In this chapter, we summarize some threads of this discussion on the structure of the VSCP. Section 3–A describes the role of the states and, more generally, the challenge of data collection given the civil registration nature of the underlying birth and death certificates. Section 3–B summarizes the constraints on the vital statistics collection system from NCHS’s perspective as national-level coordinator. Finally, Section 3–C profiles selected models of federal-state cooperation elsewhere in the federal statistical system.
Workshop presenters and participants received two background papers prepared at the workshop planning committee’s request: one on the role of the states (prepared by Steven Schwartz, New York City Department of Health and Mental Hygiene) and the second on NCHS’s role. These papers are reprinted in Appendixes A and B, respectively; they have only been minimally edited for consistency with National Research Council report style. Schwartz gave a presentation at the workshop that closely followed the content of his paper; there was no explicit counterpart presentation of the background paper by NCHS, but several of the paper’s themes were sounded by Jennifer Madans and other NCHS staff (as summarized in Section 3–B).
Schwartz emphasized the local nature of vital events and the collection of records. At the outset, records of each of the more than 11 million vital events—births, deaths, marriages, and divorces—that occur each year in the United States are processed through one of the more than 6,000 local registrars. These local registrars form a diverse and complex network, and Schwartz’s own local experience offered an interesting perspective on the geographic distribution and the workload of registrars. The state of New York has the most local registrars of any state—about 1,500—yet New York City and its more than 8 million inhabitants have only one official registrar. The New York City registrar’s office alone processes about 500 live births and 160 deaths every day—about 300,000 vital events annually.
Records data funnel through the local registrars to the 57, mainly state-level, registration jurisdictions. As already noted, two cities—New York City and Washington, DC—function as registration jurisdictions. (Schwartz observed that, at one time, registration districts were more city based and, in fact, New York City began as a registration area before New York state.) Each of the 57 registration jurisdictions reports data directly to NCHS through the VSCP. Schwartz also noted another centralizing force in the system—the National Association for Public Health Statistics and Information Systems, the professional association of the state vital records offices that was founded in 1933 and works with NCHS and the states on data collection issues.