Vital Statistics: Vital for Research
Data are the backbone of research, and vital statistics are one of the oldest, most fundamental sources of information on health. Vital statistics collected via birth and death certificates enable us to monitor prevalence of disease and overall health status, develop programs to improve public health, and evaluate the effectiveness of those interventions. Vital statistics tell us what we know about life expectancy, teenage pregnancy, racial and socioeconomic disparities in infant mortality, and pregnancy-related deaths. These data help measure the impact of health insurance, access to care, and prenatal care on birth outcomes; and monitor deaths due to injury and violence, infectious diseases such as influenza, and chronic diseases such as cancer, heart disease, diabetes, among other conditions.
Vital statistics are also essential to the efficient administration of science. In particular, death data are used in:
Clinical trials and prospective cohort studies to detect adverse events and identify when study participants have died;
Longitudinal population surveys to monitor respondents between sample periods and to verify fact and cause of death; and
Health care utilization and patient safety research to identify likely predictors of mortality, including age, sex, level of education, health insurance status, and medical expenditures.
Indeed, these data are vital to understanding health and improving it. As such, myriad data users—health care providers, public health professionals, scientists and policymakers—require that the data are robust, accurate, and timely to maximize their utility.
NCHS in the Centers for Disease Control and Prevention (CDC) obtains vital events data from the jurisdictions to compile national data on births, deaths, marriages, divorces, and fetal deaths. The process for registering vital events, reporting data to NCHS, and releasing vital statistics for research and other purposes is complex, with many steps performed by many actors from start to finish (as page 9 of our More, Better, Faster report shows). As a result, historically the release of data has been slower than necessary for researchers and others to monitor and understand public health trends. At the national level and in many states, these critical data may not have been made available for more than a year or even longer after the data year ended. For example, national level preliminary death data for 2010 were not published until January 2012. Such a lag is not acceptable in an era of rapid health care transformation and new and emerging health challenges.
In response to these concerns, states and NCHS have made great strides in improving the timeliness of vital records data for research purposes. States have invested in electronic systems for registering births and deaths and for sharing such information across jurisdictions to improve the accuracy of data before it is submitted to NCHS—addressing one major bottleneck in rapid data release. NAPHSIS members have adopted data timeliness standards, and NAPHSIS staff and member volunteers are available to work with jurisdictions at risk of failure and help them meet NCHS contract data timeliness requirements. In addition, NCHS is now releasing quarterly, provisional data that includes the vital statistics data from the jurisdictions as it has been received, rather than waiting to receive data from all jurisdictions before releasing. Taken together, all of these activities are producing much timelier estimates of important health indicators for public health practitioners, researchers, and health policy-makers than ever possible before.
Data can be good, fast, or cheap. You can only pick two. Efforts to improve timeliness and quality of data—high priorities for researchers—are not without a price. For example, mortality data obtained from the states directly or from NCHS through the National Death Index may cost more than data now obtained from the public Death Master File. But higher quality, timelier vital statistics data that are the "gold standard" will only yield better quality, more relevant, timelier research to improve health. NAPHSIS and the jurisdictions we represent will continue to strive to produce more, better, faster data in response to the user community's needs.
For more information about vital statistics and efforts to improve them, please click here.