Scientific Data DocumentationEpidemiologic Followup Study, 1992 MortalityACKNOWLEDGMENTSOverall responsibility for the data processing and the compilation and documentation for the NHANES I Epidemiologic Followup Study (NHEFS), 1992 Mortality Data Public Use data tape rested with Christine S. Cox. Assistance was provided by other members of the NHEFS data management team: Sandra T. Rothwell, Michael Mussolino, Jennifer H. Madans, Dawn M. Scott, Madelyn A. Lane, Keith Zevallos, Cordell Golden, Cynthia Reuben, Joel C. Kleinman, and Jacob J. Feldman. Special thanks are extended to Joan Cornoni-Huntley of the National Institute on Aging (NIA) who played an important role in the development and continuation of the NHEFS. The contribution of the contractor, Westat Inc., of Rockville, Maryland, who conducted the field work is also gratefully acknowledged.The NHEFS originated as a joint project between the National Center for Health Statistics (NCHS) and NIA. It has been funded primarily by NIA, with additional financial support from the following components of the National Institutes of Health and other Public Health Service agencies: the National Center for Chronic Disease Prevention and Health Promotion; the National Cancer Institute; the National Heart, Lung, and Blood Institute; the National Institute on Alcohol Abuse and Alcoholism; the National Institute of Mental Health; the National Institute of Diabetes and Digestive and Kidney Diseases; the National Institute of Arthritis and Musculoskeletal and Skin Diseases; the National Institute of Allergy and Infectious Diseases; and, the National Institute of Neurological and Communicative Disorders and Stroke. ContentsPage Use of NHEFS Data.................................................... 1Errors in the Data Tapes and Survey Differences...................... 2Introduction to the 1992 NHEFS Mortality Data Tape Documentation..... 3NCHS Procedures Used to Code Multiple Cause Data..................... 91992 NHEFS Mortality Data Tape Characteristics....................... 161992 NHEFS Mortality Data Tape Record Layout......................... 171992 NHEFS Mortality Data Public Use Tape Documentation.............. 18Appendix 1 NCHS ICD-9th Revision 282 Cause of Death Recodes.......... 37 Appendix 2 NCHS ICD-9th Revision 72 Cause of Death Recodes........... 45 Appendix 3 NCHS ICD-9th Revision 34 Cause of Death Recodes........... 47Use of NHEFS DataWith the goal of mutual benefit, NCHS requests the cooperation of recipients of data tapes in certain actions related to their use:A. Any published material derived from the data should acknowledge the National Center for Health Statistics (NCHS) as the original source. It should also include a disclaimer which credits any analyses, interpretations, or conclusions reached to the author (recipient of the tape) and not to NCHS, which is responsible only for the initial data.B. Consumers who wish to publish a technical description of the data will make a reasonable effort to insure that the description is not inconsistent with that published by NCHS. This does not mean, however, that NCHS will review such descriptions.C. Authors should provide NCHS with a reprint of published articles which utilize the 1992 NHEFS data. Please send reprints to:NHEFS Data Management Staff Division of Epidemiology National Center for Health Statistics Presidential Building, Room 730 6525 Belcrest Road Hyattsville, Maryland 20782ERRORS IN THE NHEFS DATA TAPES AND SURVEY DIFFERENCESThe NHEFS Public Use data tapes have been subjected to a great deal of careful editing. However, due to the large volume of data in the series, it is likely that a small number of errors or discrepancies remain undetected.In general, the NHEFS data management team has not attempted to resolve substantive data discrepancies that may exist 1) within the 1992 NHEFS data tapes, or 2) between the 1992 NHEFS data tapes and the data tapes of the original National Health and Nutrition Examination Survey (NHANES I) and/or other NHEFS followup waves. INTRODUCTION TO THE 1992 NHEFS MORTALITY DATA TAPE DOCUMENTATIONThe NHANES I Epidemiologic Followup Study (NHEFS) is a longitudinal study which uses as its baseline those adult persons ages 25 to 74 years who were examined in the first National Health and Nutrition Examination Survey (NHANES I). The NHEFS is comprised of a series of four followup surveys. The first wave of data collection, the 1982-84 NHEFS, was conducted from 1982 to 1984 and included all persons who were between 25 and 74 years at their NHANES I examination (n=14,407). The second wave of data collection, the 1986 NHEFS, was conducted for members of the NHEFS cohort who were 55-74 years at their baseline examination and not known to be deceased at the 1982-84 NHEFS (n=3,980). The third wave, the 1987 NHEFS, was conducted for the entire non- deceased NHEFS cohort (n=11,750). The fourth wave of data collection, the 1992 NHEFS, includes the entire non-deceased NHEFS cohort (n=11,195).NHANES I collected data from a national probability sample of the United States civilian noninstitutionalized population between the ages of 1 and 74 years. The survey, which included a standardized medical examination and questionnaires that covered various health-related topics, took place from 1971 through 1974 and was augmented by an additional national sample in 1974-75. The NHANES I sample included 20,729 persons 25 to 74 years of age, of whom 14,407 (70 percent) completed a medical examination. The design, content and operation of NHANES I has been described elsewhere (Vital and Health Statistics, Series 1, Nos. 10a, 10b, and 14).Although NHANES I provided a wealth of information on the prevalence of health conditions and risk factors, the cross-sectional nature of the original survey limits its usefulness for studying the effects of clinical, environmental, and behavioral factors and in tracing the natural history of disease. Therefore, the NHEFS was designed to investigate the association between factors measured at the baseline and the development of specific health conditions. It originated as a joint project between the National Center for Health Statistics (NCHS) and the National Institute on Aging with collaboration from components of the National Institutes of Health and other Public Health Service agencies. The 14,407 participants who were 25 to 74 years of age when they were examined in NHANES I (1971-75) were included in the followup study population.In the first wave, the 1982-84 NHEFS, data were collected on all 14,407 subjects (i.e., individuals examined at NHANES I) in the cohort. Tracing of subjects began in 1981 and data collection was conducted from 1982 to 1984. Approximately 93 percent (n=13,383) of the cohort was successfully traced by the end of the survey period. Detailed information on the design, content, and operation of the 1982-84 NHEFS may be found in the Plan and Operation of the NHANES I Epidemiologic Followup Study 1982-84, Vital and Health Statistics, Series 1, No. 22. The basic design of the 1982-84 NHEFS consisted of the following components:-- tracing subjects or their proxies to a current address;-- acquiring death certificates for deceased subjects;-- performing in-depth interviews with the subjects or with their proxies including, for surviving subjects, taking pulse, blood pressure, and weight measurements of subjects; and,-- obtaining hospital and nursing home records, including pathology reports and electrocardiograms.The second wave of NHEFS, the 1986 NHEFS, was conducted to assess changes in the health and functional status of the oldest members of the NHEFS cohort since the last contact period. It included 5,677 subjects who were 55 years or older at their NHANES I examination (almost 40 percent of the entire NHEFS cohort). Data collection was restricted to 3,980 subjects aged 55 years or older at NHANES I who were not known to be deceased at the time of the 1982-84 NHEFS, regardless of their tracing or interview status in 1982-84. The remaining 1,697 subjects who were deceased at the time of the 1982-84 NHEFS were excluded from additional data collection in the 1986 NHEFS. Detailed information on the design, content, and operation of the 1986 NHEFS may be found in the Plan and Operation of the NHANES I Epidemiologic Followup Study, 1986, Vital and Health Statistics, Series 1, No. 25.The 1987 NHEFS, the third wave of data collection, was conducted to continue to collect information on changes in the health and functional status of the NHEFS cohort since the last contact period. Tracing and data collection were conducted during this followup survey only for the members of the NHEFS cohort who had not been identified as deceased in 1982-84 or 1986 (n=11,750) regardless of their previous tracing or interview status. The 2,657 previously deceased subjects were excluded from further data collection in the 1987 NHEFS. Detailed information on the design, content, and operation of the 1987 NHEFS may be found in the Plan and Operation of the NHANES I Epidemiologic Followup Study, 1987, Vital and Health Statistics, Series 1, No. 27.The fourth wave of the NHEFS, the 1992 NHEFS, collected information on changes in the health and functional status of the NHEFS cohort since the last contact. The 1992 NHEFS cohort includes 3,212 subjects who were deceased at the time of the 1982-84, 1986 and 1987 NHEFS and 11,195 subjects who were not known to be deceased prior to the 1992 NHEFS data collection period. Tracing and data collection in the 1992 NHEFS was undertaken only for the non-deceased subjects, regardless of their tracing or interview status in previous surveys. The 3,212 previously deceased subjects were excluded from additional data collection in the 1992 NHEFS. Detailed information on the design, content, and operation of the 1992 NHEFS may be found in the Plan and Operation of the NHANES I Epidemiologic Followup Study, 1992, Vital and Health Statistics, Series 1, No. 35.The design and data collection procedures adopted in the 1992 NHEFS were very similar to the ones developed in the previous surveys: subjects were traced; subject and proxy interviews were conducted; and, health care facility abstracts and death certificates were collected. All subjects whose vital status was not obtained through tracing procedures were considered lost-to- followup in the 1992 NHEFS. In some cases, information about the death of a subject was obtained from a former neighbor, a relative or another tracing source. Although this information was noted in the subject's tracing record, he or she was considered lost-to-followup unless the information was verified by means of a death certificate or proxy interview. A subject's death had to be confirmed by either a death certificate or proxy interview.In addition to verifying the subject's vital status, the tracing process also was used to obtain the current address of surviving subjects as well as to identify a knowledgeable proxy respondent for deceased subjects. Respondents who were identified and located through the tracing procedures were asked to participate in a telephone interview. In a few cases, subjects who had been traced successfully could not be relocated for the interview. Only their vital status and the date when they were last traced in the 1992 survey are available.A major difference between the NHEFS waves was the manner in which the interviews were conducted. In the 1982-84 NHEFS, the two-hour subject interview was usually conducted in-person while, in subsequent followups, the interview was shortened to approximately 30 minutes in length and was conducted primarily by telephone. In addition, since the questionnaire was not administered in-person, no physical measurements were made in the later followups.The 1992 NHEFS interviews were conducted over the telephone using a Computer Assisted Telephone Interviewing (CATI) system. CATI is a telephone interviewing technique that allows the interviewer to enter the answers supplied by the respondent directly into the computer. Thus, editing and coding time is reduced and keypunching from a hard copy questionnaire is eliminated. A computer program drives the questionnaire so that the correct skip patterns are followed and the appropriate questions are displayed on the computer monitor. The skip patterns are based on information gathered from previous data collection waves or on responses provided during the 1992 interview. For example, certain questions on pregnancy and menstrual history in the 1992 interview were programmed to be skipped automatically if the subject was male or if the female subject was interviewed previously and was 45 years of age or older at the time of that interview. Edit and logic checks are incorporated into the data collection system itself, thus improving the quality of the data.As of July 19, 1993, the end of the 1992 NHEFS data collection period, 10,079 (90.0 percent) of the 11,195 members of the 1992 NHEFS cohort had been successfully traced. Interviews were conducted for 9,281 subjects (92.1 percent of those successfully traced). In addition, 10,535 facility stay records were collected for 4,162 subjects using information obtained from the interview, death certificate, or some other source. Death certificates were obtained for 1,374 (98.7 percent) of the 1,392 subjects who were known to have died since last contact. Detailed information on the design, content, and operation of the 1992 NHEFS may be found in the Plan and Operation of the NHANES I Epidemiologic Followup Study 1992, Vital and Health Statistics, Series 1, No. 35.The data collected from the 1992 NHEFS are stored on four separate tapes:1) Vital and Tracing Status tape -- contains summary information about the status of the entire NHEFS cohort, 2) Interview tape -- contains the data collected from the subject and proxy interviews, 3) Health Care Facility Stay tape -- contains information on reports of stays in hospitals and nursing homes as well as information abstracted from facility medical records, 4) Mortality Data tape -- contains data abstracted from the death certificates from all three NHEFS surveys. This tape is discussed below in more detail.There are 4,497 records on the 1992 NHEFS Mortality Data Public Use tape. It contains the death certificate information for all subjects who were identified as deceased in either the 1982-84, 1986, 1987, or 1992 NHEFS and for whom a death certificate was obtained. Positions 3-7 contain the Sample Sequence Number, which is the subject identification number. This number is unique for each subject and is used when linking files. By using the Sample Sequence Number, the NHEFS 1992 Followup Mortality Data tape can be linked to all other NHEFS and NHANES I data tapes.The layout of this tape is identical to the layout used for the previous NHEFS Mortality Data Public Use tapes. The source flag variable located in position 18 indicates the survey in which the subject was identified as deceased and when his or her death certificate was received. Records with a source code of 1 identify 1982-84 Followup decedents whose death certificates were received during the 1982-84 NHEFS data collection period. (Several data items on one of the records from the 1982-84 tape have been updated on this file based on data collected since the release of the 1982-84 NHEFS Mortality Public Use tape.) A source code of 2 identifies 1982-84 Followup decedents whose death certificates were received after the end of the 1982-84 survey period. Records with a source code of 3 identify 1986 Followup decedents whose death certificates were received during the 1986 NHEFS data collection period. A source code of 4 is assigned to subjects who were first identified as deceased in the 1987 NHEFS and whose death certificates were obtained during that Survey. Records with a source code of 5 identify 1992 Followup decedents whose death certificates were received during the 1992 NHEFS data collection period. Lastly, a source code of 6 identifies 1987 Followup decedents whose death certificates were received after the end of the 1987 survey period.The 1992 NHEFS Mortality Data Public Use tape follows the coding specifications used for the NCHS Multiple Cause-of-Death Public Use Data tapes. No attempts have been made to resolve any discrepancies that may exist between the demographic information coded on this data tape and the information from other NHEFS or NHANES I data tapes.An asterisk next to variables listed in the record layout documentation indicates that the variable was computer-generated. All other variables (excluding Sample Sequence Number) are extracted directly from the subject's death certificate.A change occurred in the geographic coding from the death certificate after the close of the 1982-84 NHEFS survey period. If the Death Certificate Source Flag in position 18 is coded 1, the Population Size of City of Residence and Metropolitan-Nonmetropolitan County of Residence variables coded in positions 39 and 40, respectively, are based on data from the 1970 Census. If the Death Certificate Source Flag is coded 2 through 5, then these two place of residence variables are based on data from the 1980 Census. If the Death Certificate Source Flag is coded 6 then these variables are based on data from the 1990 Census. NCHS Procedures Used to Code Multiple Cause DataThe original scheme for coding conditions listed on the death certificate was designed 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, the codification 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, the Division of Vital Statistics (DVS) at the National Center for Health Statistics chose 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. The 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 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 translation:Case 1: When reported on 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 CodesThe 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: The 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 byte indicates the position of the codes on the line, i.e., it is the first (1), second (2), ---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 is 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.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 Instructions Manual Series.ENTITY AXIS APPLICATIONS: The entity axis multiple cause data set 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 code does not necessarily reflect the best code for a condition when considered within 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 notes in 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 CodesThe 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. Locational 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 byte 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.EDIT: The record axis codes are edited for rare causes and age/cause and sex/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 conditions have been linked into the most meaningful categories for the certification. The most immediate consequences 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 code as literally representing the 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.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 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. Additional Reference DocumentsThe following documents provide detailed information on the rules employed for coding multiple cause of death information from death certificate records:1. Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death: Based on the Recommendations of the Ninth Revision Conference, 1975, and Adopted by the Twenty-ninth World Health Assembly, Volumes 1 and 2, 1977 (World Health Organization).2. NCHS Instruction Manual Data Preparation Part 2a, Vital Statistics Instructions for Classifying the Underlying Cause of Death, 1979.3. NCHS Instruction Manual Data Preparation, Part 2b, Vital Statistics Instructions for Classifying Multiple Causes of Death, 1979.4. NCHS Instruction Manual Data Preparation, Part 2c, Vital Statistics ICD-9 ACME Decision Tables for Classifying Underlying Causes of Death, 1979.5. NCHS Instruction Manual Data Preparation, Part 2f, Vital Statistics ICD-9 TRANSAX Disease Reference Tables for Classifying Multiple Causes of Death, 1981. Data Tape Characteristics Data Set Name: NHEFS3.MORT87PBRecord Length: 440Blocksize: 32560Number of Records: 4,497Number of Reels: 1Recording Mode: FIXED BLOCK, EBCDICDensity: 6250 bpiChannel: 9 TRACKCreated by: Office of Analysis and Epidemiology Division of Epidemiology National Center for Health Statistics Presidential Building, Room 730 6525 Belcrest Road Hyattsville, Maryland 20782 RECORD LAYOUTTape Data Items Positions1. Sample Sequence Number 3-72. Generala. Year of death 1-2 b. Death certificate source flag 18 c. Record type 19 d. Resident status 20 e. Month of death 55-56 f. Day of death 57-583. Occurrencea. Region 26 b. Division 27 c. Place of death--hospital and status 754. Residencea. Population size of city of residence 39 b. Metropolitan/nonmetropolitan county 40 c. Region 41 d. Division 425. The Decedenta. Sex 59 b. Race 60-63 c. Age 64-72 d. Marital status 776. Underlying Causea. ICD-9 code 142-145 b. 282 cause recode 146-150 c. 72 cause recode 151-153 d. 34 cause recode 157-159 e. Autopsy performed 84 f. Place of accident for causes E850-E929 1417. Multiple Conditionsa. Entity-Axis conditions1. Number of 160-161 2. The conditions 162-301b. Record-Axis conditions1. Number of 338-339 2. The conditions 341-4401-2 2 Year of Death71-93 ... Year of death (1971-1993)(Note: Month and Day of Death are stored in tape locations 55-56 and 57-58, respectively.)3-7 5 Sample Sequence Number8-17 2 Blank18 1 Death Certificate Source Flag (*)1 ... Death certificate received for 1982-84 NHEFS decedent in the 1982-84 NHEFS period 2 ... Death certificate received for 1982-84 NHEFS decedent after the 1982-84 NHEFS period 3 ... Death certificate received for 1986 NHEFS decedent in the 1986 NHEFS period 4 ... Death certificate received for 1987 NHEFS decedent in the 1987 NHEFS period 5 ... Death certificate received for 1992 NHEFS decedent in the 1992 NHEFS period 6 ... Death certificate received for 1987 NHEFS decendent after the 1987 NHEFS period 19 1 Record Type (*)1 ... RESIDENT State and County of Occurrence and Residence are the same. 2 ... NONRESIDENT State and/or County of Occurrence and Residence are different._____________________ *) indicates that the variable was computer-generated. All other variables (excluding Sample Sequence Number) are extracted directly from the subject's death certificate. 20 1 Resident Status (*)1 ... RESIDENT State and County of Occurrence and Residence are the same. 2 ... INTRASTATE NONRESIDENT State of Occurrence and Residence are the same, but County is different. 3 ... INTERSTATE NONRESIDENT State of Occurrence and Residence are different, but both are in the U.S. 4 ... FOREIGN RESIDENT (OCCURRENCE IS IN THE U.S.) State of Occurrence is one of the 50 States or the District of Columbia, but Place of Residence is outside of the U.S. Blank ... PLACE OF OCCURRENCE IS OUTSIDE THE U.S.21-25 5 Blank 26-27 2 Region (*) and Division (*) of Occurrence of Death Position 26 is Region. Position 27 is Division. Divisions are coded within Region and States are coded within Division. The code structure is designed to sequence the states as they appear in NCHS publications.Loc. Loc. 26 270 0 ... OCCURRENCE IS OUTSIDE THE U.S. 1 ... NORTHEAST 1 ... New England ... Maine ... New Hampshire ... Vermont ... Massachusetts ... Rhode Island ... Connecticut 2 ... Middle Atlantic ... New York ... New Jersey ... Pennsylvania 27 2 Region (*) and Division (*) of Occurrence of Death -- ContinuedLoc. Loc. 26 272 ... MIDWEST 3 ... East North Central ... Ohio ... Indiana ... Illinois ... Michigan ... Wisconsin 4 ... West North Central ... Minnesota ... Iowa ... Missouri ... North Dakota ... South Dakota ... Nebraska ... Kansas 3 ... SOUTH 5 ... South Atlantic ... Delaware ... Maryland ... District of Columbia ... Virginia ... West Virginia ... North Carolina ... South Carolina ... Georgia ... Florida 6 ... East South Central ... Kentucky ... Tennessee ... Alabama ... Mississippi 7 ... West South Central ... Arkansas ... Louisiana ... Oklahoma ... Texas26-27 2 Region (*) and Division (*) of Occurrence of Death-- ContinuedLoc. Loc. 26 274 ... WEST 8 ... Mountain ... Montana ... Idaho ... Wyoming ... Colorado ... New Mexico ... Arizona ... Utah ... Nevada 9 ... Pacific ... Washington ... Oregon ... California ... Alaska ... Hawaii28-38 11 Blank39 1 Population Size of City of Residence (*)0 ... Place of 1,000,000 or more persons 1 ... Place of 500,000 to 1,000,000 persons 2 ... Place of 250,000 to 500,000 persons 3 ... Place of 100,000 to 250,000 persons 4 ... Place of 50,000 to 100,000 persons 5 ... Place of 25,000 to 50,000 persons 6 ... Place of 10,000 to 25,000 persons 9 ... All other areas in the U.S. Z ... Foreign resident(Note: If position 18 is coded 1, this variable is based on data from the 1970 Census. If position 18 is coded 2 through 5 then this variable is based on data from the 1980 Census. If position 18 is coded 6 then this variable is based on data from the 1990 Census.)40 1 Metropolitan - Nonmetropolitan County of Residence (*)1 ... Metropolitan county 2 ... Nonmetropolitan county Z ... Foreign resident 9 ... Unknown(Note: If position 18 is coded 1, this variable is based on data from the 1970 Census. If position 18 is coded 2 through 5 then this variable is based on data from the 1980 Census. If position 18 is coded 6 then this variable is based on data from the 1990 Census.) 41-42 2 Region (*) and Division (*) of ResidencePosition 41 is Region. Position 42 is Division. Divisions are coded within Region and States are coded within Division. The code structure is designed to sequence the States as they appear in NCHS publications.Loc. Loc. 41 420 0 ... FOREIGN RESIDENT 1 ... NORTHEAST 1 ... New England ... Maine ... New Hampshire ... Vermont ... Massachusetts ... Rhode Island ... Connecticut 2 ... Middle Atlantic ... New York ... New Jersey ... Pennsylvania 2 ... MIDWEST 3 ... East North Central ... Ohio ... Indiana ... Illinois ... Michigan ... Wisconsin 41-42 2 Region (*) and Division (*) of Residence -- ContinuedLoc. Loc. 41 424 ... West North Central ... Minnesota ... Iowa ... Missouri ... North Dakota ... South Dakota ... Nebraska ... Kansas 3 ... SOUTH 5 ... South Atlantic ... Delaware ... Maryland ... District of Columbia ... Virgin ... West Virginia ... North Carolina ... South Carolina ... Georgia ... Florida 6 ... East South Central ... Kentucky ... Tennessee ... Alabama ... Mississippi 7 ... West South Central ... Arkansas ... Louisiana ... Oklahoma ... Texas 4 ... WEST 8 ... Mountain ... Montana ... Idaho ... Wyoming ... Colorado ... New Mexico ... Arizona ... Utah ... Nevada41-42 2 Region (*) and Division (*) of Residence -- ContinuedLoc. Loc. 41 429 ... Pacific ... Washington ... Oregon ... California ... Alaska ... Hawaii43-51 9 Blank52-53 2 Education00 ... 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 ... Not stated(Note: This information is only available for deaths occurring in 1989 and later. For earlier years, this field will be blank.)54 1 Education Recode1 ... 0 - 8 years 2 ... 9 - 11 years 3 ... 12 years 4 ... 13 - 15 years 5 ... 16 years or more 6 ... Not stated(Note: This information is only available for deaths occurring in 1989 and later. For earlier years, the field will be blank.) (55-58) 4 DATE OF DEATH(Note: Year of Death is given in tape locations 1-2)55-56 2 Month01 ... January 02 ... February 03 ... March 04 ... April 05 ... May 06 ... June 07 ... July 08 ... August 09 ... September 10 ... October 11 ... November 12 ... December57-58 2 Day01-31 ... As applicable to Month of Death 99 ... Not stated59 1 Sex1 ... Male 2 ... Female (60-63) 4 RACESPECIAL INSTRUCTION: For deaths occurring in 1988 and earlier, use definition (a). For deaths occurring in 1989 and later, use definition (b). The two definitions are a result of a change in coding rules.60-61 2 Detail Race (a)00 ... Other Asian or Pacific Islander 01 ... White 02 ... Black 03 ... American Indian (includes Aleuts and Eskimos) 04 ... Chinese 05 ... Japanese 06 ... Hawaiian (includes Part-Hawaiian) 07 ... All other races 08 ... Filipino60-61 1 Detail Race (b)01 ... White 02 ... Black 03 ... American Indian (includes Aleuts and Eskimos) 04 ... Chinese 05 ... Japanese 06 ... Hawaiian(includes Part-Hawaiian) 07 ... Filipino 08 ... Other Asian or Pacific Islander 09 ... All other races62 1 Race Recode #1 (*)1 ... White 2 ... Races other than white or black 3 ... Black63 1 Race Recode #2 (*)1 ... White 2 ... All other races (64-72) 9 AGE OF DEATH(Note: The age at death listed on the death certificate is often incorrect due to erroneous information provided by the informant. The NHEFS team suggests that the analyst use the computer-generated Age at Death variable in positions 67-68 on the 1992 NHEFS Vital and Tracing Status Public Use data tape, which is based on the Date of Death and the NHEFS Date of Birth.)64-66 3 Detail Age at Death029-097 ... Age in years (not inclusive) 999 ... Age not stated(Note: A leading zero in position 64 indicates that the subject was less than 100 years old at Date of Death.)67-68 2 Age of Death Recode #1 (*)31 ... 25 - 29 years 32 ... 30 - 34 years 33 ... 35 - 39 years 34 ... 40 - 44 years 35 ... 45 - 49 years 36 ... 50 - 54 years 37 ... 55 - 59 years 38 ... 60 - 64 years 39 ... 65 - 69 years 40 ... 70 - 74 years 41 ... 75 - 79 years 42 ... 80 - 84 years 43 ... 85 - 89 years 44 ... 90 - 94 years 45 ... 95 - 99 years 46 ... 100 - 104 years 47 ... 105 - 109 years 48 ... 110 - 114 years 49 ... 115 - 119 years 50 ... 120 - 124 years 51 ... 125 years and over 52 ... Age not stated69-70 2 Age of Death Recode #2 (*)11 ... 25 - 29 years 12 ... 30 - 34 years 13 ... 35 - 39 years 14 ... 40 - 44 years 15 ... 45 - 49 years 16 ... 50 - 54 years 17 ... 55 - 59 years 18 ... 60 - 64 years 19 ... 65 - 69 years 20 ... 70 - 74 years 21 ... 75 - 79 years 22 ... 80 - 84 years 23 ... 85 - 89 years 24 ... 90 - 94 years 25 ... 95 - 99 years 26 ... 100 years and over 27 ... Age not stated 71-72 2 Age of Death Recode #3 (*)05 ... 25 - 34 years 06 ... 35 - 44 years 07 ... 45 - 54 years 08 ... 55 - 64 years 09 ... 65 - 74 years 10 ... 75 - 84 years 11 ... 85 years and over 12 ... Age not stated73-74 2 Blank(75) SPECIAL INSTRUCTION: for deaths occurring in 1988 and earlier, use definition (a). For deaths occurring in 1989 and later, use definition (b). The two definitions are a result of a change in coding rules.75 1 (a) Place of Death -- Hospital and Status1 ... Hospital, clinic or medical center - Inpatient 2 ... Hospital, clinic or medical center - Outpatient or admitted to emergency room 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 institutions 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(b) Place of Death -- Decedent's Status1 ... Hospital, clinic or medical center - Inpatient 2 ... Hospital, clinic or medical center - Outpatient or admitted to emergency room 3 ... Hospital, clinic or medical center - Dead on arrival 4 ... Hospital, clinic or medical center - Patient status unknown 5 ... Nursing home 6 ... Residence 7 ... Other 9 ... Place of death unknown76 1 Blank77 1 Marital Status1 ... Never married, single 2 ... Married 3 ... Widowed 4 ... Divorced 8 ... Marital status not on certificate 9 ... Marital status not stated78-83 6 Blank84 1 Autopsy Performed1 ... Yes 2 ... No 8 ... Autopsy performed not on certificate 9 ... Autopsy performed not stated85-140 56 Blank141 1 Place of Accident for Causes E850-E9290 ... Home 1 ... Farm 2 ... Mine and quarry 3 ... Industrial place and premises 4 ... Place for recreation and sports 5 ... Street and highway 6 ... Public building 7 ... Resident institution 8 ... Other specified place 9 ... Place of accident not specified Blank ... Causes other than E850-E929 (142-159) 18 UNDERLYING CAUSE OF DEATH142-145 4 ICD Code (9th Revision)See the Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death: Based on the Recommendations of the Ninth Revision Conference, 1975, and Adopted by the Twenty- ninth World Health Assembly, Volume 1, 1977 (World Health Organization). For injuries and poisonings, the external cause is coded (E800-E999) rather than the Nature of 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, position 145 is blank.146-150 5 Cause-of-Death Recode -- 282 GroupsA recode of the ICD-9 cause-of-death code into 282 groups for NCHS publications. See Appendix 1 for a complete list of recodes and the causes included.00100-35800 ... Code range (not inclusive)151-153 3 Cause-of-Death Recode -- 72 GroupsA recode of the ICD-9 cause-of-death code into 72 groups for NCHS publications. See Appendix 2 for a complete list of recodes and the causes included.010-840 ... Code range (not inclusive)154-156 3 Blank157-159 3 Cause-of-Death Recode -- 34 Groups (*)A recode of the ICD-9 cause code into 34 groups for NCHS publications. See Appendix 3 for a complete list of recodes and the causes included.010-370 ... Code range (not inclusive)(160-440) 281 MULTIPLE CONDITIONS160-161 2 Number of Entity-Axis Conditions01-20 ... Code range (not inclusive) 162-301 140 ENTITY - AXIS CONDITIONSSpace has been provided for 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 IIPosition 2: Sequence of condition within part/line1-8 ... Code rangePositions 3 - 6: ICD-9 condition codeSee the Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death: Based on the Recommendations of the Ninth Revision Conference, 1975, and Adopted by the Twenty- ninth World Health Assembly, Volume 1, 1977 (World Health Organization) for a complete list of codes.Position 7: Nature of Injury Flag1 ... Indicates that the code in positions 3-6 is a Nature of Injury code0 ... All other codes162-168 7 1st Condition169-175 7 2nd Condition176-182 7 3rd Condition183-189 7 4th Condition190-196 7 5th Condition197-203 7 6th Condition204-210 7 7th Condition211-217 7 8th Condition218-224 7 9th Condition225-231 7 10th Condition232-238 7 11th Condition239-245 7 12th Condition246-252 7 13th Condition253-259 7 14th Condition260-266 7 15th Condition267-273 7 16th Condition274-280 7 17th Condition281-287 7 18th Condition288-294 7 19th Condition295-301 7 20th Condition302-337 36 Blank338-339 2 Number of Record-Axis Conditions01-20 ... Code range (not inclusive)340 1 Blank(341-440) 100 RECORD - AXIS CONDITIONSSpace 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.Positions 1 - 4: ICD-9 condition codeSee the Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death: Based on the Recommendations of the Ninth Revision Conference, 1975, and Adopted by the Twenty- ninth World Health Assembly, Volume 1, 1977 (World Health Organization) for a complete list of codes.Position 5: Nature of Injury Flag1 ... Indicates that the code in positions 1-4 is a Nature of Injury code0 ... All other codes341-345 5 1st Condition346-350 5 2nd Condition351-355 5 3rd Condition356-360 5 4th Condition361-365 5 5th Condition366-370 5 6th Condition371-375 5 7th Condition376-380 5 8th Condition381-385 5 9th Condition386-390 5 10th Condition391-395 5 11th Condition396-400 5 12th Condition401-405 5 13th Condition406-410 5 14th Condition411-415 5 15th Condition416-420 5 16th Condition421-425 5 17th Condition426-430 5 18th Condition431-435 5 19th Condition436-440 5 20th Condition
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