Technical Notes

Vital Event Registration

New York State consists of two registration areas, New York City and New York State Exclusive of New York City (also referred as Rest of State). New York City (NYC) includes the five counties of Bronx, Kings (Brooklyn), New York (Manhattan), Queens and Richmond (Staten Island); the remaining 57 counties comprise New York State Exclusive of New York City (NYSENYC). The Bureau of Production Systems Management (BPSM), New York State Department of Health, processes data from live birth, death, fetal death and marriage certificates recorded in New York State Exclusive of New York City. Through a cooperative agreement, the New York State Department of Health receives data on live births, deaths, fetal deaths and marriages recorded in New York City from the New York City Department of Health and on live births and deaths recorded outside of New York State to residents of New York State from other states and Canada. The Bureau of Production Systems Management processes data from dissolution of marriage certificates recorded for the entire state.

Vital Events:

Live Births

New York State Public Health Law (4130) defines a live birth as the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy, which, after such separation, breathes or shows any other evidence of life such as beating of the heart, pulsation of the umbilical cord or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached.

Spontaneous Fetal Deaths/Induced Abortions

Fetal deaths include both spontaneous fetal deaths and induced abortions which are presented separately in this report.

Fetal death is defined by New York State Public Health Law (4160) to be the death prior to the complete expulsion or extraction from its mother of a product of conception; the death is indicated by the fact that after such separation, the fetus does not breathe or show any other evidence of life such as beating of the heart, pulsation of the umbilical cord or definite movement of voluntary muscles. New York State Public Health Law requires the registration of all fetal deaths regardless of the gestation of the fetus.

The Public Health Law limits access to individual Fetal Death records, both Spontaneous Fetal Deaths and Abortions, to the patient.

Deaths

New York State Public Health Law does not require that death be pronounced by a physician. Unless there is a local law that requires otherwise, anyone may make the pronouncement of death. However, this decision is more likely to fall upon emergency medical technicians, policemen, firemen and other emergency personnel. The pronouncement may even be implied by the decision to call a funeral director or coroner/medical examiner instead of an ambulance. NYS PHL 4140 requires that a death certificate be filed within 72 hours after death, or the finding of the body, by a funeral director or undertaker licensed and currently registered by the New York State Department of Health.

Marriage and Dissolution of Marriage

Marriages in New York State are required to be reported through town and county clerks. Marriages in New York City are tabulated by borough in which the license is issued. New York City marriage data is obtained from the City of New York, Office of the City Clerk and not from the New York City Health Department. Beginning in 1997, the City Clerk's office provides New York City marriage information by borough and month only.

Dissolution of Marriage Certificates are filed by attorneys with the County Clerk of the county where the divorce is granted. The certificate is forwarded directly to the BPSM by the County Clerk. A local copy of the dissolution is not kept by the Clerk. This process applies for all counties of the state, including those in New York City.

Report Measures

Except for marriages and dissolution of marriages, which are presented by county/borough of occurrence, all the vital statistics presented in this report are based on the county/borough of residence.

Vital events occurring to inmates of state and federal institutions within the first year of their incarceration are allocated to their residence at the time of admission. After one year, the institution then becomes the place of residence. Vital events occurring to staff who reside at the institution are allocated to the institution district.

Events occurring to residents of communities neighboring major metropolitan areas are sometimes misallocated. In areas where postal boundaries and civil divisions do not coincide, the mailing address is sometimes misreported as the place of residence.

Live Births

Beginning on January 1, 2004 a web-based live birth registration system was implemented in the NYSENYC area of the state. At this same time the live birth certificate was revised based on National Center of Health Statistics (NCHS) guidelines. Both changes apply to hospitals located in the New York State Exclusive of New York City area only. New York City continues to use an older revision of the live birth certificate.

One major change associated with the adoption of the revised birth certificate is the way the variable Race is reported. Prior to 2004, a mother was allowed to select only one race category (1990 Census scheme), even when she identified herself with more than one race due to her multiple race heritage. Beginning in 2004, the Census 2000 coding scheme for race is used for NYSENYC recorded births. With the Census 2000 scheme, the mother and the father are allowed to report more than one race from among 15 race categories. Under this system, a response of White means that the respondent does not identify herself of any other race but White, a response of Black means that the respondent does not identify herself of any other race but Black. This coding scheme is distinguished from the previous scheme by the use of labels White Alone and Black Alone respectively. All other respondents are included in a race category, Other. Although not presented in this report, it is possible to tabulate the race of mother or the race of a decedent in several race combination categories.

To make the current year live birth and death tabulations by race comparable with the past, the NCHS has initiated a program of Race Code Bridging. In this method, using an algorithm derived from National Health Interview Survey, the new race categories are converted into pre-Census 2000 categories (categories of birth tables of 2003 and earlier, and categories of death tables of 2002 and earlier). The resulting race code scheme is referred to as Bridged-Race Coding. (The Bureau of Biometrics will make available a race-recoded data set that contains Original and Bridged Race Coding.)

The selection of race for the statistical reporting of live births is based upon the race of the mother only. Prior to 1991, the reporting of the infant's race was based on the race of both the mother and the father.

A second important change with the birth certificate revision in 2004 is the coding of the variable

  • Medicaid,
  • Health Maintenance Organization,
  • Private insurance,
  • Self Pay,
  • Unknown.

Whereas the Primary Payer Field beginning in 2004 for NYSENYC recorded births ONLY expanded to the following choices:

  • Medicaid / Family Health Plus,
  • Private Insurance,
  • Self-pay,
  • Indian Health Service,
  • US / TRICARE,
  • Other Government / Child Health Plus B,
  • Other,
  • Unknown.

Unchanged from previous year reports, Ethnicity is separate from race and is based on the ethnicity of the mother. Ethnicity distinguishes individuals of Spanish origin regardless of race. Vital events classified as Hispanic include Hispanic Whites, Hispanic Blacks, Hispanics of Other Races and Hispanics-race not stated.

Early prenatal care is defined as prenatal care during the first trimester of the pregnancy. Late prenatal care is defined as prenatal care during the third trimester of the pregnancy. Unknown prenatal care is broken down as follow: Start Unknown for cases where the mother received prenatal care but not enough information was available to determine when it began and Unknown when no information is available to determine whether or not any prenatal care was received. For 1993 and subsequent years, the month in which prenatal care began is determined by calculating the interval between the date of last normal menses and the date of the first prenatal visit. This calculation is consistent with the calculation of gestational age.

Attendant at birth is categorized as physician, midwife or other. Physician includes medical doctors and doctors of osteopathy. Midwife includes certified nurse midwives and midwives.

The number of out of wedlock live births is imputed. New York State Public Health Law (4135) prohibits the specific statement on the birth certificate as to whether the child was born in- or out-of-wedlock. Out-of-wedlock live births are defined as those births for which a mother reports that a paternity acknowledgement has been filed or births for which no father information is supplied by the mother. Beginning in 1993, out-of-state recorded live births to New York State residents do not have paternity acknowledgements filed with them.

With the adoption of an electronic birth certificate system in NYSENYC in 2004, the total number of cesarean deliveries is reported correctly but the response to questions on the number of previous cesarean deliveries was missing on a large number of certificates from 2004-2006. This problem precluded reporting rates for primary and repeat cesarean sections and vaginal births after cesarean section using vital statistics data for these years. In 2007 the method for reporting information on previous cesarean deliveries was changed resulting in improved recording of this information. Comparison of this data to percentages calculated using mother's hospitalization records showed a slight undercount in the recording of previous cesarean deliveries. To resolve this difference, data from the medical record was used to supplement data on the birth certificate for this variable. This resulted in rates for primary and repeat cesarean sections and vaginal births after cesarean sections that are comparable to results previously reported in Table 14a which was calculated entirely from SPARCS data.

In order to meet a continued users' need and with the availability of better geo-coding software, tables 54 and 55 have been added to this report. These tables contain data on live births by School District and Minor Civil Division respectively, for the years 2003 to Present.

Spontaneous Fetal Deaths / Abortions

New York State Public Health Law requires the registration of all fetal deaths regardless of the gestation of the fetus. Unlike birth and death registration, the registration of fetal mortality is not uniform across the United States. In order to provide data comparable to other states, this report presents data for both spontaneous fetal deaths of gestation 20 weeks or more and for spontaneous fetal deaths of all gestations. Due to suspected underreporting of spontaneous fetal deaths, particularly those under 20 weeks gestation, caution should be used when analyzing spontaneous fetal death data.

Categories used to report operative procedure for induced abortions include dilation and curettage (D&C), suction and curettage, dilation and evacuation (D&E), saline injection, prostaglandin injection, medical (non-surgical) and other that includes hysterectomy, hysterectomy and other procedures. Beginning in 1998, New York City combines saline and prostaglandin injection and this combination is reported in the saline injection procedure.

Deaths

The cause of death reported in this publication is the underlying cause classified according to the tenth revision of the International Classification of Diseases (ICD, 10th revision) adopted by New York State in 1999. Historically, several revisions of the ICD have been used, therefore, it is necessary to employ a comparability ratio when comparing cause of death statistics across revisions. Comparability ratios have been published by the National Center for Health Statistics (NCHS).

Infant and neonatal mortality rates published in this report are based on all live births regardless of birth weight or gestation. No attempt was made to account for the viability of the infant at birth. These rates for a specific year are based on deaths and live births that occurred during that year.

When tabulating deaths by place of death, other institution is defined as state institution, Veterans Administration facility, hospice, federal institution, health related facility or home for the aged.

Population

Population Estimates

All population estimates for the year 2007 in this report are derived from the NCHS released estimates of "Bridged Race Vintage 2007," which are consistent with the Bureau of the Census estimates from "Vintage 2007" (released in the Summer, 2008). This set of estimates by race is in the same categories as data prior to 2000. Census 2000 race categories are White alone, Black Alone, etc. The data on Spanish ethnicity is consistent over the years.

Life Tables

A set of three life tables (Tables 3a, 3b, 3c) is presented which includes the total, male and female populations of New York State. Each life table consists of seven columns. They are:

  • Age: the interval between two exact ages, x to x+n. For example, the age group 15-19 includes the five-year interval of all persons aged 15 to 1 day less than 20 years old.
  • q: is the probability of dying during x to x+n. This is the proportion of deaths that occurs during the interval x to x+n among a cohort who were alive at the beginning of the interval.
  • l: is the number of survivors at exact age x. Starting with a cohort of 100,000 live births, l is the number of persons who survived to the beginning of each age interval. The number of survivors at the beginning of an age interval multiplied by the probability of surviving the interval gives the number of survivors at the beginning of the next age interval.
  • d: is the number of persons dying during x to x+n. This column represents the number of persons from the cohort of 100,000 who die during x to x+n.
  • L: is the number of person-years lived during x to x+n. The number of person-years includes those who live the full n years of the interval and those who live less than n years.
  • T: is the number of person-years lived beyond exact age x.
  • E: is the expectation of life at exact age x. This is the average years of life remaining to be lived by persons of exact age x.

Data Presentation:

The variable

Race Coding Scheme used by Region
Recorded Region Resident Region
Rest of State* New York City Out-of-State
Rest of State Census 2000 Census 2000 Census 2000
New York City Census 1990 Census 1990 Census 1990
Out-of-State Varies** Varies** Varies**
  • *Rest of State Region includes 57 counties outside New York City.
  • **Race codes depend on the system used by individual states.

Matching the New York State Exclusive of New York City recorded live birth events for 2004 from the NYS Vital Records System and the race-recoded dataset from the NCHS shows that by using the race alone tabulation, the White births are undercounted by 1.7 percent and Black births are undercounted by 6.8 percent approximately. The users of the race data in the VS Annual Report for the current year, while comparing them to the past years of data for trend analysis, should bear this in mind.

The reporting of Financial Coverage in birth tables is separated into tables for New York State Exclusive of New York City recorded births (Tables 4b, 5b, 13a) and New York City recorded births (Tables 4c, 5c, 13b). Table 4b, for example, reports births to New York State residents that are recorded in the area outside New York City. Included in the counts are births to New York City residents occurring in the State but in a county other than one of the 5 New York City counties. Also included in the counts in Table 4b are births to New York State residents that occurred outside New York State.

Two panels are presented in each table - 13a and 13b. The Rest of State panel in 13b, for example, is sparsely populated since it records only those births to New York State residents living in New York City but giving birth outside New York City. Sum of all births in Tables 4b and 4c or, Tables 5b and 5c or, Tables 13a and 13b is the total for births to New York State residents.

The number of primary and the repeat cesarean sections and the number of vaginal births after cesarean (VBAC) delivery are not accurately reported for 2006 and are not included in Table 14.

Vital Statistics Rates and Ratios

The definition of the rates used for this report are given below. In a definition, the numerator reflects the number of vital events counted in a specified period of time, usually a calendar year. When the denominator is a population count, it refers to the count at a specified point in time, usually mid-calendar year.

  • Live Birth Rate: Annual number of live births per 1,000 population.
  • General Fertility Rate: Annual number of live births per 1,000 female population aged 15-44.
  • Teenage Live Birth Rate: Annual number of live births to women aged 15-19 per 1,000 female population aged 15-19.
  • Spontaneous Fetal Mortality Rate: Annual number of spontaneous fetal deaths (all gestations) per 1,000 spontaneous fetal deaths (all gestations) plus live births occurring during the year.
  • Abortion Ratio: Annual number of induced abortions per 1,000 live births occurring during the year.
  • Total Pregnancy Rate: Annual number of pregnancies per 1,000 female population aged 15-44.
  • Teenage Pregnancy Rate: Annual number of teenage pregnancies per 1,000 female population aged 15-19.
  • (Crude) Death Rate: Annual number of deaths per 1,000 population.
  • Infant Mortality Rate: Annual number of deaths under one year of age per 1,000 live births occurring during the year.
  • Neonatal Mortality Rate: Annual number of deaths under 28 days of age per 1,000 live births occurring during the year.
  • Postneonatal Mortality Rate: Annual number of deaths at age 28 days and older but less than one year per 1,000 live births occurring during the year.
  • Perinatal Mortality Rate: Annual number of (neonatal deaths plus spontaneous fetal deaths of gestation 20 weeks or more) per 1,000 (spontaneous fetal deaths of gestation 20 weeks or more plus live births) occurring during the year.
  • Age-Specific Rate: Annual number of deaths in a specified age group per 1,000 population in the same age group. Age is decedent's age at last birthday.
  • Cause-Specific Death Rate: Annual number of deaths from a specified cause or group of causes per 100,000 population. Exception: the death rate from complications of pregnancy, childbirth and the puerperium (also called Maternal Mortality Rate) is defined as number of deaths from complications of pregnancy, childbirth and the puerperium occurring during the year per 100,000 live births occurring during that year. This death rate is called the maternal mortality rate. This cause of death category also includes any maternal death which may have resulted from an induced abortion.
  • Age-Sex-Adjusted Death Rate (Direct Method): Death rate of a group calculated as a weighted average of the age-sex-specific death rate of the same group. The system of weights is the age-sex-distribution of a population called the standard population. In this report, the standard population is the United States population as enumerated by the Bureau of the Census on April 1, 2000.
  • Marriage Rate: Annual number of marriages per 1,000 population.
  • Dissolution of Marriage Rate: Annual number of dissolutions of marriage per 1,000 population.

Small Area Data

In tabulating vital events for cities and villages with 10,000 or more population, the problem of small frequencies occurs. Statistics based on a small number of vital events are subject to a large degree of variability and inferences should be made with care.

To protect the confidentiality of females whose pregnancies resulted in spontaneous fetal deaths or induced abortions in Hamilton County, it was decided to merge its events with Essex County in certain tables. In tables where pregnancies, spontaneous fetal deaths or induced abortions have been categorized by age or race the data for these events will be combined and county names Essex/Hamilton and Hamilton/Essex will give the same aggregated value.