State initiatives in geocoding vital statistics data.
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Biomedical subjects
Publications and source records attributed to G A Gay.
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This report examines the procedures followed in the 1989 revision of the U.S. Standard Certificates of Live Birth and Death; License and Certificate of Marriage; Certificate of Divorce, Dissolution of Marriage, or Annulment; and Reports of Fetal Death and Induced Termination of Pregnancy. It outlines the history and basic principles of the standard certificates and reports and describes the principal additions, modifications, and deletions of items. In addition, it discusses changes in the format of the standard certificates and reports as well as the implementation of the new certificates and reporting forms.
The 1989 revision of the U.S. Standard Certificate of Live Birth includes a number of new items on medical and life-style risk factors of pregnancy and birth, obstetric procedures performed, method of delivery, abnormal conditions and congenital anomalies of the infant, expanded information on birth attendant and place of birth, and questions on the Hispanic origin of the parents. This major enhancement of medical and health data available on mothers and infants can greatly expand the scope of research on pregnancy outcome in the United States.
The US Standard Certificates and Reports are models used by state vital statistics offices to develop documents for the collection of data about vital events. The 1989 revisions incorporate some major modifications to previous versions. Both the Standard Certificate of Live Birth and the Standard Report of Fetal Death utilize a checkbox format to elicit information on medical and other risk factors affecting the pregnancy, complications of labor and/or delivery, obstetric procedures, method of delivery, congenital anomalies, and abnormal conditions of the newborn. Revisions to the Standard Certificate of Death include modifications to the medical certification section and the addition of decedent's educational attainment. Items requesting information about Hispanic origin are added to all of these documents. The rationale behind these changes and their intended use are discussed.
Suicide is an important public health problem for which we have an inadequate public health database. In the United States, decisions about whether deaths are listed as suicides on death certificates are usually made by a coroner or medical examiner. These certification decisions are frequently marked by a lack of consistency and clarity, and laws and procedures for guiding these decisions vary from state to state and even from county to county. Without explicit criteria to aid in this decision making, coroners or medical examiners may be more susceptible to pressures from families or communities not to certify specific deaths as suicide. In addition, coroners or medical examiners may certify similar deaths differently at different times. The degree to which suicides may be underreported or misclassified is unknown. This makes it impossible to estimate accurately the number of deaths by suicide, to identify risk factors, or to plan and evaluate preventive interventions. To remedy these problems, a working group representing coroners, medical examiners, statisticians, and public health agencies developed operational criteria to assist in the determination of suicide. These criteria are based on a definition of suicide as "death arising from an act inflicted upon oneself with the intent to kill oneself." The purpose of these criteria is to improve the validity and reliability of suicide statistics by: (1) promoting consistent and uniform classifications; (2) making the criteria for decision making in death certification explicit; (3) increasing the amount of information used in decision making; (4) aiding certifiers in exercising their professional judgment; and (5) establishing common standards of practice for the determination of suicide.
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