To further understanding of vital statistics in the United States, there are a couple of documents that I would commend to your attention. The first is U.S. Vital Statistics System: Major Activities and Developments, 1950-95, published by the National Center for Health Statistics of the Centers for Disease Control. And the second is the Model Vital Statistics Act of 1992.
U.S. Vital Statistics System: Major Activities and Developments, 1950-95
The USVSS contains a wealth of information about Vital Statistics in the United States. One of the most interesting items for the discussion on this web site is Appendix I which lists the data items on the US Standard Birth Certificate of Live Birth and how it has changed over the years. The standard certificate in force with President Obama was born was from 1956. (It becomes immediately obvious that all birth certificates prepared for the public are abstracts from the total set of information collected.)
The process flow of birth certificates is presented in Appendix II (pdf page 69), showing the role of physicians and local registrars.
Model Vital Statistics Act and Regulations
The Bureau of the Census submitted the first model bill to the States in 1907, covering both birth and death registration. It provided for forms to include as a minimum the items recommended by the Bureau of the Census. Numerous revisions of both the model law and the recommended forms have followed. The development, periodic review, and revision of the recommended standards became an essential function in obtaining comparable data from State and local registration offices for producing national vital statistics. Responsibility for this function was transferred from the Bureau of the Census to the U.S. Public Health Service in 1946 and now rests with the Division of Vital Statistics in NCHS.
In response to the expressed needs of State executives and Federal agencies, a new Model State Vital Statistics Act was tentatively approved in 1940 and adopted in 1942 (U.S. Bureau of the Census, 1941). For the first time, the Model Act gave a statutory definition of vital statistics, defining them as ‘‘the registration, preparation, transcription, collection, compilation, and preservation of data pertaining to the dynamics of the population, in particular, data pertaining to births, deaths, marital status, and the data and facts incidental thereto.’’ This was the first inclusion of marriages and divorces in the model legislation pertaining to vital statistics. This revision also included the first provision for a standard certificate of stillbirth, discarding the making of a birth and a death certificate to cover a stillbirth. It declared vital statistics
records to be public records but restricted the right of public inspection.
The increasing demand for reliable certified copies in the 1940’s gave added importance to registration and uniformity in forms and consequently to the Model Act and its recommendations.
The Model State Vital Statistics Act was revised in 1959 (U.S. Department of Health, Education, and Welfare, 1960). This revision was not an abrupt departure from earlier model vital statistics acts but rather one in a series of revisions carried out periodically to keep the Model Act current with changing demands upon State vital records systems.
More substantive changes were made in the Model Act in 1977 (National Center for Health Statistics, 1978). This revision provided for a centralized system in each State for the collection, processing, registration, and certification of vital records in which all vital events are reported directly to the State office of vital statistics. It placed the local offices under the direct control of the State registrar and gave the State registrar the option to direct local offices to perform any of those functions when it was in the interest of efficient and effective service. The 1977 revision also made a significant change in the registration of fetal deaths, changing the reporting instruments to statistical reports to be used only for medical and health purposes, as opposed to permanent official records of the system of vital statistics. Modifications were added to provide for filing birth certificates for foreign-born children adopted by citizens in the State where they are adopted. This revision gave special attention to privacy concerns, confidentiality, and fraudulent use of vital records, and strengthened penalty provisions of the Model Act as a deterrent to illegal use of vital records.
Model State vital statistics regulations were first issued in 1973 (National Center for Health Statistics, 1973). It was recommended that both the Act and regulations be considered when a State modifies its vital statistics statutes. The purpose of the regulations was to augment the Model Act and to standardize many of the administrative practices and procedures in effect in vital statistics offices. Consistency among States in day-to-day administrative procedures has been found to improve the uniformity essential for national statistics. The model regulations have been revised in conjunction with all subsequent revisions of the Model Act.
The 1992 revision of the Model Act and regulations (National Center for Health Statistics, 1994) was undertaken with the intention of producing a practical rather than ideal model and one that most States could adopt with few modifications. The intent was to develop a model that was flexible enough to accommodate new technologies that are sure to evolve for the collection, storage, and retrieval of vital records. The Act specifically allows for the electronic production and transmission of vital records. It also removed the requirements for signatures except where the requirement relates to an affidavit.
Provisions of the Model Act concerned with confidentiality and security of vital records were strengthened. Several issues regarding vital records were addressed for the first time as the result of changes in societal attitudes and practices. For example, guidance is provided on the naming of the father, and in some instances the mother, on birth records involving artificial insemination, in vitro fertilization, and surrogate parenthood.
The Model Act recommends to the States that the integrity of vital records and reports be protected through reasonable control of the use of such records, restricting disclosure of information that can identify a person or institution named in any vital record or report. It further recommends that Federal agencies and researchers who are furnished copies of such records be required to enter into agreements that protect the confidentiality of the information provided. The intent is to encourage legitimate and appropriate use of the records for statistical and administrative purposes, while protecting individuals from an unwarranted invasion of privacy.