certificates has also limited capacity to use vital statistics data for research purposes.

This chapter describes the 2003 revised instrument in some additional detail, consistent with the material presented at the workshop. Three workshop presenters from the NCHS staff and one Census Bureau speaker commented on the methodological changes inherent in the 2003 revision and the types of analyses made possible by new variables added in the revision. Specifically, the presentations focused on the complications involved in working with the data in the current situation in which implementation of the revised certificate is uneven and, hence, states report information in varying formats.


NCHS convened an expert panel in 1998, consisting principally of state vital registration officials, as well as representatives from relevant user organizations, to begin the process of evaluating the content of the existing (1989 revision) birth and death certificates and recommend changes. The panel (Division of Vital Statistics, 2000) developed its final recommendations in 1999 and directed that NCHS test redesigned instruments; the resulting documents became the 2003 standard certificates, and they are reproduced in Appendix D.

The major changes to the standard certificates are described in brief in Box 4-1. As Jennifer Madans (NCHS) observed in her workshop presentation, the 2003 revision continued a long-term push to make the vital records a platform for collecting a variety of public health data items in order to meet real public health needs. The revised 2003 birth certificate now includes some 60 data items, providing extensive information on pregnancy, labor and delivery, infant health, and maternal health factors; the 2003 round specifically added queries on risk factors (smoking) and method of delivery.

Arguably the most significant change made in both instruments was described in more detail by workshop presenter James Weed (former deputy director, Division of Vital Statistics, NCHS; retired): modification of the questions on race and Hispanic origin to reflect new standards promulgated by OMB in 1997. As Weed summarized, the standards (U.S. Office of Management and Budget, 1997):

  • established a minimum set of race categories that were made mandatory for statistical data collections: American Indian or Alaska Native; Asian; black or African American; Native Hawaiian or Other Pacific Islander; and white;

  • defined a minimum set of categories for collection of Hispanic or ethnic origin: “Hispanic or Latino” or “not Hispanic or Latino”; and

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