Vital Statistics

Vital records data include information on births and deaths occurring to Lancaster County residents, whether the birth or death occurred in or out of the county. Therefore, births and deaths in Lincoln and Lancaster County as well as those occurring in other Nebraska counties or in other U.S. states, or even Canadian provinces, are all included in the database.

In addition to the date of birth of the baby, birth records (certificates) also include a number of data elements of interest to public health officials. Birth certificates include information on the demographics of parents and the newborn(s), maternal lifestyle and health characteristics, medical services utilization, and health characteristics of the infant.

Data from death records (certificates) provide a number of data elements of interest to public health professionals. Some of the most commonly reported data from death certificates include demographic information about the decedent, causes of death (underlying and contributing), place of death, and method of disposition of the body.

Birth certificate data are collected from various sources; including the mother, clinic, and hospital with most of the information coming from the hospital and other medical records. As for the source of data from death certificates, the cause of death is reported by the attending physician or coroner/medical examiners. Funeral directors and the families often are the sources of information about the person's demographic characteristics.

Data on births and deaths are entered directly into the Vital Statistics Registry system at the Nebraska Department of Health and Human Services. Currently almost 100 percent of all births (home births are an exception) and the vast majority of death records are filed electronically; with the goal that 100 percent of all vital records be submitted via electronic means.

Birth and death records are considered to be of very high quality and a good source of data because collection of the data is standardized, complete, consistently collected, and the number of available years of data provides trend information.

There are some limitations related to the use of birth records. For example, during pregnancy some health risk behaviors (e.g. alcohol or tobacco use) may be underreported by the mother completing the birth certificate form. Also, race/ethnicity reporting may present some inconsistencies because of the inadequacy of categories on the form. Another recent issue is how to deal with the increasing number of individuals who identify themselves as multi-racial, which makes it difficult to compare race from the data in prior years. Another possible source of inconsistency could be in the extraction of information from medical records by facilities throughout the state (e.g. prenatal care). Generally this is a minor issue. Please keep in mind that, due to the changes in the birth certificate form in 2005 as well as the concurrent change to rely more on the medical record, data for a number of data elements (e.g., trimester of prenatal care, number of visits, etc.) since 2005 should not be compared with data from 2004 or prior years.

Mortality data from death certificates also have some limitations. For instance, differences in causes of death could reflect a difference in death reporting practices by local physicians, coroners, or medical examiners. However, with training and education, over time these inconsistencies have decreased. Also, in 1999, the vital statistics programs nationwide adopted Version 10 (ICD 10) of the International Classification of Diseases. Until 1998 the vital statistics programs utilized a different classification (ICD 9) system to categorize cause of death and there were some significant differences for certain diseases such as Alzheimer's disease. Therefore, cause of death data (both numbers and rates) before and after 1999 should not be compared to one another. In addition, death records do not provide adequate information on factors that may contribute to the death such as the health status of an individual prior to death. Race/ethnicity reporting may also be inconsistent because it is reported by someone other than the decedent.

Still, even with the limitations mentioned above, birth and death records remain an excellent, and usually the best available, source of population data to determine rates of birth, pregnancy, prenatal care, birth weight, infant mortality and numerous other birth outcomes and causes of death.