 States, 2 cities (Washington, DC, and New York City), and 5 territories (Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands). These jurisdictions are responsible for maintaining registries of vital events and for issuing copies of birth, marriage, divorce, and death certificates.

Populations Used to Calculate Vital Rates
U.S. Public Use ICD-9/ICD-10 Comparability File
Laying the Foundation for Electronic Vital Records Standards

Standard forms for the collection of the data and model procedures for the uniform registration of the events are developed and recommended for nationwide use through cooperative activities of the jurisdictions and NCHS. The process for implementing the latest revisions of the birth and death certificates and the fetal death report is now underway. The final 2003 revised certificates and accompanying technical information are available. NCHS has procedures for collection, coding, editing, and transmitting multiple race and Hispanic original data. NCHS also produces training and instructional material, as well as a automated mortality medical data system for coding and classifying cause-of-death information from death certificates.

CDC’s National Center for Health Statistics is working with State partners represented by the National Association of Public Health Statistics and Information Systems and the Social Security Administration to fundamentally re-engineer the processes through which vital statistics are produced in the U.S., including implementation of the 2003 revised certificates. The primary objective is to improve the timeliness, quality, and sustainability of the decentralized vital statistics system, along with collection of the revised and new content of the 2003 certificates, by adopting technologically sophisticated yet cost-effective model IT systems based on nationally developed standards and models. Information on the re-engineering activities and technical documents are available at the NAPHSIS web site, as well as at the NCHS certificate revision web site.

Additional programs related to the National Vital Statistics System include the Linked Birth and Infant Death Data Set, the National Survey of Family Growth, the Matched Multiple Birth Data Set, National Death Index, National Maternal and Infant Health Survey, and the National Mortality Followback Survey.

Through the National Vital Statistics System, data on vital events are now published in electronic form: Vital Statistics of the United States, National Vital Statistics Reports (formerly the Monthly Vital Statistics Report), and other selected reports. The special report U.S. Vital Statistics System provides an overview and history of the data system. For details, see related pages on specific vital events or related programs. Copies of birth, death, marriage, and divorce certificates may be obtained directly from the States; see Where to Write for Vital Records.

NCHS Data Release Program and Access Policy for Micro-Data and Compressed Vital Statistics Files

 Populations Used to Calculate Vital Rates

To permit the calculation of race-specific vital rates for 2000 and beyond and for revised vital rates for 1991-99 (using intercensal population estimates), the National Center for Health Statistics, in collaboration with the National Cancer Institute and the Census Bureau, has released bridged-race estimates of the U.S. resident population. NCHS has also released U.S. Intercensal Population Estimates by Specified Hispanic Origin Groups for the time period July 1, 1991 - July 1, 1999 for use in calculating vital rates.

 U.S. Public Use ICD-9/ICD-10 Comparability File

Data pertaining to causes of death are classified and coded according to the International Classification of Diseases (ICD). This system is revised about every 10 years. The United States implemented the latest (tenth) revision of the ICD (ICD-10) starting with mortality data for 1999. Implementing a new revision of this system helps the national mortality system stay abreast of advances in medical science and terminology. This implementation, however, may introduce changes to mortality trend data for certain causes of death. This may be due to changes in the classification of medical conditions or in the rules that determine selection of the underlying cause of death. In order to estimate the effect of these changes on cause-specific mortality data, NCHS has performed a study of the comparability (also called a bridge-coding study) between ICD-9 and ICD-10, based on the 1996 public use multiple cause-of-death data file. This study produced a double-coded file, using both the ICD-9 and ICD-10 classification systems (ICD-9/ICD-10 Comparability File), which is now available as a public-use file.

 Laying the Foundation for Electronic Vital Records Standards

The Division of Vital Statistics has initiated two projects at Health Level 7 (HL7) to develop vital records standards that may serve as the foundation for standardizing electronic transmission of birth and death events. An American National Standards Institute (ANSI) accredited standards development organization (SDO), HL7 develops international standards for electronic exchange, management and integration of clinical and administrative data within the healthcare arena.

The first project is focused on developing an Electronic Health Record System (EHR-S) Vital Records Functional Profile based on the HL7 EHR-S Functional Model. The EHR-S Functional Model is a standard that outlines important features and functions that should be contained in an EHR-S. Functional profiles, a subset of the EHR-S Functional Model, provide a standardized description and common understanding of the functions needed or required for a specific care setting or subject area, such as vital registration.

State registrars, providers, vital records systems developers, and other interested stakeholders participate in bi-weekly conference calls supported by NCHS for the development of the HL7 Electronic Health Record System (EHR-S) Vital Records (VR) Functional Profile. The participants divided into Birth and Death work groups. Progress to date includes assessing and mapping the Model Vital Events Registration System business functional requirements to the EHR-S Functional Model. These requirements were developed through collaboration with NAPHSIS and the Social Security Administration. Currently, the WGs are focused on reviewing and mapping the U.S. Standard birth and death certificate edit specifications to the HL7 EHR-S model. The mapping exercises serves as a mechanism to determine where functional requirements may need to be added or modified to meet the requirements for capturing vital records data. Subsequently, the workgroup will evaluate every EHR-S functional requirement to assess if they are applicable to the vital records processes and where additional requirements are needed.

We are seeking additional participation by VR stakeholders and subject matter experts to join this work group. Please contact Hetty Khan (HKhan@cdc.gov ) or Michelle Williamson (MWilliamson@cdc.gov) if you are interested in participating in this VR standards activity.

The second project is the development of a Vital Records Domain Analysis Model (VR DAM). Several state representatives are collaborating with NCHS/Division of Vital Statistics (NCHS DVS) and the National Association for Public Health Statistics and Information Systems (NAPHSIS) on the development of the model. The goal of the VR DAM is to identify the birth and death registration work flow processes and stakeholders. The VR DAM will serve to guide future design and implementation efforts for standardizing the electronic data exchanges between vital records systems and other public and private information systems in order to meet current and emerging needs.

In 2009 DVS is planning to solicit review and input from Federal, state and local vital records representatives, electronic health record (EHR) and vital records systems developers, funeral directors, healthcare providers, other stakeholders and subject matter experts to ensure that the models provide an accurate representation of the vital records birth and death domain. NCHS is also planning to host a webinar with interested vital records stakeholders to present the VR DAM and solicit broader feedback on the model. Please contact Michelle Williamson (MWilliamson@cdc.gov) if you are interested in participating in the webinar and/or serving as a reviewer of the VR DAM.

• VR Functional Profile Call for Participation

• VSCP Presentation on Laying the Foundations for VR Standards
  
  
  
   

This page last reviewed April 30, 2009