In the United States, legal authority for the registration of births, deaths, marriages, divorces, fetal deaths, and induced terminations of pregnancy (abortions) resides individually with the states (as well as cities in the case of New York City and Washington, D.C.) and Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands. In effect, these 57 jurisdictions are the full legal proprietors of the records and the information contained therein and are responsible for maintaining registries according to jurisdiction law, including issuing copies of birth, marriage, divorce, and death certificates.1

As a result of this state2 authority, the collection of registration-based vital statistics at the national level has always depended on a cooperative relationship between the states and the federal government. Since its inception in 1960, NCHS has been the organization responsible for the federal aspects of this enterprise. NCHS has legislative authority and is mandated under 42 U.S.C. § 242k, Section 306(h) of the Public Health Service Act to collect vital statistics annually: “There shall be an annual collection of data from the records of births, deaths, marriages, and divorces in registration areas. The data shall be obtained only from and restricted to such records of the States and municipalities which the Secretary, in his discretion, determines possess records affording satisfactory data in necessary detail and form.” Currently this data collection is limited to data from birth and death records (including fetal deaths), as NCHS discontinued the collection of individual-record marriage and divorce reports after 1995.

The states are collectively represented in their dealings with the federal government by the National Association for Public Health Statistics and Information Systems (NAPHSIS). NAPHSIS is a professional organization whose members include primarily, but not exclusively, the vital registration and statistics executives and other employees of state registration offices. In addition to providing the states with a common point of contact with the


The NVSS is based on the local registration of vital events. For births and deaths, this typically works, in outline form, as follows: Demographic information on the birth certificate is provided by the mother at the time of birth, and medical and health information is based on medical (i.e., prenatal care, hospital, etc.) records. Demographic information on the death certificate is provided by the funeral director based on information supplied by the informant (usually the next of kin). A physician, medical examiner, or coroner provides medical information on cause of death. The completed birth and death certificates are registered with the local or state registrar by, respectively, the hospital records officer or the funeral director. The local registrar subsequently files the records with the state vital registration office, which codes and keys the data and transmits a copy of the electronic file to NCHS. The state offices are responsible for maintaining archival copies of records and for issuing certificate copies. Upon receipt at NCHS, the data are edited and assembled into national files for analysis and publication. NCHS sets uniform standards for data that will be collected and for item coding.


In the following text, the word “state” will be used to refer to all jurisdictions.

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