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Scientific Data Documentation
Linked Birth/Infant Death File, 1985
DSN: CC36.NATAL85.LINK CC36.NATAL85.DENOM ABSTRACT Table of Contents Linked Birth/Infant Death (Numerator) File and Birth (Denominator) File Table of Contents 1. Introduction, Methodology, and Classification of Data. 2. Machine used, file and data characteristics. 3. List of data elements and locations. 4. Record layout and definition of items and codes. 5. County geographic codes available on the public-use file. 6. City geographic codes available on the public-use file. 7. Titles and codes for the 61 cause-of-death list. 8. Documentation tables 1-5. 9. Technical Appendix for the 1985 Natality file. 10. Technical Appendix for the 1985 Mortality file. 11. Technical Appendix for the 1985 Mortality file. 2Symbols Used in Tables Symbol Explanation --- Data not available. ... Category not applicable - Quantity zero 0.0 Quantity more than 0 but less than 0.05 * Figure does not meet standards of reliability or precision 2Introduction The Linked Birth/Infant Death Data Set consists of two separate data files. The first file includes linked records of live births and infant deaths for the 1985 birth cohort -- also referred to as the numerator file. The second file is the live birth file for 1985 -- referred to as the denominator file. The files are offered as a numerator/denominator data set to give users the means to compute infant mortality rates. The 1985 linked file is comprised of deaths to infants born in 1985 who died in 1985 or 1986 before their first birthday. Infant death records were extracted from the 1985 and 1986 National Center for Health Statistics (NCHS) mortality statistical files. Linked birth records were extracted from a denominator file that Linked birth records were extracted from a denominator file that contained the 1985 NCHS natality statistical file and a small number of late-filed birth certificates. Refer to the Methodology section for a more detailed explanation of records added to the statistical file. the denominator file is not identical with the NCHS natality statistical file. The linked file of live births and infant deaths includes linked records for births and deaths that occurred in the United States to U.S. residents and to U.S. nonresidents. Excluded are deaths that occurred outside the United States to infants born in the U.S.; deaths that occurred in the United States to foreign-born infants; and births and deaths that occurred outside the United States to U.S. residents. Sources for denominator data and for birth records included in the numerator file are described in detail in the 1985 Technical Appendix from the Natality Annual Volume; sources for death records included in the numerator file are described in detail in the 1985 and 1986 Technical Appendices, from the Mortality Annual Volumes. Copies of these Technical Appendices are included in the this tape documentation. Because of confidentiality concerns, only those counties of 250,000 or more population and only those cities of 250,000 or more population are identified in this data set. The population counts are based on the results of the 1980 census. Users should refer to the geographic code outline in this document for the list of available areas and codes. In tabulations of linked data and denominator data, events occurring in the United States to U.S. nonresidents are included in tabulations that are by place of occurrence, and excluded from tabulations by place of residence. For linked data, these exclusions are based on the usual place of residence item of the Mother. This item is contained in both the denominator file and the birth section of the numerator (linked) file. U.S. nonresidents are identified by a code 4 in location 11 of these files. 1METHODOLOGY The methodology used to create the national file of linked birth and infant death records takes advantage of two existing data sources: 1. State linked files for the identification of linked birth and infant death certificates; and 2. NCHS natality and mortality computerized statistical files, the source of computer records for the two linked certificates. Virtually all States routinely link infant death certificates to their corresponding birth certificates for legal and statistical purposes. When the birth and death of an infant occur in different States, linking the two records that are filed in different jurisdictions requires State cooperation for the exchange of records. In accordance with the terms of the "Association for Vital Records and Health Statistics Agreement for Administering the Vital Records Exchange System," copies of the records are exchanged by the State of death and State of birth in order to effect a link. In addition, if a third State is identified as the State of residence at the time of birth or death, that State is also sent a copy of the appropriate certificate by the State where the birth or death occurred. The NCHS natality and mortality files, produced annually, include statistical data from birth and death certificates that are provided to NCHS by States under the Vital Statistics Cooperative Program (VSCP). The data have been coded according to uniform coding specifications, have passed rigid quality control standards, have been edited and reviewed, and are the basis for official U.S. birth and death statistics. To initiate processing, NCHS obtained computerized linked files from States that had them and extracted only the birth and death certificate numbers for linked records and State and year of occurrence. The States of Alaska, Arizona, Delaware, Indiana, and Nevada provided linkage information by posting birth certificate numbers on a computer-generated list of infant death certificate numbers that was provided by NCHS. A file that contained only State-provided identifiers for linked certificates was then matched to the NCHS mortality and natality statistical files. Individual birth and death records were selected from their respective files and linked into a single statistical record, thereby establishing a national linked record file. After the initial linkage, NCHS returned to the States of death copies or computer lists of unlinked infant death certificates for followup linking. If the birth occurred in a State different from the State of death, the State of birth identified on the death certificate was contacted to obtain the linking birth certificate. If the linking birth certificate from another State had been renumbered, the State of death requested the original certificate number from the State of birth. If the linked birth certificate had been filed after NCHS closed its statistical files, States provided NCHS a copy of the late-filed birth certificate. These certificates were coded, keyed, processed, added to the denominator file and then linked to the infant death record. Approximately 270 late-filed records were added to the denominator. The birth record in the denominator file includes an item in tape location 1 that identifies whether or not the record is linked to an infant death. This item is included in the denominator record for users who would want to identify individual records for which the infant died in the first year of life, or survived. 1DEMOGRAPHIC AND MEDICAL CLASSIFICATION The documents listed below described in detail the procedures employed for demographic classification on both the birth and death records and medical classification on death records. While not absolutely essential to the proper interpretation of the data for a number of general applications, these documents should nevertheless be studied carefully prior to any detailed analysis of demographic or medical (especially multiple cause) data variables. In particular, there are a number of exceptions to the ICD rules in multiple cause-of-death coding which, if not treated properly, may result in faulty analysis of the data. A. Manual of the International Statistical Classification of Diseases, Injuries, and the Cause-of-Death, Ninth Revision (ICD-9) Volumes 1 and 2. B. NCHS Instruction Manual Data Preparation Part 2a, Vital Statistics Instructions for Classifying the Underlying Cause-of Death, 1985. C. NCHS Instruction Manual Data Preparation, Part 2b, Vital Statistics, Instructions for Classifying Multiple Cause-of-Death, 1985. D. NCHS Instruction Manual Data Preparation, Part 2c, Vital Statistics ICD- 9 ACME Decision Tables for Classifying Underlying Causes-of-Death, 1985. E. NCHS Instruction Manual Data Preparation, Part 2d, Vital Statistics NCHS Procedures for Mortality Medical Data System File Preparation and Maintenance, Effective 1979. F. NCHS Instruction Manual Data Tabulation, Part 2f, Vital Statistics ICD-9 TRANSAX Disease Reference Tables for Classifying Multiple Causes-of- Death, 1982-86. G. NCHS Instruction Manual Data Preparation, Part 3a, Vital Statistics Classification and Coding Instructions for Live Birth Records, 1985. H. NCHS Instruction Manual Data Preparation, Part 3a, Vital Statistics Classification and Coding Instructions for Live Birth records, 1985. I. NCHS Instruction Manual Tabulation, Part 11, Vital Statistics Computer Edits for Mortality Data, Effective, 1979. Volumes 1 and 2 of the ICD-9 may be purchased from WHO Publication Center USA, 49 Sheridan Avenue, Albany, New York, 12210. The remaining documents may be requested from the Chief, Data Preparation Branch, Division of Data Processing, National Center for Health Statistics, P.O. Box 12214, Research Triangle Park, North Carolina 27709. In addition, the user should refer to the Technical Appendices of the Vital Statistics of the Untied States for information on the source of data, coding procedures, quality of the data, etc. The Technical Appendices for natality and mortality are part of this documentation package. 1CAUSE-OF-DEATH DATA Mortality data are traditionally analyzed and published in terms of underlying cause-of-death. The underlying cause-of-death data are coded and classified as described in the 1984 and 1985 Mortality Technical Appendices. NCHS has augmented underlying cause-of-death data with data on multiple causes reported on the death certificate. The linked file includes both underlying and multiple causes-of-death data. The multiple cause of death codes were developed with two objectives in mind. First, to facilitate etiological studies of the relationships among conditions, it was necessary to reflect accurately in coded form each condition and its location on the certification in the exact manner given by the certifier. Secondly, coding needed to be carried out in a manner by which the underlying cause-of-death could be assigned through computer applications. The approach was to suspend the linkage provisions of the ICD for the purpose of condition coding and code each entity with minimum regard to other conditions present on the certification. This general approach is hereafter called entity coding. Unfortunately, the set of multiple cause codes produced by entity coding is not conducive to a third objective -- the generation of person based multiple cause statistics. Person based analysis requires that each condition be coded within the context of every other condition on the same certificate and modified or linked to such conditions as provided by ICD-9. By definition, the entity data cannot meet this requirement since the linkage provisions distort the character and placement of the information originally recorded by the certifying physician. Since the two objectives are incompatible, NCHS has chosen to create from the original set of entity codes a new code set called record axis multiple cause data. Essentially, the axis of classification has been converted from an entity basis to a record (or person) basis. The record axis codes are assigned in terms of the set of codes that best describe the overall medical certification portion of the death certificate. This translation is accomplished by a computer system called TRANSAX (TRANSLATION OF AXIS) through selective use of traditional linkage and modification rules for mortality coding. Underlying cause linkages which simply prefer one code over another for purposes of underlying cause selection are not included. Each entity code on the record is examined and modified or deleted as necessary to create a set of codes which are free of contradictions and are the most precise within the constraints of contradictions and are the most precise within the constraints of ICD-9 and medical information on the record. Repetitive codes are deleted. the process may (1) combine two entity axis categories together to a new category thereby eliminating a contradiction or standardizing the data; or (2) eliminate one category in favor of another to promote specificity of the data or resolve contradictions. The following examples from ICD-9 illustrate the effect of this translations. Case 1: When reported o the same record as separate entities, cirrhosis of liver and alcoholism are coded to 5715 (cirrhosis of liver without mention of alcohol) and 303 (alcohol dependence syndrome). Tabulation of records with 5715 would on the surface falsely imply that such records had no mention of alcohol. A preferable codification would be 5712 (alcoholic cirrhosis of liver) in lieu of both 5715 and 303. Case 2: If "gastric ulcer" and "bleeding gastric ulcer" are reported on a record they are coded to 5319 (gastric ulcer, unspecified as acute or chronic, without mention of hemorrhage or perforation) and 5314 (gastric ulcer, chronic or unspecified, with hemorrhage). A more concise codification would be to code 5314 only since the 5314 shows both the gastric ulcer and the bleeding. A. Entity Axis Codes The original conditions coded for selection of the underlying cause-of- death are reformatted and edited prior to creating the public-use tape. The following paragraphs describe the format and application of entity axis data. FORMAT: Each entity-axis code is displayed as an overall seven byte code with subcomponents as follows: 1. Line indicator: This first byte represents the line of the certificate on which the code appears. Six lines (1-6) are allowable with the fourth and fifth denoting one or two written in "due to"s beyond the three lines provided in Part I of the U.S. standard death certificate. Line "6" represents Part II of the certificate. 2. Position indicator: The next bye indicates the position of the code on the line, i.e., it is the first (1), second (2), third (3),... eighth (8) code on the line. 3. Cause category: The next four bytes represent the ICD- 9 cause code. 4. Nature of injury flag: ICD-9 uses the same series of numbers (800-999) to indicate nature of injury (N codes) and external cause codes (E codes). This flag distinguishes between the two with a one (1) representing nature of injury codes and a zero (0) representing all other cause codes. A maximum of 20 of these seven byte codes are captured on a record for multiple cause purposes. this may consist of a maximum of 8 codes on any given line with up to 20 codes distributed across three or more lines depending on where the subject conditions are located on the certificate. Codes may be omitted from one or more lines, e.g., line 1 with one or more codes, line 2 with no codes, line 3 with one or more codes. In writing out these codes, they are ordered as follows: line 1 first code, line 1 second code, etc. ----- line 2 first code, line 2 second code, etc. --- -- line 3 ----- line 4 ----- line 5 ----- line 6. Any space remaining in the field is left blank. The specifics of locations are contained in the record layout given later in this document. EDIT: The original conditions are edited to remove invalid codes, reverify the coding of certain rare causes of death, and assure age/cause and sex/cause compatibility. Detailed information relating to the edit criteria and the sets of cause codes which are valid to underlying cause coding and multiple cause coding are provided in Part 11 of the NCHS Vital Statistics Instruction Manual Series. ENTITY AXIS APPLICATIONS: The entity axis multiple cause data is appropriate to analyses which require that each condition be coded as a stand alone entity without linkage to other conditions and/or require information on the placement of such conditions in the certificate. Within this framework, the entity data are appropriate to the examination of etiological relationships among conditions, accuracy of certification reporting, and the validity of traditional assumptions in underlying cause selection. Additionally, the entity data provide in certain categories a more detailed code assignment which is linked out in the creation of record axis data. Where such detail is needed for a study, the user should selectively employ entity data. Finally, the researcher may not wish to be bound by the assumptions used in the axis translation process preferring rather to investigate hypotheses of his own predilection. By definition, the main limitation of entity axis data is that an entity codes does not necessarily reflect the best code for a condition when considered with the context of the medical certification as a whole. As a result certain entity codes can be misleading or even contradict other codes in the record. For example, category 5750 is titled "Acute cholecystitis without mention of calculus". Within the framework of entity codes this is interpreted to mean that the codable entity itself contained no mention of calculus rather than that calculus was not mentioned anywhere on the record. Tabulation of records with a "5750" as a count of persons having acute cholecystitis without mention of calculus would therefore be erroneous. This illustrates the fact that under entity coding the ICD-9 titles cannot be taken literally. the user must study the rules for entity coding as they relate to his/her research prior to utilization of entity data. The user is further cautioned that the inclusion note sin ICD-9 which relate to modifying and combining categories are seldom applicable to entity coding (except where provided in Part 2b of the Vital Statistics Instruction Manual Series). In tabulating the entity axis data, one may count codes with the resultant tabulation of an individual code representing the number of times the disease(s) represented by the code appears in the file. In this kind of tabulation of morbid condition prevalence, the counts among categories may be added together to produce counts for groups of codes. Alternatively, subject to the limitations given above, one may count persons having mention of the disease represented by a code or codes. In this instance it is not correct to add counts for individual codes to create person counts for groups of codes. Since more than one code in the researcher's interest may appear together on the certificate, totaling must account for higher order interactions among codes. Up to 20 codes may be assigned on a record; therefore, a 20-way interaction is theoretically possible. All totaling must be based on mention of one or more of the categories under investigation. B. Record Axis Codes The following paragraphs describe the format and application of record- axis data. Part 2f of the Vital Statistics Instruction Manual Series describes the TRANSAX process for creating record axis data from entity axis data. FORMAT: Each record (or person) axis code is displayed in five bytes. Location information is not relevant. The Code consists of the following components: 1. Cause category: The first four bytes represent the ICD-9 cause code. 2. Nature of injury flag:The last bye contains a 0 or 1 with the 1 indicating that the cause is a nature of injury category. Again, a maximum of 20 codes are captured on a record for multiple cause purposes. The codes are written in a 100-byte field in ascending code number (5 bytes) order with any unused bytes left blank. EDIT:The record axis codes are edited for rare causes and age/cause and se/cause compatibility. Likewise, individual code validity is checked. The valid code set for record axis coding is the same as that for entity coding. RECORD AXIS APPLICATIONS: The record axis multiple cause data set is the basis for NCHS core multiple cause tabulations. Location of codes is not relevant to this data set and condition shave been linked in to the most meaningful categories for the certification. the most immediate consequence for the user is that the codes on the record already represent mention of a disease assignable to that particular ICD-9 category. This is in contrast to the entity code which is assigned each time such a disease is reported on two different lines of the certification. Secondly, the linkage implies that within the constraints of ICD-9 the most meaningful code has been assigned. The translation process creates for the user a data set which is edited for contradictions, duplicate codes, and imprecisions. In contrast to entity axis data, record axis data are classified in a manner comparable to underlying cause of death classification thereby facilitating joint analysis of these variables. Likewise, they are comparable to general morbidity coding where the linkage provisions of ICD-9 are usually utilized. A potential disadvantage of record axis data is that some detail is sacrificed in a number of the linkages. The user can take the record axis codes as literally represen0000000e information conveyed in ICD-9 category titles. While knowledge of the rules for combining and linking and coding conditions is useful, it is not a prerequisite to meaningful analysis of the data as long as one is willing to accept the assumptions of the axis translation process. The user is cautioned, however, that due to special rules in mortality coding, not all linkage notes in ICD-9 are utilized. (See part 2f of the Vital Statistics Instruction Manual Series). The user should proceed with caution in using record axis data to count conditions as opposed to people with conditions since linkages have been invoked and duplicate codes have been eliminated. As with entity data, person based tabulations which combine individual cause categories must take into account the possible interaction of up to 20 codes on a single certificate. In using the NCHS multiple cause data, the user is urged to review the information in this document and its references. the instructional material does change from year to year and revision to revision. The user is cautioned that coding of specific ICD-9 categories should be checked in the appropriate instruction manual. What may appear on the surface to be the correct code by ICD-9 may in fact not be correct as given in the instruction manuals. If on the surface it is not obvious whether entity axis or record axis data should be employed in a given application, detailed examination of Part 2f of the Vital Statistics Instruction Manual Series and its attachments will probably provide the necessary information to make a decision. It allows the user to determine information to make a decision. It allows the user to determine the extent of the trade-offs between the two sets of data in terms of specific categories and the assumptions of axis translation. In certain situations, a combination of entity and record axis data may be the more appropriate alternative. 1MACHINE/FILE/DATA CHARACTERISTICS I. Denominator File: A. Machine used: IBM/3091 B. Language used: PB/I C. File Organization: One file, multiple reels D. Record format: Blocked, fixed format E. Record count: 3,765,336 F. Record length: 91 G. Blocksize: 31941 H. Recording mode: IBM/EBCDIC 8-bit code I. Last block: Numeric/Alphabetic/Blank J. Code scheme: May be a short block K. Data counts: a. By occurrence: 3,765,336 b. By residence: 3,760,833 c. To foreign residents: 4,503 II. Numerator File: A. Machine used: IBM/3091 B. Language used: PB/I C. File Organization: One file, multiple reels D. Record format: Blocked, fixed format E. Record count: 39,170 F. Record length: 500 G. Blocksize: 32000 H. Recording mode: IBM/EBCDIC 8-bit code I. Last block: Numeric/Alphabetic/Blank J. Code scheme: May be a short block K. Data counts: a. By occurrence: 39,170 b. By residence: 39,145 c. To foreign residents: 25 1LIST OF DATA ELEMENTS AND LOCATIONS DenominatorNumerator File Data Items File Birth Death 1. General a. Match status 1 1 - b. Year of birth 2-5 2-5 - c. Year of death - - 194-197 d. Record type 10 10 198 e. Resident status 11 11 199 f. Record weight 91 91 - 2. Occurrence a. Region 12 12 200 b. Division 13 13 201 c. Expanded state 15-16 15-16 203-204 d. State 17-18 17-18 205-206 e. County 19-21 19-21 207-209 3. Residence a. Region 22 22 210 b. Division 23 23 211 c. Expanded state 25-26 25-26 213-214 d. State 27-28 27-28 215-216 e. County 29-31 29-31 217-219 f. City 32-34 32-34 220-222 4. Infant a. Race 36-37 36-37 - b. Sex 38 38 - c. Age - - 223-227 d. Gestation 39-42 39-42 - e. Birth weight 43-49 43-49 - f. Plurality 50 50 - g. Apgar score 51-54 51-54 - 5. Mother a. Origin or descent 55-56 55-56 - b. Race 57 57 - c. Age 58-61 58-61 - d. Education 62-64 62-64 - e. Marital status 65 65 - f. State of birth 66-67 66-67 - 6. Father a. Origin or descent 68-69 68-69 - b. Race 70 70 - c. Age 71-72 71-72 - d. Education 73-74 73-74 - 7. Pregnancy items a. Interval since last live birth75 75 - b. Outcome of last pregnancy 76 76 - c. Interval since last pregnancy77 77 - d. Month prenatal care began 78-80 78-80 - e. Number of prenatal visits 81-82 81-82 - f. Total birth order 83-85 83-85 - g. Live birth order 86-88 86-88 - 8. Medical data a. Underlying cause - - 231-237 b. Multiple conditions - - 238-481 9. Other items a. Place of delivery 89 89 - b. Attendant at birth 90 90 - c. Hospital and patient status- - 228 d. Autopsy performed - - 229 e. Place of accident - - 230 1DENOMINATOR RECORD AND NATALITY SECTION OF LINKED RECORD 21. Match Status Tape Field Location Size Item and Code Outline 1 1 Match Status 1 ... Matched Birth/Infant Death Record 2 ... Late Filed Matched Birth/Infant Death Record 3 ... Surviving Infant record 22-91. Birth Certificate Data Information Residence items in the Denominator Record and in the natality section of the Numerator (Linked) Record refer to the usual place of residence of the Mother; whereas in the mortality section of the Numerator (Linked) Record, these items refer to the residence of the Decedent. Tape Field Location Size Item and Code Outline 2-5 4 Year of Birth 1985 ... Born in 1985 6-9 4 Reserved positions 10 1 Record Type 1 ... RESIDENTS State and County of Occurrence and Residence are the same. 2 ... NONRESIDENTS State and/or County of Occurrence and Residence are different. 11 1 Resident Status 1 ... RESIDENTS State and County of Occurrence and Residence are the same. 2 ... INTRASTATE NONRESIDENTS State of Occurrence and Residence are the same, but County is different. 3 ... INTERSTATE NONRESIDENTS State of Occurrence and Residence are different, but both are in the U.S. 4 ... FOREIGN RESIDENTS State of Occurrence is one of the 50 States or the District of Columbia, but Place of Residence is outside of the U.S. Tape Field Location Size Item and Code Outline 12-21 10 PLACE OF OCCURRENCE Refer to the Geographic Code Outline in this document for a list of areas and codes available o the public-use file. 12 1 Region of Occurrence 13-14 2 Division and State Subcode of Occurrence Location 12 is Region. Location 13 is Division and Location 14 identifies States within that Division. 1 ... NORTHEAST 1 ... New England 1 ... Maine 2 ... New Hampshire 3 ... Vermont 4 ... Massachusetts 5 ... Rhode Island 6 ... Connecticut 2 ... Middle Atlantic 1 ... New York 2 ... New Jersey 3 ... Pennsylvania 2 ... MIDWEST 3 ... East North Central 1 ... Ohio 2 ... Indiana 3 ... Illinois 4 ... Michigan 5 ... Wisconsin 4 ... West North Central 1 ... Minnesota 2 ... Iowa 3 ... Missouri 4 ... North Dakota 5 ... South Dakota 6 ... Nebraska 7 ... Kansas Tape Field Location Size Item and Code Outline 12 1 Region - Continued 13-14 2 Division and State Subcode - Continued 3 ...SOUTH 5 ... South Atlantic 1 ... Delaware 2 ... Maryland 3 ... District of Columbia 4 ... Virginia 5 ... West Virginia 6 ... North Carolina 7 ... South Carolina 8 ... Georgia 9 ... Florida 6 ... East South Central 1 ... Kentucky 2 ... Tennessee 3 ... Alabama 4 ... Mississippi 7 ... West South Central 1 ... Arkansas 2 ... Louisiana 3 ... Oklahoma 4 ... Texas 4 ...WEST 8 ... Mountain 1 ... Montana 2 ... Idaho 3 ... Wyoming 4 ... Colorado 5 ... New Mexico 6 ... Arizona 7 ... Utah 8 ... Nevada 9 ... Pacific 1 ... Washington 2 ... Oregon 3 ... California 4 ... Alaska 5 ... Hawaii Tape Field Location Size Item and Code Outline 15-16 2 Expanded State of Occurrence This item is designed to separately identify New York city records from upstate New York records. 01 ... Alabama 02 ... Alaska 03 ... Arizona 04 ... Arkansas 05 ... California 06 ... Colorado 07 ... Connecticut 08 ... Delaware 09 ... District of Columbia 10 ... Florida 11 ... Georgia 12 ... Hawaii 13 ... Idaho 14 ... Illinois 15 ... Indiana 16 ... Iowa 17 ... Kansas 18 ... Kentucky 19 ... Louisiana 20 ... Maine 21 ... Maryland 22 ... Massachusetts 23 ... Michigan 24 ... Minnesota 25 ... Mississippi 26 ... Missouri 27 ... Montana 28 ... Nebraska 29 ... Nevada 30 ... New Hampshire 31 ... New Jersey 32 ... New Mexico 33 ... New York 34 ... New York city 35 ... North Carolina 36 ... North Dakota 37 ... Ohio 38 ... Oklahoma 39 ... Oregon 40 ... Pennsylvania 41 ... Rhode Island Tape Field Location Size Item and Code Outline 15-16 2 Expanded State of Occurrence - Continued 42 ... South Carolina 43 ... South Dakota 44 ... Tennessee 45 ... Texas 46 ... Utah 47 ... Vermont 48 ... Virginia 49 ... Washington 50 ... West Virginia 51 ... Wisconsin 52 ... Wyoming Tape Field Location Size Item and Code Outline 17-18 2 State of Occurrence Late filed birth certificates that were needed to match to an infant death record, have been included in this data set. 01 ... Alabama 02 ... Alaska 03 ... Arizona 04 ... Arkansas 05 ... California 06 ... Colorado 07 ... Connecticut 08 ... Delaware 09 ... District of Columbia 10 ... Florida 11 ... Georgia 12 ... Hawaii 13 ... Idaho 14 ... Illinois 15 ... Indiana 16 ... Iowa 17 ... Kansas 18 ... Kentucky 19 ... Louisiana 20 ... Maine 21 ... Maryland 22 ... Massachusetts 23 ... Michigan 24 ... Minnesota 25 ... Mississippi 26 ... Missouri 27 ... Montana 28 ... Nebraska 29 ... Nevada 30 ... New Hampshire 31 ... New Jersey 32 ... New Mexico 33 ... New York 34 ... North Carolina 35 ... North Dakota 36 ... Ohio 37 ... Oklahoma 38 ... Oregon 39 ... Pennsylvania 40 ... Rhode Island Tape Field Location Size Item and Code Outline 17-18 2 State of Occurrence - Continued 41 ... South Carolina 42 ... South Dakota 43 ... Tennessee 44 ... Texas 45 ... Utah 46 ... Vermont 47 ... Virginia 48 ... Washington 49 ... West Virginia 50 ... Wisconsin 51 ... Wyoming 19-21 3 County of Occurrence Because of confidentiality concerns, counties with a population less than 250,000 cannot be identified on the public-use file. 001-nnn ... Counties and county equivalents (independent and coextensive cities) are numbered alphabetically within each State. (Note: To uniquely identify a county, both the State and county codes must be used.) 999 ... County with less than 250,000 population Tape Field Location Size Item and Code Outline 22-35 14 PLACE OF RESIDENCE Refer to the Geographic Code Outline in this document for a list of areas and codes available on the public-use file. 22 1 Region of Occurrence 23-24 2 Division and State Subcode of Residence Location 22 is Region. Location 23 is Division and Location 24 identifies States within that Division. 000 Foreign Resident 1 ... NORTHEAST 1 ... New England 1 ... Maine 2 ... New Hampshire 3 ... Vermont 4 ... Massachusetts 5 ... Rhode Island 6 ... Connecticut 2 ... Middle Atlantic 1 ... New York 2 ... New Jersey 3 ... Pennsylvania 2 ... MIDWEST 3 ... East North Central 1 ... Ohio 2 ... Indiana 3 ... Illinois 4 ... Michigan 5 ... Wisconsin 4 ... West North Central 1 ... Minnesota 2 ... Iowa 3 ... Missouri 4 ... North Dakota 5 ... South Dakota 6 ... Nebraska 7 ... Kansas Tape Field Location Size Item and Code Outline 22 1 Region - Continued 23-24 2 Division and State Subcode - Continued 3 ...SOUTH 5 ... South Atlantic 1 ... Delaware 2 ... Maryland 3 ... District of Columbia 4 ... Virginia 5 ... West Virginia 6 ... North Carolina 7 ... South Carolina 8 ... Georgia 9 ... Florida 6 ... East South Central 1 ... Kentucky 2 ... Tennessee 3 ... Alabama 4 ... Mississippi 7 ... West South Central 1 ... Arkansas 2 ... Louisiana 3 ... Oklahoma 4 ... Texas 4 ...WEST 8 ... Mountain 1 ... Montana 2 ... Idaho 3 ... Wyoming 4 ... Colorado 5 ... New Mexico 6 ... Arizona 7 ... Utah 8 ... Nevada 9 ... Pacific 1 ... Washington 2 ... Oregon 3 ... California 4 ... Alaska 5 ... Hawaii Tape Field Location Size Item and Code Outline 25-26 2 Expanded State of Residence This item is designed to separately identify New York city records from upstate New York records. 01 ... Alabama 02 ... Alaska 03 ... Arizona 04 ... Arkansas 05 ... California 06 ... Colorado 07 ... Connecticut 08 ... Delaware 09 ... District of Columbia 10 ... Florida 11 ... Georgia 12 ... Hawaii 13 ... Idaho 14 ... Illinois 15 ... Indiana 16 ... Iowa 17 ... Kansas 18 ... Kentucky 19 ... Louisiana 20 ... Maine 21 ... Maryland 22 ... Massachusetts 23 ... Michigan 24 ... Minnesota 25 ... Mississippi 26 ... Missouri 27 ... Montana 28 ... Nebraska 29 ... Nevada 30 ... New Hampshire 31 ... New Jersey 32 ... New Mexico 33 ... New York 34 ... New York city 35 ... North Carolina 36 ... North Dakota 37 ... Ohio 38 ... Oklahoma 39 ... Oregon 40 ... Pennsylvania 41 ... Rhode Island Tape Field Location Size Item and Code Outline 25-26 2 Expanded State of Residence - Continued 42 ... South Carolina 43 ... South Dakota 44 ... Tennessee 45 ... Texas 46 ... Utah 47 ... Vermont 48 ... Virginia 49 ... Washington 50 ... West Virginia 51 ... Wisconsin 52 ... Wyoming 53-58,60 ... Foreign Residents 53 ... Puerto Rico 54 ... Virgin Island 55 ... Guam 56 ... Canada 57 ... Cuba 58 ... Mexico 60 ... Remainder of the world Tape Field Location Size Item and Code Outline 27-28 2 State of Occurrence 01 ... Alabama 02 ... Alaska 03 ... Arizona 04 ... Arkansas 05 ... California 06 ... Colorado 07 ... Connecticut 08 ... Delaware 09 ... District of Columbia 10 ... Florida 11 ... Georgia 12 ... Hawaii 13 ... Idaho 14 ... Illinois 15 ... Indiana 16 ... Iowa 17 ... Kansas 18 ... Kentucky 19 ... Louisiana 20 ... Maine 21 ... Maryland 22 ... Massachusetts 23 ... Michigan 24 ... Minnesota 25 ... Mississippi 26 ... Missouri 27 ... Montana 28 ... Nebraska 29 ... Nevada 30 ... New Hampshire 31 ... New Jersey 32 ... New Mexico 33 ... New York 34 ... North Carolina 35 ... North Dakota 36 ... Ohio 37 ... Oklahoma 38 ... Oregon 39 ... Pennsylvania 40 ... Rhode Island Tape Field Location Size Item and Code Outline 27-28 2 State of Residence - Continued 41 ... South Carolina 42 ... South Dakota 43 ... Tennessee 44 ... Texas 45 ... Utah 46 ... Vermont 47 ... Virginia 48 ... Washington 49 ... West Virginia 50 ... Wisconsin 51 ... Wyoming 52-57,59 ... Foreign Residents 52 ... Puerto Rico 53 ... Virgin Islands 54 ... Guam 55 ... Canada 56 ... Cuba 57 ... Mexico 59 ... Remainder of the world Tape Field Location Size Item and Code Outline 29-31 3 County of Residence Because of confidentiality concerns, counties with a population less than 250,000 cannot be identified on the public-use file. 001-nnn ... Counties and county equivalents (independent and coextensive cities) are numbered alphabetically within each State. (Note: To uniquely identify a county, both the State and county codes must be used.) 999 ... County with less than 250,000 population ZZZ ... Foreign residents 32-34 3 City of Residence Because of confidentiality concerns, cities with a population less than 250,000 cannot be identified on the public-use file. 001-nnn ... Cities are numbered alphabetically within each State. (Note: To uniquely identify a city, both the State and city codes must be used.) 999 ... Entire county, Balance of County, or city less than 250,000 population ZZZ ... Foreign residents 35 1 Reserved position 36 1 Detail Race of Child 1 ... White 2 ... Black 3 ... American Indian (includes Aleuts and Eskimos) 4 ... Chinese 5 ... Japanese 6 ... Hawaiian (includes Part-Hawaiian) 7 ... Filipino 8 ... Other Asian or Pacific Islander 0 ... Other races Tape Field Location Size Item and Code Outline 37 1 Race of Child Recode 3 1 ... White 2 ... Races other than White or Black 3 ... Black 38 1 Sex of Child 1 ... Male 2 ... Female 39-40 2 Detail Gestation in Weeks 17-52 ... 17th through 52nd week of gestation 99 ... Gestation not stated 41-42 2 Gestation Recode 10 01 ... Under 20 weeks 02 ... 20 - 27 weeks 03 ... 28 - 31 weeks 04 ... 32 - 35 weeks 05 ... 36 weeks 06 ... 37 - 39 weeks 07 ... 40 weeks 08 ... 41 weeks 09 ... 42 weeks and over 10 ... Gestation not stated 43-46 4 Birth weight - Detail in Grams 0227-8165 ... Number of grams 9999 ... Birth weight not stated Tape Field Location Size Item and Code Outline 47-48 2 Birth weight Recode 14 01 ... 499 grams or less 02 ... 500 - 749 grams 03 ... 750 - 999 grams 04 ... 1000 - 1249 grams 05 ... 1250 - 1499 grams 06 ... 1500 - 1999 grams 07 ... 2000 - 2499 grams 08 ... 2500 - 2999 grams 09 ... 3000 - 3499 grams 10 ... 3500 - 3999 grams 11 ... 4000 - 4499 grams 12 ... 4500 - 4999 grams 13 ... 5000 - 8165 grams 14 ... Birth weight not stated 49 1 Birth weight Recode 3 1 ... 2499 grams or less 2 ... 2500 grams or more 3 ... Birth weight not stated 50 1 Plurality - Detail 1 ... Single Birth 2 ... Twin 3 ... Other Multiple Births 51-52 2 One Minute Apgar Score 00-10 ... A score of 0-10 99 ... One minute Apgar score unknown or not stated 53-54 2 Five Minute Apgar Score 00-10 ... A score of 0-10 99 ... Five minute Apgar score unknown or not stated Tape Field Location Size Item and Code Outline 55-56 2 Origin or Descent of Mother The Technical Appendix contains a table that shows which States report Detail Ethnicity (codes 01-24, 99), which States report Hispanic origin or Descent (codes 00-05, 99), and which States do not report either item (code 88). 00 ... Non - spanish 01 ... Mexican 02 ... Puerto Rican 03 ... Cuban 04 ... Central or South American 05 ... Other and Unknown Spanish 06 ... American 07 ... American Indian 08 ... British, Scottish, Welsh, Scotch-Irish 09 ... Irish 10 ... German 11 ... French 12 ... Norwegian, Swedish, Danish 13 ... Polish 14 ... Italian 15 ... Other North, Central and South American 16 ... Other Western European 17 ... Other Northern European 18 ... Other Eastern European 19 ... Other Southern European (excluding Spain) 20 ... Southeast Asian and Pacific Islander 21 ... South Central Asian 22 ... Other Asian 23 ... North African 24 ... Other African 88 ... Origin or descent of Mother not reported 99 ... Origin or descent of Mother not classifiable Tape Field Location Size Item and Code Outline 57 1 Detail Race of Mother 1 ... White 2 ... Black 3 ... American Indian (includes Aleuts and Eskimos 4 ... Chinese 5 ... Japanese 6 ... Hawaiian (includes Part-Hawaiian) 7 ... Filipino 8 ... Other Asian or Pacific Islander 0 ... Other races 9 ... Race of Mother not stated 58-59 2 Detail Age of Mother 10-49 ... Age in single years 60-61 2 Age of Mother Recode 12 01 ... Under 15 years 03 ... 15 years 04 ... 16 years 05 ... 17 years 06 ... 18 years 07 ... 19 years 08 ... 20 - 24 years 09 ... 25 - 29 years 10 ... 30 - 34 years 11 ... 35 - 39 years 12 ... 40 - 44 years 13 ... 45 - 49 years Tape Field Location Size Item and Code Outline 62 - 63 2 Mother's Education - Detail 00 ... No formal education 01-08 ... Years of elementary school 09 ... 1 year of high school 10 ... 2 years of high school 11 ... 3 years of high school 12 ... 4 years of high school 13 ... 1 year of college 14 ... 2 years of college 15 ... 3 years of college 16 ... 4 years of college 17 ... 5 or more years of college 99 ... Mother's education not stated 64 1 Mother's Education Recode 6 1 ... 0 - 8 years 2 ... 9 - 11 years 3 ... 12 years 4 ... 13 - 15 years 5 ... 16 years and over 6 ... Mother's education not stated 65 1 Marital Status 1 ... Married 2 ... Unmarried Tape Field Location Size Item and Code Outline 66-67 2 Mother's Place of Birth 01 ... Alabama 02 ... Alaska 03 ... Arizona 04 ... Arkansas 05 ... California 06 ... Colorado 07 ... Connecticut 08 ... Delaware 09 ... District of Columbia 10 ... Florida 11 ... Georgia 12 ... Hawaii 13 ... Idaho 14 ... Illinois 15 ... Indiana 16 ... Iowa 17 ... Kansas 18 ... Kentucky 19 ... Louisiana 20 ... Maine 21 ... Maryland 22 ... Massachusetts 23 ... Michigan 24 ... Minnesota 25 ... Mississippi 26 ... Missouri 27 ... Montana 28 ... Nebraska 29 ... Nevada 30 ... New Hampshire 31 ... New Jersey 32 ... New Mexico 33 ... New York 34 ... North Carolina 35 ... North Dakota 36 ... Ohio 37 ... Oklahoma 38 ... Oregon 39 ... Pennsylvania 40 ... Rhode Island Tape Field Location Size Item and Code Outline 27-28 2 Mother's Place of Birth - Continued 41 ... South Carolina 42 ... South Dakota 43 ... Tennessee 44 ... Texas 45 ... Utah 46 ... Vermont 47 ... Virginia 48 ... Washington 49 ... West Virginia 50 ... Wisconsin 51 ... Wyoming 52 ... Puerto Rico 53 ... Virgin Islands 54 ... Guam 55 ... Canada 56 ... Cuba 57 ... Mexico 59 ... Remainder of the world 99 ... Mother's place of birth not classifiable Tape Field Location Size Item and Code Outline 68-69 2 Origin or Descent of Father The Technical Appendix contains a table that shows which States report Detail Ethnicity (codes 01-24, 99), which States report Hispanic origin or Descent (codes 00-05, 99), and which States do not report either item (code 88). 00 ... Non - spanish 01 ... Mexican 02 ... Puerto Rican 03 ... Cuban 04 ... Central or South American 05 ... Other and Unknown Spanish 06 ... American 07 ... American Indian 08 ... British, Scottish, Welsh, Scotch-Irish 09 ... Irish 10 ... German 11 ... French 12 ... Norwegian, Swedish, Danish 13 ... Polish 14 ... Italian 15 ... Other North, Central and South American 16 ... Other Western European 17 ... Other Northern European 18 ... Other Eastern European 19 ... Other Southern European (excluding Spain) 20 ... Southeast Asian and Pacific Islander 21 ... South Central Asian 22 ... Other Asian 23 ... North African 24 ... Other African 88 ... Origin or descent of Father not reported 99 ... Origin or descent of Father not classifiable Tape Field Location Size Item and Code Outline 70 1 Detail Race of Father 1 ... White 2 ... Black 3 ... American Indian (includes Aleuts and Eskimos 4 ... Chinese 5 ... Japanese 6 ... Hawaiian (includes Part-Hawaiian) 7 ... Filipino 8 ... Other Asian or Pacific Islander 0 ... Other races 9 ... Race of Father not stated 71-72 2 Detail Age of Father 10-98 ... Age in single years 99 ... Age of Father not stated 73-74 2 Father's Education - Detail 00 ... No formal education 01-08 ... Years of elementary school 09 ... 1 year of high school 10 ... 2 years of high school 11 ... 3 years of high school 12 ... 4 years of high school 13 ... 1 year of college 14 ... 2 years of college 15 ... 3 years of college 16 ... 4 years of college 17 ... 5 or more years of college 99 ... Father's education not stated Tape Field Location Size Item and Code Outline 75 1 Interval Since Last Live Birth 0 ... Not applicable (no previous live birth) 1 ... Zero Months (plural birth) 2 ... 1 - 11 months 3 ... 12 - 23 months 4 ... 24 - 35 months 5 ... 36 - 47 months 6 ... 48 - 71 months 7 ... 72 months and over 9 ... Interval since last live birth not stated 76 1 Outcome of Last Pregnancy 0 ... Not applicable (no previous pregnancy) 1 ... Last pregnancy was a live birth 2 ... Last pregnancy was some other termination 3 ... Last pregnancy's outcome is unknown 77 1 Interval Since Termination of Last Pregnancy 0 ... Not applicable (no previous pregnancy) 1 ... Zero Months (plural delivery) 2 ... 1 - 11 months 3 ... 12 - 17 months 4 ... 18 - 23 months 5 ... 24 - 35 months 6 ... 36 - 47 months 7 ... 48 - 59 months 8 ... 60 months and over 9 ... Interval since termination of last pregnancy not stated Tape Field Location Size Item and Code Outline 78-79 2 Detail Month of Pregnancy Prenatal Care Began 01 ... 1st month 02 ... 2nd month 03 ... 3rd month 04 ... 4th month 05 ... 5th month 06 ... 6th month 07 ... 7th month 08 ... 8th month 09 ... 9th month 00 ... No prenatal care 99 ... Month of pregnancy prenatal care began not stated 80 1 Month of Pregnancy Prenatal Care Began Recode 6 1 ... 1st - 2nd month 2 ... 3rd month 3 ... 4th - 6th month 4 ... 7th - 9th month 5 ... No prenatal Care 6 ... Month of pregnancy prenatal care began not stated 81-82 2 Total Number of Prenatal Visits 00 ... No prenatal visits 01-49 ... Stated number of visits 99 ... Number of prenatal visits not stated 83-84 2 Detail Total Birth Order 01-50 ... Total number of live births and other terminations 99 ... Total birth order unknown or not stated Tape Field Location Size Item and Code Outline 85 1 Total Birth Order Recode 9 1 ... First Child 2 ... Second Child 3 ... Third Child 4 ... Fourth Child 5 ... Fifth Child 6 ... Sixth Child 7 ... Seventh Child 8 ... Eighth Child and over 9 ... Total birth order not stated 86-87 2 Detail Total Birth Order 01-50 ... Total number of children ever born alive to mother 99 ... Live birth order unknown or not stated 88 1 Live Birth Order Recode 9 1 ... First Child 2 ... Second Child 3 ... Third Child 4 ... Fourth Child 5 ... Fifth Child 6 ... Sixth Child 7 ... Seventh Child 8 ... Eighth Child and over 9 ... Total birth order not stated 89 1 Place of Delivery 1 ... Hospital Births 2 ... Nonhospital Births 3 ... En route or born on arrival (BOA) 9 ... Place of delivery not classifiable 90 1 Attendant at Birth 1 ... Physician 2 ... Midwife 3 ... Attendant specified other than physician or midwife 9 ... Attendant at birth unknown Tape Field Location Size Item and Code Outline 91 1 Record Weight Numerator (Linked) record 1 ... All records contain a 1 Denominator record Each record contains a record weight that is used to inflate totals to national birth figures. 1-2 ... Code range The denominator record ends in Location 91. 292-193. Numerator (Linked) Record Reserved Positions 92-193 102 These positions are contained in the Numerator (Linked) Record only and are reserved for possible additional data. If data are added in the future, they will be included in both files. The record length of the Denominator file would expand, but it is expected that the Numerator record would remain constant. 1MORTALITY SECTION OF THE NUMERATOR (LINKED) RECORD Tape Field Location Size Item and Code Outline Locations 194-500 contain data from the Death Certificate Residence items in the Denominator Record and in the natality section of the Numerator (Linked) Record refer to the usual Place of residence of the Mother whereas in the mortality section of the Numerator (Linked) Record, there items refer to the residence of the Decedent. 194-197 4 Year of Death 1984 ... Death occurred in 1984 1985 ... Death occurred in 1985 198 1 Record Type 1 ... RESIDENTS State and County of Occurrence and Residence are the same. 2 ... NONRESIDENTS State and/or County of Occurrence and Residence are different. 199 1 Resident Status 1 ... RESIDENTS State and County of Occurrence and Residence are the same. 2 ... INTRASTATE NONRESIDENTS State of Occurrence and Residence are the same, but County is different. 3 ... INTERSTATE NONRESIDENTS State of Occurrence and Residence are different, but both are in the U.S. 4 ... FOREIGN RESIDENTS State of Occurrence is one of the 50 States or the District of Columbia, but Place of Residence is outside of the U.S. Tape Field Location Size Item and Code Outline 200-209 10 PLACE OF OCCURRENCE Refer to the Geographic Code Outline in this document for a list of areas and codes available on the public-use file. 200 1 Region of Occurrence 201-202 2 Division and State Subcode of Occurrence Location 200 is Region. Location 201 is Division and Location 202 identifies States within that Division. 1 ... NORTHEAST 1 ... New England 1 ... Maine 2 ... New Hampshire 3 ... Vermont 4 ... Massachusetts 5 ... Rhode Island 6 ... Connecticut 2 ... Middle Atlantic 1 ... New York 2 ... New Jersey 3 ... Pennsylvania 2 ... MIDWEST 3 ... East North Central 1 ... Ohio 2 ... Indiana 3 ... Illinois 4 ... Michigan 5 ... Wisconsin 4 ... West North Central 1 ... Minnesota 2 ... Iowa 3 ... Missouri 4 ... North Dakota 5 ... South Dakota 6 ... Nebraska 7 ... Kansas Tape Field Location Size Item and Code Outline 200 1 Region - Continued 201-202 2 Division and State Subcode - Continued 3 ...SOUTH 5 ... South Atlantic 1 ... Delaware 2 ... Maryland 3 ... District of Columbia 4 ... Virginia 5 ... West Virginia 6 ... North Carolina 7 ... South Carolina 8 ... Georgia 9 ... Florida 6 ... East South Central 1 ... Kentucky 2 ... Tennessee 3 ... Alabama 4 ... Mississippi 7 ... West South Central 1 ... Arkansas 2 ... Louisiana 3 ... Oklahoma 4 ... Texas 4 ...WEST 8 ... Mountain 1 ... Montana 2 ... Idaho 3 ... Wyoming 4 ... Colorado 5 ... New Mexico 6 ... Arizona 7 ... Utah 8 ... Nevada 9 ... Pacific 1 ... Washington 2 ... Oregon 3 ... California 4 ... Alaska 5 ... Hawaii Tape Field Location Size Item and Code Outline 203-204 2 Expanded State of Occurrence This item is designed to separately identify New York city records from upstate New York records. 01 ... Alabama 02 ... Alaska 03 ... Arizona 04 ... Arkansas 05 ... California 06 ... Colorado 07 ... Connecticut 08 ... Delaware 09 ... District of Columbia 10 ... Florida 11 ... Georgia 12 ... Hawaii 13 ... Idaho 14 ... Illinois 15 ... Indiana 16 ... Iowa 17 ... Kansas 18 ... Kentucky 19 ... Louisiana 20 ... Maine 21 ... Maryland 22 ... Massachusetts 23 ... Michigan 24 ... Minnesota 25 ... Mississippi 26 ... Missouri 27 ... Montana 28 ... Nebraska 29 ... Nevada 30 ... New Hampshire 31 ... New Jersey 32 ... New Mexico 33 ... New York 34 ... New York city 35 ... North Carolina 36 ... North Dakota 37 ... Ohio 38 ... Oklahoma 39 ... Oregon 40 ... Pennsylvania 41 ... Rhode Island Tape Field Location Size Item and Code Outline 203-204 2 Expanded State of Occurrence - Continued 42 ... South Carolina 43 ... South Dakota 44 ... Tennessee 45 ... Texas 46 ... Utah 47 ... Vermont 48 ... Virginia 49 ... Washington 50 ... West Virginia 51 ... Wisconsin 52 ... Wyoming Tape Field Location Size Item and Code Outline 205-206 2 State of Occurrence 01 ... Alabama 02 ... Alaska 03 ... Arizona 04 ... Arkansas 05 ... California 06 ... Colorado 07 ... Connecticut 08 ... Delaware 09 ... District of Columbia 10 ... Florida 11 ... Georgia 12 ... Hawaii 13 ... Idaho 14 ... Illinois 15 ... Indiana 16 ... Iowa 17 ... Kansas 18 ... Kentucky 19 ... Louisiana 20 ... Maine 21 ... Maryland 22 ... Massachusetts 23 ... Michigan 24 ... Minnesota 25 ... Mississippi 26 ... Missouri 27 ... Montana 28 ... Nebraska 29 ... Nevada 30 ... New Hampshire 31 ... New Jersey 32 ... New Mexico 33 ... New York 34 ... North Carolina 35 ... North Dakota 36 ... Ohio 37 ... Oklahoma 38 ... Oregon 39 ... Pennsylvania 40 ... Rhode Island Tape Field Location Size Item and Code Outline 205-206 2 State of Occurrence - Continued 41 ... South Carolina 42 ... South Dakota 43 ... Tennessee 44 ... Texas 45 ... Utah 46 ... Vermont 47 ... Virginia 48 ... Washington 49 ... West Virginia 50 ... Wisconsin 51 ... Wyoming 207-209 3 County of Occurrence Due to confidentiality requirements, counties with a population less than 250,000 cannot be identified on the public-use file. 001-nnn ... Counties and county equivalents (independent and coextensive cities) are numbered alphabetically within each State. (Note: To uniquely identify a county, both the State and county codes must be used.) 999 ... County with less than 250,000 population Tape Field Location Size Item and Code Outline 210-223 14 PLACE OF RESIDENCE Refer to the Geographic Code Outline in this document for a list of areas and codes available on the public-use file. 210 1 Region of Residence 211-212 2 Division and State Subcode of Residence Location 210 is Region. Location 211 is Division and Location 212 identifies States within that Division. 000 Foreign Resident 1 ... NORTHEAST 1 ... New England 1 ... Maine 2 ... New Hampshire 3 ... Vermont 4 ... Massachusetts 5 ... Rhode Island 6 ... Connecticut 2 ... Middle Atlantic 1 ... New York 2 ... New Jersey 3 ... Pennsylvania 2 ... MIDWEST 3 ... East North Central 1 ... Ohio 2 ... Indiana 3 ... Illinois 4 ... Michigan 5 ... Wisconsin 4 ... West North Central 1 ... Minnesota 2 ... Iowa 3 ... Missouri 4 ... North Dakota 5 ... South Dakota 6 ... Nebraska 7 ... Kansas Tape Field Location Size Item and Code Outline 210 1 Region - Continued 211-212 2 Division and State Subcode - Continued 3 ...SOUTH 5 ... South Atlantic 1 ... Delaware 2 ... Maryland 3 ... District of Columbia 4 ... Virginia 5 ... West Virginia 6 ... North Carolina 7 ... South Carolina 8 ... Georgia 9 ... Florida 6 ... East South Central 1 ... Kentucky 2 ... Tennessee 3 ... Alabama 4 ... Mississippi 7 ... West South Central 1 ... Arkansas 2 ... Louisiana 3 ... Oklahoma 4 ... Texas 4 ...WEST 8 ... Mountain 1 ... Montana 2 ... Idaho 3 ... Wyoming 4 ... Colorado 5 ... New Mexico 6 ... Arizona 7 ... Utah 8 ... Nevada 9 ... Pacific 1 ... Washington 2 ... Oregon 3 ... California 4 ... Alaska 5 ... Hawaii Tape Field Location Size Item and Code Outline 213-214 2 Expanded State of Residence This item is designed to separately identify New York city records from upstate New York records. 01 ... Alabama 02 ... Alaska 03 ... Arizona 04 ... Arkansas 05 ... California 06 ... Colorado 07 ... Connecticut 08 ... Delaware 09 ... District of Columbia 10 ... Florida 11 ... Georgia 12 ... Hawaii 13 ... Idaho 14 ... Illinois 15 ... Indiana 16 ... Iowa 17 ... Kansas 18 ... Kentucky 19 ... Louisiana 20 ... Maine 21 ... Maryland 22 ... Massachusetts 23 ... Michigan 24 ... Minnesota 25 ... Mississippi 26 ... Missouri 27 ... Montana 28 ... Nebraska 29 ... Nevada 30 ... New Hampshire 31 ... New Jersey 32 ... New Mexico 33 ... New York 34 ... New York city 35 ... North Carolina 36 ... North Dakota 37 ... Ohio 38 ... Oklahoma 39 ... Oregon 40 ... Pennsylvania 41 ... Rhode Island Tape Field Location Size Item and Code Outline 213-214 2 Expanded State of Residence - Continued 42 ... South Carolina 43 ... South Dakota 44 ... Tennessee 45 ... Texas 46 ... Utah 47 ... Vermont 48 ... Virginia 49 ... Washington 50 ... West Virginia 51 ... Wisconsin 52 ... Wyoming 53-58,60 ... Foreign Residents 53 ... Puerto Rico 54 ... Virgin Island 55 ... Guam 56 ... Canada 57 ... Cuba 58 ... Mexico 60 ... Remainder of the world Tape Field Location Size Item and Code Outline 215-216 2 State of Occurrence 01 ... Alabama 02 ... Alaska 03 ... Arizona 04 ... Arkansas 05 ... California 06 ... Colorado 07 ... Connecticut 08 ... Delaware 09 ... District of Columbia 10 ... Florida 11 ... Georgia 12 ... Hawaii 13 ... Idaho 14 ... Illinois 15 ... Indiana 16 ... Iowa 17 ... Kansas 18 ... Kentucky 19 ... Louisiana 20 ... Maine 21 ... Maryland 22 ... Massachusetts 23 ... Michigan 24 ... Minnesota 25 ... Mississippi 26 ... Missouri 27 ... Montana 28 ... Nebraska 29 ... Nevada 30 ... New Hampshire 31 ... New Jersey 32 ... New Mexico 33 ... New York 34 ... North Carolina 35 ... North Dakota 36 ... Ohio 37 ... Oklahoma 38 ... Oregon 39 ... Pennsylvania 40 ... Rhode Island Tape Field Location Size Item and Code Outline 215-216 2 State of Residence - Continued 41 ... South Carolina 42 ... South Dakota 43 ... Tennessee 44 ... Texas 45 ... Utah 46 ... Vermont 47 ... Virginia 48 ... Washington 49 ... West Virginia 50 ... Wisconsin 51 ... Wyoming 52-57,59 ... Foreign Residents 52 ... Puerto Rico 53 ... Virgin Islands 54 ... Guam 55 ... Canada 56 ... Cuba 57 ... Mexico 59 ... Remainder of the world 217-219 3 County of Residence Due to confidentiality requirements, counties with a population less than 250,000 cannot be identified on the public-use file. 001-nnn ... Counties and county equivalents (independent and coextensive cities) are numbered alphabetically within each State. (Note: To uniquely identify a county, both the State and county codes must be used.) 999 ... County with less than 250,000 population ZZZ ... Foreign residents 220-222 3 City of Residence Due to confidentiality requirements, cities with a population less than 250,000 cannot be identified on the public-use file. 001-nnn ... Cities are numbered alphabetically within each State. (Note: To uniquely identify a city, both the State and city codes must be used.) 999 ... Entire county, Balance of County, or city less than 250,000 population ZZZ ... Foreign residents 223-227 5 AGE Age is as computed using the dates of birth and death. For ages less than 2 days and when age could not be computed, the reported age from the death certificate was used. 223 1 Infant Age Recode 5 1 ... Under 1 hour 2 ... 1 - 23 hours 3 ... 1 - 6 days 4 ... 7 - 27 days (late neonatal) 5 ... 28 days and over (post neonatal) Tape Field Location Size Item and Code Outline 224-225 2 Infant Age Recode 76 00 ... Less than 1 day 01-27 ... 1 - 27 days 28 ... 4th week 29 ... 5th week 30 ... 6th week 31-76 ... 7th - 52nd weeks 226-227 2 Infant Age Recode 38 00 ... Less than 1 day 01-27 ... 1 - 27 days 28 ... 1 month 29 ... 2 months 30 ... 3 months 31 ... 4 months 32 ... 5 months 33 ... 6 months 34 ... 7 months 35 ... 8 months 36 ... 9 months 37 ...10 months 38 ...11 months 228 1 Hospital and Patient Status 1 ... Hospital, Clinic or Medical Center - Inpatient 2 ... Hospital, Clinic or Medical Center - Outpatient or admitted to Emergency 3 ... Hospital, Clinic or Medical Center - Dead on Arrival 4 ... Hospital, Clinic or Medical Center - Patient status unknown 5 ... Hospital, Clinic or Medical Center - Patient status not on certificate 6 ... Other institution providing patient care 7 ... All other reported entries 8 ... Dead on Arrival - Hospital, Clinic or Medical Center name not given 9 ... Hospital and patient status not stated Tape Field Location Size Item and Code Outline 229 1 Autopsy Performed 1 ... Yes 2 ... No 3 ... Autopsy performed not on certificate 4 ... Autopsy performed not stated 230 1 Place of Accident for Causes E850-E929 Blank ... Causes other than E850-E929 0 ... Home 1 ... Farm 2 ... Mine and Quarry 3 ... Industrial Place and Premises 4 ... Place for Recreation and Sport 5 ... Street and Highway 6 ... Public Building 7 ... Resident Institution 8 ... Other Specified Places 9 ... Place of accident not specified 231-237 7 UNDERLYING CAUSE OF DEATH 231-234 4 ICD Code (9th Revision) See the "International Classification of Diseases", 1975 Revision, Volume 1. For injuries and poisoning, the external cause is coded (E800-E999) rather than the Nature of the Injury (800-999). These positions do not include the letter E for the external cause of injury. For those causes that do not have a 4th digit, location 234 is blank. 235-237 3 61 Infant Cause Recode A recode of the ICD cause code into 61 groups for NCHS publications. Further back in this document is a complete list of recodes and the causes included. 010-680 ... Code range (not inclusive) Tape Field Location Size Item and Code Outline 238-481 244 MULTIPLE CONDITIONS See the "International Classification of Diseases", 1975 Revision, Volume 1. Both the entity-axis and record-axis conditions are coded according to this revision (9th). 238-239 2 Number of Entity-Axis Conditions 00-20 ... Code range 240-379 140 ENTITY - AXIS CONDITIONS Space has been provided for a maximum of 20 conditions. Each condition takes 7 positions in the record. Records that do not have 20 conditions are blank in the unused area. Position 1: Part/line number on certificate 1 ... Part I, Line 1 (a) 2 ... Part I, Line 2 (b) 3 ... Part I, Line 3 (c) 4 ... Part I, Line 4 (d) 5 ... Part I, Line 5 (e) 6 ... Part II Position 2: Sequence of condition within part/line 1-7 ... Code range Position 3 - 6: Condition code (ICD 9th Revision) Position 7: Nature of Injury Flag 1 ... Indicates that the code in positions 3-6 is a Nature of Injury code 0 ... All other codes Tape Field Location Size Item and Code Outline 240-246 7 1st Condition 247-253 7 2nd Condition 254-260 7 3rd Condition 261-267 7 4th Condition 268-274 7 5th Condition 275-281 7 6th Condition 282-288 7 7th Condition 289-295 7 8th Condition 296-302 7 9th Condition 303-309 7 10th Condition 310-316 7 11th Condition 317-323 7 12th Condition 324-330 7 13th Condition 331-337 7 14th Condition 338-344 7 15th Condition 345-351 7 16th Condition 352-358 7 17th Condition 359-365 7 18th Condition 366-372 7 19th Condition 373-379 7 20th Condition 380-381 2 Number of Entity-Axis Conditions 00-20 ... Code range Tape Field Location Size Item and Code Outline 382-481 100 RECORD - AXIS CONDITIONS Space has been provided for a maximum of 20 conditions. Each condition takes 5 positions in the record. Records that do not have 20 conditions are blank in the unused area. Position 1-4: Condition Code (ICD 9th Revision) Position 5: Nature of injury Flag 1 ... Indicates that the code in positions 1-4 is a Nature of injury code 0 ... All other codes 382-386 5 1st Condition 387-391 5 2nd Condition 392-396 5 3rd Condition 397-401 5 4th Condition 402-406 5 5th Condition 407-411 5 6th Condition 412-416 5 7th Condition 417-421 5 8th Condition 422-426 5 9th Condition 427-431 5 10th Condition 432-436 5 11th Condition 437-441 5 12th Condition 442-446 5 13th Condition 447-451 5 14th Condition 452-456 5 15th Condition Tape Field Location Size Item and Code Outline 382-481 100 RECORD - AXIS CONDITIONS - Continued 457-461 5 16th Condition 462-466 5 17th Condition 467-471 5 18th Condition 472-476 5 19th Condition 477-481 5 20th Condition 482-500 19 Reserved positions 1GEOGRAPHIC CODE OUTLINE 2Introduction The following pages show in detail the geographic codes used by the Division of Vital Statistics in the processing of vital event data occurring in the United States. For the linked data set, counties and cities with a population of 250,000 or more are identified. When an event occurs to a nonresident of the United States, residence data are coded only to the "State" level; several western hemisphere countries or the remainder of the world are uniquely identified. The vital statistics codes are effective with the 1982 data year and are based on results of the 1980 Census. To aid the user in interpreting the geographic codes, a brief explanation of the codes of the column headings/abbreviations shown on the following pages are: State: Each State and the District of Columbia are numbered alphabetically. In addition, several unique codes are used to identify nonresidents of the U.S. County: Counties and county equivalents (independent and coextensive cities) are numbered alphabetically within each State. City: Cities are numbered alphabetically within each State. Name: Each State, county, and city name is listed along with its respective code. In addition, places used to identify nonresidents of the U.S. are also listed along with their codes. 2Listing of Counties Identified in the Linked Data Set Vital Statistics Geographic Code Outline Effective With 1982 Data State County State and County Name 01 Alabama 037 Jefferson 049 Mobile 02 Alaska 03 Arizona 007 Maricopa 010 Pima 04 Arkansas 060 Pulaski 05 California 001 Alameda 007 Contra Costa 010 Fresno 015 Kern 019 Los Angeles 027 Monterey 030 Orange 033 Riverside 034 Sacramento 036 San Bernardino 037 San Diego 038 San Francisco, coext. with San Francisco city 039 San Joaquin 041 San Mateo 042 Santa Barbara 043 Santa Clara 049 Sonoma 050 Stanislaus 056 Ventura 06 Colorado 003 Arapahoe 016 Denver, coext. with Denver city 021 El Paso 030 Jefferson 07 Connecticut 001 Fairfield 002 Hartford 003 New Haven State County State and County Name 08 Delaware 002 New Castle 09 District of Columbia 001 District of Columbia 10 Florida 005 Brevard 006 Broward 013 Dade 016 Duval 029 Hillsborough 048 Orange 050 Palm Beach 052 Pinellas 053 Polk 064 Volusia 11 Georgia 033 Cobb 044 De Kalb 060 Fulton 12 Hawaii 002 Honolulu 13 Idaho 14 Illinois 016 Cook 022 Du Page 045 Kane 049 Lake 082 St. Clair 099 Will 101101 Winnebago 15 Indiana 002 Allen 045 Lake 049 Marion 16 Iowa 077 Polk State County State and County Name 17 Kansas 046 Johnson 087 Sedgwick 18 Kentucky 056 Jefferson 19 Louisiana 009 Caddo 017 East Baton Rouge 026 Jefferson 036 Orleans, coext. with New Orleans city 20 Maine 21 Maryland 002 Anne Arundel 003 Baltimore 004 Baltimore city 016 Montgomery 017 Prince George's 22 Massachusetts 003 Bristol 005 Essex 007 Hampden 009 Middlesex 011 Norfolk 012 Plymouth 013 Suffolk 014 Worcester 23 Michigan 025 Genesee 033 Ingham 041 Kent 050 Macomb 063 Oakland 081 Washtenaw 082 Wayne 24 Minnesota 027 Hannepin 062 Ramsey State County State and County Name 25 Mississippi 025 Hinds 26 Missouri 048 Jackson 096 St. Louis 097 St. Louis city 27 Montana 28 Nebraska 028 Douglas 29 Nevada 003 Clark 30 New Hampshire 006 Hillsborough 31 New Jersey 002 Bergen 003 Burlington 004 Camden 007 Essex 009 Hudson 011 Mercer 012 Middlesex 013 Monmouth 014 Morris 015 Ocean 016 Passaic 020 Union 32 New Mexico 001 Bernalillo State County State and County Name 33 New York 001 Albany 014 Erie 026 Monroe 028 Nassau 029 New York city 031 Oneida 032 Onondaga 034 Orange 040 Rockland 048 Suffolk 056 Westchester 34 North Carolina 041 Guilford 060 Mecklenburg 092 Wake 35 North Dakota 36 Ohio 009 Butler 018 Cuyahoga 025 Franklin 031 Hamilton 047 Lorain 048 Lucas 050 Mahoning 057 Montgomery 076 Stark 077 Summit 37 Oklahoma 055 Oklahoma 072 Tulsa 38 Oregon 020 Lane 026 Multnomah State County State and County Name 39 Pennsylvania 002 Allegheny 006 Berks 009 Bucks 015 Chester 023 Delaware 025 Erie 036 Lancaster 039 Lehigh 040 Luzerne 046 Montgomery 051 Philadelphia, coext. with Philadelphia city 065 Westmoreland 067 York 40 Rhode Island 004 Providence 41 South Carolina 010 Charleston 023 Greenville 040 Richland 42 South Dakota 43 Tennessee 019 Davidson 033 Hamilton 047 Knox 079 Shelby 44 Texas 015 Bexar 057 Dallas 071 El Paso 101 Harris 108 Hidalgo 123 Jefferson 178 Nueces 220 Tarrant 227 Travis 45 Utah 018 Salt Lake State County State and County Name 46 Vermont 47 Virginia 040 Fairfax 088 Norfolk city 127 Virginia Beach city 48 Washington 017 King 027 Pierce 031 Snohomish 032 Spokane 49 West Virginia 50 Wisconsin 013 Dane 041 Milwaukee 068 Waukesha 51 Wyoming 2Listing of Cities Identified in the Linked Data Set Vital Statistics Geographic Code Outline Effective with 1982 Data State City State and City Name 01 Alabama 008 Birmingham 02 Alaska 03 Arizona 011 Phoenix 016 Tucson 04 Arkansas 05 California 112 Long Beach 115 Los Angeles 146 Oakland 186 Sacramento 194 San Diego 197 San Francisco 200 San Jose 06 Colorado 009 Denver 07 Connecticut 08 Delaware 09 District of Columbia 001 Washington 10 Florida 033 Jacksonville 047 Miami 086 Tampa 11 Georgia 004 Atlanta 12 Hawaii 004 Honolulu 13 Idaho 14 Illinois 032 Chicago State City State and City Name 15 Indiana 002 Allen 045 Lake 049 Marion 16 Iowa 17 Kansas 033 Wichita 18 Kentucky 016 Louisville 19 Louisiana 024 New Orleans 20 Maine 21 Maryland 003 Baltimore 22 Massachusetts 012 Boston 23 Michigan 023 Detroit 24 Minnesota 035 Minneapolis 055 St. Paul 25 Mississippi 26 Missouri 026 Kansas City 044 St. Louis 27 Montana 28 Nebraska 011 Omaha 29 Nevada 30 New Hampshire State City State and City Name 33 New York 009 Bronx borough, Bronx county 010 Buffalo 043 Brooklyn borough, Kings county 060 Manhattan borough, New York county 077 Queens borough, Queens county 078 Staten Island borough, Richmond county 34 North Carolina 008 Charlotte 35 North Dakota 36 Ohio 028 Cincinnati 030 Cleveland 032 Columbus 126 Toledo 37 Oklahoma 023 Oklahoma city 031 Tulsa 38 Oregon 39 Pennsylvania 096 Philadelphia 098 Pittsburgh 40 Rhode Island 41 South Carolina 42 South Dakota 43 Tennessee 026 Memphis 030 Nashville 44 Texas 009 Austin 036 Dallas 047 El Paso 052 Fort Worth 066 Houston 121 San Antonio 45 Utah State City State and City Name 46 Vermont 47 Virginia 021 Norfolk 032 Virginia Beach 48 Washington 030 Seattle 49 West Virginia 50 Wisconsin 032 Milwaukee 51 Wyoming 52 ZZZ Puerto Rico 53 ZZZ Virgin Islands 54 ZZZ Guam 55 ZZZ Canada 56 ZZZ Cuba 57 ZZZ Mexico 59 ZZZ Remainder of World 2Ninth Revision 61 Causes of Death Adapted for Use by DVS ST: 1 = Subtotal Limited: Sex: 1 = Males: 2 = Females Length = of Cause Title Age: 1 = 5 & Over: 2 = 10-54: 3 = 28 Days & Over ***** Cause Subtotals are not Identified in this File ***** 61 S Limited Len- Recode T Sex Age gth Cause Title and ICD-9 Codes Included 010 039 Certain intestinal infections (008-009) 020 020 Whooping cough (033) 030 029 Meningococcal infection (036) 040 3 016 Septicemia (038) 050 024 Viral Diseases (045-079) 060 025 Congenital syphilis (090) 070 100 Remainder of infectious and parasitic diseases (001-007, 010-032, 034-035, 037, 039-041, 080-088, 091-139) 080 089 Malignant neoplasms, including neoplasms of lymphatic and hematopoietic tissues (140-208) 090 108 Benign neoplasms, carcinoma in situ, and neoplasms of uncertain behavior and of unspecified nature (210-239) 100 030 Diseases of thymus gland (254) 110 023 Cystic fibrosis (277.0) 120 052 Diseases of blood and blood-forming organs (280- 289) 130 020 Meningitis (320-322) 140 059 Other diseases of nervous system and sense organs (323-389) 150 044 Acute upper respiratory infections (460-465) 160 042 Bronchitis and bronchiolitis (466, 490-491) 170 1 033 Pneumonia and influenza (480-487) 180 021 Pneumonia (480-486) 190 017 Influenza (487) 200 061 Remainder of diseases of respiratory system (470- 478, 492-519) 210 093 Hernia of abdominal cavity and intestinal obstruction without mention of hernia (550- 553, 560) 220 075 Gastritis, duodenitis, and noninfective enteritis and colitis (535, 555-558) 230 067 Remainder of diseases of digestive system (520-534, 536-543, 562-579) 240 1 030 Congenital anomalies (740-759) 250 042 Anencephalus and similar anomalies (740) 260 020 Spina bifida (741) 61 S Limited Len- Recode T Sex Age gth Cause Title and ICD-9 Codes Included 270 034 Congenital hydrocephalus (742.3) 280 092 Other congenital anomalies of central nervous system and eye (742.0-742.2, 742.4-742.9, 743) 290 041 Congenital anomalies of hear (745-746) 300 056 Other congenital anomalies of circulatory system (747) 310 050 Congenital anomalies of respiratory system (748) 320 052 Congenital anomalies of digestive system (749- 751) 330 056 Congenital anomalies of genitourinary system (752-753) 340 058 Congenital anomalies of musculoskeletal system (754-756) 350 025 Down's syndrome (758.0) 360 043 Other chromosomal anomalies (758.1-758.9) 370 062 All other and unspecified congenital anomalies (744, 757, 759) 380 1 064 Certain conditions originating in the perinatal period (760-779) 390 091 Newborn affected by maternal conditions which may be unrelated to present pregnancy (760) 400 063 Newborn affected by maternal complications of pregnancy (761) 410 074 Newborn affected by complications of placenta, cord, and membranes (762) 420 069 Newborn affected by other complications of labor and delivery (763) 430 048 Slow fetal growth and fetal malnutrition (764) 440 077 Disorders relating to short gestation and unspecified low birthweight (765) 450 065 Disorders relating to long gestation and high birthweight (766) 460 020 Birth trauma (767) 470 1 047 Intrauterine hypoxia and birth asphyxia (768) 480 051 Fetal distress in liveborn infant (768.2- 768.4) 490 032 Birth asphyxia (768.5-7768.9) 500 037 Respiratory distress syndrome (769) 61 S Limited Len- Recode T Sex Age gth Cause Title and ICD-9 Codes Included 510 047 Other respiratory conditions of newborn (770) 520 051 Infections specific to the perinatal period (771) 530 027 Neonatal hemorrhage (772) 540 094 Hemolytic diseases of newborn, due to isoimmunization, and other perinatal jaundice (773-774) 550 088 Syndrome of "infant of a diabetic mother" and neonatal diabetes mellitus (775.2-775.9, 776.1-779) 560 040 Hemorrhagic disease of newborn (776.0) 570 098 All other and ill-defined conditions originating in the perinatal period (775.2-775.9, 776.1- 779) 580 1 053 Symptoms, signs, and ill-defined conditions (780- 799) 590 038 Sudden infant death syndrome (798.0) 600 075 Symptoms, signs, and all other ill-defined conditions (780 -797, 798.1-799) 610 1 041 Accidents and adverse effects (E800-E949) 620 118 Inhalation and ingestion of food or other object causing obstruction of respiratory tract or suffocation (E911-E912) 630 042 Accidental mechanical suffocation (E913) 640 067 Other accidental causes and adverse effects (E800-E910, E914-E949) 650 1 020 Homicide (E960-E969) 660 047 Child battering and other maltreatment (E967) 670 038 Other homicide (E960-E966, E968-E969) 680 027 All other causes (Residual) 1TABLES 21. Live Births & Infant Deaths by State of Occurrence & Residence LIVE BIRTHS BY STATE OF OCCURRENCE AND BY STATE RESIDENCE AND INFANT DEATHS BY STATE OF OCCURRENCE AND BY STATE OF RESIDENCE: 1985 BIRTH COHORT (RESIDENCE AT BIRTH IS OF THE MOTHER. RESIDENCE AT DEATH IS OF THE DECEDENT) _____________________________________________________________________________ | | | LIVE BIRTHS | |____________________________________________| AREA | | | | | | | OCCURRENCE | RESIDENCE | | | | _______________________________|________________________|___________________| UNITED STATES . . . . . 3,765,336 3,760,833 ALABAMA. . . . . . . . . . 58,627 59,739 ALASKA . . . . . . . . . . 12,659 12,846 ARIZONA. . . . . . . . . . 59,320 59,348 ARKANSAS . . . . . . . . . 34,515 35,222 CALIFORNIA . . . . . . . . 471,209 471,005 COLORADO . . . . . . . . . 55,440 55,123 CONNECTICUT. . . . . . . . 43,839 44,010 DELAWARE . . . . . . . . . 9,882 9,618 DISTRICT OF COLUMBIA . . . 19,938 9,871 FLORIDA. . . . . . . . . . 163,611 163,816 GEORGIA. . . . . . . . . . 98,033 96,340 HAWAII . . . . . . . . . . 18,329 18,307 IDAHO. . . . . . . . . . . 17,327 17,567 ILLINOIS . . . . . . . . . 177,447 180,738 INDIANA. . . . . . . . . . 80,967 80,955 IOWA . . . . . . . . . . . 41,743 41,221 KANSAS . . . . . . . . . . 38,500 39,679 KENTUCKY . . . . . . . . . 51,856 52,885 LOUISIANA. . . . . . . . . 81,649 81,458 MAINE. . . . . . . . . . . 16,245 16,904 MARYLAND . . . . . . . . . 61,539 68,021 MASSACHUSETTS. . . . . . . 83,367 81,839 MICHIGAN . . . . . . . . . 136,806 138,068 MINNESOTA. . . . . . . . . 67,523 67,413 MISSISSIPPI. . . . . . . . 42,719 43,449 MISSOURI . . . . . . . . . 78,764 76,982 ____________________________________________________________________________ | | | INFANT DEATHS | |____________________________________________________________________________| | | | | AT BIRTH | AT DEATH | |______________________________________|_____________________________________| | | | | | | OCCURRENCE | RESIDENCE | OCCURRENCE | RESIDENCE | |__________________|___________________|____________________|________________| 755 763 784 765 136 140 128 141 555 569 558 576 366 389 357 396 4,430 4,427 4,438 4,414 527 504 566 506 422 428 409 428 139 132 136 137 371 202 423 201 1,833 1,830 1,838 1,819 1,236 1,207 1,221 1,216 157 156 152 154 166 175 153 179 2,034 2,104 2,005 2,100 824 834 786 835 374 383 347 385 363 383 340 378 523 554 506 553 924 912 907 906 147 152 141 154 603 743 566 742 733 726 785 730 1,561 1,574 1,562 1,575 593 576 614 574 554 583 542 587 836 777 911 790 _____________________________________________________________________________ | | | LIVE BIRTHS | |____________________________________________| AREA | | | | | | | OCCURRENCE | RESIDENCE | | | | _______________________________|________________________|___________________| MONTANA. . . . . . . . . . 58,627 59,739 NEBRASKA . . . . . . . . . 25,884 25,551 NEVADA . . . . . . . . . . 15,216 15,325 NEW HAMPSHIRE. . . . . . . 15,308 15,454 NEW JERSEY . . . . . . . . 102,426 105,566 NEW MEXICO . . . . . . . . 27,296 27,757 NEW YORK . . . . . . . . . 260,293 259,470 UPSTATE . . . . . . . . 142,152 145,398 CITY. . . . . . . . . . 118,141 114,072 NORTH CAROLINA . . . . . . 89,982 89,399 NORTH DAKOTA . . . . . . . 12,734 11,721 OHIO . . . . . . . . . . . 161,241 160,483 OKLAHOMA . . . . . . . . . 51,876 53,138 OREGON . . . . . . . . . . 40,778 39,486 PENNSYLVANIA . . . . . . . 161,982 160,559 RHODE ISLAND . . . . . . . 13,674 13,033 SOUTH CAROLINA . . . . . . 49,510 51,900 SOUTH DAKOTA . . . . . . . 12,056 12,130 TENNESSEE. . . . . . . . . 71,506 66,757 TEXAS. . . . . . . . . . . 312,604 308,171 UTAH . . . . . . . . . . . 38,443 37,451 VERMONT. . . . . . . . . . 7,825 8,036 VIRGINIA . . . . . . . . . 82,952 86,052 WASHINGTON . . . . . . . . 69,302 70,235 WEST VIRGINIA. . . . . . . 25,259 24,132 WISCONSIN. . . . . . . . . 73,302 73,743 WYOMING. . . . . . . . . . 8,780 9,366 FOREIGN RESIDENTS. . . . . ... 4,503 ____________________________________________________________________________ | | | INFANT DEATHS | |____________________________________________________________________________| | | | | AT BIRTH | AT DEATH | |______________________________________|_____________________________________| | | | | | | OCCURRENCE | RESIDENCE | OCCURRENCE | RESIDENCE | |__________________|___________________|____________________|________________| 122 130 101 130 265 253 281 251 126 125 129 130 135 145 112 144 978 1,029 883 1,011 287 291 274 288 2,724 2,724 2,753 2,718 1,261 1,306 1,243 1,308 1,463 1,418 1,510 1,410 1,048 1,049 1,060 1,044 116 98 117 99 1,653 1,634 1,661 1,629 540 550 528 538 414 392 406 394 1,754 1,726 1,828 1,738 133 110 134 111 696 736 695 737 110 120 106 121 867 759 884 761 2,864 2,850 2,882 2,852 364 350 387 349 66 66 64 68 968 974 932 982 738 748 755 746 278 267 288 266 671 687 664 683 91 109 71 108 ... 25 ... 31 22. Live Births & Infant Deaths/Mort. Rates by Race, Sex, Birth Wt. LIVE BIRTHS, INFANT DEATHS, AND INFANT MORTALITY RATES BY RACE OF CHILD, SEX, AND BIRTH WEIGHT: UNITED STATES. 1985 BIRTH COHORT (RATES ARE PER 1000 LIVE BIRTHS) ______________________________________________________________________________ | | | | | | RACE OF CHILD AND | | <500 | 500-749 | 750-999 | 1000-1249| SEX | TOTAL | GRAMS | GRAMS | GRAMS | GRAMS | _____________________|__________|__________|__________|__________|__________| ALL RACES 1/ BOTH SEXES LIVE BIRTHS.... 3,760,833 4,860 8,291 9,452 10,578 INFANT DEATHS.. 39,145 4,341 6,137 3,661 1,964 INF.MORT.RATE.. 10.4 893.2 740.2 387.3 185.7 MALE LIVE BIRTHS.... 1,928,138 2,508 4,282 4,968 5,510 INFANT DEATHS.. 22,466 2,233 3,399 2,246 1,233 INF.MORT.RATE.. 11.7 890.4 793.8 452.1 223.8 FEMALE LIVE BIRTHS.... 1,832,695 2,352 4,009 4,484 5,068 INFANT DEATHS.. 16,679 2,108 2,738 1,415 731 INF.MORT.RATE.. 9.1 896.3 683.0 315.6 144.2 WHITE BOTH SEXES LIVE BIRTHS.... 2,991,521 2,747 4,863 5,734 6,755 INFANT DEATHS.. 26,526 2,465 3,683 2,402 1,390 INF.MORT.RATE.. 8.9 897.3 757.4 418.9 205.8 MALE LIVE BIRTHS.... 1,536,729 1,430 2,532 3,093 3,552 INFANT DEATHS.. 15,446 1,276 2,064 1,506 861 INF.MORT.RATE.. 10.1 892.3 815.2 486.9 242.4 FEMALE LIVE BIRTHS.... 1,454,792 1,317 2,331 2,641 3,203 INFANT DEATHS.. 11,080 1,189 1,619 896 529 INF.MORT.RATE.. 7.6 902.8 694.6 339.3 165.2 BLACK BOTH SEXES LIVE BIRTHS.... 680,309 1,972 3,197 3,444 3,464 INFANT DEATHS.. 11,140 1,747 2,282 1,146 491 INF.MORT.RATE.. 18.3 885.9 713.8 332.8 141.7 MALE LIVE BIRTHS.... 308,643 1,012 1,629 1,728 1,754 INFANT DEATHS.. 6,161 898 1,236 672 316 INF.MORT.RATE.. 20.0 887.4 758.7 388.9 180.2 ______________________________________________________ | | | | | | | | <500 | 500-749 | 750-999 | 1000-1249| | TOTAL | GRAMS | GRAMS | GRAMS | GRAMS | |__________|__________|__________|__________|__________| 12,540 48,402 159,588 2,502,342 4,780 1,316 2,544 3,247 14,807 1,128 104.9 52.6 20.3 4.2 236.0 6,510 23,785 72,908 1,805,121 2,546 818 1,424 1,736 8,744 633 125.7 59.9 23.8 4.8 248.6 6,030 24,617 86,680 1,697,221 2,234 498 1,120 1,511 6,063 495 82.6 45.5 17.4 3.6 221.6 8,026 32,057 108,296 2,819,364 3,679 948 1,807 2,264 10,857 710 118.1 56.4 20.9 3.9 193.0 4,259 16,046 58,533 1,454,116 1,938 586 1,000 1,226 6,536 391 137.6 62.3 24.6 4.5 201.8 3,767 16,011 58,533 1,365,248 1,741 362 807 1,038 4,321 319 96.1 50.4 17.7 3.2 183.2 4,099 14,596 44,710 531,968 859 320 645 845 3,291 373 78.1 44.2 18.9 6.2 434.2 2,023 6,861 20,099 273,056 481 202 361 441 1,819 216 99.9 52.6 21.9 6.7 449.1 LIVE BIRTHS, INFANT DEATHS, AND INFANT MORTALITY RATES BY RACE OF CHILD, SEX, AND BIRTH WEIGHT: UNITED STATES. 1985 BIRTH COHORT (RATES ARE PER 1000 LIVE BIRTHS) ______________________________________________________________________________ | | | | | | RACE OF CHILD AND | | <500 | 500-749 | 750-999 | 1000-1249| SEX | TOTAL | GRAMS | GRAMS | GRAMS | GRAMS | _____________________|__________|__________|__________|__________|__________| ALL RACES 1/ BLACK - Continued FEMALE LIVE BIRTHS.... 299,666 960 1,568 1,716 1,710 INFANT DEATHS.. 4,979 849 1,046 474 175 INF.MORT.RATE.. 16.6 884.4 667.1 276.2 102.3 ______________________________________________________________________________ 1/ INCLUDES RACES OTHER THAN WHITE AND BLACK ______________________________________________________ | | | | | | | | <500 | 500-749 | 750-999 | 1000-1249| | TOTAL | GRAMS | GRAMS | GRAMS | GRAMS | |__________|__________|__________|__________|__________| 2,076 7,735 24,611 258,912 378 118 284 404 1,472 157 56.8 36.7 16.4 5.7 415.3 23. Live Birth & Infant Death/Mort Rates by Wt,Race,Gestational Age LIVE BIRTHS, INFANT DEATHS, AND INFANT MORTALITY RATES BY BIRTH WEIGHT, RACE OF CHILD, AND GESTATIONAL AGE: UNITED STATES, 1985 BIRTH COHORT (RATES ARE PER 1000 LIVE BIRTHS) ______________________________________________________________________________ | | GESTATION BIRTH WEIGHT AND |________________________________________________________ RACE OF CHILD | | <28 | 28-31 | 32-35 | 36 | | TOTAL | WEEKS | WEEKS | WEEKS | WEEKS | _____________________|__________|__________|__________|__________|__________|_ ALL RACES 1/ TOTAL. . . . . . LIVE BIRTHS. . 3,760,833 27,658 40,373 168,271 116,806 INFANT DEATHS. 39,145 11,672 3,561 3,574 1,313 INF.MORT.RATE. 10.4 422.0 88.2 21.2 11.2 LESS THAN 2500 GRAMS LIVE BIRTHS. . 253,711 20,821 26.674 68,342 23,019 INFANT DEATHS. 23,210 11,011 3,353 2,608 636 INF.MORT.RATE. 91.5 528.8 125.7 38.2 27.6 LESS THAN 500 GRAMS LIVE BIRTHS. 4,860 3,652 168 51 8 INFANT DEATHS 4,341 3,368 145 34 2 INF.MORT RATE 893.2 922.2 863.1 666.7 250.0 500-749 GRAMS 8,291 5,825 856 195 44 LIVE BIRTHS. 6,137 4,519 534 125 23 INFANT DEATHS 740.2 775.8 623.8 641.0 522.7 INF.MORT RATE 750-999 GRAMS 9,452 5,120 2,131 592 81 LIVE BIRTHS. 3,661 2,195 681 173 21 INFANT DEATHS 387.3 428.7 319.6 292.2 259.3 INF.MORT RATE 1,000-1,249 GRAMS 10,578 2,436 4,651 1,596 158 LIVE BIRTHS. 1,964 584 758 258 29 INFANT DEATHS 185.7 239.7 163.0 161.7 183.5 INF.MORT RATE 1,250-1,499 GRAMS 12,540 1,098 5,447 3,143 415 LIVE BIRTHS. 1,316 171 524 291 43 INFANT DEATHS 104.9 155.7 96.2 92.6 103.6 INF.MORT RATE ________________________________________________________ GESTATION ________________________________________________________ 37-39 | 40 | 41 | 42 WEEKS | NOT | WEEKS | WEEKS | WEEKS | OR MORE | STATED | __________|__________|__________|__________|__________|_ 1,400,106 797,930 551,067 513,233 145,389 7,227 3,085 2,162 2,697 3,854 5.2 3.9 3.9 5.3 26.5 65,210 13,835 8,069 10,761 16,980 1,702 421 314 439 2,726 26.1 30.4 38.9 40.8 160.5 77 40 46 33 785 35 19 22 15 701 454.5 475.0 478.3 454.5 893.0 170 69 55 73 1,004 75 29 23 37 772 441.2 420.3 418.2 506.8 768.9 212 100 54 82 1,080 56 30 13 26 466 264.2 300.3 240.7 317.1 431.5 377 81 73 159 1,047 65 7 13 20 230 172.4 86.4 178.1 125.8 219.7 800 166 127 206 1,138 92 23 22 26 124 115.0 138.6 173.2 126.2 109.0 LIVE BIRTHS, INFANT DEATHS, AND INFANT MORTALITY RATES BY BIRTH WEIGHT, RACE OF CHILD, AND GESTATIONAL AGE: UNITED STATES, 1985 BIRTH COHORT (RATES ARE PER 1000 LIVE BIRTHS) ______________________________________________________________________________ | | GESTATION BIRTH WEIGHT AND |________________________________________________________ RACE OF CHILD | | <28 | 28-31 | 32-35 | 36 | | TOTAL | WEEKS | WEEKS | WEEKS | WEEKS | _____________________|__________|__________|__________|__________|__________|_ ALL RACES 1/ - Continued 1,500-1,999 GRAMS LIVE BIRTHS. 48,402 1,384 9,124 20,461 3,524 INFANT DEATHS 2,544 116 557 893 170 INF.MORT RATE 52.6 83.8 61.0 43.6 48.2 2,000-2,499 GRAMS LIVE BIRTHS. 159,588 1,306 4,297 42,304 18,789 INFANT DEATHS 3,247 58 834 834 348 INF.MORT RATE 52.6 44.4 19.7 19.7 18.5 2,500-2,999 GRAMS LIVE BIRTHS. . 595,548 1,901 4,879 43,049 40,817 INFANT DEATHS. 4,553 31 75 489 350 INF.MORT RATE. 7.6 16.3 15.4 11.4 8.6 3,000-3,499 GRAMS LIVE BIRTHS. . 1,378,114 2,492 5,374 35,574 34,926 INFANT DEATHS. 5,734 39 51 269 203 INF.MORT RATE. 4.2 15.7 9.5 7.6 5.8 3,500-3,999 GRAMS LIVE BIRTHS. . 1,110,700 1,388 2,603 16,718 14,019 INFANT DEATHS. 3,203 29 18 97 72 INF.MORT RATE. 2.9 20.9 6.9 5.8 5.1 4,000-4,499 GRAMS LIVE BIRTHS. . 345,358 330 582 3,675 3,260 INFANT DEATHS. 958 20 8 27 19 INF.MORT RATE. 2.8 60.6 13.7 7.3 5.8 4,500-4,999 GRAMS LIVE BIRTHS. . 64,293 94 90 570 575 INFANT DEATHS. 240 30 3 7 3 INF.MORT RATE. 3.7 319.1 33.3 12.3 5.2 ________________________________________________________ GESTATION ________________________________________________________ 37-39 | 40 | 41 | 42 WEEKS | NOT | WEEKS | WEEKS | WEEKS | OR MORE | STATED | __________|__________|__________|__________|__________|_ 7,189 1,313 825 1,223 3,359 389 79 53 82 205 54.1 60.2 64.2 67.0 61.0 56,385 12,066 6,889 8,985 8,567 990 234 168 233 228 17.6 19.4 24.4 25.9 26.6 281,897 90,624 50,705 56,258 25,418 1,815 614 371 509 299 6.4 6.8 7.3 9.0 11.8 585,910 302,123 185,533 175,750 50,432 2,243 1,074 703 842 310 3.8 3.6 3.8 4.8 6.1 366,311 283,922 208,010 180,471 37,258 1,049 660 530 603 145 2.9 2.3 2.5 3.3 3.9 85,262 89,870 79,886 71,181 11,312 250 214 166 204 50 2.9 2.4 2.1 2.9 4.4 12,844 15,313 16,458 16,211 2,138 48 40 45 47 17 3.7 2.6 2.7 2.9 8.0 LIVE BIRTHS, INFANT DEATHS, AND INFANT MORTALITY RATES BY BIRTH WEIGHT, RACE OF CHILD, AND GESTATIONAL AGE: UNITED STATES, 1985 BIRTH COHORT (RATES ARE PER 1000 LIVE BIRTHS) ______________________________________________________________________________ | | GESTATION BIRTH WEIGHT AND |________________________________________________________ RACE OF CHILD | | <28 | 28-31 | 32-35 | 36 | | TOTAL | WEEKS | WEEKS | WEEKS | WEEKS | _____________________|__________|__________|__________|__________|__________|_ ALL RACES 1/ - Continued 5,000 GRAMS OR MORE LIVE BIRTHS. . 8,329 64 32 103 92 INFANT DEATHS. 119 40 10 2 9 INF.MORT RATE. 14.3 625.0 312.5 19.4 54.3 NOT STATED LIVE BIRTHS. . 4,780 568 139 240 98 INFANT DEATHS. 1,128 472 43 75 25 INF.MORT RATE. 236.0 831.0 309.4 312.5 255.1 _________________________________________________________ ________________________________________________________ GESTATION ________________________________________________________ 37-39 | 40 | 41 | 42 WEEKS | NOT | WEEKS | WEEKS | WEEKS | OR MORE | STATED | __________|__________|__________|__________|__________|_ 1,726 1,732 2,075 2,211 294 10 13 8 13 18 5.8 7.5 3.9 5.9 61.2 946 511 331 390 1,557 100 49 25 40 289 116.3 95.9 75.5 102.6 185.6 ________________________________________________________ LIVE BIRTHS, INFANT DEATHS, AND INFANT MORTALITY RATES BY BIRTH WEIGHT, RACE OF CHILD, AND GESTATIONAL AGE: UNITED STATES, 1985 BIRTH COHORT (RATES ARE PER 1000 LIVE BIRTHS) ______________________________________________________________________________ | | GESTATION BIRTH WEIGHT AND |________________________________________________________ RACE OF CHILD | | <28 | 28-31 | 32-35 | 36 | | TOTAL | WEEKS | WEEKS | WEEKS | WEEKS | _____________________|__________|__________|__________|__________|__________|_ WHITE TOTAL. . . . . . LIVE BIRTHS. . 2,991,521 15,997 24,808 111,827 83,444 INFANT DEATHS. 26,526 7,095 2,446 2,525 916 INF.MORT.RATE. 8.9 443.0 98.6 22.6 11.0 LESS THAN 2500 GRAMS LIVE BIRTHS. . 168,478 12,042 16,897 46,774 15,895 INFANT DEATHS. 14,959 6,724 2,327 1,871 440 INF.MORT.RATE. 88.8 558.4 137.7 40.0 27.7 LESS THAN 500 GRAMS LIVE BIRTHS. 2,747 2,087 99 35 4 INFANT DEATHS 2,465 1,941 88 23 1 INF.MORT RATE 897.3 930.0 888.9 657.1 250.0 500-749 GRAMS 4,863 3,413 516 111 25 LIVE BIRTHS. 3,683 2,719 335 71 14 INFANT DEATHS 757.4 796.7 649.2 639.6 560.0 INF.MORT RATE 750-999 GRAMS 5,734 3,092 1,294 377 42 LIVE BIRTHS. 2,402 1,440 457 124 12 INFANT DEATHS 418.9 465.7 353.2 328.9 285.7 INF.MORT RATE 1,000-1,249 GRAMS 6,755 1,549 2,992 1,016 98 LIVE BIRTHS. 1,390 416 554 183 20 INFANT DEATHS 205.8 268.6 185.2 180.1 204.1 INF.MORT RATE 1,250-1,499 GRAMS 8,026 603 3,553 2,023 277 LIVE BIRTHS. 948 110 385 215 32 INFANT DEATHS 118.1 182.4 108.4 106.3 115.5 INF.MORT RATE ________________________________________________________ GESTATION ________________________________________________________ 37-39 | 40 | 41 | 42 WEEKS | NOT | WEEKS | WEEKS | WEEKS | OR MORE | STATED | __________|__________|__________|__________|__________|_ 1,092,654 661,215 467,404 423,786 110,386 5,166 2,247 1,645 2,034 2,452 4.7 3.4 3.5 4.8 22.2 43,946 9,288 5,484 7,265 10,887 1,162 266 212 296 1,661 26.4 28.6 38.7 40.7 152.6 48 29 27 18 400 19 10 9 7 367 395.8 344.8 333.3 388.9 917.5 104 43 33 43 575 45 14 12 23 450 432.7 325.6 363.6 534.9 782.6 130 57 29 50 663 37 15 5 14 298 284.6 263.2 172.4 280.0 449.5 218 53 52 94 683 42 6 9 12 148 192.7 113.2 173.1 127.7 216.7 505 102 95 119 749 61 17 21 17 90 120.8 166.7 221.1 142.9 120.2 LIVE BIRTHS, INFANT DEATHS, AND INFANT MORTALITY RATES BY BIRTH WEIGHT, RACE OF CHILD, AND GESTATIONAL AGE: UNITED STATES, 1985 BIRTH COHORT (RATES ARE PER 1000 LIVE BIRTHS) ______________________________________________________________________________ | | GESTATION BIRTH WEIGHT AND |________________________________________________________ RACE OF CHILD | | <28 | 28-319 | 32-35 | 36 | | TOTAL | WEEKS | WEEKS | WEEKS | WEEKS | _____________________|__________|__________|__________|__________|__________|_ WHITE - Continued 1,500-1,999 GRAMS LIVE BIRTHS. 32,057 648 6,097 2,387 4,816 INFANT DEATHS 1,807 65 400 119 275 INF.MORT RATE 56.4 100.3 65.6 49.9 57.1 2,000-2,499 GRAMS LIVE BIRTHS. 108,296 650 2,346 29,455 13,062 INFANT DEATHS 2,264 33 108 604 242 INF.MORT RATE 20.9 50.8 46.0 20.5 18.5 2,500-2,999 GRAMS LIVE BIRTHS. . 421,418 966 2,503 28,185 28,834 INFANT DEATHS. 3,145 20 39 335 241 INF.MORT RATE. 7.5 20.7 15.6 11.9 8.4 3,000-3,499 GRAMS LIVE BIRTHS. . 1,079,510 1,415 3,087 21,980 25,139 INFANT DEATHS. 4,171 23 30 176 145 INF.MORT RATE. 3.9 16.3 9.7 8.0 5.8 3,500-3,999 GRAMS LIVE BIRTHS. . 945,835 917 1,746 11,413 10,412 INFANT DEATHS. 2,487 19 9 58 52 INF.MORT RATE. 2.6 20.7 5.2 5.1 5.0 4,000-4,499 GRAMS LIVE BIRTHS. . 307,164 236 400 2,794 2,552 INFANT DEATHS. 779 9 4 22 13 INF.MORT RATE. 2.5 38.1 10.0 7.9 5.1 4,500-4,999 GRAMS LIVE BIRTHS. . 58,046 72 72 441 466 INFANT DEATHS. 193 21 3 5 3 INF.MORT RATE. 3.3 291.7 41.7 11.3 6.4 ________________________________________________________ GESTATION ________________________________________________________ 37-39 | 40 | 41 | 42 WEEKS | NOT | WEEKS | WEEKS | WEEKS | OR MORE | STATED | __________|__________|__________|__________|__________|_ 4,816 783 538 820 2,211 275 52 39 53 153 57.1 66.4 72.5 64.6 69.2 38,125 8,221 4,710 6,121 5,606 683 152 117 170 155 17.9 18.5 24.8 27.8 27.6 199,881 66,083 37,476 40,261 17,249 1,217 403 267 356 213 6.4 6.1 7.1 8.8 12.3 454,782 243,737 151,737 139,573 38,022 1,608 822 520 622 225 3.5 3.4 3.4 4.5 5.9 306,648 245,672 182,630 155,449 30,948 799 508 437 493 112 2.6 2.1 2.4 3.2 3.6 73,972 80,599 72,685 64,062 9,864 197 169 147 180 38 2.7 2.1 2.0 2.8 3.9 11,224 13,894 15,176 14,810 1,891 40 32 36 39 14 3.6 2.3 2.4 2.6 7.4 LIVE BIRTHS, INFANT DEATHS, AND INFANT MORTALITY RATES BY BIRTH WEIGHT, RACE OF CHILD, AND GESTATIONAL AGE: UNITED STATES, 1985 BIRTH COHORT (RATES ARE PER 1000 LIVE BIRTHS) ______________________________________________________________________________ | | GESTATION BIRTH WEIGHT AND |________________________________________________________ RACE OF CHILD | | <28 | 28-31 | 32-35 | 36 | | TOTAL | WEEKS | WEEKS | WEEKS | WEEKS | _____________________|__________|__________|__________|__________|__________|_ WHITE - Continued 5,000 GRAMS OR MORE LIVE BIRTHS. . 7,391 42 22 76 1,452 INFANT DEATHS. 82 25 6 4 6 INF.MORT RATE. 11.1 595.2 272.7 52.6 4.1 NOT STATED LIVE BIRTHS. . 3,679 307 81 175 70 INFANT DEATHS. 710 254 28 56 18 INF.MORT RATE. 193.0 827.4 345.7 320.0 257.1 _________________________________________________________ ________________________________________________________ GESTATION ________________________________________________________ 37-39 | 40 | 41 | 42 WEEKS | NOT | WEEKS | WEEKS | WEEKS | OR MORE | STATED | __________|__________|__________|__________|__________|_ 1,452 1,543 1,900 2,033 258 6 11 6 12 10 4.1 7.1 3.2 5.9 38.8 749 419 278 333 1,267 83 36 20 36 179 110.8 85.9 71.9 108.1 141.3 ________________________________________________________ LIVE BIRTHS, INFANT DEATHS, AND INFANT MORTALITY RATES BY BIRTH WEIGHT, RACE OF CHILD, AND GESTATIONAL AGE: UNITED STATES, 1985 BIRTH COHORT (RATES ARE PER 1000 LIVE BIRTHS) ______________________________________________________________________________ | | GESTATION BIRTH WEIGHT AND |________________________________________________________ RACE OF CHILD | | <28 | 28-31 | 32-35 | 36 | | TOTAL | WEEKS | WEEKS | WEEKS | WEEKS | _____________________|__________|__________|__________|__________|__________|_ BLACK TOTAL. . . . . . LIVE BIRTHS. . 608,309 10,835 14,056 48,707 28,094 INFANT DEATHS. 11,140 4,247 985 901 348 INF.MORT.RATE. 18.3 392.0 70.1 18.5 12.4 LESS THAN 2500 GRAMS LIVE BIRTHS. . 75,482 8,193 8,913 19,070 6,206 INFANT DEATHS. 7,476 3,977 906 641 175 INF.MORT.RATE. 99.0 485.4 101.6 33.6 28.2 LESS THAN 500 GRAMS LIVE BIRTHS. 1,972 1,461 67 14 4 INFANT DEATHS 1,747 1,328 55 11 1 INF.MORT RATE 885.9 909.0 820.9 785.7 250.0 500-749 GRAMS LIVE BIRTHS. 3,197 2,261 314 79 18 INFANT DEATHS 2,282 1,678 184 50 8 INF.MORT RATE 713.8 742.1 586.0 632.9 444.4 750-999 GRAMS LIVE BIRTHS. 3,444 1,894 766 200 37 INFANT DEATHS 1,146 696 195 43 9 INF.MORT RATE 332.8 367.5 254.6 215.0 243.2 1,000-1,249 GRAMS LIVE BIRTHS. 3,464 820 1,510 528 56 INFANT DEATHS 491 152 171 64 9 INF.MORT RATE 141.7 185.4 113.2 121.2 160.7 1,250-1,499 GRAMS LIVE BIRTHS. 4,099 462 1,725 1,002 128 INFANT DEATHS 320 56 124 62 11 INF.MORT RATE 78.1 121.2 71.9 61.9 85.9 ________________________________________________________ GESTATION ________________________________________________________ 37-39 | 40 | 41 | 42 WEEKS | NOT | WEEKS | WEEKS | WEEKS | OR MORE | STATED | __________|__________|__________|__________|__________|_ 241,498 104,336 64,105 70,648 26,030 1,727 702 431 556 1,243 7.2 6.7 6.7 7.9 47.8 18,461 4,002 2,248 3,093 5,296 465 133 96 129 954 25.2 33.2 42.7 41.7 180.1 26 11 18 14 357 15 9 13 7 308 576.9 818.2 722.2 500.0 862.7 62 23 20 28 392 30 15 11 13 293 483.9 652.2 550.0 464.3 747.4 76 36 23 29 383 19 11 8 10 155 250.0 305.6 347.8 344.8 404.7 130 26 17 62 315 16 1 4 8 66 123.1 38.5 235.3 129.0 209.5 266 60 27 79 350 25 5 1 8 28 94.0 83.3 37.0 101.3 80.0 LIVE BIRTHS, INFANT DEATHS, AND INFANT MORTALITY RATES BY BIRTH WEIGHT, RACE OF CHILD, AND GESTATIONAL AGE: UNITED STATES, 1985 BIRTH COHORT (RATES ARE PER 1000 LIVE BIRTHS) ______________________________________________________________________________ | | GESTATION BIRTH WEIGHT AND |________________________________________________________ RACE OF CHILD | | <28 | 28-319 | 32-35 | 36 | | TOTAL | WEEKS | WEEKS | WEEKS | WEEKS | _____________________|__________|__________|__________|__________|__________|_ BLACK - Continued 1,500-1,999 GRAMS LIVE BIRTHS. 14,596 679 2,730 5,972 1,014 INFANT DEATHS 645 42 135 215 45 INF.MORT RATE 44.2 61.9 49.5 36.0 44.4 2,000-2,499 GRAMS LIVE BIRTHS. 44,710 616 1,801 11,275 4,949 INFANT DEATHS 845 25 42 196 92 INF.MORT RATE 18.9 40.6 23.3 17.4 18.6 2,500-2,999 GRAMS LIVE BIRTHS. . 143,378 869 2,155 12,875 10,185 INFANT DEATHS. 1,225 15 34 131 98 INF.MORT RATE. 8.5 15.3 15.8 10.2 9.6 3,000-3,499 GRAMS LIVE BIRTHS. . 232,934 983 2,022 11,546 8,101 INFANT DEATHS. 1,293 15 17 77 51 INF.MORT RATE. 5.6 15.3 8.4 6.7 6.3 3,500-3,999 GRAMS LIVE BIRTHS. . 123,198 428 735 4,377 2,913 INFANT DEATHS. 560 10 8 30 12 INF.MORT RATE. 4.5 23.4 10.9 6.9 4.1 4,000-4,499 GRAMS LIVE BIRTHS. . 27,436 81 152 678 564 INFANT DEATHS. 144 11 4 5 5 INF.MORT RATE. 5.2 135.8 26.3 7.4 8.9 4,500-4,999 GRAMS LIVE BIRTHS. . 4,374 20 18 86 88 INFANT DEATHS. 34 9 - 2 - INF.MORT RATE. 7.8 450.0 - 23.3 - ________________________________________________________ GESTATION ________________________________________________________ 37-39 | 40 | 41 | 42 WEEKS | NOT | WEEKS | WEEKS | WEEKS | OR MORE | STATED | __________|__________|__________|__________|__________|_ 2,093 487 251 360 1,010 99 24 13 28 44 47.3 49.3 51.8 77.8 43.6 15,808 3,359 1,892 2,521 2,489 261 68 46 55 60 16.5 20.2 24.3 21.8 24.1 66,476 20,129 10,927 13,479 6,283 467 185 92 133 75 7.0 9.2 8.4 9.9 11.9 101,892 44,437 26,003 29,056 8,894 527 209 143 180 74 5.2 4.7 5.5 6.2 8.3 44,809 28,058 18,778 18,856 4,244 193 122 72 88 25 4.3 4.3 3.8 4.7 5.9 8,328 6,540 5,108 5,056 929 41 37 15 19 7 4.9 5.7 2.9 3.8 7.5 1,204 978 889 941 150 7 2 7 5 2 5.8 2.0 7.9 5.3 13.3 LIVE BIRTHS, INFANT DEATHS, AND INFANT MORTALITY RATES BY BIRTH WEIGHT, RACE OF CHILD, AND GESTATIONAL AGE: UNITED STATES, 1985 BIRTH COHORT (RATES ARE PER 1000 LIVE BIRTHS) ______________________________________________________________________________ | | GESTATION BIRTH WEIGHT AND |________________________________________________________ RACE OF CHILD | | <28 | 28-31 | 32-35 | 36 | | TOTAL | WEEKS | WEEKS | WEEKS | WEEKS | _____________________|__________|__________|__________|__________|__________|_ BLACK - Continued 5,000 GRAMS OR MORE LIVE BIRTHS. . 648 22 9 25 14 INFANT DEATHS. 35 15 4 - 1 INF.MORT RATE. 54.0 681.8 444.4 - 71.4 NOT STATED LIVE BIRTHS. . 859 239 52 50 23 INFANT DEATHS. 373 200 12 15 6 INF.MORT RATE. 434.2 836.8 230.8 300.0 260.9 _________________________________________________________ 1/ INCLUDES RACES OTHER THAN WHITE AND BLACK ________________________________________________________ GESTATION ________________________________________________________ 37-39 | 40 | 41 | 42 WEEKS | NOT | WEEKS | WEEKS | WEEKS | OR MORE | STATED | __________|__________|__________|__________|__________|_ 187 133 112 125 21 4 2 1 - 8 21.4 15.0 8.9 - 381.0 141 59 40 42 213 23 12 5 2 98 163.1 203.4 125.0 47.6 460.1 ________________________________________________________ 24. Live Births & Infant Deaths/Mort Rates by Wt,Race,Age at Death LIVE BIRTHS, INFANT DEATHS, AND INFANT MORTALITY RATES BY BIRTH WEIGHT, RACE OF CHILD, AND AGE AT DEATH UNITED STATES, 1985 BIRTH COHORT (INFANT DEATHS ARE UNDER 1 YEAR. NEONATAL DEATHS ARE UNDER 28 DAYS; EARLY NEONATAL, 0-6 DAYS; LATE NEONATAL, 7-27 DAYS; AND POSTNEONATAL, 28 DAYS THROUGH 11 MONTHS) (RATES ARE PER 1000 LIVE BIRTHS) _________________________________________________________________________ | | | | BIRTH WEIGHT AND RACE OF CHILD |LIVE BIRTHS | INFANT | TOTAL | | | DEATHS | NEONATAL | ____________________________________|____________|___________|___________| ALL RACES 1/ TOTAL (ALL BIRTH WEIGHTS)...NUMBER.. 3,760,833 39,145 25,573 RATE.. 10.4 6.8 LESS THAN 2,500 GRAMS.......NUMBER.. 253,711 23,210 18,804 RATE.. 91.5 74.1 LESS THAN 500 GRAMS.......NUMBER.. 4,860 4,341 4,311 RATE.. 893.2 887.0 500-749 GRAMS.............NUMBER.. 8,291 6,137 5,655 RATE.. 740.2 682.1 750-999 GRAMS.............NUMBER.. 9,452 3,661 2,965 RATE.. 387.3 313.7 1,000-1249 GRAMS..........NUMBER.. 10,578 1,964 1,489 RATE.. 185.7 140.8 1,250-1,499 GRAMS.........NUMBER.. 12,540 1,316 935 RATE.. 104.9 74.6 1,500-1,999 GRAMS.........NUMBER.. 48,402 2,544 1,656 RATE.. 52.6 34.2 2,000-2,499 GRAMS.........NUMBER.. 159,588 3,247 1,793 RATE.. 20.3 11.2 2,500-2,999 GRAMS...........NUMBER.. 595,548 4,553 1,870 RATE.. 7.6 3.1 3,000-3,499 GRAMS...........NUMBER.. 1,378,114 5,734 2,079 RATE.. 4.2 1.5 ____________________________________ | | | | | EARLY | LATE | POST- | | NEONATAL | NEONATAL | NEONATAL | |____________|___________|___________| 21,317 4,256 13,572 5.7 1.1 3.6 16,390 2,414 4,406 64.6 9.5 17.4 4,258 53 30 876.1 10.9 6.2 5,175 480 482 624.2 57.9 58.1 2,454 511 696 259.6 54.1 73.6 1,146 343 475 108.3 32.4 44.9 735 200 381 58.6 15.9 30.4 1,277 379 888 26.4 7.8 18.3 1,345 448 1,454 26.4 2.8 9.1 1,285 585 2,683 2.2 1.0 4.5 1,399 680 3,655 1.0 .5 2.7 LIVE BIRTHS, INFANT DEATHS, AND INFANT MORTALITY RATES BY BIRTH WEIGHT, RACE OF CHILD, AND AGE AT DEATH UNITED STATES, 1985 BIRTH COHORT (INFANT DEATHS ARE UNDER 1 YEAR. NEONATAL DEATHS ARE UNDER 28 DAYS; EARLY NEONATAL, 0-6 DAYS; LATE NEONATAL, 7-27 DAYS; AND POSTNEONATAL, 28 DAYS THROUGH 11 MONTHS) (RATES ARE PER 1000 LIVE BIRTHS) _________________________________________________________________________ | | | | BIRTH WEIGHT AND RACE OF CHILD |LIVE BIRTHS | INFANT | TOTAL | | | DEATHS | NEONATAL | ____________________________________|____________|___________|___________| ALL RACES 1/ - Continued 3,500-3,999 GRAMS...........NUMBER.. 1,110,700 3,203 1,155 RATE.. 2.9 1.0 4,000-4,499 GRAMS...... ....NUMBER.. 345,358 958 382 RATE.. 2.8 1.1 4,500-4,999 GRAMS...........NUMBER.. 64,293 240 138 RATE.. 3.7 2.1 5,000 GRAMS OR MORE.........NUMBER.. 8,329 119 96 RATE.. 14.3 11.5 NOT STATED..................NUMBER.. 4,780 1,128 1,049 RATE.. 236.0 219.5 ________________________________________ ____________________________________ | | | | | EARLY | LATE | POST- | | NEONATAL | NEONATAL | NEONATAL | |____________|___________|___________| 778 377 2,048 .7 .3 1.8 267 115 576 .8 .3 1.7 117 21 102 1.8 .3 1.6 88 8 23 10.6 1.0 2.8 993 56 79 207.7 11.7 16.5 _____________________________________ LIVE BIRTHS, INFANT DEATHS, AND INFANT MORTALITY RATES BY BIRTH WEIGHT, RACE OF CHILD, AND AGE AT DEATH UNITED STATES, 1985 BIRTH COHORT (INFANT DEATHS ARE UNDER 1 YEAR. NEONATAL DEATHS ARE UNDER 28 DAYS; EARLY NEONATAL, 0-6 DAYS; LATE NEONATAL, 7-27 DAYS; AND POSTNEONATAL, 28 DAYS THROUGH 11 MONTHS) (RATES ARE PER 1000 LIVE BIRTHS) _________________________________________________________________________ | | | | BIRTH WEIGHT AND RACE OF CHILD |LIVE BIRTHS | INFANT | TOTAL | | | DEATHS | NEONATAL | ____________________________________|____________|___________|___________| WHITE TOTAL (ALL BIRTH WEIGHTS)...NUMBER.. 2,991,521 26,526 17,381 RATE.. 8.9 5.8 LESS THAN 2,500 GRAMS.......NUMBER.. 168,478 14,959 12,368 RATE.. 88.8 73.4 LESS THAN 500 GRAMS.......NUMBER.. 2,747 2,465 2,447 RATE.. 897.3 890.8 500-749 GRAMS.............NUMBER.. 4,863 3,683 3,456 RATE.. 757.4 710.7 750-999 GRAMS.............NUMBER.. 5,734 2,402 2,036 RATE.. 418.9 355.1 1,000-1249 GRAMS..........NUMBER.. 6,755 1,390 1,118 RATE.. 205.8 165.5 1,250-1,499 GRAMS.........NUMBER.. 8,026 948 710 RATE.. 118.1 88.5 1,500-1,999 GRAMS.........NUMBER.. 32,057 1,807 1,257 RATE.. 56.4 39.2 2,000-2,499 GRAMS.........NUMBER.. 108,296 2,264 1,344 RATE.. 20.9 12.4 2,500-2,999 GRAMS...........NUMBER.. 421,418 3,145 1,371 RATE.. 7.5 3.3 3,000-3,499 GRAMS...........NUMBER.. 1,079,510 4,171 1,583 RATE.. 3.9 1.5 ____________________________________ | | | | | EARLY | LATE | POST- | | NEONATAL | NEONATAL | NEONATAL | |____________|___________|___________| 14,323 3,058 9,145 4.8 1.0 3.1 10,699 1,669 2,591 63.5 9.9 15.4 2,414 33 18 878.8 12.0 6.6 3,177 279 227 653.3 57.4 46.7 1,681 355 366 293.2 61.9 63.8 873 245 272 129.2 36.3 40.3 550 160 238 68.5 19.9 29.7 978 279 550 30.5 8.7 17.2 1,026 318 920 9.5 2.9 8.5 958 413 1,774 2.3 1.0 4.2 1,079 504 2,588 1.0 .5 2.4 LIVE BIRTHS, INFANT DEATHS, AND INFANT MORTALITY RATES BY BIRTH WEIGHT, RACE OF CHILD, AND AGE ST DEATH UNITED STATES, 1985 BIRTH COHORT (INFANT DEATHS ARE UNDER 1 YEAR. NEONATAL DEATHS ARE UNDER 28 DAYS; EARLY NEONATAL, 0-6 DAYS; LATE NEONATAL, 7-27 DAYS; AND POSTNEONATAL, 28 DAYS THROUGH 11 MONTHS) (RATES ARE PER 1000 LIVE BIRTHS) _________________________________________________________________________ | | | | BIRTH WEIGHT AND RACE OF CHILD |LIVE BIRTHS | INFANT | TOTAL | | | DEATHS | NEONATAL | ____________________________________|____________|___________|___________| WHITE - Continued 3,500-3,999 GRAMS...........NUMBER.. 45,835 2,487 918 RATE.. 2.6 1.0 4,000-4,499 GRAMS...... ....NUMBER.. 307,164 779 315 RATE.. 2.5 1.0 4,500-4,999 GRAMS...........NUMBER.. 58,046 193 104 RATE.. 3.3 1.8 5,000 GRAMS OR MORE.........NUMBER.. 7,391 82 65 RATE.. 11.1 8.8 NOT STATED..................NUMBER.. 3,679 710 657 RATE.. 193.0 178.6 ________________________________________ ____________________________________ | | | | | EARLY | LATE | POST- | | NEONATAL | NEONATAL | NEONATAL | |____________|___________|___________| 616 302 2,048 .7 .3 1.8 216 99 576 .7 .3 1.7 86 18 23 1.5 .3 2.8 57 56 79 7.7 11.7 16.5 612 45 53 166.3 12.2 14.4 _____________________________________ LIVE BIRTHS, INFANT DEATHS, AND INFANT MORTALITY RATES BY BIRTH WEIGHT, RACE OF CHILD, AND AGE AT DEATH UNITED STATES, 1985 BIRTH COHORT (INFANT DEATHS ARE UNDER 1 YEAR. NEONATAL DEATHS ARE UNDER 28 DAYS; EARLY NEONATAL, 0-6 DAYS; LATE NEONATAL, 7-27 DAYS; AND POSTNEONATAL, 28 DAYS THROUGH 11 MONTHS) (RATES ARE PER 1000 LIVE BIRTHS) _________________________________________________________________________ | | | | BIRTH WEIGHT AND RACE OF CHILD |LIVE BIRTHS | INFANT | TOTAL | | | DEATHS | NEONATAL | ____________________________________|____________|___________|___________| BLACK TOTAL (ALL BIRTH WEIGHTS)...NUMBER.. 608,309 11,140 7,339 RATE.. 18.3 12.1 LESS THAN 2,500 GRAMS.......NUMBER.. 75,482 7,476 5,832 RATE.. 99.0 77.3 LESS THAN 500 GRAMS.......NUMBER.. 1,972 1,747 1,735 RATE.. 885.9 879.8 500-749 GRAMS.............NUMBER.. 3,197 2,282 2,039 RATE.. 713.8 637.8 750-999 GRAMS.............NUMBER.. 3,444 1,146 842 RATE.. 332.8 244.5 1,000-1249 GRAMS..........NUMBER.. 3,464 491 308 RATE.. 141.7 88.9 1,250-1,499 GRAMS.........NUMBER.. 4,099 320 190 RATE.. 78.1 46.4 1,500-1,999 GRAMS.........NUMBER.. 14,596 645 341 RATE.. 44.2 23.4 2,000-2,499 GRAMS.........NUMBER.. 44,710 845 377 RATE.. 18.9 8.4 2,500-2,999 GRAMS...........NUMBER.. 143,378 1,225 438 RATE.. 8.5 3.1 3,000-3,499 GRAMS...........NUMBER.. 232,934 1,293 414 RATE.. 5.6 1.8 ____________________________________ | | | | | EARLY | LATE | POST- | | NEONATAL | NEONATAL | NEONATAL | |____________|___________|___________| 6,294 1,045 3,801 10.3 1.7 6.2 5,172 660 1,644 68.5 8.7 21.8 1,718 17 12 871.2 8.6 6.1 1,856 183 243 580.5 57.2 76.0 698 144 304 202.7 41.8 88.3 221 87 183 63.8 25.1 52.8 156 34 130 38.1 8.3 31.7 255 86 304 17.5 5.9 20.8 268 109 468 6.0 2.4 10.5 286 152 787 2.0 1.1 5.5 260 154 879 1.1 .7 3.8 LIVE BIRTHS, INFANT DEATHS, AND INFANT MORTALITY RATES BY BIRTH WEIGHT, RACE OF CHILD, AND AGE ST DEATH UNITED STATES, 1985 BIRTH COHORT (INFANT DEATHS ARE UNDER 1 YEAR. NEONATAL DEATHS ARE UNDER 28 DAYS; EARLY NEONATAL, 0-6 DAYS; LATE NEONATAL, 7-27 DAYS; AND POSTNEONATAL, 28 DAYS THROUGH 11 MONTHS) (RATES ARE PER 1000 LIVE BIRTHS) _________________________________________________________________________ | | | | BIRTH WEIGHT AND RACE OF CHILD |LIVE BIRTHS | INFANT | TOTAL | | | DEATHS | NEONATAL | ____________________________________|____________|___________|___________| BLACK - Continued 3,500-3,999 GRAMS...........NUMBER.. 123,198 560 185 RATE.. 4.5 1.5 4,000-4,499 GRAMS...... ....NUMBER.. 27,436 144 62 RATE.. 5.2 2.3 4,500-4,999 GRAMS...........NUMBER.. 4,374 34 26 RATE.. 7.8 5.9 5,000 GRAMS OR MORE.........NUMBER.. 648 35 30 RATE.. 54.0 46.3 NOT STATED..................NUMBER.. 859 373 352 RATE.. 434.2 409.8 ____________________________________________________________________________ 1/ INCLUDES RACES OTHER THAN WHITE AND BLACK ____________________________________ | | | | | EARLY | LATE | POST- | | NEONATAL | NEONATAL | NEONATAL | |____________|___________|___________| 129 56 375 1.0 .5 3.0 50 12 82 1.8 .4 3.0 23 3 8 5.3 .7 1.8 30 - 5 46.3 - 7.7 344 8 21 400.5 9.3 24.4 _____________________________________ 25. Live Births & Infant Deaths/Mort. Rates for 10 Leading Causes LIVE BIRTHS, BY BIRTH WEIGHT AND RACE OF CHILD AND INFANT DEATHS AND, INFANT MORTALITY RATES BY AGE AT DEATH, BIRTH WEIGHT, AND RACE OF CHILD FOR 10 LEADING CAUSES OF INFANT DEATH: UNITED STATES, 1985 BIRTH COHORT (INFANT DEATHS ARE UNDER 1 YEAR. NEONATAL DEATHS ARE UNDER 28 DAYS; EARLY NEONATAL, 0-6 DAYS; LATE NEONATAL, 7-27 DAYS; AND POSTNEONATAL, 28 DAYS THROUGH 11 MONTHS) (RATES ARE PER 100,000 LIVE BIRTHS) ___________________________________________________________________________ | | | CAUSE OF DEATH, BIRTH WEIGHT, AND RACE OF CHILD | LIVE | INFANT | | BIRTHS | DEATHS | _________________________________________________|____________|___________| ALL RACES 1/ ALL BIRTH WEIGHTS ..ALL CAUSES...........................NUMBER.. 3,760,833 39,145 RATE.. 1,040.9 1 CONGENITAL ANOMALIES (740-759).......NUMBER.. 8,405 RATE.. 223.5 2 SUDDEN INFANT DEATH SYNDROM (798.0)..NUMBER.. 5,242 RATE.. 139.4 3 RESPIRATORY DISTRESS YSNDROM (769)...NUMBER.. 3,633 RATE.. 96.6 4 PREMATURITY (765)....................NUMBER.. 3,189 RATE.. 84.8 5 MATERNAL COMPLICATIONS (761).........NUMBER.. 1,309 RATE.. 34.8 6 HYPOXIA AND ASPHYXIA (768)...........NUMBER.. 1,123 RATE.. 29.9 7 ACCIDENTS (E800-E949)................NUMBER.. 867 RATE.. 23.1 8 INFECTIONS (771).....................NUMBER.. 927 RATE.. 24.6 9 COMPLICATIONS OF PLACENTA,ETC. (762).NUMBER.. 875 RATE.. 23.3 10 PNEUMONIA AND INFLUENZ (480-487).....NUMBER.. 677 RATE.. 18.0 ...ALL OTHER CAUSES (RESIDUAL)..........NUMBER.. 1,829 RATE.. 48.6 __________________________________________________ | | | | | | TOTAL | EARLY | LATE | POST- | | NEONATAL | NEONATAL | NEONATAL | NEONATAL | |_____________|____________|___________|___________| 25,573 21,317 4,256 13,572 680.0 566.8 113.2 360.9 6,276 5,075 1,201 2,129 166.9 134.9 31.9 56.6 354 38 316 4,888 9.4 1.0 8.4 130.0 3,372 2,788 584 261 89.7 74.1 15.5 6.9 3,155 3,124 31 34 83.9 83.1 .8 .9 1,296 1,286 10 13 34.5 34.2 .3 .3 1,052 897 155 71 28.0 23.9 4.1 1.9 75 30 45 792 2.0 .8 1.2 21.1 885 560 325 42 23.5 14.9 8.6 1.1 866 844 22 9 23.0 22.4 .6 .2 151 73 78 526 4.0 1.9 2.1 14.0 657 407 250 1,172 17.5 10.8 6.6 31.2 LIVE BIRTHS, BY BIRTH WEIGHT AND RACE OF CHILD AND INFANT DEATHS AND, INFANT MORTALITY RATES BY AGE AT DEATH, BIRTH WEIGHT, AND RACE OF CHILD FOR 10 LEADING CAUSES OF INFANT DEATH: UNITED STATES, 1985 BIRTH COHORT (INFANT DEATHS ARE UNDER 1 YEAR. NEONATAL DEATHS ARE UNDER 28 DAYS; EARLY NEONATAL, 0-6 DAYS; LATE NEONATAL, 7-27 DAYS; AND POSTNEONATAL, 28 DAYS THROUGH 11 MONTHS) (RATES ARE PER 100,000 LIVE BIRTHS) ___________________________________________________________________________ | | | CAUSE OF DEATH, BIRTH WEIGHT, AND RACE OF CHILD | LIVE | INFANT | | BIRTHS | DEATHS | _________________________________________________|____________|___________| ALL RACES 1/ LESS THAN 2,500 GRAMS ..ALL CAUSES...........................NUMBER.. 253,711 23,210 RATE.. 9,148.2 1 CONGENITAL ANOMALIES (740-759).......NUMBER.. 3,917 RATE.. 1,565.2 2 SUDDEN INFANT DEATH SYNDROM (798.0)..NUMBER.. 996 RATE.. 392.6 3 RESPIRATORY DISTRESS YSNDROM (769)...NUMBER.. 3,408 RATE.. 1,343.3 4 PREMATURITY (765)....................NUMBER.. 2,873 RATE.. 1,132.4 5 MATERNAL COMPLICATIONS (761).........NUMBER.. 1,170 RATE.. 461.2 6 HYPOXIA AND ASPHYXIA (768)...........NUMBER.. 596 RATE.. 234.9 7 ACCIDENTS (E800-E949)................NUMBER.. 160 RATE.. 63.1 8 INFECTIONS (771).....................NUMBER.. 625 RATE.. 246.3 9 COMPLICATIONS OF PLACENTA,ETC. (762).NUMBER.. 673 RATE.. 265.3 10 PNEUMONIA AND INFLUENZ (480-487).....NUMBER.. 243 RATE.. 95.8 ...ALL OTHER CAUSES (RESIDUAL)..........NUMBER.. 806 RATE.. 317.7 __________________________________________________ | | | | | | TOTAL | EARLY | LATE | POST- | | NEONATAL | NEONATAL | NEONATAL | NEONATAL | |_____________|____________|___________|___________| 18,804 16,390 2,414 4,406 7,411.6 6,460.1 951.5 1,736.6 3,242 2,770 472 729 1,277.8 1,091.8 186.0 287.3 49 5 44 947 19.3 2.0 17.3 373.3 3,166 2,662 544 242 1,247.9 1,033.5 214.4 95.4 2,845 2,817 28 28 1,121.4 1,110.3 11.0 11.0 1,162 1,156 6 8 458.0 455.6 2.4 3.2 575 520 55 21 226.6 205.0 21.7 8.3 28 19 9 132 11.0 7.5 3.5 52.0 595 375 220 30 234.5 147.8 86.7 11.8 670 659 11 3 264.1 259.7 4.3 1.2 65 39 26 178 25.6 15.4 10.2 70.2 344 219 125 462 135.6 86.3 49.3 182.1 LIVE BIRTHS, BY BIRTH WEIGHT AND RACE OF CHILD AND INFANT DEATHS AND, INFANT MORTALITY RATES BY AGE AT DEATH, BIRTH WEIGHT, AND RACE OF CHILD FOR 10 LEADING CAUSES OF INFANT DEATH: UNITED STATES, 1985 BIRTH COHORT (INFANT DEATHS ARE UNDER 1 YEAR. NEONATAL DEATHS ARE UNDER 28 DAYS; EARLY NEONATAL, 0-6 DAYS; LATE NEONATAL, 7-27 DAYS; AND POSTNEONATAL, 28 DAYS THROUGH 11 MONTHS) (RATES ARE PER 100,000 LIVE BIRTHS) ___________________________________________________________________________ | | | CAUSE OF DEATH, BIRTH WEIGHT, AND RACE OF CHILD | LIVE | INFANT | | BIRTHS | DEATHS | _________________________________________________|____________|___________| ALL RACES 1/ LESS THAN 2,500 GRAMS OR MORE ..ALL CAUSES...........................NUMBER.. 3,502,342 14,807 RATE.. 422.8 1 CONGENITAL ANOMALIES (740-759).......NUMBER.. 4,213 RATE.. 120.3 2 SUDDEN INFANT DEATH SYNDROM (798.0)..NUMBER.. 4,239 RATE.. 121.0 3 RESPIRATORY DISTRESS YSNDROM (769)...NUMBER.. 152 RATE.. 4.3 4 PREMATURITY (765)....................NUMBER.. 89 RATE.. 2.5 5 MATERNAL COMPLICATIONS (761).........NUMBER.. 39 RATE.. 1.1 6 HYPOXIA AND ASPHYXIA (768)...........NUMBER.. 454 RATE.. 13.0 7 ACCIDENTS (E800-E949)................NUMBER.. 705 RATE.. 20.1 8 INFECTIONS (771).....................NUMBER.. 292 RATE.. 8.3 9 COMPLICATIONS OF PLACENTA,ETC. (762).NUMBER.. 139 RATE.. 4.0 10 PNEUMONIA AND INFLUENZ (480-487).....NUMBER.. 429 RATE.. 12.2 ...ALL OTHER CAUSES (RESIDUAL)..........NUMBER.. 995 RATE.. 28.4 __________________________________________________ | | | | | | TOTAL | EARLY | LATE | POST- | | NEONATAL | NEONATAL | NEONATAL | NEONATAL | |_____________|____________|___________|___________| 5,704 3,934 1,786 9,097 163.3 163.3 51.0 259.5 2,830 2,115 715 1,383 80.8 60.4 20.4 39.5 305 33 272 3,934 8.7 8.0 7.8 112.3 135 106 29 17 3.9 3.0 .8 .5 84 81 3 5 2.4 2.3 .1 .1 35 31 4 4 1.0 .9 .1 .1 411 317 94 43 11.7 9.1 2.7 1.2 46 10 36 659 1.3 .3 1.0 18.8 281 178 103 11 8.0 5.1 2.9 .3 133 122 11 6 3.8 3.5 .3 .2 86 34 52 343 2.5 1.0 1.5 9.8 298 176 122 697 8.5 5.0 3.5 19.9 LIVE BIRTHS, BY BIRTH WEIGHT AND RACE OF CHILD AND INFANT DEATHS AND, INFANT MORTALITY RATES BY AGE AT DEATH, BIRTH WEIGHT, AND RACE OF CHILD FOR 10 LEADING CAUSES OF INFANT DEATH: UNITED STATES, 1985 BIRTH COHORT (INFANT DEATHS ARE UNDER 1 YEAR. NEONATAL DEATHS ARE UNDER 28 DAYS; EARLY NEONATAL, 0-6 DAYS; LATE NEONATAL, 7-27 DAYS; AND POSTNEONATAL, 28 DAYS THROUGH 11 MONTHS) (RATES ARE PER 100,000 LIVE BIRTHS) ___________________________________________________________________________ | | | CAUSE OF DEATH, BIRTH WEIGHT, AND RACE OF CHILD | LIVE | INFANT | | BIRTHS | DEATHS | _________________________________________________|____________|___________| ALL RACES 1/ NOT STATED BIRTH WEIGHT ..ALL CAUSES...........................NUMBER.. 4,780 1,128 RATE.. 23,598.3 1 CONGENITAL ANOMALIES (740-759).......NUMBER.. 221 RATE.. 4,723.4 2 SUDDEN INFANT DEATH SYNDROM (798.0)..NUMBER.. 7 RATE.. 146.4 3 RESPIRATORY DISTRESS YSNDROM (769)...NUMBER.. 73 RATE.. 1,527.2 4 PREMATURITY (765)....................NUMBER.. 227 RATE.. 4,749.0 5 MATERNAL COMPLICATIONS (761).........NUMBER.. 100 RATE.. 2,092.1 6 HYPOXIA AND ASPHYXIA (768)...........NUMBER.. 73 RATE.. 1,527.2 7 ACCIDENTS (E800-E949)................NUMBER.. 2 RATE.. 41.8 8 INFECTIONS (771).....................NUMBER.. 10 RATE.. 209.2 9 COMPLICATIONS OF PLACENTA,ETC. (762).NUMBER.. 63 RATE.. 1,318.0 10 PNEUMONIA AND INFLUENZ (480-487).....NUMBER.. 5 RATE.. 1104.6 ...ALL OTHER CAUSES (RESIDUAL)..........NUMBER.. 28 RATE.. 585.8 __________________________________________________ | | | | | | TOTAL | EARLY | LATE | POST- | | NEONATAL | NEONATAL | NEONATAL | NEONATAL | |_____________|____________|___________|___________| 1,049 993 56 79 21,945.6 20,774.1 1,171.5 1,652.7 204 190 14 17 4,267.8 3,974.9 292.9 355.6 - - - 7 - - - 146.4 71 60 11 2 1,485.4 1,255.2 230.1 41.8 226 226 - 1 4,728.0 4,728.0 - 20.9 99 99 - 1 2,071.1 2,071.1 - 20.9 66 66 6 7 1,308.8 1,255.2 125.5 146.4 1 1 - 1 20.9 20.9 - 20.9 9 7 2 1 188.3 146.4 41.8 20.9 63 63 - - 1,318.0 1,318.0 - - - - - 5 - - - 104.6 15 12 3 13 313.8 251.0 62.8 272.0 LIVE BIRTHS, BY BIRTH WEIGHT AND RACE OF CHILD AND INFANT DEATHS AND, INFANT MORTALITY RATES BY AGE AT DEATH, BIRTH WEIGHT, AND RACE OF CHILD FOR 10 LEADING CAUSES OF INFANT DEATH: UNITED STATES, 1985 BIRTH COHORT (INFANT DEATHS ARE UNDER 1 YEAR. NEONATAL DEATHS ARE UNDER 28 DAYS; EARLY NEONATAL, 0-6 DAYS; LATE NEONATAL, 7-27 DAYS; AND POSTNEONATAL, 28 DAYS THROUGH 11 MONTHS) (RATES ARE PER 100,000 LIVE BIRTHS) ___________________________________________________________________________ | | | CAUSE OF DEATH, BIRTH WEIGHT, AND RACE OF CHILD | LIVE | INFANT | | BIRTHS | DEATHS | _________________________________________________|____________|___________| WHITE - ALL BIRTH WEIGHTS ..ALL CAUSES...........................NUMBER.. 2,991,521 26,526 RATE.. 886.7 1 CONGENITAL ANOMALIES (740-759).......NUMBER.. 6,598 RATE.. 220.6 2 SUDDEN INFANT DEATH SYNDROM (798.0)..NUMBER.. 3,632 RATE.. 121.4 3 RESPIRATORY DISTRESS YSNDROM (769)...NUMBER.. 2,593 RATE.. 86.7 4 PREMATURITY (765)....................NUMBER.. 1,769 RATE.. 59.1 5 MATERNAL COMPLICATIONS (761).........NUMBER.. 891 RATE.. 29.8 6 HYPOXIA AND ASPHYXIA (768)...........NUMBER.. 734 RATE.. 24.5 7 ACCIDENTS (E800-E949)................NUMBER.. 569 RATE.. 19.0 8 INFECTIONS (771).....................NUMBER.. 616 RATE.. 20.6 9 COMPLICATIONS OF PLACENTA,ETC. (762).NUMBER.. 624 RATE.. 20.9 10 PNEUMONIA AND INFLUENZ (480-487).....NUMBER.. 422 RATE.. 14.1 ...ALL OTHER CAUSES (RESIDUAL)..........NUMBER.. 1,214 RATE.. 40.6 __________________________________________________ | | | | | | TOTAL | EARLY | LATE | POST- | | NEONATAL | NEONATAL | NEONATAL | NEONATAL | |_____________|____________|___________|___________| 17,381 14,323 3,058 9,145 581.0 478.8 102.2 305.7 4,985 4,034 951 1,613 166.6 134.8 31.8 53.9 234 23 211 3,398 7.8 .8 7.1 113.6 2,418 1,968 450 175 80.8 65.8 15.0 5.8 1,750 1,728 22 19 58.5 57.8 .7 .6 885 878 7 6 29.6 29.3 .2 .2 685 571 114 49 22.9 19.1 3.8 1.6 52 20 32 517 1.7 .7 1.1 17.3 592 389 203 24 19.8 13.0 6.8 .8 617 604 13 7 20.6 20.2 .4 .2 102 49 53 320 3.4 1.6 1.8 10.7 469 301 168 745 15.7 10.1 5.6 24.9 LIVE BIRTHS, BY BIRTH WEIGHT AND RACE OF CHILD AND INFANT DEATHS AND, INFANT MORTALITY RATES BY AGE AT DEATH, BIRTH WEIGHT, AND RACE OF CHILD FOR 10 LEADING CAUSES OF INFANT DEATH: UNITED STATES, 1985 BIRTH COHORT (INFANT DEATHS ARE UNDER 1 YEAR. NEONATAL DEATHS ARE UNDER 28 DAYS; EARLY NEONATAL, 0-6 DAYS; LATE NEONATAL, 7-27 DAYS; AND POSTNEONATAL, 28 DAYS THROUGH 11 MONTHS) (RATES ARE PER 100,000 LIVE BIRTHS) ___________________________________________________________________________ | | | CAUSE OF DEATH, BIRTH WEIGHT, AND RACE OF CHILD | LIVE | INFANT | | BIRTHS | DEATHS | _________________________________________________|____________|___________| WHITE - LESS THAN 2,500 GRAMS ..ALL CAUSES...........................NUMBER.. 168,478 14,959 RATE.. 8,878.9 1 CONGENITAL ANOMALIES (740-759).......NUMBER.. 3,070 RATE.. 1,822.2 2 SUDDEN INFANT DEATH SYNDROM (798.0)..NUMBER.. 579 RATE.. 343.7 3 RESPIRATORY DISTRESS YSNDROM (769)...NUMBER.. 2,424 RATE.. 1,438.8 4 PREMATURITY (765)....................NUMBER.. 1,600 RATE.. 949.7 5 MATERNAL COMPLICATIONS (761).........NUMBER.. 799 RATE.. 474.3 6 HYPOXIA AND ASPHYXIA (768)...........NUMBER.. 342 RATE.. 203.0 7 ACCIDENTS (E800-E949)................NUMBER.. 78 RATE.. 46.3 8 INFECTIONS (771).....................NUMBER.. 396 RATE.. 235.0 9 COMPLICATIONS OF PLACENTA,ETC. (762).NUMBER.. 473 RATE.. 280.7 10 PNEUMONIA AND INFLUENZ (480-487).....NUMBER.. 129 RATE.. 76.6 ...ALL OTHER CAUSES (RESIDUAL)..........NUMBER.. 491 RATE.. 291.4 __________________________________________________ | | | | | | TOTAL | EARLY | LATE | POST- | | NEONATAL | NEONATAL | NEONATAL | NEONATAL | |_____________|____________|___________|___________| 12,368 10,699 1,669 2,591 7,341.0 6,350.4 990.6 1,537.9 2,558 2,194 364 512 1,518.3 1,302.2 216.1 303.9 24 3 21 555 14.2 1.8 12.5 329.4 2,262 1,848 414 162 1,342.6 1,096.9 245.7 96.2 1,585 1,566 19 15 940.8 929.5 11.3 8.9 795 791 4 4 471.9 469.5 2.4 2.4 331 297 34 11 196.5 176.3 20.2 6.5 19 11 8 59 11.3 6.5 4.7 35.0 379 247 132 17 225.0 146.6 78.3 10.1 472 467 5 1 280.2 277.2 3.0 .6 36 21 15 93 21.4 12.5 8.9 55.2 229 156 73 262 135.9 92.6 43.3 155.5 LIVE BIRTHS, BY BIRTH WEIGHT AND RACE OF CHILD AND INFANT DEATHS AND, INFANT MORTALITY RATES BY AGE AT DEATH, BIRTH WEIGHT, AND RACE OF CHILD FOR 10 LEADING CAUSES OF INFANT DEATH: UNITED STATES, 1985 BIRTH COHORT (INFANT DEATHS ARE UNDER 1 YEAR. NEONATAL DEATHS ARE UNDER 28 DAYS; EARLY NEONATAL, 0-6 DAYS; LATE NEONATAL, 7-27 DAYS; AND POSTNEONATAL, 28 DAYS THROUGH 11 MONTHS) (RATES ARE PER 100,000 LIVE BIRTHS) ___________________________________________________________________________ | | | CAUSE OF DEATH, BIRTH WEIGHT, AND RACE OF CHILD | LIVE | INFANT | | BIRTHS | DEATHS | _________________________________________________|____________|___________| WHITE - 2,500 GRAMS OR MORE ..ALL CAUSES...........................NUMBER.. 2,819,364 10,857 RATE.. 385.1 1 CONGENITAL ANOMALIES (740-759).......NUMBER.. 3,354 RATE.. 119.0 2 SUDDEN INFANT DEATH SYNDROM (798.0)..NUMBER.. 3,046 RATE.. 108.0 3 RESPIRATORY DISTRESS YSNDROM (769)...NUMBER.. 124 RATE.. 4.4 4 PREMATURITY (765)....................NUMBER.. 55 RATE.. 2.0 5 MATERNAL COMPLICATIONS (761).........NUMBER.. 26 RATE.. .9 6 HYPOXIA AND ASPHYXIA (768)...........NUMBER.. 336 RATE.. 11.9 7 ACCIDENTS (E800-E949)................NUMBER.. 489 RATE.. 17.3 8 INFECTIONS (771).....................NUMBER.. 216 RATE.. 7.7 9 COMPLICATIONS OF PLACENTA,ETC. (762).NUMBER.. 108 RATE.. 3.8 10 PNEUMONIA AND INFLUENZ (480-487).....NUMBER.. 291 RATE.. 10.3 ...ALL OTHER CAUSES (RESIDUAL)..........NUMBER.. 704 RATE.. 25.0 __________________________________________________ | | | | | | TOTAL | EARLY | LATE | POST- | | NEONATAL | NEONATAL | NEONATAL | NEONATAL | |_____________|____________|___________|___________| 4,356 3,012 1,344 6,501 154.5 106.8 47.7 230.6 2,264 1,687 577 1,090 80.3 59.8 20.5 38.7 210 20 190 2,836 7.4 .7 6.7 100.6 113 87 26 11 4.0 3.1 .9 .4 51 48 3 4 1.8 1.7 .1 .1 24 21 3 2 .9 .7 .1 .1 304 229 75 32 10.8 8.1 2.7 1.1 32 8 24 457 1.1 .3 .9 16.2 210 140 70 6 7.4 5.0 2.5 .2 102 94 8 6 3.6 3.3 .3 .2 66 28 38 225 2.3 1.0 1.3 8.0 230 137 93 474 8.2 4.9 3.3 16.8 LIVE BIRTHS, BY BIRTH WEIGHT AND RACE OF CHILD AND INFANT DEATHS AND, INFANT MORTALITY RATES BY AGE AT DEATH, BIRTH WEIGHT, AND RACE OF CHILD FOR 10 LEADING CAUSES OF INFANT DEATH: UNITED STATES, 1985 BIRTH COHORT (INFANT DEATHS ARE UNDER 1 YEAR. NEONATAL DEATHS ARE UNDER 28 DAYS; EARLY NEONATAL, 0-6 DAYS; LATE NEONATAL, 7-27 DAYS; AND POSTNEONATAL, 28 DAYS THROUGH 11 MONTHS) (RATES ARE PER 100,000 LIVE BIRTHS) ___________________________________________________________________________ | | | CAUSE OF DEATH, BIRTH WEIGHT, AND RACE OF CHILD | LIVE | INFANT | | BIRTHS | DEATHS | _________________________________________________|____________|___________| WHITE - NOT STATED BIRTH WEIGHT ..ALL CAUSES...........................NUMBER.. 3,679 710 RATE.. 19,298.7 1 CONGENITAL ANOMALIES (740-759).......NUMBER.. 174 RATE.. 4,729.5 2 SUDDEN INFANT DEATH SYNDROM (798.0)..NUMBER.. 7 RATE.. 190.3 3 RESPIRATORY DISTRESS YSNDROM (769)...NUMBER.. 45 RATE.. 1,223.2 4 PREMATURITY (765)....................NUMBER.. 114 RATE.. 3,098.7 5 MATERNAL COMPLICATIONS (761).........NUMBER.. 66 RATE.. 1,794.0 6 HYPOXIA AND ASPHYXIA (768)...........NUMBER.. 56 RATE.. 1,522.2 7 ACCIDENTS (E800-E949)................NUMBER.. 2 RATE.. 54.4 8 INFECTIONS (771).....................NUMBER.. 4 RATE.. 108.7 9 COMPLICATIONS OF PLACENTA,ETC. (762).NUMBER.. 43 RATE.. 1,168.8 10 PNEUMONIA AND INFLUENZ (480-487).....NUMBER.. 2 RATE.. 54.4 ...ALL OTHER CAUSES (RESIDUAL)..........NUMBER.. 19 RATE.. 516.4 __________________________________________________ | | | | | | TOTAL | EARLY | LATE | POST- | | NEONATAL | NEONATAL | NEONATAL | NEONATAL | |_____________|____________|___________|___________| 657 612 45 53 17,858.1 16,635.0 1,223.2 1,440.6 163 153 10 11 4,430.6 4,158.7 271.8 299.0 - - - 7 - - - 190.3 43 33 10 2 1,168.8 897.0 271.8 54.4 114 114 - - 3,098.7 3,098.7 - - 66 66 - - 1,794.0 1,794.0 - - 50 45 5 6 1,359.1 1,223.2 135.9 163.1 1 1 - 1 27.2 27.2 - 27.2 3 2 1 1 81.5 54.4 27.2 27.2 43 43 - - 1,168.8 1,168.8 - - - - - 2 - - - 54.4 10 8 2 9 271.8 217.5 54.4 244.6 LIVE BIRTHS, BY BIRTH WEIGHT AND RACE OF CHILD AND INFANT DEATHS AND, INFANT MORTALITY RATES BY AGE AT DEATH, BIRTH WEIGHT, AND RACE OF CHILD FOR 10 LEADING CAUSES OF INFANT DEATH: UNITED STATES, 1985 BIRTH COHORT (INFANT DEATHS ARE UNDER 1 YEAR. NEONATAL DEATHS ARE UNDER 28 DAYS; EARLY NEONATAL, 0-6 DAYS; LATE NEONATAL, 7-27 DAYS; AND POSTNEONATAL, 28 DAYS THROUGH 11 MONTHS) (RATES ARE PER 100,000 LIVE BIRTHS) ___________________________________________________________________________ | | | CAUSE OF DEATH, BIRTH WEIGHT, AND RACE OF CHILD | LIVE | INFANT | | BIRTHS | DEATHS | _________________________________________________|____________|___________| BLACK - ALL BIRTH WEIGHTS ..ALL CAUSES...........................NUMBER.. 608,309 11,140 RATE.. 1,831.8 1 CONGENITAL ANOMALIES (740-759).......NUMBER.. 1,475 RATE.. 242.5 2 SUDDEN INFANT DEATH SYNDROM (798.0)..NUMBER.. 1,357 RATE.. 223.1 3 RESPIRATORY DISTRESS YSNDROM (769)...NUMBER.. 927 RATE.. 152.4 4 PREMATURITY (765)....................NUMBER.. 1,336 RATE.. 219.6 5 MATERNAL COMPLICATIONS (761).........NUMBER.. 388 RATE.. 63.8 6 HYPOXIA AND ASPHYXIA (768)...........NUMBER.. 358 RATE.. 58.9 7 ACCIDENTS (E800-E949)................NUMBER.. 250 RATE.. 41.1 8 INFECTIONS (771).....................NUMBER.. 287 RATE.. 47.2 9 COMPLICATIONS OF PLACENTA,ETC. (762).NUMBER.. 225 RATE.. 37.8 10 PNEUMONIA AND INFLUENZ (480-487).....NUMBER.. 228 RATE.. 37.5 ...ALL OTHER CAUSES (RESIDUAL)..........NUMBER.. 526 RATE.. 86.5 __________________________________________________ | | | | | | TOTAL | EARLY | LATE | POST- | | NEONATAL | NEONATAL | NEONATAL | NEONATAL | |_____________|____________|___________|___________| 7,339 6,294 1,045 3,801 1,206.5 1,034.7 171.8 624.8 1,043 841 202 432 171.5 138.3 33.2 71.0 106 11 95 1,251 17.4 1.8 15.6 205.7 853 747 106 74 140.2 122.8 17.4 12.2 1,321 1,313 8 15 217.2 215.8 1.3 2.5 382 379 3 6 62.8 62.3 .5 1.0 337 304 33 21 55.4 50.0 5.4 3.5 19 8 11 231 3.1 1.3 1.8 38.0 270 159 111 17 44.4 26.1 18.2 2.8 223 216 7 2 36.7 35.5 1.2 .3 43 22 21 185 7.1 3.6 3.5 30.4 155 89 66 371 25.5 14.6 10.8 61.0 LIVE BIRTHS, BY BIRTH WEIGHT AND RACE OF CHILD AND INFANT DEATHS AND, INFANT MORTALITY RATES BY AGE AT DEATH, BIRTH WEIGHT, AND RACE OF CHILD FOR 10 LEADING CAUSES OF INFANT DEATH: UNITED STATES, 1985 BIRTH COHORT (INFANT DEATHS ARE UNDER 1 YEAR. NEONATAL DEATHS ARE UNDER 28 DAYS; EARLY NEONATAL, 0-6 DAYS; LATE NEONATAL, 7-27 DAYS; AND POSTNEONATAL, 28 DAYS THROUGH 11 MONTHS) (RATES ARE PER 100,000 LIVE BIRTHS) ___________________________________________________________________________ | | | CAUSE OF DEATH, BIRTH WEIGHT, AND RACE OF CHILD | LIVE | INFANT | | BIRTHS | DEATHS | _________________________________________________|____________|___________| BLACK - LESS THAN 2,500 GRAMS ..ALL CAUSES...........................NUMBER.. 75,482 7,476 RATE.. 9,904.3 1 CONGENITAL ANOMALIES (740-759).......NUMBER.. 745 RATE.. 987.0 2 SUDDEN INFANT DEATH SYNDROM (798.0)..NUMBER.. 379 RATE.. 502.1 3 RESPIRATORY DISTRESS YSNDROM (769)...NUMBER.. 875 RATE.. 1,159.2 4 PREMATURITY (765)....................NUMBER.. 1,195 RATE.. 1,583.2 5 MATERNAL COMPLICATIONS (761).........NUMBER.. 346 RATE.. 458.4 6 HYPOXIA AND ASPHYXIA (768)...........NUMBER.. 244 RATE.. 323.3 7 ACCIDENTS (E800-E949)................NUMBER.. 74 RATE.. 98.0 8 INFECTIONS (771).....................NUMBER.. 211 RATE.. 279.5 9 COMPLICATIONS OF PLACENTA,ETC. (762).NUMBER.. 180 RATE.. 238.5 10 PNEUMONIA AND INFLUENZ (480-487).....NUMBER.. 105 RATE.. 139.1 ...ALL OTHER CAUSES (RESIDUAL)..........NUMBER.. 281 RATE.. 372.3 __________________________________________________ | | | | | | TOTAL | EARLY | LATE | POST- | | NEONATAL | NEONATAL | NEONATAL | NEONATAL | |_____________|____________|___________|___________| 5,832 5,172 660 1,644 7,726.3 6,852.0 874.4 2,178.0 555 466 89 190 735.3 617.4 117.9 251.7 22 1 21 357 29.1 1.3 27.8 473.0 806 703 103 69 1,067.8 931.3 136.5 91.4 1,182 1,174 8 13 1,565.9 1,555.3 10.6 17.2 342 340 2 4 453.1 450.4 2.6 5.3 234 215 19 10 310.0 284.8 25.2 13.2 8 7 1 66 10.6 9.3 1.3 87.4 199 118 81 12 263.6 156.3 107.3 15.9 178 173 5 2 235.8 229.2 6.6 2.6 26 17 9 79 34.4 22.5 11.9 104.7 99 55 44 182 131.2 72.9 58.3 241.1 LIVE BIRTHS, BY BIRTH WEIGHT AND RACE OF CHILD AND INFANT DEATHS AND, INFANT MORTALITY RATES BY AGE AT DEATH, BIRTH WEIGHT, AND RACE OF CHILD FOR 10 LEADING CAUSES OF INFANT DEATH: UNITED STATES, 1985 BIRTH COHORT (INFANT DEATHS ARE UNDER 1 YEAR. NEONATAL DEATHS ARE UNDER 28 DAYS; EARLY NEONATAL, 0-6 DAYS; LATE NEONATAL, 7-27 DAYS; AND POSTNEONATAL, 28 DAYS THROUGH 11 MONTHS) (RATES ARE PER 100,000 LIVE BIRTHS) ___________________________________________________________________________ | | | CAUSE OF DEATH, BIRTH WEIGHT, AND RACE OF CHILD | LIVE | INFANT | | BIRTHS | DEATHS | _________________________________________________|____________|___________| BLACK - 2,500 GRAMS OR MORE ..ALL CAUSES...........................NUMBER.. 531,968 3,291 RATE.. 618.6 1 CONGENITAL ANOMALIES (740-759).......NUMBER.. 700 RATE.. 131.6 2 SUDDEN INFANT DEATH SYNDROM (798.0)..NUMBER.. 978 RATE.. 183.8 3 RESPIRATORY DISTRESS YSNDROM (769)...NUMBER.. 25 RATE.. 4.7 4 PREMATURITY (765)....................NUMBER.. 33 RATE.. 6.2 5 MATERNAL COMPLICATIONS (761).........NUMBER.. 10 RATE.. 1.9 6 HYPOXIA AND ASPHYXIA (768)...........NUMBER.. 99 RATE.. 18.6 7 ACCIDENTS (E800-E949)................NUMBER.. 176 RATE.. 33.1 8 INFECTIONS (771).....................NUMBER.. 70 RATE.. 13.2 9 COMPLICATIONS OF PLACENTA,ETC. (762).NUMBER.. 27 RATE.. 5.1 10 PNEUMONIA AND INFLUENZ (480-487).....NUMBER.. 120 RATE.. 22.6 ...ALL OTHER CAUSES (RESIDUAL)..........NUMBER.. 236 RATE.. 44.4 __________________________________________________ | | | | | | TOTAL | EARLY | LATE | POST- | | NEONATAL | NEONATAL | NEONATAL | NEONATAL | |_____________|____________|___________|___________| 1,555 778 377 2,136 217.1 146.2 70.9 401.5 462 351 111 238 86.8 66.0 20.9 44.7 84 10 74 894 15.8 1.9 13.9 168.1 20 18 2 5 3.8 3.4 .4 .9 32 32 - 1 6.0 6.0 - .2 9 8 1 1 1.7 1.5 .2 .2 89 75 14 10 16.7 14.1 2.6 1.9 11 1 10 165 2.1 .2 1.9 31.0 65 36 29 5 12.2 6.8 5.5 .9 27 25 2 - 5.1 4.7 .4 - 17 5 12 103 3.2 .9 2.3 19.4 51 30 21 185 9.6 5.6 3.9 34.8 LIVE BIRTHS, BY BIRTH WEIGHT AND RACE OF CHILD AND INFANT DEATHS AND, INFANT MORTALITY RATES BY AGE AT DEATH, BIRTH WEIGHT, AND RACE OF CHILD FOR 10 LEADING CAUSES OF INFANT DEATH: UNITED STATES, 1985 BIRTH COHORT (INFANT DEATHS ARE UNDER 1 YEAR. NEONATAL DEATHS ARE UNDER 28 DAYS; EARLY NEONATAL, 0-6 DAYS; LATE NEONATAL, 7-27 DAYS; AND POSTNEONATAL, 28 DAYS THROUGH 11 MONTHS) (RATES ARE PER 100,000 LIVE BIRTHS) ___________________________________________________________________________ | | | CAUSE OF DEATH, BIRTH WEIGHT, AND RACE OF CHILD | LIVE | INFANT | | BIRTHS | DEATHS | _________________________________________________|____________|___________| BLACK - NOT STATED BIRTH WEIGHT ..ALL CAUSES...........................NUMBER.. 859 373 RATE.. 43,422.6 1 CONGENITAL ANOMALIES (740-759).......NUMBER.. 30 RATE.. 3,492.4 2 SUDDEN INFANT DEATH SYNDROM (798.0)..NUMBER.. - RATE.. - 3 RESPIRATORY DISTRESS YSNDROM (769)...NUMBER.. 27 RATE.. 3,143.2 4 PREMATURITY (765)....................NUMBER.. 108 RATE.. 12,572.8 5 MATERNAL COMPLICATIONS (761).........NUMBER.. 32 RATE.. 3,725.3 6 HYPOXIA AND ASPHYXIA (768)...........NUMBER.. 15 RATE.. 1,746.2 7 ACCIDENTS (E800-E949)................NUMBER.. - RATE.. - 8 INFECTIONS (771).....................NUMBER.. 6 RATE.. 698.5 9 COMPLICATIONS OF PLACENTA,ETC. (762).NUMBER.. 18 RATE.. 2,095.5 10 PNEUMONIA AND INFLUENZ (480-487).....NUMBER.. 3 RATE.. 349.2 ...ALL OTHER CAUSES (RESIDUAL)..........NUMBER.. 9 RATE.. 1,047.7 1/ INCLUDES RACES OTHER THAN WHITE AND BLACK __________________________________________________ | | | | | | TOTAL | EARLY | LATE | POST- | | NEONATAL | NEONATAL | NEONATAL | NEONATAL | |_____________|____________|___________|___________| 352 344 8 21 40,977.9 40,046.6 931.3 2,444.7 26 24 2 4 3,026.8 2,793.9 232.8 465.7 - - - - - - - - 27 26 1 - 3,143.2 3,026.8 116.4 - 107 107 - 1 12,456.3 12,456.3 - 116.4 31 31 - 1 3,608.8 3,608.8 - 116.4 14 14 - 1 1,629.8 1,629.8 - 116.4 - - - - - - - - 6 5 1 - 698.5 582.1 116.4 - 18 18 - - 2,095.5 2,095.5 - - - - - 3 - - - 349.2 5 4 1 4 582.1 465.7 116.4 465.7 1TECHNICAL APPENDIX (LIVE BIRTH) 2Definition of Live Birth Every product of conception that gives a sign of life after birth, regardless of the length of the pregnancy, is considered a live birth. This concept is included in the definition set forth by the World Health Organization (1950, pp. 16-17) as follows: Live birth is the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy, which, after such separation, breathes or shows any other evidence of life, such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached; each product of such a birth is considered liveborn. This definition distinguishes in precise terms a live birth from a fetal death ( see section on fetal deaths in the Technical Appendix of Volume II of this report). In the interest of comparable natality statistics, both the Statistical Commission of the United Nations and the National Center of Health Statistics have adopted this definition (National Office of Vital Statistics, 1950, p. 6; Statistical Office of the United Nations, 1953, p. 6). 2History of Birth-Registration Area The national birth-registration area was proposed in 1850 and established in 1915. By 1933 all 48 States and the District of Columbia were participating in the registration system. The organized territories of Hawaii and Alaska were admitted in 1929 and 1950, respectively; data from these areas were prepared separately until they became States-Alaska in 1959 and Hawaii in 1960. At present the birth-registration system of the United States covers the 50 States, the District of Columbia, the independent registration area of New York City, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Trust Territory of the Pacific Islands, However, in the statistical tabulations, "United States" refers only to the aggregate of the 50 States (including New York City) and the District of Columbia. Tabulations for Puerto Rico, the Virgin Islands, and Guam are shown separately in section 3 of this volume. The original birth-registration area of 1915 consisted of 10 States and the District of Columbia. The growth of this area is indicated in table 4-1. This table also presents for each year through 1932 the estimated midyear population of the United States and of those States included in the registration system. Because of the growth of the area for which data have been collected and tabulated, a national series of geographically comparable data before 1933 can be obtained only by estimation. Annual estimates of births have been prepared by P. K. Whelpton (National Office of Vital Statistics, 1954) for the period 1909-34 (table 1-1). These estimates include adjustment both for underregistration and for States that were not part of the birth-registration area before 1933. 2Sources of Data 3Natality Statistics Beginning in 1985 natality statistics for all States and the District of Columbia are based on information from the total file of records for these areas. The information is received on computer data tapes coded by the States and provided to the National Center for Health Statistics (NCHS) through the Vital Statistics Cooperative Program. NCHS receives these tapes from the registration offices of the States, the District of Columbia, and New York City. Data for Puerto Rico, the Virgin Islands, and Guam for 1985 are also based on information from the total file of records. Information from the Virgin Islands and Guam is received on microfilm copies of original birth certificates; information from Puerto Rico is received on computer tapes through the Vital Statistics Cooperative Program. Birth statistics presented in this report for years before 1951 and for 1955 are based on the total file of birth records. Statistics for 1951-54, 1956-66, and 1968-71 are based on 50-percent samples with the exception of data for Guam and the Virgin Islands, which are based on all records filed. During the processing of the 1967 data, the sampling rate was reduced from 50 percent to 20 percent. For details of this procedure and its consequences for the 1967 data, see Vital Statistics of the United States, 1967, Volume I, pages 3-9 to 3-11. From 1972 to 1984, statistics are based on all records filed in the States submitting computer tapes and on a 50-percent sample of records in all other States. For Puerto Rico beginning in 1977, statistics are based on all records filed. Information for years prior to 1970 for Puerto Rico, the Virgin Islands, and Guam is published in the annual vital statistics reports of the Department of Health of the Commonwealth of Puerto Rico, the Department of Public Health of the Virgin Islands, the Department of Public Health and Social Services of the Government of Guam, and in selected Vital Statistics of the United States annual reports. U.S. natality data are limited to births occurring within the United States, including those occurring to U.S. residents and nonresidents. Births to nonresidents of the United States have been excluded from all tabulations by place of residence beginning in 1970. (See "Classification by occurrence and residence" for further discussion.) Births occurring to U.S. citizens outside the United States are not included in any tabulations in this report. Similarly the data for Puerto Rico, the Virgin Islands, and Guam are limited to births registered in these areas. 3Standard Certificate of Live Birth The U.S. Standard Certificate of Live Birth, issued by the Public Health Service, has served for many years as the principal means of attaining uniformity in the content of the documents used to collect information on births in the United States. It has been modified in each State to the extent required by the particular State's needs or by special provisions of the State's vital statistics law. However, most State certificates conform closely in content to the standard certificate. The first standard certificate of birth was developed 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 the fields of public health, social welfare, demography, and insurance. This procedure has assured careful evaluation of each item for its current and future usefulness for legal, medical, 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, dropped when their usefulness appeared to be limited. 1978 revision-Effective January 1, 1978, a revised U.S. Standard Certificate of Live Birth (figure 4-A) replaced the 1968 revision. Changes on the 1978 standard certificate included a new item on 1- and 5-minute Apgar scores, the deletion of the item on birth injuries, and revisions of the items on legitimacy status and previous pregnancies. The item on legitimacy status was changed to real "Is mother married?" This is now a factual piece of information about the mother rather than an attribute ascribed to the child, and the person completing the record does not have the responsibility for making what may be a legal determination. The item on previous deliveries was changed to pregnancy history and expanded to include two categories of fetal loss, before and after 20 completed weeks of gestation. This changes provides information on two groups that are of interest in medical research and emphasizes the fact that all previous fetal losses should be included, both spontaneous and induced, regardless of length of gestation. For further discussion see individual sections for each item. 2Classification of Data 3General Information One of the principal values of vital statistics data is realized through the presentation of rates that are computed by relating the vital events of a class to the population of a similarly defined class. Vital statistics and population statistics must therefore be classified according to similarly defined systems and tabulated in comparable groups. Even when the variables common to both, such as geographic area, age, race, and sex, have been similarly classified and tabulated, differences between the enumeration method of obtaining population data and the registration method of obtaining vital statistics data may result in significant discrepancies. The general rules used to classify geographic and personal items for live births are set forth in "Vital Statistics Classification and Coding Instructions for Live Birth Records, 1985," NCHS Instruction Manual, Part 3a. The classification of certain important items is discussed in the following pages. 3Classification by Occurrence and Residence All but three tabulations for States and other areas within the United States are by place of mother's residence. These three tabulations (1-49, 1- 50, and 2-1) show births by place of occurrence. Births to U.S. residents occurring outside this country are not reallocated to the United States. In tabulations by place of residence, births occurring within the United States to U.S. citizens and to resident aliens are allocated to the usual place of residence of the mother in the United States as reported on the birth certificate. Beginning in 1970, births to nonresidents of the United States occurring in the United States have been excluded from these tabulations. From 1966 to 1969, births occurring in the United States to mothers who were nonresidents of the United States were considered as birth to residents of the exact place of occurrence; in 1964 and 1965 all such births were allocated to "balance of county" of occurrence even if the birth had occurred in a city. The change in coding beginning in 1970 to exclude births to nonresidents of the United States from residence data significantly affects the comparability of data with years before 1970 only for Texas. In 1985 births to residents of Mexico constituted 84.4 percent of the 4,503 nonresident births in the United States. No evaluation of the effect of the change in procedure between 1965 and 1966 has been made. For the total United States the tabulations by place of residence and by place of occurrence are not identical. Births to nonresidents of the United States are included in data by place of occurrence but excluded from data by place of residence, as previously indicated. Residence error-A nationwide test of birth-registration completeness in 1950 provided measures of residence error for natality statistics. According to this test, errors in residence reporting for the country as a whole tend to overstate the number of births to residents of urban areas and to understate the number of births to residents of other areas. This tendency has assumed special importance because of a concomitant development-the increased utilization of hospitals in cities by residents of nearby places-with the result that a number of births are erroneously reported as having occurred to residents of urban areas. Another factor that contributes to this overstatement of urban births is the customary procedure of using "city" addresses for persons living outside the city limits. Incomplete residence-Beginning in 1973 where only the State of residence is reported with no city or county specified, and the State named is different from the State of occurrence, the birth has been allocated to the largest city of the State of residence. Before 1973 such births were allocated to the exact place of occurrence. 3Geographic Classification The rules followed in the classification of geographic areas for live births are contained in the instruction manual mentioned previously. The geographic code structure for 1985 is given in another manual, "Vital Records Geographic Classification, 1982." United States-In the statistical tabulations, "United States" refers only to the aggregate of the 50 States and the District of Columbia. Alaska has been included in the U.S. tabulations since 1959 and Hawaii since 1960. Standard metropolitan statistical areas-The standard metropolitan statistical areas (SMSA's) used in this report are those established by the U.S. Office of Management and Budget (1981 a, pp. 1-20) from final 1980 census population counts and used by the U.S. Bureau of the Census except in the New England States. Except in the New England States, an SMSA is a county or a group of contiguous counties containing either a city of 50,000 inhabitants or more or an urbanized area of 50,000 with a total metropolitan population of at least 100,000. In addition to the county or counties containing such a city or urbanized area, contiguous counties are included in an SMSA if, according to specified criteria, they are essentially metropolitan in character and are socially and economically integrated with the central city or urbanized area (U.S. Office of Management and Budget, 1981b. p. 420). In the New England States the U. S. Office of Management and Budget uses towns and cities rather than counties as geographic components of SMSA's. The National Center for Health Statistics cannot, however, use the SMSA classification for these States because its data are not coded to identify all towns. Instead, the New England County Metropolitan Areas (NECMA's) are used. These areas are established by the U.S. Office of Management and Budget (1975, pp. 89-90; 1981b, p. 420) are made up o;f county units. Metropolitan and nonmetropolitan counties-Independent cities and counties included in SMSA's or NECMA's are included in data for metropolitan counties; all other counties are classified as nonmetropolitan. Population-size groups-Beginning in 1982 vital statistics data for cities and certain other urban places have been classified according to the population enumerated in the 1980 Census of Population. Data are available for individual cities and other urban places of 10,000 or more population. Data for the remaining areas not separately identified are shown in the tables under the heading "Balance of area" or "Balance of county." Classification of areas for the years 1970-81 was determined by the population enumerated in the 1970 Census of Population. As a result of changes in the enumerated population between 1970 and 1980, some urban places identified in previous reports are no longer included, and a number of other urban places have been added. Urban places other than incorporated cities for which vital statistics data are shown in this report include the following; . Each town in New England, New York, and Wisconsin and each township in Michigan, New Jersey, and Pennsylvania that had no incorporated municipality as a subdivision and had either 25,000 inhabitants or more or a population of 10,000 to 25,000 and a density of 1,000 persons or more per square mile. . Each county in States other than those indicated above that had no incorporated municipality within its boundary and had a density of 1,000 persons or more per square mile. (Arlington County, Virginia, is the only county classified as urban under this rule.) . Each place in Hawaii with 10,000 or more population, as there are no incorporated cities in the State. 3Race or National Origin The race or national origin shown in a tabulation is that of the newborn child. Classification of the child's race or national origin for statistical purposes is based on the race or national origin of the parents. The categories are "White," "Black," "American Indian," "Chinese," "Japanese," "Hawaiian," "Filipino," "Other Asian or Pacific Islander," and "Other." Before 1978 the category "Other Asian or Pacific Islander" was not identified separately but included with "Other" races. The separation of this category allows identification of the category "Asian or Pacific Islander" by combining the new category "Other Asian or Pacific Islander" with Chinese, Japanese, Hawaiian, and Filipino. If the parents are of different races or national origins, the following rules are used to assign race or national origin to the newborn child. When only one parent is white, the child is assigned the other parent's race or national origin. When neither parent is white, the child is assigned the father's race or national origin with one exception; if the mother is Hawaiian or part-Hawaiian, the child is assigned to Hawaiian. If race is missing for one parent, the child is assigned the race of the parent for whom race is given. When information on race is missing for both parents, the race of the child is considered not stated and the birth is allocated according to rules discussed in the section "Race or national origin not stated." White-The category "White" comprises births reported as white, and births where race is reported as Hispanic. Before 1964, all births for which race or national origin was not stated were classified as white. Beginning in 1964 changes in the procedures for allocating race when race or national origin is not stated have changed the composition of this category. (See discussion on "Race or national origin not stated.") All other-The category "All Other" comprises black, American Indian, Chinese, Japanese, Hawaiian and part-Hawaiian, Filipino, other Asian or Pacific Islander including Asian Indian, and "Other." Aleuts and Eskimos are included in "American Indian." If the race or national origin of an Asian parent is ill-defined or not clearly identifiable with one of the categories used in the classification (for example, if "Oriental" is entered), an attempt is made to determine the specific race from the entry for place of birth. If the birthplace is China, Japan, or the Philippines, the parent's race is assigned to that category. When race cannot be determined from the birthplace, it is assigned to the category "Other Asian or Pacific Islander." Race or national origin not stated-The race of a child is considered not stated in those cases in which information for both parents is missing. Before 1964 all such cases were tabulated as white. From 1964 through 1968 the race of the child was allocated by the computer as follows. If the race on the preceding record were white the assignment was to white; otherwise the assignment was to black. Beginning in 1969 the race of the child has been allocated electronically according to the specific race of the child on the preceding record. Consequently, some of the not-stated frequencies that had previously been assigned to the black category may now be assigned to one of the other race or national origin categories. Nearly all statistics by race or national origin for the United States as a whole in 1962 and 1963 are affected by a lack of information for New Jersey, which did not report parents' race in those years. Birth rates by race for those years are computed on a population base that excludes New Jersey. (For the method of estimating the U.S. population by age, sex, and race excluding New Jersey in 1962 and 1963, see Vital Statistics of the United States, 1963, Volume I, page 4-8). Estimates of births to unmarried mothers by race for the United States, which include special estimates for New Jersey for 1962 and 1963, have been prepared and are shown in table 1-31. Interracial parentage-Because of interracial parentage, the number of births for each racial or national origin group classified according to the child's race by the preceding rules differs from the number of births classified according to the mother's race. For white and black births, the differences are relatively small. In 1985 there were 1.6 percent more white mothers than there were births classified as white and 4.3 percent fewer black mothers than births classified as black. The number of mothers of other racial and national origin groups was considerably lower than the number of births classified according to the child's race: American Indian, 20.2 percent; Chinese, 7.9 percent; Japanese, 17.9 percent; Hawaiian, 31.3 percent; Filipino, 6.6 percent; Other Asian and Pacific Islander, 7.0 percent; and Other, 19.8 percent. 3Age of Mother The birth certificate asks for "Age (at time of this birth)." The age of the mother is edited for upper and lower limits. When mothers are reported to be under 10 years of age or 50 years and over, the age of the mother is considered not stated and is assigned as described below. Age-specific birth rates shown in this report are based on populations of women by age, which are prepared by the U.S. Bureau of the Census. In census years the decennial census counts are used. In intercensal years, estimates of the population of women by age are published by the U.S. Bureau of the Census in Current Population Reports. The 1980 Census of Population derived age in completed years as of April 1, 1980, from the responses to questions on age at last birthday and month and year of birth, with the latter given preference. In the 1960 and the 1970 Census of Population, age was also derived from month and year of birth. "Age in completed years" was asked in censuses before 1960. This was nearly the equivalent of the birth certificate question, which the 1950 test of matched birth and census records confirms by showing a high degree of consistency in the reporting of age in these two sources (National Vital Statistics Division, 1962). Median age of mother-Median age is the value that divides an age distribution into two equal parts, one-half of the values being less and one- half being greater. Median ages of mothers for 1960 to the present have been computed from birth rates for 5-year age groups rather than from birth frequencies. This method eliminates the effects of changes in the age composition of the childbearing population over time. Changes in the median ages from year to year can thus be attributed solely to changes in the age- specific birth rates. Not stated age of mother-Beginning in 1964 birth records with age of mother not stated have been allocated according to the age appearing on the record previously processed for a mother of identical race and having the same total-birth order (total of fetal deaths and live births). In 1963 birth records with age not stated were allocated according to the age appearing on the record previously processed for a mother of identical race and parity (number of live births). For 1960-62, not stated and unknown ages were distributed in proportion to the known ages for each racial group. Before 1960 this was done for age-specific birth rates but not for the birth frequency tables, which showed a separate category for age not stated. 3Age of Father Age of father is coded as stated on the birth certificate. If the age is under 10 years, it is considered not stated and grouped with those cases for which age is not stated on the certificate. Information on father's age is often missing on birth certificates of children born to unwed mothers, greatly inflating the number of "not stated" in all tabulations by age of father. In computing birth rates by age of father, births tabulated as age of father not stated are distributed in the same proportions as births with known age within each 5-year age classification of the mother. This procedure is done separately by race. The resulting distributions are summed to form a composite frequency distribution which is the basis for computing birth rates by age of father. This procedure avoids the distortion in rates that would result if the relationship between age of mother and age of father were disregarded. 3Live-Birth Order and Parity Birth order and parity classifications shown in this volume refer to the total number of live births the mother has had including the 1985 birth. Fetal deaths are excluded. Birth order indicates what number the present birth represents; for example, a baby born to a mother who has had two previous live births (even if one or both are not now living) has a birth order of three. Parity indicates how many live births a mother has had. Before delivery a mother having her first baby has a parity of zero and a mother having her third baby has a parity of two. After delivery the mother of a baby who is a first live birth has a parity of one and the mother of a baby who is a third live birth has a parity of three. Birth order and parity are determined from two items on the birth certificate, "Live births-now living" and "Live births-now dead." Not stated birth order-Before 1969 if both of these items were blank, the birth was considered a first birth. Beginning in 1969, births for which the pregnancy history items were not completed have been tabulated as birth order not stated. As a result of this revised procedure, 22,686 births in 1969 that would have been assigned to the "First birth order" category under the old rules were assigned to the "Not stated" category. All births tabulated in the "Not stated birth order" category are excluded from the computation of percents. In computing birth rates by live- birth order, births tabulated as birth order not stated are distributed in the same proportion as births of known live-birth order. 3Dates of Last Live Birth and Last Fetal Death Date of last live birth and date of last fetal death were added to the U.S. Standard Certificate of Live Birth in 1968 for the purpose of providing information on child spacing and pregnancy intervals. Tabulations of these items were presented for the first time in 1969. In 1978 the item "Date of last fetal death" was reworded to "Date of last other termination" to ensure inclusion of both spontaneous fetal deaths and induced terminations of pregnancy. In 1985 this information was obtained from all States except Texas. Intervals since last live birth and last other termination-These data are computed from the date of birth, date of last live birth, and date of last other termination. The interval since last live birth is the difference between the date of last live birth and the date of present birth; the interval since last other termination is the difference between the date of last other termination and the date of present birth. For an interval to be computed, both the month and year of the last live birth or the last other termination must be valid. These intervals are computed only for events to mothers who have had at least one previous delivery. Births for which the interval since last live birth or last other termination is not stated are excluded from the computation of percents and means. Interval since last pregnancy and outcome of last pregnancy-These data are derived from the computed intervals since the last live birth and the last other termination. Before 1982, the outcome of the last pregnancy was considered not stated if the interval since either the last live birth or the last fetal death was not computed because only the year of the event was recorded. Beginning in 1982, the outcome of the last pregnancy has been derived for such records if the year of the last live birth and the year of the last fetal death were not the same. The effect of this revised procedure is to reduce substantially the number of records with outcome of last pregnancy not stated. In addition, for such records, the interval since the termination of the last pregnancy is determined if both the month and year were reported for the event immediately preceding the current live birth. Before 1982, the interval since the termination of the last pregnancy was considered not stated for such births. Births for which the interval since last pregnancy is not stated are excluded from the computation of percents and means. Zero interval-An interval of zero months since the last live birth or fetal death indicates the second born of a set of twins, the second or third born of a set of triplets, and so forth. Births with an interval of zero months are excluded from the computation of mean intervals. 3Educational Attainment Data on the educational attainment of both parents were collected beginning in 1968 and tabulated for publication in 1969 for the first time. In 1985, data on education were obtained from 47 States and the District of Columbia, as indicated in table A. The educational attainment of either parent is defined as "the number of years of school completed." Only those years completed in "regular" schools, that is, a formal educational system of public schools or the equivalent in accredited private or parochial schools, are counted. Business or trade schools, such as beauty and barber schools, are not considered "regular" schools for the purposes of this item. No attempt has been made to convert years of school completed in foreign school systems, ungraded school systems, and so forth, to equivalent grades in the American school system. Such entries are included in the category "Not stated." Persons who have completed only a partial year in high school or college are tabulated as having completed the highest preceding grade. For those certificates on which a specific degree is stated, years of school completed is coded to the level at which the degree is most commonly attained; for example, persons reporting B.A., A.B., or B.S. degrees are considered to have completed 16 years of school. Education not stated-The category "Not stated" includes all records in reporting areas for which there is not information on years of school completed as well as all records for which the information provided is not Table A. Areas reporting selected items on the live-birth certificate: Each State, 1985 | | Dates of | | | | | last live | | | | Educational | birth and | Number of | Marital | | attainment | last | prenatal | status | | of parents | other | visits |of mother | | |termination | | | | | | | | Alabama | X | X | X | X | Alaska | X | X | X | X | Arizona | X | X | X | X | Arkansas | X | X | X | X | California | | X | | | Colorado | X | X | X | X | Connecticut | X | X | X | | Delaware | X | X | X | X | District of Columbia | X | X | X | X | Florida | X | X | X | X | Georgia | X | X | X | X | Hawaii | X | X | X | X | Idaho | X | X | X | X | Illinois | X | X | X | X | Indiana | X | X | X | X | Iowa | X | X | X | X | Kansas | X | X | X | X | Kentucky | X | X | X | X | Louisiana | X | X | X | X | Maine | X | X | X | X | Maryland | X | X | X | | Massachusetts | X | X | X | X | Michigan | X | X | X | | Minnesota | X | X | X | X | Mississippi | X | X | X | X | Missouri | X | X | X | X | Montana | X | X | X | | Nebraska | X | X | X | X | Nevada | X | X | X | | New Hampshire | X | X | X | X | New Jersey | X | X | X | X | New Mexico | X | X | X | X | New York | X | X | X | | North Carolina | X | X | X | X | North Dakota | X | X | X | X | Ohio | X | X | X | | Oklahoma | X | X | X | X | Oregon | X | X | X | X | Pennsylvania | X | X | X | X | Rhode Island | X | X | X | X | South Carolina | X | X | X | X | South Dakota | X | X | X | X | Tennessee | X | X | X | X | Texas | | | X | | Utah | | X | | | Vermont | X | X | X | X | Virginia | X | X | X | X | Washington | | X | X | X | West Virginia | X | X | X | X | Wisconsin | X | X | X | X | Wyoming | X | X | X | X | 1New York City only. 2Excludes New York City. Table A. Areas reporting selected items on the live-birth certificate: Each State, 1985 | | | | | | | | | | | 1-minute | 5-minute | | | | Apgar | Apgar | Ethnic | Hispanic | | score | score | origin | origin | | | | | | | | | | | Alabama | X | X | | | Alaska | X | X | | | Arizona | X | X | | X | Arkansas | X | X | | X | California | | | | X | Colorado | X | X | X | | Connecticut | X | X | | | Delaware | | | | | District of Columbia | X | X | | X | Florida | X | X | X | | Georgia | X | X | X | | Hawaii | X | X | | X | Idaho | X | X | | | Illinois | X | X | X | | Indiana | X | X | | X | Iowa | X | X | | | Kansas | X | X | X | | Kentucky | X | X | | | Louisiana | X | X | | | Maine | X | X | X | | Maryland | X | X | | | Massachusetts | X | X | | | Michigan | X | X | | | Minnesota | X | X | | | Mississippi | X | X | X | | Missouri | X | X | | | Montana | X | X | | | Nebraska | X | X | X | | Nevada | X | X | X | | New Hampshire | X | X | | | New Jersey | X | X | X | | New Mexico | X | X | | X | New York | X | X | 1X | 2X | North Carolina | X | X | | | North Dakota | X | X | X | | Ohio | X | X | X | | Oklahoma | | | | | Oregon | X | X | | | Pennsylvania | X | X | | | Rhode Island | X | X | | | South Carolina | X | X | | | South Dakota | X | X | | | Tennessee | X | X | X | | Texas | | | | X | Utah | X | X | | X | Vermont | X | X | | | Virginia | X | X | | | Washington | X | X | | | West Virginia | X | X | | | Wisconsin | X | X | | | Wyoming | X | X | X | | 1New York City only. 2Excludes New York City. compatible with coding specifications. Births tabulated as education not stated are excluded from the computations of percents. 3Marital Status Beginning with 1980 data, national estimates of births to unmarried women have been derived from two sources. For 41 States and the District of Columbia, marital status of the mother was reported directly on the birth certificate in 1985 (see table A); for the remaining 9 States that lack this item, marital status was inferred from a comparison of the child's and parents' surnames. This procedure represents a substantial departure from the previous method used to prepare national estimates, which assumed that the incidence of births to unmarried women in States with no direct question on marital status was the same as the incidence in reporting States in the same geographic division. Ratios of births to unmarried women were computed by race for the reporting States in each geographic division, applied to all births in the division, and then summed to obtain national estimates by race. The figures by race were summed to yield the totals for the United States. The new method attempts to use related information on the birth certificate to improve the quality of national data on this topic, as well as to provide data for the individual nonreporting States. Beginning in 1980, a birth in a nonreporting State has been classified as occurring to a married woman if the parents' surnames are the same or if the child's and father's surnames are the same and the mother's current surname cannot be obtained from the informant item of the birth certificate. A birth is classified as occurring to an unmarried woman if the father's name is missing, if the parents' surnames are different, or if the father's and child's surnames are different and the mother's current surname is missing. Because of the substantial increase in all measures of nonmarital childbearing in 1985, an intensive evaluation of the national data was made. There has been continuing concern that the new method, incorporating data based on a comparison of surnames, might overstate the number of births to unmarried women, particularly among women who retained their maiden surname as their legal surname after marriage. The evaluation included comparisons of trends in all measures of births to unmarried mothers between 1980, when the new method was first put into use, and 1985. Trends in States with a marital status item on the birth certificate were compared with trends in those States providing inferential data based on a comparison of surnames. Comparisons were made for white and black births separately and by age of mother. The results were remarkably similar for both data sets. Nonmarital births increased at virtually the same rate in each set of States. The findings were similar for white and black women and for the various age-of-mother groups. No adjustments are made during the data processing for errors in the reporting of marital status on the birth records of the 41 reporting States and the District of Columbia because the extent of this reporting problem is unknown. When marital status is not stated on the birth certificate of a reporting area, the mother is considered married. When out-of-wedlock births are reported as second or higher order births, it is not known whether the mother's previous deliveries occurred out of wedlock, because her marital status at the time of these earlier births is not available from the birth record. Rates for 1940 and 1950 are based on decennial census counts. In this volume, rates for 1955-85 are based on a smoothed series of population estimates (NCHS, 1980). Because of sampling error, the original U.S. Bureau of the Census population estimates fluctuate erratically from year to year; therefore, they have been smoothed so that the rates do not show similar variations. The rates shown in this volume differ from those published in issues of Vital Statistics of the United States before 1969, which were based on the original estimates provided annually by the U. S. Bureau of the Census. Birth rates by marital status for 1971-79 have been revised and differ from rates published before 1980 in issues of Vital Statistics of the United States (see "Computation of Rates and Other Measures"). 3Place of Delivery and Attendant at Birth Births occurring in hospitals, institutions, clinics, centers, or homes are included in the category "In hospital." In this context the word "homes" does not refer to the mother's residence but to an institution such as a home for unwed mothers. Beginning in 1975, the attendant at birth and place of delivery items have been coded independently, primarily to permit the identification of the person in attendance at hospital deliveries. Tables 1- 37 and 1-38 of this report present this more detailed information for the years 1975-85. Data shown in this volume for the "In hospital" category for the years 1975-85 include all births in clinics or maternity centers, regardless of the attendant. Data for 1975-77 published before 1980 included clinic and center births in the category "In hospital" only when the attendant was a physician. Data shown for 1975-77 in tables 1-37 and 1-38 therefore differ from data published before 1980. As a result of this change, for 1975 an additional 12,352 births are now classified as occurring in hospitals, raising the percent of births occurring in hospitals from 98.7 to 99.1. Similarly, for 1976 the number of births occurring in hospitals is increased by 14,133 and the percent in hospital raised from 98.6 to 99.1; for 1977, the increase is 15,937 and the percent in hospitals raised from 98.5 to 99.0. For 1974 and earlier, the "In hospital" category includes all births in hospitals or institutions and births in clinics, centers, or maternity homes only when attended by physicians. For births occurring outside of hospitals, separate classifications are shown for physicians, midwives, and "Other" attendants. The "Out-of-hospital" category also includes births for which no information is reported on place of birth. Before 1975, the category "In hospital" included births for which the stated place of birth was a "doctor's office" and delivery was by a physician. Beginning in 1975, births that were delivered by physician in a "doctor's office" have been tabulated as "Not in hospital" and included with births delivered by physicians in this category. Although the actual number of such births is unknown, the effect of the change is minimal. In 1974, 0.3 percent of all births were delivered by physicians outside of hospitals; in 1975 this proportion was 0.4 percent. Babies born on the way to or on arrival at the hospital are classified as having been born in the hospital. This may account for some of the hospital births not delivered by physicians or midwives. The percent distributions by attendant at birth for 1975-81 shown in table 1-38 have been revised to exclude births for which the attendant was unspecified. In recent years, the number of births with unspecified attendant has fluctuated substantially. Excluding these births from the percent distributions allows for a more meaningful year-to-year comparison in the proportion of births for each specified attendant. 3Birth Weight Birth weight is reported in some areas in pounds and ounces rather than in grams. However, the metric system has been used in tabulating and presenting the statistics to facilitate comparison with data published by other groups. The categories for birth weight were changed in 1979 to be consistent with the recommendations in the Ninth Revision of the International Classification of Diseases (ICD-9). The revised categories in gram intervals and their equivalents in pounds and ounces are as follows: Less than 500 grams = 1 lb 1 oz or less 500 - 999 grams = 1 lb 2 oz- 2 lb 3 oz 1,000 - 1,499 grams = 2 lb 4 oz- 3 lb 4 oz 1,500 - 1,999 grams = 3 lb 5 oz- 4 lb 6 oz 2,000 - 2,499 grams = 4 lb 7 oz- 5 lb 8 oz 2,500 - 2,999 grams = 5 lb 9 oz- 6 lb 9 oz 3,000 - 3,499 grams = 6 lb 10 oz- 7 lb 11 oz 3,500 - 3,999 grams = 7 lb 12 oz- 8 lb 13 oz 4,000 - 4,499 grams = 8 lb 14 oz- 9 lb 14 oz 4,500 - 4,999 grams = 9 lb 15 oz-11 lb 0 oz 5,000 grams or more =11 lb 1 oz or more The ICD-9 defines low birth weight as less than 2,500 grams. This is a shift of 1 gram from the previous criterion of 2,500 grams or less, which was recommended by the American Academy of Pediatrics in 1935 and adopted by the World Health Organization in the Sixth Revision of the International Lists of Diseases and Causes of Death (1948). After data classified by pounds and ounces are converted to grams, median wights are computed and rounded before publication. To establish the continuity of class intervals needed to convert pounds and ounces to grams, the end points of these intervals are assumed to be half an ounce less at the lower end and half an ounce more at the upper end. For example, 2 lb 4 oz - 3 lb 4 oz is interpreted as 2 lb 3 1/2 oz - 3 lb 4 1/2 oz. Births for which birth weight is not reported are excluded from the computation of percents and medians. 3Period of Gestation The period of gestation is defined as beginning with the first day of the last normal menstrual period (LMP) and ending with the day of the birth. The LMP is used as the initial date as it can be more accurately determined than the date of conception, which usually occurs 2 weeks after the LMP. Births occurring before 37 weeks of gestation are considered to be "preterm" or "premature" for purposes of classification. At 37-41 weeks gestation, births are considered to be "term," and at 42 weeks and over, "post term." These distinctions are according to the ICD-9 definitions. Before 1981, the period of gestation was computed only when there was a valid month, day, and year of LMP. However, length of gestation could not be determined from a substantial number of live birth certificates each year because the day of LMP was missing. Beginning in 1981 weeks of gestation have been imputed for records with missing day of LMP when there is a valid month and year. Each such record is assigned the gestational period in weeks of the preceding record that has a complete LMP date with the same computed months of gestation and the same 500-gram birth weight interval. The effect of the imputation procedure is to increase slightly the proportion of premature births and to lower the proportion of births at 39, 40, 41, and 42 weeks of gestation. A more complete discussion of this procedure and its implications is presented in a previous report (NCHS, 1982). The calculated period of gestation in completed weeks is edited for upper and lower limits. If the interval between date of last normal menstrual period and date of birth is 16 weeks or less, or 53 weeks or more, the period of gestation is considered not stated. Because of post-conception bleeding or menstrual irregularities, the presumed date of LMP may be in error. In these instances the computed gestational period may be longer or shorter than the true gestational period, but the extent of such errors is unknown. 3Month of Pregnancy Prenatal Care Began For those records in which the name of the month is entered for this item, instead of first, second, third, and so forth, the month of pregnancy in which prenatal care began is determined from the month named and the month last normal menses began. For these births, if the item "Date last normal menses began" is not on the certificate or is not stated, the month of pregnancy in which prenatal care began is tabulated as not stated. 3Number of Prenatal Visits Tabulations of the number of prenatal visits were presented for the first time in 1972. In 1985 these data were collected from the birth certificates of all States except California. 3Apgar Score One- and 5-minute Apgar scores were added to the U.S. Standard Certificate of Live Birth in 1978 to evaluate the condition of the newborn infant at 1 and 5 minutes after birth. The Apgar score is a useful measure of the need for resuscitation and a predictor of the infant's chances of surviving the first year of life. It is a summary measure of the infant's condition based on heart rate, respiratory effort, muscle tone, reflex irritability, and color. Each of these factors is given a score of 0, 1, or 2; the sum of these 5 values is the Apgar score, which ranges from 1 to 10. A score of 10 is optimum, and a low score raises some doubts about the survival and subsequent health of the infant. In 1985 the 1- and 5-minute Apgar scores were included on the birth certificates of 46 States and the District of Columbia. See table A for a listing of reporting areas. 3Hispanic Parentage Concurrent with the 1978 revision of the U.S. Standard Certificate of Live Birth, NCHS recommended that States add items to identify the Hispanic or ethnic origin of the newborn's parents. Two formats were used: An open-ended item to obtain the specific origin or descent of each parent, for example, Italian, Mexican, or English; and an item directed toward the Hispanic population, requesting only the specific Hispanic origin (Mexican, Puerto Rican, Cuban, and so forth). In 1985 items requesting Hispanic or ethnic origin were included on the birth certificates of 23 States (see table A). 2Quality of Data 3General Information Although vital statistics data are useful for a variety of administrative and scientific purposes, they cannot be correctly interpreted unless various qualifying factors and methods of classification are taken into account. The factors to be considered depend on the specific purposes for which the data are to be used. It is not feasible to discuss all the pertinent factors in the use of vital statistics tabulations, but some of the more important ones should be mentioned. Most of the factors limiting the use of data arise from imperfections in the original records or from the impracticability of tabulating these data in very detailed categories. These limitations should not be ignored, but their existence does not vitiate the value of the data for most general purposes. 3Completeness of Registration An estimated 99.3 percent of all births occurring in the United States in 1985 were registered; for white births registration was 99.4 percent complete and for all other births, 98.6 percent complete. These estimates are based on the results of the 1964-68 test of birth-registration completeness according to place of delivery (in or out of hospital) and race and on the 1985 proportions of births in these categories. The primary purpose of the test was to obtain current measures of registration completeness for births in and out of hospital by race on a national basis. Data for States were not available as they had been from the previous birth-registration tests in 1940 and 1950. A detailed discussion of the method and results of the 1964-68 birth-registration test is available (U.S. Bureau of the Census, 1973). The 1964-68 test has provided an opportunity to revise the estimates of birth-registration completeness for the years since the previous test in 1950 to reflect the improvement in registration. This has been done using registration completeness figures from the two tests by place of delivery and race. Estimates of registration completeness for four groups (based on place of delivery and race) for 1951-65 were computed by interpolation between the test results. (It was assumed that the data from the more recent test are for 1966, the midpoint of the test period). The results of the 1964-68 test are assumed to prevail for 1966 and later years. These estimates were used with the proportions of births registered in these categories to obtain revised numbers of births adjusted for underregistration for each year. The overall percent of birth-registration completeness by race was then computed. The figures for 1951-68 shown in table 1-21 differ slightly from those shown in annual reports for years prior to 1969. Data adjusted for underregistration for 1951-59 shown in tables 1-1, 1-3, 1-4, 1-6, and 1-8 have been revised to be consistent with the 1964-68 test results and differ slightly from data shown in annual reports for years before 1969. For these years the published number of births and birth rates for both racial groups have been revised slightly downward because the 1964-68 test indicated that previous adjustments to registered births were slightly inflated. Because registration completeness figures by age of mother and by live-birth order are not available from the 1964-68 test, it must be assumed that the relationships among these variables have not changed since 1950. Discontinuation of adjustment for underregistration, 1960-Adjustment for underregistration of births was discontinued in 1960, when birth registration for the United States was estimated to be 99.1 percent complete. This removed a bias introduced into age-specific rates when adjusted births classified by age were used. Age-specific rates are calculated by dividing the number of births to an age group of mothers by the population of women tin that age group. Tests have shown that population figures are likely to be understated through census undercounts; these errors compensate for underenumeration, biasing the age-specific rates more than when uncorrected birth and population data are used. (For further details see Vital Statistics of the United States, 1963, Volume I, page 4-11). The age-specific rates used in the cohort fertility tables (tables 1-12 through 1-19) are an exception to the above statement. These rates are computed from births corrected for underregistration and population estimates adjusted for underenumeration and misstatement of age. Adjusted births and population estimates are used for the cohort rates because they are an integral part of a series of rates estimated with a consistent methodology. It was considered desirable to maintain consistency with respect to the cohort rates, even though it means that they will not be precisely comparable with other rates shown for 5-year age groups. 3Quality Control Procedures States in the Vital Statistics Cooperative Program are required to have an error rate of less than 2.0 percent for each item for 3 consecutive data months during the initial qualifying period. Once a State is qualified, NCHS monitors the quality of data received through independent verification of a sample of records to ensure that the item error rate is not more than approximately 4 percent. In addition, there is verification at the State level before NCHS is sent the data. After completion of coding, counts of the taped records are balanced against control totals for each shipment of records from a registration area. Impossible codes are eliminated during the editing processes on the computer and corrected on the basis of reference to the source record or adjusted by arbitrary code assignment. All subsequent operations involved in tabulation and table preparation are verified during the computer processing or by statistical clerks. 3Small Frequencies The numbers of births reported for an area represent complete counts. As such, they are not subject to sampling error, although they are subject to errors in the registration process. However, when the figures are used for analytical purposes, such as the comparison of rates over a time period or for different areas, the number of events that actually occurred may be considered as one of a large series of possible results that could have arisen under the same circumstances. The probable range of values may be estimated from the actual figures according to certain statistical assumptions. In general, distributions of vital events may be assumed to follow the binomial distribution. Estimates of standard errors and tests of significance under this assumption are described in most standard statistics texts. When the number of events is large, the standard error, expressed as a percent of the number or rate, is usually small. When the number of events is small (perhaps less than 100) and the probability of such an event is small, considerable caution must be observed in interpreting the conditions described by the figures. Events of rare nature may be assumed to follow a Poison probability distribution. For this distribution, a simple approximation may be used to estimate the error as follows: If N is the number of births and R is the corresponding rate, the chances are 19 in 20 that 1. The "true" number of events lies between N - 2 N and N + 2 N 2. The "true" rate lies between R R R - 2 --- and R + 2 --- N N If the rate R corresponding to N events is compared with the rate S corresponding to M events, the difference between the two rates may be regarded as statistically significant if it exceeds 2 R2 + S2 N M For example, suppose that the observed birth rate for area A was 15.0 per 1,000 population and that this rate was based on 50 recorded births. Given prevailing conditions, the chances are 19 in 20 that the "true" or underlying birth rate for that area lies between 10.8 and 19.2 per 1,000 population. Let it be further supposed that the birth rate for area A of 15.0 per 1,000 population is being compared with a rate of 20.0 per 1,000 population for area B, which is based on 40 recorded births. Although the difference between the rates for the two areas is 5.0, this difference is less than twice the standard error of the difference 2 (15.0)2 + (20.0)2 50 40 of the two rates that is computed to be 7.6. From this, it is concluded that the difference between the rates for the two areas is not statistically significant. 2Computation of Rates and Other Measures 3Population Bases The rates shown in this report were computed on the basis of population statistics prepared by the U.S. Bureau of the Census. Rates for 1940, 1950, 1960, 1970, and 1980 are based on the population enumerated as of April 1 in the censuses of those years. Rates for all other years are based on the estimated midyear (July 1) population for the respective years. Birth rates for the United States, individual States, and SMSA's are based on the total resident populations of the respective areas. Except as noted these populations exclude the Armed Forces abroad but include the Armed Forces stationed in each area. The resident population of the birth-and death-registration States for 1900-1932 and for the United States for 1900-1985 is shown in table 4-1. In addition, the population including Armed Forces abroad is shown for the United States. Table B shows the sources for these populations. Population estimates for 1981-85-The population of the United States by age, race and sex for 1985 is shown in table 4-2. The population for each State is shown in table 4-3 and the monthly population figures were published in Current Population Reports, Series P-25, Number 1000. Comparable data for 1981, 1982, 1983, and 1984 were shown in tables 4-2 and 4-3 of Vital Table B. Sources for resident population and population including Armed Forces abroad: Birth- and death- registration States, 1900-1932, and United States, 1900-1985 Year Source 1985-----------------U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 1000, Feb. 1987. 1984-----------------U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 985, Apr. 1986. 1983-----------------U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 965, Mar. 1985. 1982-----------------U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 949, May 1984 1981-----------------U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 929, May 1983 1980-----------------U.S. Bureau of the Census, U.S. Census of Population: 1980, Number of Inhabitants, PC80-1-A1, United States Summary, 1983. 1971-79--------------U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 917, July 1982. 1970-----------------U.S. Bureau of the Census, U.S. Census of Population: 1970, Number of Inhabitants, Final Report PC(1)-A1. United States Summary, 1971. 1961-69--------------U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 519, April 1974 1960-----------------U.S. Bureau of the Census, U.S. Census of Population: 1960, Number of Inhabitants, PC80-1-A1, United States Summary, 1964. 1951-59--------------U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 310, June 30, 1965. 1940-50--------------U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 499, May 1973. 1930-39--------------U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 499, May 1973, and National Office of Vital Statistics, Vital Statistics Rates in the United State, 1900-1940, 1947. 1920-29--------------National Office of Vital Statistic, Vital Statistics Rates in the United States, 1900-1940, 1947. 1917-19--------------Same as for 1930-39 1900-1916------------Same as for 1920-29 Statistics of the United States, Volume I, for those years and in Current Population Reports, Series P-25, Numbers 931, 949, 961, and 980. Population data by race are consistent with the modified 1980 populations by race. Populations for 1980-The population of the United States by age, race, and sex, and the population for each State are shown in tables 4-2 and 4-3 of Vital Statistics of the United States, 1980, Volume I. The figures by race have been modified as described below. Monthly population figures were published in Current Population Reports, Series P-25, Number 899. The racial counts in the 1980 census are affected by changes in racial reporting practices, particularly by the Hispanic population, and in coding and classifying racial groups in the 1980 census. One particular change has created a major inconsistency between the 1980 census data and historical data series, including censuses and vital statistics. About 40 percent of the Hispanic population counted in 1980, over 5.8 million persons, did not mark one of the specified races listed on the census questionnaire but instead marked the "Other" category. In the 1980 census, coding procedures were modified for persons who marked "Other" race and wrote in a national origin designation of a Latin American country or a specific Hispanic origin group in response to the racial question. These persons remained in the "Other" racial category in 1980 census data, in previous censuses and in vital statistics such responses were almost always coded into the "White" category. In order to maintain comparability, the "Other" racial category in the 1980 census was reallocated to be consistent with previous procedures. Persons who marked the "Other" racial category and reported any Spanish origin on the Spanish origin question (5,840,648 persons) were distributed to white and black races in proportion to the distribution of persons of Hispanic origin who reported their race to be white or black. This was done for each age-sex group. As a result of this procedure, 5,705,155 persons were added to the white population and 135,493 persons to the black population. Persons who marked the "Other" racial category and reported that they were not of Spanish origin (916,338 persons) were distributed as follows: 20 percent in each age-sex group were added to the "Asian and Pacific Islander" category (183,268 persons), and 80 percent were added to the "White" category (733,070 persons). The count of American Indians, Eskimos, and Aleuts was not affected by these procedures. Unpublished tabulations of these modified census counts were obtained from the U.S. Bureau of the Census and used to compute the 1980 rates for this report, except for tables 1-12 through 1-19. Population estimates for 1971-79-Birth rates for 1971-79 (except those for cohorts of women in tables 1-12 through 1-19) have been revised, based on revised population estimates that are consistent with the 1980 census levels. The 1980 census counted approximately 5.5 million more persons than had earlier been estimated for April 1, 1980 (U.S. Bureau of the Census, 1982). The revised estimates for the United States by age, race, and sex were published by the U.S. Bureau of the Census in Current Population Reports, Series P-25, Number 917. Population estimates by month are based on data published in Current Population Reports, Series P-25, Number 899. Unpublished revised estimates for States were obtained from the U.S. Bureau of the Census. Population estimates for 1961-69-Birth rates in this volume for 1961-69 (except for those shown in tables 1-4 and 1-5) are based on revised estimates of the population and thus may differ slightly from rates published before 1976. The revised estimates used in computing these rates were published in Current Population Reports, Series P-25, Number 519. The rates shown in tables 1-4 and 1-5 for 1961-64 are based on revised estimates of the population published in Current Population Reports, Series P-25, Numbers 321 and 324 and may differ slightly from rates published in those years. Population estimates for 1951-59-Final intercensal estimates of the population by age, race, and sex and total population by State for 1951-59 are shown in tables 4-4 and 4-5 of Vital Statistics of the United States, 1966, Volume I. Beginning with 1963 these final estimates have been used to compute birth rates for 1951-59 in all issues of Vital Statistics of the United States. 3Net Census Undercounts and Overcounts The U.S. Bureau of the Census has conducted extensive research to evaluate the coverage of the U.S. population (including undercount and overcount and misstatement of age, race, and sex) in the last four decennial censuses-1950, 1960, 1970, and 1980. These studies provide estimates of the national population that was not enumerated or overenumerated in the respective censuses, by age, race, and sex (U.S. Bureau of the Census, 1974, 1977, and 1986). The report for 1980 (U.S. Bureau of the Census, 1986) includes estimates of net underenumeration and overenumeration for age, sex, and racial subgroups of the national population, modified for race consistency with previous population counts as described in the section "Populations for 1980." These studies indicate that there is differential coverage in the censuses among the population subgroups; that is, some age, race, and sex groups are more completely enumerated than others. To the extent that these estimates of overcounts or undercounts are valid, that they are substantial, and that they vary among subgroups and geographic areas, census miscounts can have consequences for vital statistics measures (U.S. Bureau of the Census, 1974). However, the effects of undercounts in the census are reduced to the extent that there is underregistration of births. If these two factors are of equal magnitude, rates based on the unadjusted populations are more accurate than those based on adjusted populations because the births have not been adjusted for underregistration. The impact of net census miscounts on vital statistics measures includes the effects on levels of the rates and effects on differentials among groups. If adjustments were made for persons who were not counted in the census of population, the size of the denominators would generally increase and the rates would be smaller than without an adjustment. Adjusted rates for 1980 can be computed by multiplying the reported rates by ratios of the 1980 census-level population adjusted for the estimated net census miscounts, which are shown in table C. A ratio of less than 1.0 indicates a net census undercount and would result in a corresponding decrease in the rate. A ratio in excess of 1.0 indicates a net census overcount and would result in a corresponding increase in the rate. Enumeration of white females in the childbearing ages was at least 99 percent complete for all ages. Among women of races other than white, the undercount ranges up to 4 percent. Generally, females in the childbearing ages were more completely enumerated than males for similar race-age groups. If vital statistics measures were calculated with adjustments for net census miscounts for each of these subgroups the resulting rates would have been differentially changed from their original levels; that is, rates for those groups with the greatest estimated overcounts or undercounts would show the greatest relative changes due to these adjustments. Thus the racial differential in fertility between the white and the all other population can be affected by such adjustments. 3Cohort Fertility Tables The various fertility measures shown for cohorts of women in tables 1-12 through 1-19 are computed from births adjusted for underregistration and population estimates corrected for underenumeration and misstatement of age. The data shown in this volume are not consistent with data published in annual reports before 1974. These data use revised population estimates prepared by the U.S. Bureau of the Census and have been expanded to include data for the two major racial groups. Heuser (NCHS, 1976) has prepared a detailed description of the methods used in deriving these measures as well as more detailed data for earlier years. 3Age-Sex-Adjusted Birth Rates The age-sex-adjusted birth rates shown in table 1-3 are computed by the direct method. The age distribution of women aged 10-49 years as enumerated in 1940 and the total population of the United States for that year are used as the standard populations. The birth rates by age of mother and race that are used to compute these adjusted rates are shown in table 1-6. The age-sex- adjusted birth rates show differences in the level of fertility independent of differences in the age and sex composition of the population. It is important not to confuse these adjusted rates with the crude rates shown in other tables. 3Total Fertility Rate The total fertility rate is the sum of the birth rates by age of mother (in 5-year age groups) multiplied by 5. It is an age-adjusted rate because it is based on the assumption that there are the same number of women in each age group. In table 1-6 the rate of 1,843 in 1985, for example, means that if a hypothetical group of 1,000 women were to have the same birth rates in each age group that were observed in the actual childbearing population in 1985, they would have a total of 1,843 children by the time they reached the end of the reproductive period (taken here as age 50), assuming that all of the women survived to that age. 3Intrinsic Vital Rates The intrinsic vital rates shown in table 1-5 are calculated from a stable population. A stable population is that hypothetical population, closed to external migration, which would become fixed in age-sex structure after repeated applications of a constant set of age-sex specific birth and death rates. For the mathematical derivation of intrinsic vital rates, see Vital Statistics of the United States, 1962, Volume I, pages 4-13 and 4-14. The technique of calculating intrinsic vital rates is described by Barclay (1958, pp. 216-222). 3Parity Distribution The percent distribution of women by parity (number of children ever born alive to mother) shown in tables 1-13 and 1-17 is derived from cumulative birth rates by order of birth, which are shown in tables 1-15 and 1-19. The percent of zero-parity women is found by subtracting the cumulative first birth rate from 1,000 and dividing by 10. The proportions of women at parities one through six are found from the following formula: Percent at N parity = (cum. rate, order N) - (cum. rate, order N + 1) 10 The percent of women at seventh and higher parities is found by dividing the cumulative rate for seventh-order births by 10. 3Seasonal Adjustment of Rates The seasonally adjusted birth and fertility rates shown in table 1-23 are computed from the X-11 variant of Census Method II (U.S. Bureau of the Census, 1965). This method of seasonal adjustment used since 1964 differs slightly from the U.S. Bureau of Labor Statistics Seasonal Factor Method, which was used for Vital Statistics of the United States, 1964. The fundamental technique is the same in that it is an adaptation of the ratio-to-moving- average method. Before 1964 the method of seasonal adjustment was based on the X-9 variant and other variants of Census Method II. A comparison of the Census Method II with the BLS Seasonal Factor Method shows the differences in the seasonal patterns of births to be negligible. 3Computation of Percents, Medians, and Means Percent distributions, medians, and means are computed using only events for which the characteristic is reported. The "Not stated" category is subtracted from the total before computation of these measures. 2Symbols Used in Tables Data not available _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Category not applicable_ _ _ _ _ _ _ _ _ _ _ _ _ . . . Quantity zero_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Quantity more than zero but less than 0.05 _ _ _ 0.0 Figure does not meet standards of reliability or precision _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ * 2References Barclay, G. W. 1958. Techniques of Population Analysis. New York: John Wiley & Sons, Inc. National Center for Health Statistics, R. Heuser, 1976, Fertility Tables for Birth Cohorts by Color: United States, 1917-73. DHEW Pub. No. (HRA) 76- 1152. Health Resources Administration. Washington: U.S. Government Printing Office. National Center for Health Statistics, S. J. Ventura, 1980. Trends and differentials in births to unmarried women, United States, 1970-76. Vital and Health Statistics. Series 21, No. 36. DHHS Pub. No. (PHS) 80-1914. Public Health Service. Washington: U.S. Government Printing Office. National Center for Health Statistics, S. Taffel, D. Johnson, and R. Heuser, 1982. A method of imputing length of gestation on birth certificates. Vital and Health Statistics. Series 2, No. 93. DHHS Pub. No. (PHS) 82-1367. Public Health Service. Washington: U.S. Government Printing Office. National Office of Vital Statistics. 1950. International Recommendations on Definitions of Live Birth and Fetal Deaths. PHS Pub. No. 39. Public Health Service. Washington: U.S. Government Printing Office. National Office of Vital Statistics. 1954. Births and birth rates in the entire United States, 1909 to 1948. Vital Statistics-Special Reports, Vol. 33. No. 8, 1950. Public Health Service. Washington: U.S. Government Printing Office. National Vital Statistics Division, J. Schachter, 1962. Matched record comparison of birth certificate and census information in the United States, 1950. Vital Statistics-Special Reports. Vol. 47, No. 12. Public Health Service. Washington, D.C. Statistical Office of the United Nations, 1953. Principles for a Vital Statistics System: Recommendations for the Improvement and Standardization of Vital Statistics. Doc. ST/STAT/SERM/19. New York: United Nations. U.S. Bureau of the Census, 1967. The X-11 Variant of the Census Method II Seasonal Adjustment Program. Technical Paper No. 15, 1967 revision. Washington: U.S. Government Printing Office. U.S. Bureau of the Census, 1973. Test of Birth-registration completeness, 1964 to 1968. 1970 Census of Population and Housing. Evaluation and Research Program. PHC(E)-2. Washington: U.S. Government Printing Office. U.S. Bureau of the Census, 1974. Estimates of coverage of the population by sex, race, and age-demographic analysis. 1970 Census of Population and Housing. Evaluation and Research Program. PHC(E)-4. Washington: U.S. Government Printing Office. U.S. Bureau of the Census, 1977. Developmental estimates of the coverage of the population of States in the 1970 census-demographic analysis. Current Population Reports. Series P-23, No. 65. Washington: U.S. Government Printing Office. U.S. Bureau of the Census, 1982. Coverage of the national population in the 1980 census by age, sex, and race. Preliminary estimates by demographic analysis. Current Population Reports. Series P-23, No. 115. Washington: U.S. Government Printing Office. U.S. Bureau of the Census, 1986. Estimates of the population of the United States, by age, sex, and race: 1980 to 1985. Current Population Reports. Series P-25, No. 985. Washington: U.S. Government Printing Office. U.S. Office of Management and Budget, 1975. Standard Metropolitan Statistical Areas, rev. ed. Washington: U.S. Government Printing Office. U.S. Office of Management and Budget, 1981a. Standard metropolitan statistical areas and standard consolidated areas. Statistical Reporter. pp. 1-20. Washington: U.S. Government Printing Office. U.S. Office of Management and Budget, 1981b. 36 new standard metropolitan statistical areas. Statistical Reporter. Washington: U.S. Government Printing Office. World Health Organization, 1950. Official Records, No. 28 (WHA 3.6), Third World Health Assembly. Geneva: World Health Organization. 1TECHNICAL APPENDIX (DEATH AND FETAL DEATH) 2Sources of Data 3Death 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. 1971 1977 Florida Alaska Idaho 1972 Massachusetts New York City Maine Ohio Missouri Puerto Rico New Hampshire Rhode Island 1978 Vermont Indiana 1973 Utah Washington Colorado Michigan 1979 New York (except New York City) Connecticut Hawaii 1974 Mississippi New Jersey Illinois Pennsylvania Iowa Wyoming Kansas Montana 1980 Nebraska Oregon Arkansas South Carolina New Mexico South Dakota 1975 1982 Louisiana Maryland North Dakota North Carolina Oklahoma 1985 Tennessee Virginia Arizona Wisconsin California Delaware 1976 Georgia District of Alabama Columbia Kentucky Minnesota Nevada Texas West Virginia 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 Iowa Maine Michigan 1983 1975 Minnesota Louisiana Nebraska 1984 North Carolina Virginia Maryland Wisconsin New York State (except New York City) 1980 Vermont Colorado 1986 Kansas Massachusetts California Mississippi Florida New Hampshire Texas Pennsylvania South Carolina 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. 2Standard 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. 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 U.S. Standard Certificate of Death and the U.S. Standard Report of Fetal Death are shown in figures 7-A and 7-B. The certificate of death shown in figure 7-A 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. 2History The first death statistics published by the Federal Government concerned events in 1850 and were based on statistics collected during the decennial census of that year. In 1880 a national "registration area" was created for deaths. Originally consisting of two States (Massachusetts and New Jersey), the District of Columbia, and several large cities having efficient systems for death registrations, the death-registration area continued to expand until 1933, when it included the entire United States for the first time. Tables that show data for death-registration States include the District of Columbia for all years; registration cities in nonregistration States are not included. For more details on the history of the death-registration area, see the Technical Appendix in Vital Statistics of the United States, 1979, Volume II, Mortality, Part A, Section 7, pages 3-4, and the section "History and Organization of the Vital Statistics System," chapter 1, Vital Statistics of the United States, 1950, Volume I, pages 2-19. Statistics on fetal deaths were first published for the birth-registration area in 1918, and then every year beginning with 1922. 2Classification of Data 3General Information The principal value of vital statistics data is realized through the presentation of rates, which are computed by relating the vital events of a class to the population of a similarly defined class. Vital statistics and population statistics must therefore be classified according to similarly defined systems and tabulated in comparable groups. Even when the variables common to both, such as geographic area, age, sex, and race, have been similarly classified and tabulated, differences between the enumeration method of obtaining population data and the registration method of obtaining vital statistics data may result in significant discrepancies. The general rules used in the classification of geographic and personal items for deaths and fetal deaths for 1986 are set forth in two instruction manuals (NCHS, 1986a, 1986b). A discussion of the classification of certain important items is presented below. 2Classification by Occurrence and Residence Tabulations for the United States and specific geographic areas in this volume are by place of residence unless stated as by place of occurrence. Before 1970, resident mortality statistics for the United States included all deaths occurring in the United States, with deaths of "nonresidents of the United States" assigned to place of death. "Deaths of nonresidents of the United States" refers to deaths that occur in the United States of nonresident aliens, nationals residing abroad, and residents of Puerto Rico, the Virgin Islands, Guam, and other territories of the United States. Beginning with 1970, deaths of nonresidents of the United States are not included in tables by place of residence. Tables by place of occurrence, on the other hand, include deaths of both residents and nonresidents of the United States. Consequently, for each year beginning with 1970, the total number of deaths in the United States by place of occurrence was somewhat greater than the total by place of residence. For 1986 this difference amounted to 3,023 deaths. Mortality statistics by place of occurrence are shown in tables 1-10, 1-18, 1-19, 1-28, 1-29, 3-1, 3-8, 8-1, and 8-7. Before 1970, except for 1964 and 1965, deaths of nonresidents of the United States occurring in the United States were treated as deaths of residents of the exact place of occurrence, which in most instances was an urban area. In 1964 and 1965, deaths of nonresidents of the United States occurring in the United States were allocated as deaths of residents of the balance of the county in which they occurred. Residence error-Results of a 1960 study showed that the classification of residence information on the death certificates corresponded closely to the residence classification of the census records for the decedents whose records were matched (NCHS, 1969). A comparison of the results of this study of deaths with those of a previous matched record study of births (National Vital Statistics Division, 1962) showed that the quality of residence data had considerably improved between 1950 and 1960. Both studies found that events in urban areas were overstated by the NCHS classification in comparison with the U.S. Bureau of the Census classification. The magnitude of the difference was substantially less for deaths in 1960 than it was for births in 1950. The improvement is attributed to an item added in 1956 to the U.S. Standard Certificates of Birth and of Death, asking if residence was inside or outside city limits. This new item aided in properly allocating the residence of persons living near cities but outside the corporate limits. 3Geographic Classification The rules followed in the classification of geographic areas for deaths and fetal deaths are contained in the two instruction manuals referred to previously (NCHS, 1986a, 1986b). The geographic codes assigned by the National Center for Health Statistics during data reduction of source information on birth, death, and fetal-death records are given in another instruction manual (NCHS, 1985). Beginning with 1982 data, the geographic codes were modified to reflect results of the 1980 census. For 1970-81, codes area based on results of the 1970 census. Standard metropolitan statistical areas-The standard metropolitan statistical areas (SMSA's) used in this volume are those established by the U.S. Office of Management and Budget (1981a, pp. 1-20) from final 1980 census population counts and used by the U.S. Bureau of the Census, except in the New England States. Except in the New England States, an SMSA is a county or a group of contiguous counties containing a city of 50,000 inhabitants or more or an urbanized area of 50,000 with a total metropolitan population of at least 100,000. In addition to the county or counties containing such a city or urbanized area, contiguous counties are included in an SMSA if, according to specified criteria, they are essentially metropolitan in character and are socially and economically integrated with the central city or urbanized area (U.S. Office of Management and Budget, 1981b, p. 420). In the New England States the U.S. Office of Management and Budget uses towns and cities rather than counties as geographic components of SMSA's. The National Center for Health Statistics cannot, however, use the SMSA classification for these States because its data are not coded to identify all towns. Instead, NCHS uses New England County Metropolitan Areas (NECMA's). Made up of county units, these areas are established by the U.S. Office of Management and Budget (1975, pp. 89-90; 1981b, p. 420). Metropolitan and nonmetropolitan counties-Independent cities and counties included in SMSA's or in NECMA's are included in data for metropolitan counties, all other counties are classified as nonmetropolitan. Population-size groups-Vital statistics data for cities and certain other urban places in 1986 are classified according to the population enumerated in the 1980 Census of Population. Data are available for individual cities and other urban places of 10,000 or more population. Data for the remaining areas not separately identified are shown in the tables under the heading "balance of area" or "balance of county." For the years 1970-81, classification of areas was determined by the population enumerated in the 1970 Census of Population. Beginning with 1982 data, as a result of changes in the enumerated population between 1970 and 1980, some urban places identified in previous reports are no longer included, and a number of other urban places have been added. Urban places other than incorporated cities for which vital statistics data are shown in this volume included the following: Each town in New England, New York, and Wisconsin and each township in Michigan, New Jersey, and Pennsylvania that had no incorporated municipality as a subdivision and had either 25,000 inhabitants or more or a population of 10,000 to 25,000 and a density of 1,000 persons or more per square mile. Each county in States other than those indicated above that had no incorporated municipality within its boundary and had a density of 1,000 persons or more per square mile. (Arlington County, Virginia is the only county classified as urban under this rule.) Each place in Hawaii with 10,000 or more population, as there are no incorporated cities in the State. Before 1964, places were classified as "urban" or "rural." The Technical Appendixes for earlier years discuss the previous classification system. 3State or Country of Birth Mortality statistics by State or country of birth (table 1-32) became available beginning with 1979. State or country of birth of a decedent is assigned to 1 of the 50 States or the District of Columbia; or to Puerto Rico, the Virgin Islands, or Guam-if specified on the death certificate. The place of birth is also tabulated for Canada, Cuba, Mexico, and for the Remainder of the World. Deaths for which information on State or country of birth was unknown, not stated, or not classifiable accounted for a small proportion of all deaths in 1986, about 0.5 percent. Early mortality reports published by the U.S. Bureau of the Census contained tables showing nativity of parents as well as nativity of decedent. Publication of these tables was discontinued in 1933. Mortality data showing nativity of decedent were again published in annual reports for 1939-41 and for 1950. 3Age The age recorded on the death record is the age at last birthday. With respect to the computation of death rates, the age classification used by the U.S. Bureau of the Census is also based on the age of the person in completed years. 3Race For vital statistics in the United States in 1986, deaths are classified by race-white, black, Indian, Chinese, Japanese, Filipino, Other Asian or Pacific Islander, and Other. Mortality data for Filipino and Other Asian or Pacific Islander were shown for the first time in 1979. The white category includes, in addition to persons reported as white, those reported as Mexican, Puerto Rican, Cuban, and all other Caucasians. The Indian category includes American, Alaskan, Canadian, Eskimo, and Aleut. If the racial entry on the death certificate indicates a mixture of Hawaiian and any other race, the entry is coded to Hawaiian. If the race is given as a mixture of white and any other race, the entry is coded to the appropriate other race. If a mixture of races other than white is given (except Hawaiian), the entry is coded to the first race listed. This procedure for coding the first race listed has been in use since 1969. Before 1969, if the entry for race was a mixture of black and any other race except Hawaiian, the entry was coded to black. Most of the tables in this volume, however, do not show data for this detailed classification by race. In about half of all the tables the divisions are white, all other (including black), and black separately. In other tables by race, where the main purpose is to isolate the major groups, the classifications are simply white and all other. Race not stated-For 1986 the number of death records for which race was unknown, not stated, or not classifiable was 4,583 or 0.2 percent of the total deaths. Death records with race entry not stated are assigned to a racial designation as follows: If the preceding record is coded white, the code assignment is made to white; if the code is other than white, the assignment is made to black. Before 1964 all records with race not stated were assigned to white except records of residents of New Jersey for 1962-64. New Jersey, 1962-64-New Jersey omitted the race item from its certificates of live birth, death, and fetal death in use in the beginning of 1962. The item was restored during the latter part of 1962. However, the certificate revision without the race item was used for most of 1962 as well as 1963. Therefore figures by race for 1962 and 1963 exclude New Jersey. For 1964, 6.8 percent of the death records in use for residents of New Jersey did not contain the race item. Adjustments made in vital statistics to take into account the omission of the race item in New Jersey for part of the certificates filed during 1962 through 1964 are described in the Technical Appendix of Vital Statistics of the United States for each of those data years. 3Hispanic Origin Mortality statistics for the Hispanic-origin population were published in 1984 for the first time. They are based on information for those States and the District of Columbia that included items on the death certificate to identify Hispanic or ethnic origin of decedents. Data were obtained from the District of Columbia and the following 22 States: Arizona, Arkansas, California, Colorado, Georgia, Hawaii, Illinois, Indiana, Kansas, Maine, Mississippi, Nebraska, Nevada, New Jersey, New Mexico, New York (including New York City), North Dakota, Ohio, Tennessee, Texas, Utah, and Wyoming. Generally, the reporting States used items similar to one of two basic formats recommended by NCHS. The first format is open-ended to obtain the specific origin or descent of the decedent (for example, Italian, Mexican, Puerto Rican, English, and Cuban). The second format is directed specifically toward the Hispanic population and asks whether the decedent is of Spanish origin. If so, the specific origin-for example, Mexican, Puerto Rican, or Cuban-is to be indicated. For 1986, mortality data in tables 1-33 and 2-18 are based on deaths to residents of all 22 reporting States and the District of Columbia. In tables 1-34, 2-19, 2-20, and 2-21 mortality data for the Hispanic-origin population are based on deaths to residents of 18 reporting States and the District of Columbia whose data were at least 90 percent complete on a place-of- occurrence basis and considered to be sufficiently comparable to be used for analysis. The 18 States are as follows: Arizona, Arkansas, California, Colorado, Georgia, Hawaii, Illinois, Indiana, Kansas, Mississippi, Nebraska, New Jersey, New York (including New York City), North Dakota, Ohio, Texas, Utah, and Wyoming. Excluded from these tables are data for New Mexico because the format for the Hispanic item on the New Mexico death certificate departs sufficiently from that of other areas to result in noncomparable data. In addition, in tables 1-33 and 1-34 for New Mexico, no deaths are shown for the category "not stated" origin. Because of the way in which the item on the death certificate for New Mexico is worded, it was not possible to determine whether a black entry represented a response of "non-Hispanic origin" or of "unknown origin." Accordingly, black entries were coded to "non-Hispanic." Data for the other three States-Maine, Nevada, and Tennessee-are excluded from tables 1-34, 2-19, 2-20, and 2-21 because of the large proportion of deaths (in excess of 10 percent) occurring in these States for which Hispanic origin was not stated or was unknown. In 1980, the 18 reporting States and the District of Columbia accounted for about 80 percent of the Hispanic population in the United States, including about 89 percent of the Mexican population, 78 percent of the Puerto Rican population, 34 percent of the Cuban population, and 68 percent of the "Other Hispanic" population (U.S. Bureau of the Census, 1982a). Accordingly, caution should be exercised in generalizing mortality patterns from the reporting area to the Hispanic-origin population (especially Cubans) of the entire United States. For qualifications regarding infant mortality of the Hispanic-origin population, see "Infant deaths." 3Marital Status Mortality statistics by marital status (table 1-31) were published in 1979 for the first time since 1961. (Previously they had been published in the annual volumes for the years 1949-51 and 1959-61.) Several reports analyzing mortality by marital status have been published, including the special study based on 1959-61 special study. Mortality statistics by marital status are tabulated separately for never married, married, widowed, and divorced. Certificates in which the marriage is specified as being annulled are classified as never married. Where marital status is specified as separated or common-law marriage, it is classified as married. Of the 2,049,203 resident deaths 15 years of age and over in 1986, 10,171 certificates (0.5 percent) had marital status not stated. 3Place of Death and Status of Decedent Mortality statistics by place of death were published in 1979 for the first time since 1958 (tables 1-28 and 1-29). In addition, mortality data were also available for the first time in 1979 for the status of decedent when death occurred in a hospital or medical center (table 1-28). These data were obtained from the following two items that appear on the U.S. Standard Certificate of Death: Item 7c. Hospital or Other Institution-Name (If not in either, give street and number) Item 7d. If Hosp. or Inst. Indicate DOA, OP/Emer. Rm., Inpatient (Specify) All of the States and the District of Columbia have item 7c (or its equivalent) on the death certificate. For all States and the District of Columbia in the Vital Statistics Cooperative Program, NCHS accepts the State definition, classification, or codes for hospitals medical centers, or other institutions. Table 1-28 shows mortality data for the total of the following 43 States (including New York City) that have item 7d or its equivalent on their death certificates: Alaska Nevada Arizona New Hampshire Arkansas New Jersey Colorado New Mexico Connecticut New York Florida North Carolina Georgia North Dakota Hawaii Ohio Idaho Oregon Illinois Pennsylvania Indiana Rhode Island Iowa South Carolina Kansas South Dakota Kentucky Tennessee Louisiana Utah Maine Vermont Michigan Virginia Mississippi Washington Missouri West Virginia Montana Wisconsin Nebraska Wyoming Effective with data for 1980, the coding of place of death and status of decedent was changed. A new coding category was added: "Dead on arrival- hospital, clinic, medical center name not given." Deaths coded to this category are tabulated in table 1-28 as "Dead on arrival" and in table 1-29 as "Not in hospital or medical center." Had the 1979 coding categories been used, these deaths would have been tabulated as "Place unknown." 3Mortality by Month and Date of Death Deaths by month have been regularly tabulated and published in the annual volume for each year beginning with data year 1900. For 1986, deaths by month are shown in tables 1-19, 1-20, 1-23, 2-12, 2-13, 2-14, and 3-9. Date of death was first published for data year 1972. In addition, unpublished data for selected causes by date of death for 1962 are available from NCHS. Numbers of deaths by date of death in this volume are shown in table 1-30 for the total number of deaths and for the number of deaths for the following three causes, for which the greatest interest in date of occurrence of death has been expressed: Motor vehicle accidents, Suicide, and Homicide and legal intervention. These data show the frequency distribution of deaths for the selected causes by day of week. They also make it possible to identify holidays with peak numbers of deaths from specified causes. 3Report of Autopsy Before 1972, the last year for which autopsy data were tabulated was 1958. Beginning in 1972, all registration areas requested information on the death certificate as to whether autopsies were performed. For 1986, autopsies were reported on 257,890 death certificates, 12.2 percent of the total (table 1-27). Information as to whether the autopsy findings were used in determining the cause of death was tabulated for 1972-73 for all but nine registration areas and from 1974-77 for all but eight registration areas. The item "autopsy findings used" was deleted from the 1978 U.S. Standard Certificate of Death. For eight of the cause-of-death categories shown in table 1-27, autopsies were reported as performed for 50 percent or more of all deaths (Whooping cough; Meningococcal infection; Pregnancy with abortive outcome; Other complications of pregnancy; childbirth, and the puerperium; Motor vehicle accidents; Suicide; Homicide and legal intervention; and All other external causes). There were three other categories for which 40 percent or more of the death certificates reported autopsies. Autopsies were reported for only 7.8 percent of the Major cardiovascular diseases. 3Cause of Death Cause-of-death classification-Since 1949, cause-of-death statistics have been based on the underlying cause of death, which is defined as "(a) the disease or injury which initiated the train of events leading directly to death, or (b) the circumstances of the accident or violence which produced the fatal injury" (World Health Organization, 1977). For each death the underlying cause is selected from an array of conditions reported in the medical certification section on the death certificate. This section provides a format for entering the causes of death in a sequential order. These conditions are translated into medical codes through use of the classification structure and the selection and modification rules contained in the applicable revision of the International Classification of Diseases (ICD) published by the World Health Organization (WHO). Selection rules provide guidance for systematically identifying the underlying cause of death. Modification rules are intended to improve the usefulness of mortality statistics by giving preference to certain classification categories over others and/or to consolidate two or more conditions on the certificate into a single classification category. As a statistical datum, the underlying cause of death is a simple, one- dimensional statistic; it is conceptually easy to understand and a well- accepted measure of mortality. It identifies the initiating cause of death and is therefore most useful to public health officials in developing measures to prevent the start of the chain of events leading to death. The rules for selecting the underlying cause of death are included with the ICD as a means of standardizing classification, which contributes toward comparability and uniformity in mortality medical statistics among countries. Beginning with data year 1979, the cause-of-death statistics published by the National Center for Health Statistics have been classified according to the Ninth Revision of the International Classification of Diseases (ICD-9) (World Health Organization, 1977). In addition to specifying that the classification be used,, WHO also recommends how the data should be tabulated in order to promote international comparability. The recommended system for tabulating data in the Ninth Revision allows countries to construct their own mortality and morbidity tabulation lists from the rubrics of the WHO Basic Tabulation List as long as rubrics from the WHO mortality an morbidity lists, respectively, are included. This tabulation system for the Ninth Revision is more flexible than that of the Eighth Revision in which specific lists were recommended for tabulating mortality and morbidity data. The Basic Tabulation List (BTL) recommended under the Ninth Revision consists of 57 two-digit rubrics that add to the "all causes" total. Within each two-digit rubric, up to 9 three-digit rubrics numbered from 0 to 8 are identified, but these do not add to the total of the two-digit rubric. The two-digit rubrics of the BTL 01 through 46 provide for the tabulation of nonviolent deaths to ICD categories 001-799. Rubrics relating to chapter 17 (nature-of-injury causes 47 through 56) are not used by NCHS for selecting underlying cause of death; rather, preference is given to rubrics E47 through E56. The 57th two-digit rubric V0 is the Supplementary Classification of Factors Influencing Health Status and Contact with Health Services and is not appropriate for the tabulation of mortality data. The WHO Mortality List, a subset of the titles contained in the BLT, consists of 50 rubrics which are a minimum for the national display of mortality data. Five lists of causes have been developed for tabulation and publication of mortality data in this volume: The Each-Cause List, List of 282 Selected Causes of Death, List of 72 Selected Causes of Death, List of 61 Selected Causes of Infant Death, and List of 34 Selected Causes of Death. These lists were designed to be as comparable as possible with the NCHS lists more recently in use under the Eighth Revision. However, complete comparability could not always be achieved. The Each-Cause List is made up of each three-digit category of the WHO Detailed List to which deaths may be validly assigned and most four-digit subcategories. The list is used for tabulation for the entire United States. The published Each-Cause table does not show the four-digit subcategories provided for Motor vehicle accidents (E810-E825); however, these subcategories, which identify persons injured, are shown in the accident tables of this report (section 5). Special fifth-digit subcategories are also used in the accident tables to identify place of accident when deaths from nontransport accidents are shown. These are not shown in the Each-Cause table. The List of 282 Selected Causes of Death is constructed form BTL rubrics 01-46 and E47-E56. Each of the 56 BTL two-digit titles can be obtained either directly or by combining titles in the List. The three-digit level of the BTL is modified more extensively. Where more detail was desired, categories not shown in the three-digit rubrics were added to the List of 282 Selected Causes of Death. Where less detail was needed, the three-digit rubrics were combined. Moreover, each of the 50 rubrics of the WHO Mortality List can be obtained form the List of 282 Selected Causes of Death. The List of 72 Selected Causes of Death was constructed by combining titles in the List of 282 Selected Causes of Death. It is used in tables published for the United States and each States, and for standard metropolitan statistical areas. The List of 61 Selected Causes of Infant Death shows more detailed titles for Congenital anomalies and Certain conditions originating in the perinatal period than any other list except the Each-Cause List. The List of 34 Selected causes of Death was created by combining titles in the List of 72 Selected Causes. A table using this list is published for detailed geographic areas. Effect of list revisions-The International Lists or adaptations of them, in use in this country since 1900, have been revised approximately every 10 years so that the disease classification may be consistent with advances in medical science and with changes in diagnostic practice. Each revision of the International Lists has produced some break in comparability of cause-of- death statistics. Cause-of-death statistics beginning with 1979 are classified by NCHS according to the ICD-9 (World Health Organization, 1977). For a discussion of each of the classifications used with death statistics since 1900, see the Technical Appendix in Vital Statistics of the United States, 1979, Volume II, Mortality, Part A, section 7, pages 9-14. A dual coding study was undertaken between the Ninth and the Eighth Revisions to measure the extent of discontinuity in cause-of-death statistics resulting from introducing the new Revision. An initial study for the List of 72 Selected Causes of Death and the List of 10 Selected Causes of Infant Death has been published (NCHS, 1980). The List of 10 Selected Causes of Infant Death is a basic NCHS tabulation list but is not used in this volume. Comparability studies were also undertaken between the Eighth and Seventh, Seventh and Sixth, and Sixth and Fifth Revisions. For additional information about these studies, again see the 1979 Technical Appendix. Significant coding changes during the Ninth Revision-Since the implementation of ICD-9 in the United States, effective with mortality data for 1979, several coding changes have been introduced. The more important changes will be discussed below. In early 1983, a change was made in the coding of Acquired immunodeficiency syndrome (AIDS) and Human immunodeficiency virus (HIV) infection, which affected data from 1981 onward. Also effective with data year 1981 was a coding change for poliomyelitis. For data year 1982, a changes was made in the definition of child (which affects the classification of deaths to a number of categories, including Child battering and other maltreatment), and in guidelines for coding deaths to the category Child battering and other maltreatment (ICD No. E 967). During the calendar year 1985 detailed instructions for coding motor vehicle accidents involving all-terrain vehicles (ATV's) were implemented to ensure consistency in coding these accidents. Detailed discussion of these changes may be found in the Technical Appendix for previous volumes. Coding in 1986-The rules and instructions used in coding the 1986 mortality medical data remained essentially the same as those used for the 1985 data. Notable changes include classifying "primary" and "invasive" tumors, unspecified, as "malignant" beginning 1986. Previously, these neoplasms had been classified to Neoplasms of unspecified nature (ICD-0 No. 239). Medical certification-The use of a standard classification list, although essential for State, regional, and international comparison, does not assure strict comparability of the tabulated figures. A high degree of comparability between areas could be attained only if all records of cause of death were reported with equal accuracy and completeness. The medical certification of cause of death can be made only be a qualified person, usually a physician, a medical examiner, or a coroner. Therefore, the reliability and accuracy of cause-of-death statistics are, to a large extent, governed by the ability of the certifier to make the proper diagnosis and by the care with which he or she records this information on the death certificate. A number of studies have been undertaken on the quality of medical certification on the death certificate. In general, these have been for relatively small samples and for limited geographic areas. A bibliography, prepared by NCHS (1982), covering 128 references over a period of 23 years indicates that no definitive conclusions have been reached about the quality of medical certification on the death certificate. No country has a well- defined program for systematically assessing the quality of medical certifications reported on death certificates or for measuring the error effects on the levels and trends of cause-of-death statistics. One index of the quality of reporting causes of death is the proportion of death certificates coded to the Ninth Revision Chapter XVI Symptoms, signs, and ill-defined conditions (ICD-9 Nos. 780-799). Although there are cases for which it is not possible to determine the cause of death, this proportion indicates the care and consideration given to the certification by the medical certifier. It may also be used as a rough measure of the specificity of the medical diagnoses made by the certifier in various areas. In 1986, 1.5 percent of all reported deaths in the United States were assigned to ill- defined or unknown causes. However, this percentage varied among the States, from 0.3 percent to 4.0 percent. Automated selection of underlying cause of death-Beginning with data year 1968, NCHS began using a computer system for assigning the underlying cause of death. It has been used every year since to select the underlying cause of death. The system is called "Automated Classification of Medical Entities" (ACME). The ACME system applies the same rules for selecting the underlying cause as applied manually by a nosologist; however, under this system, the computer consistently applies the same criteria, thus eliminating intercoder variation in this step of the process. The ACME computer program requires the coding of all conditions shown on the medical certification. These codes are matched automatically against decision tables that consistently select the underlying cause of death for each record according to the international rules. The decision tables provide the comprehensive relationships between the conditions classified by ICD when applying the rules of selection and modification. The decision tables were developed by NCHS staff on the basis of their experience in coding underlying causes of death under the earlier manual coding system and as a result of periodic independent validations. These tables are periodically updated to reflect additional new information on the relationship among medical conditions. For 1986, the content of these tables was identical to that in the 1985 tables. Coding procedures for selecting the underlying cause of death by the ACME computer program, as well as the ACME decision tables, are documented in NCHS instruction manuals (NCHS, 1986c, 1986d, 1986e). Cause-of-death ranking-Cause-of-death ranking (except for infants) is based on the List of 72 Selected Causes of Death. Cause-of-death ranking for infants is based on the List of 61 Selected Causes of Infant Death. The group titles Major cardiovascular diseases and Symptoms, signs, and ill-defined conditions are not ranked from the List of 72 Selected Causes; and Certain conditions originating in the perinatal period and Symptoms, signs, and ill- defined conditions are not ranked from the List of 61 Selected Causes of Infant Death. In addition, category titles that begin with the words "Other" or "All other" are not ranked to determine the leading causes of death. When one of the titles that represents a subtotal is ranked (such as Tuberculosis), its component parts (in this case, Tuberculosis of respiratory system and Other tuberculosis) are not ranked. 3Maternal Deaths Maternal deaths are those for which the certifying physician has designated a maternal condition as the underlying cause of death. Maternal conditions are those assigned to Complications of pregnancy, childbirth, and the puerperium (ICD-9 Nos. 630-676). In the Ninth Revision, the World Health Organization (1977, p. 764) for the first time defined a maternal death as follows: A maternal death is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes. Under the Eighth Revision, maternal deaths were assigned to category title "Complications of pregnancy, childbirth, and the puerperium" (ICDA-8 Nos. 630-678). Although WHO did not define maternal mortality, there was an NCHS classification rule that limited a maternal death to a death within a year after termination of pregnancy from any "maternal cause," that is, any cause within the range of ICDA-8 Nos. 630-678. This rule applied only if a duration of time for the condition was given. If no duration was specified and the underlying cause of death was a maternal condition, then the duration was assumed to be within a year and the death was coded by NCHS as a maternal death. The change from an under-1-year limitation on duration used in the Eighth Revision to an under-42-days limitation used in the Ninth Revision is not expected to have much effect on the comparability of maternal mortality statistics. However, comparability is affected by the following classification change. Under the Ninth Revision, maternal causes have been expanded to include Indirect obstetric causes (ICD-9 Nos. 647;-648). These causes include Infective and parasitic conditions as well as other current conditions in the mother that are classifiable elsewhere but which complicate pregnancy, childbirth, and the puerperium, such as Syphilis, Tuberculosis, Diabetes mellitus, Drug dependence, and Congenital cardiovascular disorders. Maternal mortality rates are computed on the basis of the number of live births. The maternal mortality rate indicates the likelihood that a pregnant woman will die from maternal causes. The number of live births used in the denominator is an approximation of the population of pregnant women who are at risk of a maternal death. 3Infant Deaths Age-An infant death is defined as a death under 1 year of age. The term excludes fetal deaths. Infant deaths are usually divided into two categories according to age, neonatal and postneonatal. Neonatal deaths are those that occur during the first 27 days of life, and postneonatal deaths are those that occur between 28 days and 1 year of age. It has generally been believed that different factors influencing the child's survival predominate in these two periods: Factors associated with prenatal development, heredity, and the birth process were considered dominant in the neonatal period; and environmental factors, such as nutrition, hygiene, and accidents, were considered more important in the postneonatal period. Recently, however, the distinction between these two periods has blurred due in part to advances in neonatology, which have enabled more very small, premature infants to survive the neonatal period. Rates-Infant mortality rates shown in section 2 and section 8 are the most commonly used index for measuring the risk of dying during the first year of life, they are calculated by dividing the number of infant deaths in a calendar year by the number of live births registered for the same period and are presented as rates per 1,000 or per 100,000 live births. Infant mortality rates use the number of live births in the denominator to approximate the population at risk of dying before the first birthday. This measure is an approximation of the risk of dying in infancy because some of the live births will not have been exposed to a full year's risk of dying and some of the infants that die during a year will have been born in the previous year. The error introduced in the infant mortality rate by this inexactness is usually small, especially when the birth rate is relatively constant from year to year (Guralnick and Winter, 1965; NCHS, 1968a). Other sources of error in the infant mortality rate have been attributed to differences in applying the definitions for infant death and fetal death when registering the event (McCarthy, et al, 1980; National Office of Vital Statistics, 1947). In contrast to infant mortality rates based on live births, infant death rates shown in section 1 are based on the estimated population under 1 year of age. Infant death rates, which appear in tabulations of age-specific death rates, are calculated by dividing the number of infant deaths in a calendar year by the estimated midyear population of persons under 1 year of age and are presented as rates per 100,000 population in this age group. Patterns and trends in the infant death rate may differ somewhat from those of the more commonly used "infant mortality rate" mainly because of differences in the nature of the denominator and in the time reference period. Whereas the population denominator for the infant death rate is estimated using data on births, infant deaths, and migration for the 12-month period of July through June, the denominator for the infant mortality rate is a count of births occurring during the 12 months of January through December. The difference in the time reference period can result in different trends between the two indices during periods when birth rates are markedly moving up or down. In addition, the infant death rate is also subject to greater imprecision than is the infant mortality rate because of problems of enumerating and estimating the population under 1 year of age (National Office of Vital Statistics, 1947). Race-Infant mortality rates for specified races other than white or black may be underestimated, based on results of studies in which race on the birth and death certificates for the same infant were compared (Frost and Shy, 1980). The figures should be interpreted with caution because of possible inconsistencies in reporting of race between the numerator and denominator of the rates. This reflects differences in the nature of reporting and processing race on these two vital records. On the birth certificate, race of parents is reported by the mother at the time of delivery. On the death certificate, race of the deceased infant is reported by the funeral director based on observation or on information supplied by an informant, such as a parent. With respect to processing, race of infant at birth is coded using coding rules that take account of the race of each parent (see the Technical Appendix in Vital Statistics of the United States, 1986, Volume I, Natality, section entitled "Race or national origin"). For infant deaths, the race of child is coded directly from the race reported on the death certificate. Hispanic origin-Infant mortality rates for the Hispanic-origin population are based on numbers of resident infant deaths reported to be of Hispanic origin (see section "Hispanic origin") and number of resident live births by Hispanic origin of mother for the 18 reporting States and the District of Columbia. In computing infant mortality rates, deaths and live births of unknown origin are not distributed among the specified Hispanic and non- Hispanic groups. Because for 1986 the percent of infant deaths of unknown origin was 8.1 percent and the percent of live births of unknown origin was 3.1 percent, infant mortality rates by specified Hispanic origin and race for non-Hispanic origin may be somewhat underestimated. Small numbers of infant deaths for specific Hispanic-origin groups can result in infant mortality rates subject to relatively large random variation (see section "Random variation in numbers of deaths, death rates, and mortality rates and ratios"). Tabulation list-Causes of death for infants are tabulated according to a list of causes that is different from the list of causes for the population of all ages, except for the Each Cause List. (See section "Cause-of-death classification"). 3Fetal Deaths In May 1950 the World Health Organization recommended the following definition of fetal death be adopted for international us (National Office of Vital Statistics, 1950): Death prior to the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy; the death is indicated by the fact that after such separation, the fetus does not breathe or show any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles. The term "fetal death" was defined on an all-inclusive basis to end confusion arising from use of such terms as stillbirth, abortion, and miscarriage. Shortly thereafter, this definition of fetal death was adopted by the National Center for Health Statistics as the nationally recommended standard. Currently all registration areas except Puerto Rico have definitions similar to the standard definition. Puerto Rico has no formal definition. (For definitions used by the States and other registration areas, see NCHS (1981).) As another step toward increasing the comparability of data on fetal deaths for different countries, the World Health Organization recommended that for statistical purposes fetal deaths be classified as early, intermediate, and late. These groups are defined as follows: Less than 20 completed weeks of gestation (early fetal deaths)..................... Group I 20 completed weeks of gestation but less than 28 (intermediate fetal deaths)..... Group II 28 completed weeks of gestation and over (late fetal deaths)..................... Group III Gestation period not classifiable in groups I, II, and III.................... Group IV Note that in table 3-13, group IV consists of fetal deaths with gestation not stated but presumed to be 20 weeks or more gestation. Until 1939 the nationally recommended procedure for registration of a fetal death required the filing of both a live-birth and a death certificate. In 1939 a separate Standard Certificate of Stillbirth (fetal death) was created to replace the former procedure. This was revised in 1949, 1955, 1956, and 1968. In 1978 the Standard Certificate of Fetal Death was replaced by the Standard Report of Fetal Death (figure 7-B). The 1977 revision of the Model State Vital Statistics Act and Model State Vital Statistics Regulations (NCHS, 1978) recommended that spontaneous fetal deaths of 20 weeks or more gestation, or a weight of 350 grams or more, and all induced terminations of pregnancy regardless of gestational age be reported and further that they be reported on separate forms. These forms are to be considered legally required statistical reports rather than legal documents. Beginning with 1970 fetal deaths, procedures were implemented that attempted to separate reports of spontaneous fetal deaths from those of induced terminations of pregnancy. These procedures were implemented because the health implications are different for spontaneous fetal deaths and induced terminations of pregnancy. These procedures are still in use. Comparability and completeness of data-Registration area requirements for reporting fetal deaths vary. Most of these areas require reporting fetal deaths of gestations of 20 weeks or more. Table A shows the minimum period of gestation required by each State for fetal-death reporting. There is substantial evidence that not all fetal deaths for which reporting is required are reported (Gred, Pauli, and Kirby, 1987). For registration areas not requiring the reporting of fetal deaths of all periods of gestation, underreporting is more likely to occur in the earlier gestational periods. This is illustrated by the fact that for most areas requiring reporting of fetal deaths of 20 weeks or more, the total number reported for 20-23 weeks is lower than the numbers reported for 24-27 and 28- 31 weeks. For areas requiring the reporting of all fetal deaths, however, the opposite is generally true. To maximize the comparability of data by year and by State, most of the tables in section 3 are based on fetal deaths occurring at gestations of 20 weeks or more. These tables also include fetal deaths of not stated gestation for those States requiring reporting at 20 weeks or more only. Beginning with 1969, fetal deaths of not stated gestation were excluded for States requiring reporting of all products of conception except for those with a stated birth weight of 500 grams or more. In 1986 this rule was applied to the following States: Colorado, Georgia, Hawaii, New York (including New York City), Rhode Island, and Virginia. Each year there are some exceptions to this procedure. The data in table 3-3 include only fetal deaths to residents of selected areas in the United States that reported all periods of gestation. The areas are Colorado, Georgia, Hawaii, New York (including New York City), Rhode Island, and Virginia; excluded are fetal deaths to residents of Maine. Arkansas-Since 1971, Arkansas has been using two reporting forms for fetal deaths: A confidential Spontaneous Abortion form that is not sent to the National Center for Health Statistics and a Fetal Death Certificate that is. During the period 1971 through 1980, it is believed that most spontaneous fetal deaths of less than 20 weeks' gestation were reported on the confidential form and, therefore, were not reported to NCHS. During the period 1981 through 1983, Arkansas specified that fetal deaths of less than 28 weeks' gestation or weighing less than 1,000 grams could be reported on the confidential form; beginning with 1984 data, the State specified that fetal deaths of 20 weeks' gestation or weighing 500 grams be reported on the Fetal Death Certificate. Because of these changes, the comparability of counts of early fetal deaths may be affected. In particular, counts of fetal deaths aged 20-27 weeks during 1981-83 were not comparable between Arkansas and other reporting areas nor with data for 1984-86. It is believed that reporting has improved but is still not comparable with data for 1980 and earlier years. Idaho-Beginning in 1983, Idaho changed its reporting requirements for spontaneous fetal deaths from "after 20 weeks" to "after 20 weeks or a weight of 350 grams or more." Table A. Period of gestation at which fetal death reporting is required: Each reporting area, 1986 | | | | |All periods | | | | of | 16 | 20 | | gestation | weeks | weeks | | | | | Alabama | | | X | Alaska | | | X | Arizona | | | 1X | Arkansas | X | | | California | | | X | Colorado | X | | | Connecticut | | | X | Delaware | | | X | District of Columbia | | | | Florida | | | X | Georgia | X | | | Hawaii | X | | | Idaho | | | | Illinois | | | X | Indiana | | | X | Iowa | | | X | Kansas | | | | Kentucky | | | | Louisiana | | | | Maine | X | | | Maryland | | | 2X | Massachusetts | | | | Michigan | | | | Minnesota | | | X | Mississippi | | | | Missouri | | | | Montana | | | X | Nebraska | | | X | Nevada | | | X | New Hampshire | | | | New Jersey | | | X | New Mexico | | | | New York | X | | | New York excluding New York City | X | | | New York City | | | | North Carolina | | | X | North Dakota | | | X | Ohio | | | X | Oklahoma | | | X | Oregon | | | 3X | Pennsylvania | | X | | Rhode Island | X | | | South Carolina | | | | South Dakota | | | | Tennessee | | | | Texas | | | X | Utah | | | X | Vermont | | | 5X | Virginia | X | | | Washington | | | X | West Virginia | | | X | Wisconsin | | | | Wyoming | | | X | 1If gestational age is unknown, weight of 350 grams or more. 2If gestational age is unknown, weight of 500 grams or more. 3If gestational age is unknown, weight of 450 grams or more, or crown- heel length of 28 centimeters or more. 4If weight is unknown, 22 completed weeks' gestation or more. 5If gestation age is unknown, weight of 400 or more grams, 15 or more ounces. Table A. Period of gestation at which fetal death reporting is required: Each reporting area, 1986 - Continued | | | | | 20 weeks | 20 weeks | 20 weeks | | or | or | or | | 350 grams | 400 grams | 500 grams | | | | | Alabama | | | | Alaska | | | | Arizona | | | | Arkansas | | | | California | | | | Colorado | | | | Connecticut | | | | Delaware | | | | District of Columbia | | | X | Florida | | | | Georgia | | | | Hawaii | | | | Idaho | X | | | Illinois | | | | Indiana | | | | Iowa | | | | Kansas | | | | Kentucky | X | | | Louisiana | X | | | Maine | | | | Maryland | | | | Massachusetts | X | | | Michigan | | X | | Minnesota | | | | Mississippi | X | | | Missouri | X | | | Montana | | | | Nebraska | | | | Nevada | | | | New Hampshire | X | | | New Jersey | | | | New Mexico | | | | New York | | | | New York excluding New York City | | | | New York City | | | | North Carolina | | | | North Dakota | | | | Ohio | | | | Oklahoma | | | | Oregon | | | | Pennsylvania | | | | Rhode Island | | | | South Carolina | X | | | South Dakota | | | | Tennessee | | | | Texas | | | | Utah | | | | Vermont | | | | Virginia | | | | Washington | | | | West Virginia | | | | Wisconsin | X | | | Wyoming | | | | 1If gestational age is unknown, weight of 350 grams or more. 2If gestational age is unknown, weight of 500 grams or more. 3If gestational age is unknown, weight of 450 grams or more, or crown- heel length of 28 centimeters or more. 4If weight is unknown, 22 completed weeks' gestation or more. 5If gestation age is unknown, weight of 400 or more grams, 15 or more ounces. Table A. Period of gestation at which fetal death reporting is required: Each reporting area, 1986 - Continued | | | | | | | | | 5 | 350 | 500 | | months | grams | grams | | | | | Alabama | | | | Alaska | | | | Arizona | | | | Arkansas | | | | California | | | | Colorado | | | | Connecticut | | | | Delaware | | | | District of Columbia | | | | Florida | | | | Georgia | | | | Hawaii | | | | Idaho | | | | Illinois | | | | Indiana | | | | Iowa | | | | Kansas | | X | | Kentucky | | | | Louisiana | | | | Maine | | | | Maryland | | | | Massachusetts | | | | Michigan | | | | Minnesota | | | | Mississippi | | | | Missouri | | | | Montana | | | | Nebraska | | | | Nevada | | | | New Hampshire | | | | New Jersey | | | | New Mexico | | | X | New York | | | | New York excluding New York City | | | | New York City | | | | North Carolina | | | | North Dakota | | | | Ohio | | | | Oklahoma | | | | Oregon | | | | Pennsylvania | | | | Rhode Island | | | | South Carolina | | | | South Dakota | | | X | Tennessee | | | 4X | Texas | | | | Utah | | | | Vermont | | | | Virginia | | | | Washington | | | | West Virginia | | | | Wisconsin | | | | Wyoming | | | | 1If gestational age is unknown, weight of 350 grams or more. 2If gestational age is unknown, weight of 500 grams or more. 3If gestational age is unknown, weight of 450 grams or more, or crown- heel length of 28 centimeters or more. 4If weight is unknown, 22 completed weeks' gestation or more. 5If gestation age is unknown, weight of 400 or more grams, 15 or more ounces. Maine-Maine uses two reporting forms for fetal deaths: A Report of Abortion (Spontaneous and Induced) and a Report of Fetal Death. Most spontaneous fetal deaths of less than 20 weeks' gestation are reported on the Report of Abortion and, therefore, are excluded from fetal death counts in this volume. Missouri-Beginning in 1984, Missouri changed its reporting requirements for spontaneous fetal deaths from "after 20 weeks" to "after 20 weeks or a weight of 350 grams or more." Wisconsin-Beginning in 1986, Wisconsin changed its reporting requirements for spontaneous fetal deaths from "20 weeks" to "20 weeks or 350 grams." Period of gestation-The period of gestation is the number of completed weeks elapsed between the first day of the last normal menstrual period and the date of delivery. The first day of the last normal menstrual period (LMP) is used as the initial date because it can be more accurately determined than the date of conception, which usually occurs 2 weeks after LMP. Data on period of gestation are computed from information on "date of delivery" and "date last normal menses began." If "date last normal menses began" is not on the record or the calculated gestation falls beyond a duration considered biologically plausible, "gestation in weeks" or "Physician's estimate of gestation is used. When the period of gestation is reported in months on the report, it is allocated to gestational intervals in weeks as follows: 1-3 months to under 16 weeks 4 months to 16-19 weeks 5 months to 20-23 weeks 6 months to 24-27 weeks 7 months to 28-31 weeks 8 months to 32-35 weeks 9 months to 40 weeks 10 months and over to 43 weeks and over All areas reported LMP in 1986 except Delaware, New Mexico, Puerto Rico, and South Dakata. Birth weight-Most of the 55 registration areas do not specify how weight should be given, that is, in pounds and ounces or in grams. In the tabulation and presentation of birth weight data, the metric system (grams) has been used to facilitate comparison with other data published in the United States and internationally. Birth weight specified in pounds and ounces is assigned the equivalent of the gram intervals as follows: Less than 350 grams = 0 lb 12 oz or less 350- 499 grams = 0 lb 13 oz- 1 lb 1 oz 500- 999 grams = 1 lb 2 oz- 2 lb 3 oz 1,000-1,499 grams = 2 lb 4 oz- 3 lb 4 oz 1,500-1,999 grams = 3 lb 5 oz- 4 lb 6 oz 2,000-2,499 grams = 4 lb 7 oz- 5 lb 8 oz 2,500-2,999 grams = 5 lb 9 oz- 6 lb 9 oz 3,000-3,499 grams = 6 lb 10 oz- 7 lb 11 oz 3,500-3,999 grams = 7 lb 12 oz- 8 lb 13 oz 4,000-4,499 grams = 8 lb 14 oz- 9 lb 14 oz 4,500-4,999 grams = 9 lb 15 oz-11 lb 0 oz 5,000 grams or more = 11 lb 1 oz or more With the introduction of the Ninth Revision, International Classification of Diseases, the birth-weight classification intervals for perinatal mortality statistics were shifted downward by 1 gram, as shown above. Previously, the intervals were, for example, 1,001-1,500; 1,501-2,000; etc. Race-The race of the fetus is ordinarily classified based on the race of the parents. If the parents are of different races, the following rules apply. (1) When only one parent is white, the fetus is assigned the other parent's race. (2) When neither parent is white, the fetus is assigned the father's race with one exception: If the mother is Hawaiian or Part-Hawaiian, the fetus is classified as Hawaiian. When the race of one parent is missing or ill defined, the race of the other determines that of the fetus. When race of both parents is missing, the race of the fetus is allocated to the specific race of the fetus on the preceding record. Total-birth order-Total-birth order refers to the sum of the live births and other terminations (including both spontaneous fetal deaths and induced terminations of pregnancy) that a woman has had including the fetal death being recorded. For example, if a woman has previously given birth to two live babies and to one born dead, the next fetal death to occur is counted as number four in total-birth order. In the 1978 revision of the Standard Report of Fetal Death, total-birth order is calculated from four items on pregnancy history: Number of previous live births, now living, number of previous live births, now dead; number of other terminations before 20 weeks; and number of other terminations after 20 weeks. All registration areas use the two standard items pertaining to the number of previous live births. Most areas use the two standard items pertaining to the number of "other terminations" before and after 20 weeks' gestation, but some areas use other criteria. Total-birth order for all areas is calculated from the sum of available information. Thus, information on total-birth order may not be completely comparable among the registration areas. Marital status-Table 3-4 shows fetal deaths and fetal-death ratios by mother's marital status. States excluded from this table are as follows: California, Connecticut, Maryland, Michigan, Montana, New York (including New York City), Ohio, Texas, and Vermont. Because live births comprise the denominator of the ratio, marital status must also be reported for mothers of live births. Marital status of the mother of the live birth is inferred for States that did not report it on the birth certificate. There are no quantitative data on the characteristics of unmarried women who may misreport their marital status or who fail to register fetal deaths. Underreporting may be greater for the unmarried group than for the married group. Age of mother-The fetal-death report asks for the mother's "age (at time of delivery)," and the ages are edited in NCHS for upper and lower limits. When mothers are reported to be under 10 years of age or 50 years and over, the age of the mother is considered not stated and is assigned as follows; Age on all fetal-death records with age of mother not stated is allocated according to the age appearing on the record previously processed for a mother of identical race and having the same total-birth order (total of live births and other terminations). 3Perinatal Mortality Perinatal definitions- Beginning with data year 1979, perinatal mortality data for the United States and each State have been published in section 4. The World Health Organization in the ninth Revision of the International Classification of Diseases (ICD-9) recommended that "national perinatal statistics should include all fetuses and infants delivered weighing at least 500 grams (or when birth weight is unavailable, the corresponding gestational age (22 weeks) or body length (25 cm crown-hell)), whether alive or dead...." It was further recommended that "countries should present, solely for international comparisons, 'standard perinatal statistics' in which both the numerator and denominator of all rates are restricted to fetuses and infants weighing 1,000 grams or more (or, where birth weight is unavailable, the corresponding gestational age (28 weeks) or body length (35 cm crown-heel))." Because birth weight and gestational age are not reported on the death certificate in the United States, NCHS was unable to recommend adopting these definitions. Three definitions of perinatal mortality are currently used by NCHS: Perinatal Definition I, generally used for international comparisons, which includes fetal deaths of 28 weeks or more gestation and infant deaths of less than 7 days; Perinatal Definition II, which includes fetal deaths of 20 weeks or more gestation and infant deaths of less than 28 days; and Perinatal Definition III, which includes fetal deaths of 20 weeks or more gestation and infant deaths of less than 7 days. Variations in fetal death reporting requirements and practices have implications for comparing perinatal rates among States. Because reporting is generally poorer near the lower limit of the reporting requirement, States that require reporting of all products of pregnancy regardless of gestation are likely to have more complete reporting of fetal deaths of 20 weeks or more than are other States. The larger number of fetal deaths reported by these "all periods" States may result in higher perinatal rates compared with States whose reporting is less complete. Accordingly, reporting completeness may account, in part, for differences among the State perinatal rates, particularly differences for Definitions II and III, which use data for fetal deaths of 20-27 weeks. Not stated-Fetal deaths with gestational age not stated are presumed to be of 20 weeks' gestation or more if (1) the State requires reporting of all fetal deaths of gestational age 20 weeks or more or (2) the fetus weighed 500 grams or more, in those States requiring reporting of all fetal deaths regardless of gestational age. For Definition I, fetal deaths with gestation not stated but presumed to be 20 weeks or more are allocated to the category 28 weeks or more, according to the proportion of fetal deaths with stated gestational age that falls into that category. For Definitions II and III, fetal deaths with presumed gestation of 20 weeks or more are included with those of stated gestation of 20 weeks or more. For all three definitions, following the distribution of gestation not stated described above, fetal deaths with not-stated sex are allocated within gestational age groups on the basis of the distribution of stated cases. The allocation of not-stated gestational age and sex for fetal deaths is made individually for each State, for metropolitan and nonmetropolitan areas, and separately for the United States as a whole. Accordingly, the sum of perinatal deaths for the areas according to Definition I may not equal the total number of perinatal deaths for the United States. 2Quality of Data 3Completeness of Registration All States have adopted laws that require the registration of births and deaths, and the reporting of fetal deaths. It is believed that over 99 percent of the births and deaths occurring in this country are registered. Reporting requirements for fetal deaths vary somewhat from State to State (see "Comparability and completeness of data"). Overall reporting completeness is not as good for fetal deaths as for births and deaths, but it is believed to be relatively complete for fetal deaths of 28 weeks' gestation or more. National statistical data on fetal deaths include only those fetal deaths with stated or presumed gestation of 20 weeks or more. 3Massachusetts Data The 1964 statistics for deaths exclude approximately 6,000 events registered in Massachusetts, primarily to residents of that State. Microfilm copies of these records were not received by NCHS. Figures for the United States and the New England Division are also somewhat affected. 3Quality Control Procedures Demographic items on the death certificate-As previously indicated, for 1986 the mortality data for these items were obtained from two sources: (1) Microfilm images of the original certificates furnished by the Virgin Islands and photocopies from Guam; and (2) records on data tape furnished by the 50 States, the District of Columbia, New York City, and Puerto Rico. For the Virgin Islands and Guam, which sent only copies of the original certificates, the demographic items were coded for 100 percent of the death certificates. The demographic coding for 100 percent of the certificates was independently verified. As part of the quality control procedures for mortality data, each registration area has to go through a calibration period during which it must achieve the specified error tolerance level of 2 percent per item for 3 consecutive months, based on NCHS independent verification of a 50-percent sample of that area's records. Once the area has achieved the required error tolerance level, a sample of 70-80 records per month is used to monitor quality of coding. All areas providing data on computer tapes prior to 1986 have achieved the specified error tolerance; accordingly, the demographic items on about 70-80 records per area per month were independently verified by NCHS. The estimated average error rate for all demographic items in 1986 was 0.25 percent. These verification procedures involve controlling two types of error (coding and entering into the data record tape) at the same time, and the error rates are a combined measure of both types. It may be assumed that the entering errors are randomly distributed across all items on the record, but this assumption cannot be made as readily for coding errors. Although systematic errors in coding infrequent events may escape detection during sample verification, it is probable that some of these errors were detected during the initial period when 50 percent of the file was being verified, thus providing an opportunity to retrain the coders. Medical items on the death certificate-As for demographic data, mortality medical data are also subject to quality control procedures which control for errors of both coding and data entry. Each of the 22 registration areas that furnished NCHS with coded medical information according to NCHS specifications first had to qualify for sample verification. During an initial calibration period, the area had to demonstrate that its staff could achieve a specified error tolerance level of less than 5 percent for coding all medical items. After the area has achieved the required error tolerance level, a sample of 70-80 records per month is used to monitor quality of medical coding. For these 22 States, the average coding error rate in 1986 was estimated at just over 4 percent. For the remaining 33 registration areas-28 States, the District of Columbia, New York City, Puerto Rico, the Virgin Island, and Guam-NCHS coded the medical items for 100 percent of the death records. A 1-percent sample of the records was independently coded for quality control purposes. The estimated average error rate for these areas was about 3 percent. The ACME system for selecting the underlying cause of death through computer application contributes to the quality control of medical items on the death certificate. (See section "Automated selection of underlying cause of death.") Demographic items on the report of fetal death-For 1986, all data on fetal deaths, except for New York State (excluding New York City), were coded under contract by the U.S. Bureau of the Census. Coding and entering information on data tapes were verified on a 100-percent basis because of the relatively small number of records involved. Other control procedures-After coding and entering on data tape are completed, record counts are balanced against control totals for each shipment of records from a registration area. Editing procedures ensure that records with inconsistent or impossible codes are modified. Inconsistent codes are those, for example, where there is contradiction between cause of death and age or sex of the decedent. Records so identified during the computer-editing process are either corrected by reference to the source record or adjusted by arbitrary code assignment (NCHS, 1979). Further, conditions specified on a list of infrequent or rare causes of death need to be confirmed by the certifier or State Health Officer. For 1985 records, cryptosporidiosis was no longer confirmed by NCHS although this condition was still on the list of infrequent or rare causes of death through 1986. Because cryptosporidiosis has increased in frequency due to its association with the human immunodeficiency virus (HIV) infection, it is no longer considered infrequent. All subsequent operations in tabulating and in preparing tables are verified during the computer processing or by statistical clerks. 3Estimates of Errors Arising from 50-Percent Sample for 1972 Death statistics for 1972 in this report (excluding fetal-death statistics) are based on a 50-percent sample of all deaths occurring in the 50 States and the District of Columbia. A description of the sample design and a table of the percent errors of the estimated numbers of deaths by size of estimate and total deaths in the area are shown in the Technical Appendix of Vital Statistics of the United States, 1972, Volume II, Mortality, Part A. 2Computation of Rates and Other Measures 3Population Bases The population bases from which death rates shown in this report are computed are prepared by the U.S. Bureau of the Census. Rates for 1940, 1950, 1960, 1970, and 1980 are based on the population enumerated as of April 1 in the censuses of those years. Rates for all other years use the estimated midyear (July 1) population. Death rates for the United States, individual States, and SMSA's are based on the total resident populations of the respective areas. Except as noted these populations exclude the Armed Forces abroad but include the Armed Forces stationed in each area. The resident populations of the birth- and death-registration States for 1900-32 and of the United States for 1900-86 are shown in table 7-1. In addition, the population including Armed Forces abroad is shown for the United States. Table B lists the sources for these populations Population estimates for 1986-The population of the United States estimated by age, race, and sex for 1986 is shown in table 7-2, and the population for each State by broad age groups follows in table 7-3. Population estimates for 1984-86 incorporate new estimation procedures for net migration and net undocumented immigration. The 1986 estimates are comparable with those for 1984 and 1985 but are not strictly comparable with the postcensal estimates for 1981-83 shown in table 7-2 and 7-3 of Vital Statistics of the United States, Volume II, for those years. Although the death rates and estimates of life expectancy for 1984-86 are not strictly comparable with those for previous years, the trends for the total population and most age-race-sex groups are not substantially affected. For additional details, see the Technical Appendix in Vital Statistics of the United States, 1984, Volume II, and the report of the U.S. Bureau of the Census (1988). Population data by race are consistent with the modified (see below) 1980 population by race. Population for 1980-The population of the United States by age, race, and sex, and the population for each State by age, are shown in tables 7-2 and 7- 3, respectively, of Vital Statistics of the United States, 1980, Volume II. The figures by race have been modified as described below. The racial counts in the 1980 census are affected by changes in reporting practices, particularly of the Hispanic population, and in coding and classifying. One particular change created a major inconsistency between the 1980 census data and historical data series, including censuses and vital statistics. About 40 percent of the Hispanic population counted in 1980, over 5.8 million persons did not mark one of the specified races listed on the census questionnaire but instead marked the "Other" category. In the 1980 census, coding procedures were modified for persons who marked "Other" race and wrote in a national origin designation of a Latin Table B. Sources for resident population and population including Armed Forces abroad: Birth- and death- registration States, 1900-1932, and United States, 1900-1986 Year Source 1986-----------------U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 1022, Mar. 1988. 1985-----------------U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 1000, Feb. 1987. 1984-----------------U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 985, Apr. 1986. 1983-----------------U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 965, Mar. 1985. 1982-----------------U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 949, May 1984 1981-----------------U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 929, May 1983 1980-----------------U.S. Bureau of the Census, U.S. Census of Population: 1980, Number of Inhabitants, PC80-1-A1, United States Summary, 1983. 1971-79--------------U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 917, July 1982. 1970-----------------U.S. Bureau of the Census, U.S. Census of Population: 1970, Number of Inhabitants, Final Report PC(1)-A1. United States Summary, 1971. 1961-69--------------U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 519, April 1974 1960-----------------U.S. Bureau of the Census, U.S. Census of Population: 1960, Number of Inhabitants, PC80-1-A1, United States Summary, 1964. 1951-59--------------U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 310, June 30, 1965. 1940-50--------------U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 499, May 1973. 1930-39--------------U.S. Bureau of the Census, Current Population Reports, Series P-25, No. 499, May 1973, and National Office of Vital Statistics, Vital Statistics Rates in the United State, 1900-1940, 1947. 1920-29--------------National Office of Vital Statistic, Vital Statistics Rates in the United States, 1900-1940, 1947. 1917-19--------------Same as for 1930-39 1900-1916------------Same as for 1920-29 American country or a specific Hispanic-origin group in response to the racial question. These persons remained in the "Other" racial category in 1980 census data; in previous censuses and in vital statistics such responses had almost always been coded into the "White" category. In order to maintain comparability, the "Other" racial category in the 1980 census was reallocated to be consistent with previous procedures. Persons who marked the "Other" racial category and reported any Spanish origin on the Spanish origin question (5,840,648 persons) were distributed to white and black races in proportion to the distribution of persons of Hispanic origin who actually reported their race as "White" or "Black." This was done for each age-sex group. As a result of this procedure, 5,705,155 persons (98 percent) were added to the white population and 135,493 persons (2 percent) to the black population. Persons who marked the "Other" racial category and reported that they were not of Spanish origin (916,338 persons) were distributed as follows: 20 percent in each age-sex group were added to the "Asian and Pacific Islander" category (183,268 persons), and 80 percent were added to the "White" category (733,070 persons). The count of American Indians, Eskimos, and Aleuts was not affected by these procedures. Unpublished tabulations of these modified census counts were obtained from the U.S. Bureau of the Census and used to compute the rates for this volume. Population estimates for 1971-79-Death rates in this volume for 1971-79 used revised population estimates that are consistent with the 1980 census levels. The 1980 census enumerated approximately 5.5 million more persons than had previously been estimated for April 1, 1980 (U.S. Bureau of the Census, 1982b). These revised estimates for the United States by age, race, and sex are published by the U.S. Bureau of the Census in Current Population Reports, Series P-25, Number 917. Unpublished revised estimates for States were obtained from the U.S. Bureau of the Census. For Puerto Rico, the Virgin Islands, and Guam, revised estimates are published in Current Population Reports, Series P-25, Number 919. Population estimates for 1961-69-Death rates in this volume for 1961-69 are based on revised estimates of the population and thus may differ slightly from rates published before 1976. The rates shown in tables 1-1 and 1-2, the life table values in table 6-5, and the population estimates in table 7-1 for each year in the period 1961-69 have been revised to reflect modified population bases, as published in the U.S. Bureau of the Census, Current Population Reports, Series P-25, Number 519. The data shown in table 1-10 for 1961-69 have not been revised. Rates and ratios based on live births-Infant and maternal mortality rates, and fetal death and perinatal mortality ratios, are computed on the basis of the number of live births. Fetal death and perinatal mortality rates are computed on the basis of the number of live births and fetal deaths. Counts of live births are published annually in Vital Statistics of the United States, Volume I, Natality. New Jersey-As previously indicated, data by race are not available for New Jersey for 1962 and 1963. Therefore for 1962 and 1963 the National Center for Health Statistics estimated a population by age, race, and sex excluding New Jersey for rates shown by race. The methodology used to estimate the revised population excluding New Jersey is discussed in the Technical Appendixes of the 1962 and 1963 volumes. 3Net Census Undercount Just as the underenumeration of deaths and the misreporting of demographic characteristics on the death certificate can introduce error into the annual rates, so can enumeration errors in the latest decennial census. This is because annual population estimates for the postcensal interval, which are used in the denominator for calculating death rates, are computed using the decennial census count as a base (U.S. Bureau of the Census, 1988). Net census undercount is the result of miscounting and misreporting of demographic characteristics such as age. Age-specific death rates are affected by both the net census undercount and the misreporting of age on the death certificate (NCHS, 1968b). To the extent that the net undercount is substantial and that it varies among subgroups and geographic areas, it may have important consequences for vital statistics measures. Although death rates based on a population adjusted for net census undercount may be more accurate than rates based on an unadjusted population, rates in this volume are not adjusted; rather, they are computed using population estimates that preserve the age pattern of the net census undercount across the postcensal interval. Thus, it is important to consider the possible impact of net census undercount on death rates. The U.S. Bureau of the Census has conducted extensive research on completeness of coverage of the U.S. population (including underenumeration and misstatement of age, race, and sex) in the last four decennial censuses- 1950, 1960, 1970, and 1980. From this work have come estimates of the national population that was not counted by age, race, and sex (U.S. Bureau of the Census, 1974, 1977). The reports for 1980 include estimates of net census undercount using alternative methodological assumptions for age, race, and sex subgroups of the national population (Passel and Robinson, 1985). These studies indicate that, although coverage was improved over previous censuses, there was differential coverage in the 1980 census among the population subgroups; that is, some age, race, and sex groups were more completely counted than others. Net census undercounts can affect (1) levels of the observed vital rates, (2) differences among groups, and (3) levels and group differences shown by summary measures such as age-adjusted death rates and life expectancy. Levels and differentials-If adjustments were made for net census undercount, the size of denominators of the death rates generally would increase and the rates, therefore, would decrease. The adjusted rates for 1980 can be computed by multiplying the reported rates by ratios of the census- level resident population to the resident population adjusted for the estimated net census undercount (table 7-4). A ration of less than 1.0 indicates a net census undercount and, when applied, results in a corresponding decrease in the death rate. A ratio greater than 1.0-indicating a net census overcount-multiplied by the reported rate results in an increase in the death rate. Coverage ratios for all ages show that, in general, females were more completely enumerated than males and the white population more completely than the population of all other races in the 1980 Census of Population. The black population was undercounted relative to the total population of all other races. For the total population, underenumeration varied by age group, with the greatest differences found for persons aged 80-84 and 85 years and over. All other age groups were overcounted or undercounted by less than 3 percent. Among the age-sex-race groups, coverage was lowest for black males aged 40-44 and 45-49 years. Underenumeration for these groups was 19 percent. In contrast, white females in these age groups were essentially completely enumerated. For black females and white males in these same age groups, the undercount ranged from 3 to 6 percent. For the under-1-year age group the white population was overenumerated by 2 percent, whereas infants of other races were underenumerated by 9 percent. If vital statistics measures were calculated with adjustments for net census undercounts for each population subgroup, the resulting rates would be differentially reduced from their original levels; that is, rates for those groups with the greatest estimated undercounts would show the greatest relative reductions due to these adjustments. Similar effects would be evident in the opposite direction for groups with overcounts. As a consequence, the ratio of mortality between the rates for males and females, and between the rates for the white population and the population of other races, or the black population, usually would be reduced. Similarly, the differences between the death rates among subgroups of the population by cause of death would be affected by adjustments for net census undercounts. For example, for the age group 35-39 years in 1980, the ratio of the death rate for Homicide and legal intervention for black males to that for white males is 7.3, whereas the ratio of the death rates adjusted for net census undercount is 6.2. For Ischemic heart disease for males aged 40-44 years, the ratio of the death rate for the population of all other races to that for the white population is 1.2 using the unadjusted rates, but it is 1.1 when adjusted for estimated under-enumeration. Summary measures-The effect of net census undercount on age-adjusted death rates depends on the under-enumeration of each age group and on the distribution of death by age. Thus, the age-adjusted death rate in 1980 for All causes would decrease from 585.8 to 579.3 per 100,000 population if the age-specific death rates were corrected for net census undercount. For Diseases of the heart, the age-adjusted death rate for white males would decrease from 277.5 to 273.0 per 100,000 population, a decline of 1.3 percent. For black males the change, from an unadjusted rate of 327.3 to an adjusted rate of 308.3, would amount to 5.8 percent. If death rates by age were adjusted, then the corresponding life expectancy at birth computed from these rates would change. The importance of adjustments varies by age; that is, when calculating life expectancy, the impact of an undercount or overcount is greatest at the younger ages. In general, the effect of correcting the death rates is to increase the estimate of life expectancy at birth. Differential underenumeration among race-sex groups would lead to greater changes in life expectancy for some groups than for others. For white females who were completely enumerated in 1980, revised estimates of life expectancy would remain roughly constant; those for black males would show the greatest increase. 3Age-Adjusted Death Rates Age-adjusted death rates shown in this volume are computed by using the distribution in 10-year intervals of the enumerated population of the United States in 1940 as the standard population. Each figure represents the rate that would have existed if the age-specific rates of the particular year prevailed in a population whose age distribution was the same as that of the United States in 1940. The rates for the total population and for each race- sex group were adjusted using the same standard population. It is important not to compare age-adjusted death rates with crude rates. The standard 1940 population, on the basis of one million total population, is as follows: Age Number All ages. . . . . . . . . . . 1,000,000 Under 1 year . . . . . . . . . . . 15,343 1-4 years. . . . . . . . . . . . . 64,718 5-14 years . . . . . . . . . . . . 170,355 15-24 years. . . . . . . . . . . . 181,677 25-34 years. . . . . . . . . . . . 162,066 35-44 years. . . . . . . . . . . . 139,237 45-54 years. . . . . . . . . . . . 117,811 55-64 years. . . . . . . . . . . . 80,294 65-74 years. . . . . . . . . . . . 48,426 75-84 years. . . . . . . . . . . . 17,303 85 years and over. . . . . . . . . 2,770 3Life Tables U.S. abridged life tables are constructed by reference to a standard table (NCHS, 1966). Life tables for the decennial period 1979-81 are used as the standard life tables in constructing the 1980-86 abridged life tables. With the availability of the 1979-81 standard life tables, revised life table values were computed for 1980-82; these appeared for the first time in Vital Statistics of the United States, 1983. Life tables for the decennial period 1969-71 are used as the standard life tables in constructing the 1970-79 abridged life tables. Life table values for 1970-73 were first revised in Vital Statistics of the United States, 1977; before 1977, life table values for 1970-73 were constructed using the 1959-61 decennial life tables. In addition, life table values for 1951-59, 1961-69, and 1971-79 appearing in this volume are based on revised intercensal estimates of the populations for those years. As such, these life table values may differ from life table values for those years published in previous volumes. The change in the population estimation methodology (se above section "Population bases") results in life expectancies at certain 5-year age intervals for 1984-86 that are lower than those that would have occurred had they been based on the same methodology used to compute 1983 life expectancies. For additional details, see Technical Appendix for Vital Statistics of the United States, 1984, Volume II. There has been an increasing interest in data on average length of life () for single calendar years before the initiation of the annual abridged life table series for selected race-sex groups in 1945. The figures in table 6-5 for the race and sex groups for the following years were estimated to meet these needs. For estimating procedures, see National Office of Vital Statistics (1951). Race and Years sex groups 1900-45. . . . . . . . . . . . . Total 1900-47. . . . . . . . . . . . . Male 1900-47. . . . . . . . . . . . . Female 1900-50. . . . . . . . . . . . . White 1900-44. . . . . . . . . . . . . White, male 1900-44. . . . . . . . . . . . . White, female 1900-50. . . . . . . . . . . . . All other 1900-44. . . . . . . . . . . . . All other, male 1900-44. . . . . . . . . . . . . All other, female The geographic areas covered in life tables before 1929-31 were limited to the death-registration areas. Life tables for 1900-02 and 1909-11 were constructed using mortality data from the 1900 death-registration States-10 States and the District of Columbia-and for 1919-21 from the 1920 death- registration States-34 States and the District of Columbia. The tables for 1929-31 through 1958 cover the conterminous United States. Decennial life table values for the 3-year period 1959-61 were derived from data that include both Alaska and Hawaii for each year (table 6-4). Data for each year shown in table 6-5 include Alaska beginning in 1959 and Hawaii beginning in 1960. It is believed that the inclusion of these two States does not materially affect life table values. 3Random Variation in No. of Deaths,Death Rates,Mort. Rates/Ratios Deaths and population-based rates-Except for 1972, the numbers of deaths reported for a community represent complete counts of such events. As such, they are not subject to sampling error, although they are subject to errors in the registration process. However, when the figures are used for analytical purposes, such as the comparison of rates over a time period or for different areas, the number of events that actually occurred may be considered as one of a large series of possible results that could have arisen under the same circumstances (National Office of Vital Statistics,1961). The probable range of values may be estimated from the actual figures according to certain statistical assumptions. In general, distributions of vital events may be assumed to follow the binomial distribution. Estimates of standard error and tests of significance under this assumption are described in most standard statistics texts. When the number of events is large, the standard error, expressed as a percent of the number or rate, is usually small. When the number of events is small (perhaps less than 100) and the probability of such an event is small, considerable caution must be observed in interpreting the conditions described by the figures. This is particularly true for infant mortality rates, cause-specific death rates, and death rates for counties. Events of a rare nature may be assumed to follow a Poison probability distribution. For this distribution, a simple approximation may be used to estimate a confidence interval, as follows. If N is the number of registered deaths in the population and R is the corresponding rate, the chances are 19 in 20 that 1. N - 2 N and N + 2 N covers the "true" number of events. R R 2. R - 2 -- and R + 2 -- N N If the rate R corresponding to N events is compared with the rate S corresponding to M events, the difference between the two rates may be regarded as statistically significant, if it exceeds 2 R1 + S2 N M For example, if the observed death rate for Community A were 10.0 per 1,000 population and if this rate were based on 20 recorded deaths, then the chances are 19 in 20 that the "true" death rate for that community lies between 5.5 and 14.5 per 1,000 population. If the death rate for Community A of 10.0 per 1,000 population were being compared with a rate of 20.0 per 1,000 population for Community B, which is based on 10 recorded deaths, then the difference between the rates for the two communities is 10.0. This difference is less than twice the standard error of the difference 2 (10.0)2 + (20.0)2 20 10 of the two rates, which is computed to be 13.4. From this, it is concluded that the difference between the rats for the two communities is not statistically significant. 2Symbols Used in Tables Data not available _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Category not applicable_ _ _ _ _ _ _ _ _ _ _ _ _ ... Quantity zero_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Quantity more than zero but less than 0.05 _ _ _ 0.0 Quantity more than zero but less than 500 where numbers are rounded to thousands _ _ _ Z Figure does not meet standards of reliability or precision _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . 2References Frost, F. and K. K. Shy, 1980. Racial differences between linked birth and infant death records in Washington State. Am. J. Public Health 70:974- 976. Gred, A. E., R. M. Pauli, and R. S. Kirby, 1987, Accuracy of fetal death reports: Comparison with data from an independent stillbirth assessment program. Am. J. Public Health 77:1202-1206. Guralnick, L., and E. D. Winter, 1965. A note on cohort infant mortality rates. Public Health Rep. 80:692-694. McCarthy, B., J. Terry, R. Rochat, et al. 1980. The underregistration of neonatal deaths: Georgia 1974-77. Am. J. Public Health 70:977-982. National Center for Health Statistics, M. G. Sirken, 1966. Comparison of two methods of constructing abridged life tables by reference to a "standard" table. Vital and Health Statistics, Series 2, No. 4, PHS Pub., No. 1000. Public Health Service, Washington: U.S. Government Printing Office. National Center for Health Statistics, R. D. Grove and A. M. Hetzel, 1968a. Vital Statistics Rates in the United States, 1940-60. Public Health Service, Washington: U.S. Government Printing Office. National Center for Health Statistics, T. Z. Hambright, 1968b. Comparability of age on the death certificate and matching census records. United States, May-August 1960. Vital and Health Statistics, Series 2, No. 29. PHS Pub. No. 1000. Public Health Service, Washington: U.S. Government Printing Office. National Center for Health Statistics, M. A. McCarthy, 1969. Comparison of the classification of place of residence on death certificates and matching census records. United States, May-August 1960. Vital and Health Statistics, Series 2, No. 30. PHS Pub. No. 1000. Public Health Service, Washington: U.S. Government Printing Office. National Center for Health Statistics, A. J. Klebba, 1970. Mortality from selected causes by marital status, United States, Parts A & B. Vital and Health Statistics, Series 20, No. 8a, Series 20, No. 8b. PHS Pub. No. 1000. Public Health Service, Washington: U.S. Government Printing Office. National Center for Health Statistics, 1978. Model State Vital Statistics Act and Model State Vital Statistics Regulations. DHEW Pub. No. (PHS) 78-1115. Public Health Service, Washington: U.S. Government Printing Office. National Center for Health Statistics, 1979. Vital statistics, computer edits for mortality data effective 1979. NCHS Instruction Manual, Part II. Public Health Service, Hyattsville, Md. National Center for Health Statistics, 1980. Estimates of selected comparability ratios based on dual coding of 1976 death certificates by the Eighth and Ninth Revisions of the International Classification of Diseases. Monthly Vital Statistics Report. Vol. 28, No. 11, Supp. DHEW Pub. No.(PHS) 80-1120. Public Health Service, Hyattsville, Md. National Center for Health Statistics, 1981. State Definitions and Reporting Requirement for Live Births, Fetal Deaths, and Induced Terminations of Pregnancy, DHLHS Pub. No. (PHS) 81-1119. Public Health Service, Washington: U.S. Government Printing Office. National Center for Health Statistics, A. Gittelsohn and P. N. Royston, 1982. Annotated bibliography of cause-of-death validation studies, 1958-80. Vital and Health Statistics Series 2, No. 89, DHHS Pub. No. (PHS) 82-1363. Public Health Service, Washington: U.S. Government Printing Office. National Center for Health Statistics, 1985. Vital statistics, vital records geographic classification, 1982. NCHS Instruction Manual, Part 8. Public Health Service, Hyattsville, Md National Center for Health Statistics, 1986a. Vital statistics, classification and coding instructions for fetal death records. NCHS Instruction Manual, Part 3b. Public Health Service, Hyattsville, Md. National Center for Health Statistics, 1986b. Vital statistics, demographic classification and coding instructions for death records. NCHS Instruction Manual, Part 4. Public Health Service, Hyattsville, Md. National Center for Health Statistics, 1986c. Instructions for classifying multiple causes of death, 1986. NCHS Instruction Manual, Part 2b. Public Health Service, Hyattsville, Md. National Center for Health Statistics, 1986d. Non-indexed terms, standard abbreviations, and state geographic codes used in mortality data classification, 1986. NCHS Instruction Manual, Part 2e. Public Health Service, Hyattsville, Md. National Center for Health Statistics, 1986e. Vital statistics, ICD-9 ACME decision tables for classifying underlying causes of death, 1986. NCHS Instruction Manual, Part 2c. Public Health Service, Hyattsville, Md. National Office of Vital Statistics, F. E. Linder and R. D. Grove, 1947. Vital Statistics Rates in the United States, 1900-1940. U.S. Public Health Service, Washington: U.S. Government Printing Office. National Office of Vital Statistics, 1950. International Recommendations on Definitions of Live Birth and Fetal Death, PHS Pub. No. 39. Public Health Service, Washington: U.S. Government Printing Office. National Office of Vital Statistics, T. N. E. Greville and G. A. Carlson, 1951. Estimated average length of life in the death-registration States. Vital Statistics-Special Reports, Vol. 33, No. 9. Public Health Service, Washington, D.C. National Office of Vital Statistics, C. L. Chiang, 1961. Standard error of the age-adjusted death rate. Vital Statistics-Special Reports, Vol. 47, No. 9. Public Health Service, Washington, D.C. National Vital Statistics Division, 1962. Matched record comparison of birth certificate and census information. United States, 1950. Vital Statistics-Special Reports, Vol. 47, No. 12. Public Health Service, Washington, D.C. Passel, J. S. and J. G.Robinson, 1985. Revised Demographic Estimates of the Coverage of the Population by Age, Sex, and Race in the 1980 Census. Unpublished memorandum, Apr. 8, 1985. U.S. Bureau of the Census, Washington, D.C. U.S. Bureau of the Census, 1974. Estimates of coverage of the population by sex, race, and age-demographic analysis. 1970 Census of Population and Housing, PHC(E)-4. Washington: U.S. Government Printing Office. U.S. Bureau of the Census, 1977. Developmental estimates of the coverage of the population of States in the 1970 census-demographic analysis. Current Population Reports, Series P-23, No. 65. Washington: U.S. Government Printing Office. U.S. Bureau of the Census, 1982a. 1980 Census of Population. Persons of Spanish Origin by State, 1980. Supplementary Report PC80-S1-7. Washington, D.C. U.S. Bureau of the Census, 1982b. Coverage of the national population in the 1980 census by age, sex, and race. Preliminary estimates by demographic analysis. Current Population Reports, Series P-23, No. 115. Washington: U.S. Government Printing Office. U.S. Bureau of the Census, 1988. United States population estimates by age, sex, and race: 1980 to 1987. Current Population Reports, Series P-25, No. 1022. Washington: U.S. Government Printing Office. U.S. Office of Management and Budget, 1975. Standard Metropolitan Statistical Areas, revised. Washington: U.S. Government Printing Office. U.S. Office of Management and Budget, 1981a. Standard metropolitan statistical areas and standard consolidated areas. Statistical Reporter, Washington: U.S. Government Printing Office. U.S. Office of Management and Budget, 1981b. 36 new standard metropolitan statistical areas. Statistical Reporter, Washington: U.S. Government Printing Office. World Health Organization, 1977. Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death, Based on the Recommendations of the Ninth Revision Conference, 1975. Geneva World Health Organization.
