Chapter 8 SOURCES OF DATA This document contains excerpts from the 1986 Mortality Technical Appendix. The full version of this document can be found in Vital Statistics of the United States, 1986 - Vol. II Mortality Part A. Death and fetal-death statistics Mortality statistics for 1986 are, as for all previous years except 1972, based on information from records of all deaths occurring in the United States. Fetal-death statistics for every year are based on all reports of fetal death received by the National Center for Health Statistics (NCHS). The death-registration system and the fetal-death reporting system of the United States encompass the 50 States, the District of Columbia, New York City (which is independent of New York State for the purpose of death registration), Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Trust Territory of the Pacific Islands. In the statistical tabulations of this publication, United States refers only to the aggregate of the 50 States (including New York City) and the District of Columbia. Tabulations for Guam, Puerto Rico, and the Virgin Islands are shown separately in this volume. No data have ever been included for American Samoa or the Trust Territory of the Pacific Islands. The Virgin Islands was admitted to the "registration area" for deaths in 1924; Puerto Rico, in 1932; and Guam, in 1970. Tabulations of death statistics for Puerto Rico and the Virgin Islands were regularly shown in the annual volumes of Vital Statistics of the United States from the year of their admission through 1971 except for the years 1967 through 1969, and tabulations for Guam were included for 1970 and 1971. Death statistics for Puerto Rico, the Virgin Islands, and Guam were not included in the 1972 volume but have been included in section 8 of the volumes for each of the years 1973-78 and in section 9 beginning with 1979. Information for 1972 for these three areas was published in the respective annual vital statistics reports of the Department of Health of the Commonwealth of Puerto Rico, the Department of Health of the Virgin Islands, and the Department of Public Health and Social Services of the Government of Guam. Procedures used by NCHS to collect death statistics have changed over the years. Before 1971, tabulations of deaths and fetal deaths were based solely on information obtained by NCHS from copies of the original certificates. The information from these copies was edited, coded, and tabulated. For 1960-70, all mortality information taken from these records was transferred by NCHS to magnetic tape for computer processing. Beginning with 1971, an increasing number of States have provided NCHS with computer tapes of data coded according to NCHS specifications and provided to NCHS through the Vital Statistics Cooperative Program. The year in which State-coded demographic data were first transmitted on computer tape to NCHS is shown below for each of the States, New York City, Puerto Rico, and the District of Columbia, all of which now furnish demographic or non-medical data on tape. 197l 1977 Florida Alaska Idaho Massachusetts scemor86.doc - Page 1 New York City Ohio Puerto Rico 1972 1978 Maine Indiana Missouri Utah New Hampshire Washington Rhode Island Vermont 1973 1979 Colorado Connecticut Michigan Hawaii New York (except) Mississippi New York City) New Jersey Pennsylvania Wyoming 1974 1980 Illinois Arkansas Iowa New Mexico Kansas South Dakota Montana Nebraska Oregon South Carolina 1975 1982 Louisiana North Dakota Maryland North Carolina Oklahoma Tennessee Virginia Wisconsin 1976 1985 Alabama Arizona Kentucky California Minnesota Delaware Nevada Georgia Texas District of West Virginia Columbia For the Virgin Islands and Guam mortality statistics for 1986 are based on information obtained directly by NCHS from copies of the original certificates received from the registration offices. In 1974, States began coding medical (cause-of-death) data on computer tapes according to NCHS specifications. The year in which State-coded medical data were first transmitted to NCHS is shown below for the 22 States now furnishing such data. 1974 1981 scemor86.doc - Page 2 Iowa Maine Michigan 1975 1983 Louisiana Minnesota Nebraska North Carolina Virginia Wisconsin 1980 1984 Colorado Maryland Kansas New York State (except New York City) Massachusetts Vermont Mississippi New Hampshire Pennsylvania South Carolina 1986 California Florida Texas For 1986 and previous years except 1972, NCHS coded the medical information from copies of the original certificates received from the registration offices for all deaths occurring in those States that were not furnishing NCHS with medical data coded according to NCHS specifications. For 1981 and 1982, it was necessary to change these procedures because of a backlog in coding and processing that resulted from personnel and budgetary restrictions. To produce the mortality files on a timely basis with reduced resources, NCHS used State-coded underlying cause-of-death information supplied by 19 States for 50 percent of the records; for the other 50 percent of the records for these States as well as for 100 percent of the records for the remaining 21 registration areas, NCHS coded the medical information. Mortality statistics for 1972 were based on information obtained from a 50-percent sample of death records instead of from all records as in other years. The sample resulted from personnel and budgetary restrictions. Sampling variation associated with the 50-percent sample is described below in the section "Estimates of errors arising from 50-percent sample for 1972." Fetal-death data are obtained directly from copies of original reports of fetal deaths received by NCHS, except New York State (excluding New York City), which submitted State-coded data in 1986. Fetal-death data are not published by NCHS for the Virgin Islands and Guam. Standard certificates and reports The U.S. Standard Certificate of Death and the U.S. Standard Report of Fetal Death, issued by the Public Health Service, have served for many years as the principal means of attaining uniformity in the content of documents used to collect information on these events. They have been modified in each State to the extent required by the particular needs of the State or by special provisions of the State vital statistics law. However, the certificates or reports of most States conform closely in content and arrangement to the standards. scemor86.doc - Page 3 The first issue of the U.S. Standard Certificate of Death appeared in 1900. Since then, it has been revised periodically by the national vital statistics agency through consultation with State health officers and registrars; Federal agencies concerned with vital statistics; national, State, and county medical societies; and others working in such fields as public health, social welfare, demography, and insurance. This revision procedure has assured careful evaluation of each item in terms of its current and future usefulness for legal, medical and health, demographic, and research purposes. New items have been added when necessary, and old items have been modified to ensure better reporting, or in some cases have been dropped when their usefulness appeared to be limited. New revisions of the U.S. Standard Certificate of Death and the U.S. Standard Report of Fetal Death were recommended for State use beginning January 1, 1978. The certificate of death is for use by a physician, a medical examiner, or a coroner. Two other forms of the U.S. Standard Certificate of Death are available; they are similar to the one shown except that the section on certification is designed for the physician's signature on one, and for the medical examiner's or coroner's signature on the other. Among the changes in the new revision were the additions of (1) an item asking "If Hosp. or Inst., Indicate DOA, OP/Emer. Rm., Inpatient" and (2) an item "Was Decedent Ever in U.S. Armed Forces?" The latter item was previously on the certificate but was deleted during 1968 through 1977. An item on whether autopsy findings were considered for determining cause of death was dropped. scemor86.doc - Page 4