BACKGROUND

In the United States, all vital events are local. What we see as national vital statistics start out as births, deaths, terminations of pregnancy, marriages, and divorces that are registered locally. There are 57 vital registration jurisdictions in the United States: The 50 states, 5 territories (Puerto Rico, U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands), the District of Columbia, and New York City. Each of the 57 jurisdictions has a direct statistical reporting relationship with the National Center for Health Statistics (NCHS). Some of the states have centralized vital records offices, but most have local registrars who receive, register, and issue certified copies of vital records. There are over 6,000 local vital registrars nationwide.

Each of the jurisdictions is also a member of NAPHSIS, the National Association for Public Health Statistics and Information Systems. The association was formed in 1933 to provide a forum for the study, discussion, and solution of problems related to these programs in the respective members’ health departments. NAPHSIS provides national leadership and advocacy on behalf of its members to ensure the quality, security, confidentiality, and utility of vital records and health statistics, as well as their integral role in health information systems, for monitoring and improving public health.

NAPHSIS represents the interests of jurisdictions on cross-cutting vital records and health statistics matters. These interests include national standards for data collection, exchange, issuance, and verification and electronic systems to collect, maintain, and disseminate records and data in a way that is timely, accurate, and protects confidentiality and security. NAPHSIS creates and fosters communication, best practices, training opportunities, and sharing of information across all jurisdictions. NAPHSIS works to build confidence in the integrity of public health and vital records systems and the data produced.

NAPHSIS also educates and negotiates on behalf of the jurisdictions with NCHS, the Social Security Administration (SSA) and other federal and national partners to ensure fair and equitable support and compensation for all jurisdictions, regardless of size or geographic location.

MAJOR RESPONSIBILITIES OF VITAL STATISTICS OFFICES

Some jurisdictions began recording births, deaths, and marriages as early as 1632 (Hetzel, 1997). Later, this civil registration function expanded to include collection of public health statistics, beginning with death data. Jurisdiction vital records and statistics offices have long had responsibility for these two essential governmental functions: the civil registration of vital events and the collection of public health data. It is now recognized that vital records offices have a third, equally important function: helping to en-



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