Vital statistics on births and deaths serve an integral role in understanding public health, as exemplified by headlines in major print and television media outlets recently. Nobel Prize winning economist Angus Deaton and his wife, Anne Case discovered a disturbing trend using mortality data collected by vital records jurisdictions and provided to the National Center for Health Statistics: the death rates of middle-aged, white Americans are climbing, even as death rates in other racial and age groups remain stagnant or on the decline. Further, they discovered that the death rates among middle-aged, white men with a high school education or less are actually increasing more than the death rates for any other group.
Death rates and their associated causes, collected by the states through vital records, signal the most severe impacts of serious threats to public health. In the case of high-school educated, middle-aged white males, Deaton and Case found that the increase in death rates was greatly attributable to afflictions caused by drugs and alcohol, as well as increased suicide rates in the population. With this information in hand, public health officials can examine potential causes for increased alcohol use, drug use, and suicides and implement policy changes that could prevent and reduce these deaths in the future. For instance, policymakers may need to address barriers to mental health treatment or even mental health awareness to provide resources and opportunities for these men to get help. These data can also inform educational campaigns on the effects of drugs and alcohol targeted to this and other at-risk populations.
Birth and death data collected by the vital records jurisdictions are used by the Census Bureau in calculating its population estimates and projections; by state and local governments and public health officials; by federal policymakers; and by demographers, epidemiologists, health services researchers, and other scientists. They are an essential part of the nation's statistical and public health infrastructure. However, not all jurisdictions have the resources they need to both invest in better electronic death record systems and to provide appropriate training for the people (like medical certifiers) who report the data. Only through a strong and sustained investment can we build a 21st Century vital statistics infrastructure, and get better data to myriad users more quickly so they are better equipped to understand and address public health challenges.