From Numbers to Knowledge: Building America’s Mortality Report

Today, the National Center for Health Statistics (NCHS) released final mortality data for 2022 and an accompanying data brief, “Mortality in the United States: 2022.” In 2022, 3,279,857 resident deaths were registered in the United States. When it comes to understanding the health of the nation, this annual data brief provides a key piece of the puzzle.

What’s causing the most deaths in America? Are we living longer than we used to? And how are we doing in the fight against major health issues like heart disease or diabetes? What about new diseases such as COVID-19? These questions affect the health of every U.S. citizen, and high-quality mortality data is helping us find the answers.

The annual mortality data and Mortality in the United States reports are the authoritative sources for those looking to get a real picture of American health through understanding how many people are dying and from what causes. Researchers, doctors, and public officials tend to be the power users of this information. But anyone who wants to stay informed about life expectancy and related health issues in the United States will find the report useful. People use mortality data to spot health trends, drive positive change in health care, and ultimately save lives.

Let’s explore how NCHS puts these reports together and the overall value they have in protecting the public’s health.

Where does the information on deaths come from?

NCHS uses data from the National Vital Statistics System (NVSS) to build the annual mortality reports. This system captures “vital” events such as births, deaths, marriages, divorces, and fetal deaths from 57 registration areas. These include the 50 states, Washington, D.C., New York City, and the 5 territories: American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands.

Each jurisdiction is required to register all deaths and issue death certificates. All states, New York City, and Washington, D.C., register deaths electronically. Some of the U.S. territories have electronic systems, and others use manual processes. In addition to state and local health departments, NCHS works with coroners, medical examiners, hospitals, funeral homes, and other related organizations to collect and verify information on deaths.

Why does it take a year or more to release the final mortality data for any given year?

The process of collecting and reporting death certificate data can vary, depending on where the death occurs and the conditions surrounding it. The goal is to collect every single death registered in the United States for the year, with a target release date in December of the following year.

It takes around six months from the end of the year to complete data collection. Most of the data are received within about 1–2 weeks of the date of death, but this varies by jurisdiction and the nature of the death. It can take much longer (3–6 months) to receive cause of death information for deaths that require thorough investigation and toxicological analysis.

It then takes additional time to process the data, code causes of death, review and verify, and prepare the data for publication and release.

With a focus on getting complete, accurate, and verified data from states, NCHS’s timeline is influenced by factors such as:

• Variation in State-Level Reporting: Since NCHS relies on information from all states, the speed at which each state reports its data affects the overall timeline. States with electronic reporting systems typically provide their data faster than those without.
• Lengthy Death Investigations: In cases where in-depth death investigations are needed, the reporting process can take additional time. This is especially the case in jurisdictions with limited resources and staff.
• Data Quality and Integrity Issues: If the data files have significant problems, NCHS works with states to correct these issues. This can include technical glitches or inaccuracies, especially when states are implementing new electronic systems.

Due to these factors, mortality reports don’t have a set release date each year. NCHS adjusts the release date based on the time needed to gather all data and resolve any issues to confirm data are accurate and complete.

NCHS has launched a modernization process for the National Vital Statistics System to improve both the timeliness and quality of data. Working with partners—including state, tribal, local, and territorial health departments, as well as medical examiners and coroners—NCHS is improving the technology that powers the process. The goal is rapid, real-time public health surveillance.

What’s the difference between provisional and final mortality data?

NCHS provides two types of data records for mortality statistics: provisional data and final data. The main difference between them is that provisional records are considered “in progress” and subject to change, while final data records are complete and fully verified. Here’s a quick look at each type:

Provisional Data

• Preliminary and subject to change: Provisional data are preliminary death records and may not be complete. They are based on the ongoing flow of new and updated records received from states, including cases that may require additional investigation.
• Released monthly or quarterly: Provisional data are released monthly or quarterly through the NCHS Vital Statistics Rapid Release program. The data records are provided with the understanding that the numbers and totals are estimates, and the information may be different than the later, final counts.
• Provide a timely snapshot: The benefit of NCHS releasing provisional data is speed. These rapid “snapshots” allow for a faster understanding of death trends and provide clues about emerging public health events. They also allow CDC to track and monitor any ongoing crisis,​​​​ so health authorities and everyone concerned can take action to save lives.

Final Data

• Official and verified: Final data are released only after all death records from states have been received and thoroughly reviewed for completeness and quality. They contain the most accurate and all-inclusive information.
• Released annually: Final data are usually released annually, following an extensive collection and verification process with states. As mentioned above, several variables can influence the timeline.
• Provide a complete picture: The final mortality report released each year provides an accurate basis for official mortality statistics. The final data records are complete and fully verified and are considered the authoritative source for U.S. mortality data that supports research, policy, and public awareness.

 How is mortality data used to improve the public’s health?

Mortality data tell a powerful story about the health of the nation. The information has profound impact, offering insights that shape healthcare planning, public health monitoring, and research. Five key areas that rely on NCHS’s mortality data include:

1. Public Health Monitoring and Decision-Making: This use is crucial because it influences how health crises are managed. By understanding mortality trends, health officials can make informed decisions about using resources, controlling outbreaks, and applying prevention strategies.
2. Epidemiological Research: Studying diseases and health trends in populations is essential. This research can lead to breakthroughs in understanding diseases, detecting risk factors, identifying at-risk populations, and developing new treatments or prevention methods.
3. Healthcare Policy Development: Mortality data guide the creation and assessment of healthcare policies. Effective policies can lead to improved healthcare quality, access, and cost which benefits everyone.
4. Life Expectancy Determination: Life expectancy reflects the overall health of the nation. Changes in life expectancy can indicate broader health trends and help in planning for future healthcare needs.
5. Hospital Discharge Mortality Measurement: Watching mortality rates after people leave the hospital is important for assessing healthcare quality. It helps people understand the effectiveness of hospital care and any treatments required after hospitalization.

But that’s just the beginning. Mortality data serve many purposes in advancing the nation’s health and result in a more informed public and a more prepared healthcare system. And that means better health outcomes for everyone.

Sources:

https://www.cdc.gov/surveillance/blogs-stories/understanding-death-data.html

Death Certificates & The Process That Produces National Mortality Data in the U.S. | Blogs | CDC

NVSS – About the National Vital Statistics System (cdc.gov)

NVSS – Mortality Data (cdc.gov)

NVSS – Modernization – Why Modernization Matters (cdc.gov)