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.