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INTRODUCTION
This report summarizes information about the natality, mortality, and morbidity of mothers,
children, and youth. Indicators have been selected for their relevancy to the Maternal and
Child Health (MCH) programs administered by the Arkansas Department of Health for the
delivery of comprehensive maternal, child, and adolescent health services. Thus, their
selection reflects priorities established for the Arkansas MCH program. This report also takes
into consideration national and international studies that have attempted to delineate health
risk factors for mothers and children. This report contains data for many indicators used in
other studies, however, the indicators examined here are by no means exhaustive. It is
designed to make these indicators easily accessible, while at the same time allowing flexibility
to users in their selection. To accomplish this, the frequencies of particular events or
conditions, along with rates or percentages, are presented in concise tables.
The primary time focus of this report is calendar year 1997. Data are presented for the state
as a whole to satisfy the needs of planners, policy makers, and providers of health services
at the regional and local levels.
Data from birth certificates measuring the demographic, socioeconomic, and health status of
the mother as they may effect the health and survival of the infant are tabulated. These
variables include race, age, education, and marital status of the mother; birth order; prenatal
care; maternal tobacco use and weight gain during pregnancy; medical risk factors affiliated
with the pregnancy; and complications of labor and delivery. Outcome data on birthweight,
Apgar scores, and congenital anomalies, as well as fetal, neonatal, perinatal, postneonatal, and
infant mortality are also tabulated by several measures of demographic and socioeconomic
status of the mother. The reader should be aware that outcome data for neonatal, perinatal,
postneonatal, and infant mortality are derived from the matched birth-infant death record.
Therefore, total number for these items are not representative numbers from the birth totals.
All birth certificate data are by place of residence, unless otherwise specified. This means that
events have been assigned to the area where the person lives (usually legal residence)
regardless of where the events occurred. For births and infant deaths, the reference is to the
residence of the mother. For infant deaths, the place of residence at death may differ from
the place of residence at birth. The published tables of infant death data are all based on
residence at death. Fetal deaths in this report are usually by place of residence of the mother.
Sources of Data
The main source of the statistics in this report is the vital records system maintained by the
Arkansas Division of Vital Records. Three specific files are used:
The Birth Certificate File containing information reported on live birth certificates.
The Fetal Death Certificate File containing information from fetal death certificates.
The Death Certificate File containing information reported on death certificates.
Summary tables using United States data and Arkansas data for years 1965-1997 are found
in publications produced by the National Center for Health Statistics.
Limitations and Caveats
Vital records information has a number of limitations, including completeness, accuracy, and
timeliness of registration, in addition to quality control and classification problems for variables
such as medical complications of labor and/or delivery. The reporting of live births and infant
deaths is considered to be essentially complete for births occurring in Arkansas. However,
fetal deaths are underregistered to an unknown extent. A cooperative exchange program
between the states has been in operation for several decades to allocate birth and death
certificates to the state of residence. Although incomplete, the exchange program is not of
sufficient magnitude to seriously effect results.
Errors occasionally occur in coding and keypunching large numbers of records. Extensive
computer edits and manual reviews of records are performed as this report is prepared.
Identified errors are corrected when found. Filing of vital statistics documents is an ongoing
process. Although there are filing deadlines, for a variety of reasons some records are delayed
or filed late. In the past, this report was completed several months after the publication of
Arkansas Vital Statistics. Historical totals in this report may, therefore, differ slightly and wil
usually be larger than those indicated in the aforementioned report.
The vital records data files provide an opportunity for studying the characteristics and
problems of the health of mothers and infants so that health planners and administrators can
better direct programs to address problems. The vital records registration system provides an
effective means for measuring health outcomes by place over time.
A certain degree of loss of timeliness is an inevitable structural limitation of the vital records
system. There are delays between the occurrence of a vital event and the completion of the
legal document, between completion of the legal document and its filing, and between its filing
and the completion of computer processing. In addition, calendar intervals such as months or
years must elapse and all records for that interval must be filed and processed before an
analysis of all data for that interval can be conducted. For example, there are two ways of
calculating infant mortality rates: (1) period-based, and (2) cohort-based. This report uses the
standard technique of period-based mortality rates. These rates are calculated by dividing the
number of infant deaths in a given calendar year by the number of births in that year and
multiplying by 1,000.
While the period-based rates are much more convenient and timely than cohort-based rates,
they are less accurate. This is because many of the deaths that happen in the early part of
a calendar year befall infants born late in the previous year; thus the more recent year is
credited with events that transpired in the foregoing year. This can be a serious problem in
areas experiencing extensive immigration, emigration, or rapid changes in infant mortality.
The cohort-based rate is calculated by following each infant born in a given year. The
technique uses deaths occurring only to that group, regardless of which calendar year the
death takes place. The disadvantage is that the cohort-based rate requires that a full year
elapse after the birth of the last infant on December 31 before the rate can be calculated.
Coding and data processing can result in errors that produce delays during correction and
updating of the data base. A considerable amount of time must be devoted to examining the
data before it can be considered final and complete. These delays have been reduced
considerably with the automation of the vital records system which began in 1980.
Note that in certain tables, such as Selected Live Birth Characteristics By Race of Mother or
Selected Live Birth Characteristics By Sex of Child, column values may not equal the total due
to records in which the value of the by-variable is unknown.
Sample copies of the current certificates of live birth, fetal death, and death are included as
appendices to this report.
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