New Roles and Needs Confronting State Vital Statistics Systems in the 21st Century

Over the past three centuries, the U.S. vital statistics system has evolved from a civil registration system first used for the protection of individual property rights to a system used for critical public health purposes on the local, state and national levels. Recently, uses of vital records have been expanded to include protection of national security.

The collection of vital records data is the responsibility of the 50 states, 5 U.S. territories, New York City and the District of Columbia. Each jurisdiction provides a standard set of data to the National Center for Health Statistics; these data are compiled to form national vital statistics data. The national vital statistics system is a cooperative federal/state system dependent on adequate funding from both partners. Over the years, federal budget shortfalls have resulted in elimination of data sets, reduction of data and relaxation of quality standards. As states develop costly reengineered systems to meet new and increasing public health and national security needs, reduced federal support threatens to further erode the national system. National efforts underway to use hospital-based electronic health records as the primary collection point of vital records data raise concerns about future data quality.

Users of vital statistics data share the vision of timely, complete, accurate data that is responsive to public health surveillance needs and can be used effectively for national security purposes. The purpose of this presentation is to discuss what is needed to move in the direction of this vision, and the challenges that could prevent success.