Data from the

NATIONAL VITAL STATISTICSSYSTEM

Series 22

Number 15

Infant Mortality Rates:

Relationships

Reproductive

United States

With Mother’s

History

Statistics on infant mortality rates according to mother’s

previous reproductive experience particularly whether she

had had a previous child die in infancy or a fetal death

and according to selected socioeconomic factors. Based

on data collected by a questionnaire mailed to mothers

of infant deaths. Samples selected from records of births

and infant deaths in 1964, 1965, and 1966 which were

transmitted to the National Center for Health Statistics.

DHEW Publication No. (HSM) 73-1976

U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

Public Health Service

Health Services and Mental Health Administration

National Center for Health Statistics

Rockville, Md. April 1973
Vital and Health Statistics-Series 22-No. 15

For salu by the Superintendent of Documents, U.S. Government Printing Office, Washington, D.C. 20402

Price S6 cents domestic postpaid or 60 cents GPO Bookstore
NATIONAL CENTER FOR HEALTH STATISTICS

THEODORE D. WOOLSEY, Director

EDWARD B. PERRIN, Ph.D., Deputy Director

PHILIP S. LAWRENCE, SC.D., Associate Director

OSWALD K. SAGEN, Ph.D., Assistant Director for Health Statistics Development

WALT R. SIMMONS, M.A., Assistant Director for Research and Scientific Development

JOHN J. HANLON, M.D., Medical Advisor

JAMES E. KELLY, D.D.S., Dental Advisor

EDWARD E. MINTY, Executive Officer

ALICE HAYWOOD, Information Officer

DIVISION OF VITAL STATISTICS

ROBERT A. ISRAEL, M.S., Director

JOHN E. PATTERSON, Assistant Director for Demographic Affairs

ARNE B. NELSON, M.A., ChieJ Vital Records Survey Branch

ROBERT J. ARMSTRONG, M.S., Chief, Mortality Statistics Branch

ROBERT L. HEUSER, M.A., Chief, Natality Statistics Branch

Vital and Health Statistics-Series 22-No. 15

DHEW Publication No. (HSM) 73-1976

Library of Congress Catalog Card Number 72-600224
CONTENTS

Page

Inmtiuction ----------------------------------------------------------

Source of Data --------------------------------------------------------

Findings --------------------------- -------------------- ----------- --

Previous hfant-ath -----------------------------------------------

Previous Fetal Death --------------------------- --------------------

Live-Birth Order --------------------------- -----------------------

Age of Mother ---------------------------- -------------------- -----

Comment --------------------------- --------------------------- -------

References --------------- -------------- --------------- ------- -- - ----

List of Detailed Tables ---------------------------- ----------- -----c--- -

Appendix 1. Sources and Limitations of Data --------------------------- -..

Background of This Report --------------------------- --------------

Sources of Data --------------------------- -------------------------

Sample Design -------------- --------------------- ------------------

The Death Certificate, the Birth Certificate, the Questionnaire, and the

Hospital Form --------------------------- -------------------------

Collection of Data --------------------------------------------------

Nonresponse and Imputation for Missing Data -------------------------

Weighting Procedures for National Estimates -------------------------

Reliability of Estimates --------------------------------------------

Rounding of Numkrs -----------------------------------------------

Appendix 11. Definitions ofCertain Terms Used in This Report -------------

Appendix III. Source Forms -------------------- ------------------------

Standard Certificate of Live Birth ------------------------------------

Standard Certificate of Death -------------- ---------------------- ----

1964-1966 National Natdi~Survey Questionn&re ----------------------

1964-1966 National Infant Mortality Survey Questionnaire ---------------

1964-1966 National Infant Mortality Survey Hospital Form --------------

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9

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55

...

IJ I
SYMBOLS

Data not available ------------------------ ---

Category not applicable ------------------- . . .

Quantity zero ---------------------------- -

Quantity more than Obutless than 0.05----- 0.0

Figure does not meet standards of

reliability or precision ------------------

*

iv
INFANT MORTALITY RATES:

RELATIONSHIPS WITH MOTHER’S REPRODUCTIVE HISTORY

Brian Machlahon, M.D., Department of Epidemwlogy,

Hamxwd School of Public Health,

Mary Grace Kovar, 0jt2ce of Statistical Methods

National Center fw Health Statistics, and

Jacob J. Feldman, F%.D., Department of Biostatistics,

Harvard School of Public Health

INTRODUCTION

The National Natality Survey (NNS) and the

National Infant Mortality Survey (NIMS) of 1964-66

were designed to obtain information not available

from routine vital records for samples representative of all United States births (NNS) and

infant deaths (NIMS). Data are presented in this

report on the distribution of single, live-born,

legitimate infants according to certain characteristics of the mother’s previous reproductive

experience-in particular, the frequency of previous fetal or infant deaths.

In addition, the fact that information was obtained in similar ways in the two surveys enables

the estimates of national distributions derived

from each of the surveys to be used as numerators (infant deaths) and denominators (births) for

the estimation of national infant mortalit y rates for

subgroups of the population. Data from the two surveys have been used previously to provide national

estimates of infant mortality rates by socioeconomic status. In this report infant mortality rates

for single, legitimate infants are presented by age

of mother, birth order, and whether or not the

mother had experienced previous fetal or infant

deaths.

SOURCE OF DATA

The sources of the data used in this report and

their limitations are described in detail in appendix I and will only be summarized here.

The NNS was based on a one in 1,000 probability sample of birth certificates received by the

National Center of Health Statistics from 54 registration areas of the United States. The sample

numbered 11,331 births. The NIMS sample, numbering 2,490 infant deaths, was a one in 110 sample of all registered infant deaths. Infants lmown

or inferred to be illegitimate were excluded from

analyses of both surveys. The report on socioeconomic status was therefore based on 10,395

legitimate births and 2,160 deaths of legitimate

infants. For the analyses in this report it was also

necessary to exclude infants who were twins or triplets, since a difference between the two surveys in

the rules for coding birth order in cases of rnJltiple births led to inconsistency on this variable.

There were 196 twins or triplets in the NNS sample and 161 among the infant deaths, exclusion of

which left 10,199 single-born legitimate births and

1,999 deaths of single-born legitimate infants.

The primary source of information on the variables used in this report was a questiomaire
mailed to the mothers. Usable questionnaires were

returned for 89 percent of the births and 88 percent

of the infant deaths. Where data were not available

for individual sample members they were imputed,

using information from similar sample members

for whom the relevant data were available. The

method of imputation is described in appendix I.

Also described there is the procedure for assignment of weights to individual sample members

based on the representation of the sample within

categories derived from variables for which information was available nationally for all births

or infant deaths. The objective, both of the weighting procedure and of the information imputing,

was to improve the estimates of total United States

births and infant deaths.

Data on birth weight were not collected for

the NIMS sample in 1966. Tabulations involving

this variable are therefore based on births and

deaths in 1964 and 1965 only.

METHODS

Estimates of the distribution of live births

with respect to the frequency with which the mothers reported previous reproductive loss and other

characteristics are based only on the NNSsample.

For estimation of infant mortality rates, the

national estimates of the distributions of births and

infant deaths with respect to a particular variable

or variables derived from the two samples were

used as denominators and numerators, respectively.

Estimates of numbers of births are shown in

the tables as annual averages, rounded to the nearest 1,000. However, the infant mortality rates and

percentages shown in the tables were computed on

the unrounded estimates of the total births or

deaths in the period.

In the tables, estimates of the number of births

are not shown for cells with less than 5,000 annual

births, and estimates of infant mortality rates are

not given for cells in which the average annual

number of births was less than 25,000. Approximate sampling errors of the estimated numbers

and rates are given in tables VIII through XI of

appendix I.

The number of black infants in the two surveys

is such that, while most estimates of infant mortality rates by single variables are reasonably reliable, few cross-tabulations can be made. For

races other than white or black even marginal

rates are unreliable, and no separate estimates

are given for this group of infants. Races other

than white or black are, however, included in the

data for “all races. ”

FINDINGS

Previous Infant Death

Of the mothers of single, live-born, legitimate

infants, 5.4 percent reported that they had had a

previous live-born infant die under 1 yearn of age.

The proportion of mothers reporting a previous

infant death was approximately twice as high for

black as for white infants (lo.6 and 4.7 percent,

respectively). The proportion of mothers who had

had a previous infant death increased markedly

with birth order of the sample child (table 1) and

age of the mother (table 2). The higher frequency

of previous infants death among black mc~thers, is

however, seen within specific subcategories of

both these variables.

Infant mortality rates were approximately

two and a half times as high among infants born

to mothers who had had a previous infant death

as among those born to mothers without a previous infant death (figure 1). Within each birth

order or maternal age group in which there are

sufficient numbers to compute reliable rates, differences according to presence or absence of previous infant deaths were of the same order of magnitude as those in the overall rates (tables 1 and 2).

The increased infant mortality rates associated

with prior infant death were present in both racial

groups, although relatively more pronounced

among the white infants than among the black

infants. Numbers are inadequate for examination

of the effects on infant mortality of previous

infant death, race, and birth order or ]maternal

age in combination, but in those subcategories in

which there are adequate numbers there was

consistently an excess mortality for infants born

to mothers with a previous infant death.

Tables 3-5 present data on the frequency of

previous infant deaths according to three indexes

of socioeconomic status—family income, education of mother, and education of fatlher. The

2
la No previous infant death

70

[

-o ne or more previous infant deaths

60

t 1

) I I 1 -

ALL RACES WHITE BLACK

Figure 1. Estimated infant mortal ity rates according

to whether the mother had or had not had a previous

infant death, by race of infant.

probability of there having been a previous infant

death was highest in the lower socioeconomic

groups.This trend is more clearly evident in the

data on parental education (tables 4 and 5) than in

those on family income (table 3)—particularly

among white infants. The trend no doubt reflects

both the higher average birth order of the sample births in the lower socioeconomic groups and

the high infant mortality rate in these categories.

These tables also show that the difference in infant

mortality rates between infants whose mothers had

had a prior infant death and those whose mothers

had not was at least as great within socioeconomic

subcategories as in the overall rates. Illustrative

data are given in figure 2.

Examination of the data on cause of death, age

at death, and birth weight ik restricted to white

infants, since all these associations are confounded by racial differences and numbers are inadequate for separate analysis of the data for black

infants. Table 6 shows that the differential in mor -

talit y rates according to whether or not the mother

had had a previous infant death was present for

most causes of death, although the discrepancy

was relatively greater for deaths ascribed to hemolytic disease of the newborn, posmatal asphyxia

and atelectasis, immaturity unqualified, or certain

diseases of early infancy. As would therefore be

expected, the differential was greatest for deaths

in the first day of life, although it is seen for

deaths throughout the first year (table 7 and figure

3).

The proportion of mothers who had hada previous infant death was approximately twice as high

for live-born infants weighing 2,500 grams or less

as for those weighing more than 2,500 grams

(table 8). The high infant mortality rate among infants born to mothers with a previous infant death

is, therefore, due in part to a high frequency of low

Ezl No pfevious infant death

One or more previous infant deaths

L I I 1 1 1

8 yearsc+ less 9-II years I 2 yews w more

COMPLETED EDUCATION OF MOTHER

Figure 2. Estimated infant mortal ity rates for white

infants accord ing to whether the mother had or had

not had a previous infant death, by completed education of mother.

3
~ *O Vwlcw,nfo”tdd.,il

AGE m DEATH

Figure 3. Estimated infant mortality rates for white

infants according to whether the mother had or had

not had a previous infant death, by age at death of

infant.

birth weight, as the data on cause of death would

indicate. Nevertheless, even among infants weighing more than 2,500 grams the mortality rate was

greater for those whose mothers had experienced

a previous infant loss than for those whose mothers

had not.

Previous Fetal Death

Twenty-two percent of the mothers reported

having had a fetal death in a previous pregnancy

(table 9). The proportion is again greater among

the mothers of black than of white infants, but the

differential is considerably smaller than in the

case of previous infant deaths, particularly when

specific categories of birth order (table 9) or

maternal age (table 10) are compared.

Infant mortality was higher for infants whose

mothers did than for those whose mothers did not

report a previous fetal death (figure 4). The differential was again smaller than that associated

with reporting of prior infant death but, nevertheless, the overall infant mortality rate for infants

whose mothers reported one or more fetal deaths

was almost twice as high as the rate for those

whose mothers did not report any fetal deaths.

Again, the differential is evident within subcategories by race (figure 4), birth order (table 9),

and maternal age (table 10).

Association between socioeconomic status

and the frequency of previous fetal death is less

strong than that between socioeconomic status

and previous infant death. Indeed, the direction of

relationship is not consistent between the three

indexes of socioeconomic status. Table 11 shows

increasing frequency of fetal death with increase

in income among mothers who later had a liveborn child, but tables 12 and 13 show decreasing

frequency with increase in parental education. In

all three tables, however, the differential in mortality rates for infants of mothers with and without fetal death is seen within all socioeconomic

categories.

Because more mothers reported previous

fetal deaths (22 percent) than previous infant

deaths (5 percent), the numbers are large enough

to permit comparison of mortality rates among

infants of mothers who reported only one and those

who reported two or more fetal deaths. The data

are given in table A. In both ra’cial groups, mortalitv rates for infants whose mothers reported

two or more fetal deaths were substantially higher

than for those whose mothers reported onl!y one.

m No previous fetal death

One or more previous fetal deaths

t 1

ALL RACES

I 1

WHITE

~J

BLACK

Fiaure k Est imated infant mortal ity rates according

;O tiether the mother had or had not had a fetal

death, by race of infant.
Table A. Estimated average annual number of live births, percent in which the ❑other

reported a previous fetal death, and infant deaths per 1,000 live births, by number

of previous fetal deaths reported and race of infant: United States, 1964-66 legitimate, single births

Race of infant

AIX races ---------------- -----------

White -----------------z----.- -------------

Black ---------------- ----------------------

All races ------- ------- -.----- ------

Black ------------------------ -------- -----

All races ---------------------------

White -------------------------------------

Black -------------------------------------

Tables 14-16 give data on the relationship of

infant mortality to previous fetal deathbycauseof

death, age at death, and birth weight, for white

infants. Thedifferentialinmortalityrates accordingtowhetherornotthemotherhadhad zero~ ~ne,

or two or more previous fetal deaths was much

greater in those causes leading toearlydeath—

birth injuries, postnatal asphyxia and atelectasis,

hemolytic disease of the newborn, immaturity

unqualified, and diseases of early infancy (table

14)—and consequently among deaths inthe first

week of life (table 15). The percentageofmothers

who reported a previous fetal death was higher

among themothers ofinfantsweighing 2,500grams

or less than among those of infants weighing between2,501 and4,000 grams, but itwas also high

among mothers whose infants weighed over 4,000

grams (table 16). However,thedifferentialtimortality rates between infantswhosemothers hadhad

and those whose mothers had not hadafetal death

Number of previous

fetal deaths

All

infants

None One Two or

❑ or e

Average annual live births in thousands

2,961 I

2,315 447

402 287 74

198

42

Percent distribution

Infant deaths per thousand live births

21.7 II 18.3 I 28.8 I 43.6

19.5 16.5 27.4 36.9

37.6 32.6 37.1 72.6

was substantial only among the infants weighing

3,000 grams or less.

Live-Birth Order

The definition of live-birth order used here

is the number of live births to the mother including

the sample child. Infant mortality rates by birth

order and race are given in table 1, and the data

for whites are illustrated in figure 5. For white

infants the lowest mortality rate occurred among

first births and the highest rate in the highest

birth order category. There was, however, no

trend between birth orders two and five. Among

black infants, no consistent trend of mortality

with change in birth order can be discerned (table

1), but numbers are small and the pattern of relationship camot be determined reliably in these

data.

5
I 2 3 4

LIVE-BIRTHORDER

5 6+

Figure 5. Estimated infant mortal i ty rates for white

infants, by 1ive-bi rth order.

The relationship of mortality rates to birth

order is considered within categories of socioeconomic status in tables 17-19. Because of the

lack of difference in infant mortality rates among

the three highest categories of socioeconomic status—noted in the previous reportl and seen in the

earlier tables of this report—these categories

have been combined in these and subsequent tables.

The patterns are not entirely consistent among the

three tables, but in general it can be said that the

increase in infant mortality rates with birth order

is seen in each socioeconomic group, and that the

high mortality rates of infants in the lower socioeconomic categories are seen in all birth orders.

Birth order and cause of death are examined

in table 20. The table shows data for white infants

only because of the instability of the rates for

other racial groups. There were some variations

between causes of death in the strength of their

associations with birth order, but the consistency

of the direction of the relationship is remarkable

considering the different biologic mechanisms of

these causes of death.

For white infants, association of mortality

rates with birth order is examined according to

age of the infant at death in table 21. The general

pattern of association observed for all tifant

deaths is seen in all five subdivisions by age at

death.

Age of Mother

The relationship of infant mortality to age of

mother was considered in the report on socioeconomic status. 1 The overall data for the particular samples used here (i.e., after exclusion

of multiple births) are given in table 2, and show

that rates tended to be highest among children

born to the youngest mothers (under 20) and to

those of the oldest (35 and over). This was true in

all socioeconomic groups examined. Similarly,

the decline in infant mortality with increasing

socioeconomic status was seen in all maternal age

categories.

The relationship of mortality to birth clrder

and maternal age simultaneously is examined in

table 22. Again limiting the data to white infants

because of small numbers in other races, the owerall patterns seen for maternal age and for birth

order in table margins are both generally reflected in thq body of the table, indicating the independence of the two associations. Of significance is the high infant mortality rate for the

second infants born to mothers under 20 years

of age.

Mo~tality by age of mother and cause of death

for white infants is examined in table 23. It is seen

that some causes of death contributed predominantly to one or the other of the two peaks c)f the

maternal age association. Thus, high mor~alit y

rates for the infants of mothers under 20 were

characteristic of deaths due to infective and parasitic deseases, pneumonia and other respiratory

diseases, and immaturity unqualified, while deaths

due to congenital malformations, birth injuries,

and hemolytic disease contributed most heavily to

the high rates for infants of older mothers. Some

cause categories—notably postnatal asphyxia and

atelectasis and to some extent congenital malformations and immaturity unqualified—corittributed to both peaks.

Table 24 gives mortality rates by age of

mother according to infant’s age at death. The Ushaped pattern of association with materna 1 age

exhibited by all infant deaths its seen within all ageat-death groups under one month. For deaths at

1-11 months, the oldest maternal age group did not

show the usual increase over the younger ages.

6
COMMENT

The only previous national data for the United

States on the relationship of infant mortality risk

to history of previous reproductive loss come from

a “study of births during January-March of 1950

conducted by the National Office of Vital Statistics.z The data were limited to deaths under 28

days and to relationship to prior fetal death. Somewhat more recent data for Upstate New York in

1959-1960 provided information on risk of late

fetal and infant death, but the infant mortality data

were again restricted to deaths under 28 days and

no information was available on history of death

of previous live-born infants.3 Neither of these

sources provides data by cause of death. A study

of births in England and Wales in 1949 and 1950

gives data on all infant deaths by cause of death,

but no distinction is drawn between history of prior

fetal death and of prior deaths of live-born infants.4

Insofar as the results of these three previous

studies can be compared with the present findings,

the overall conclusions are quite similar-a history of reproductive loss inan earlier pregnancy of

the mother increases the risk of infant death by a

factor of two or three. The present data indicate

that while either prior fetal death or prior infant

death is associated with increased infant mortality

and both are associated with particular causes of

death, particularly causes of very early death,

there are nevertheless some differences in their

implications. Previous infant death is a ketter

predictor than is previous fetal death of a subsequent death due to infectious disease or to

accident, and in general to deaths after the first

month of life. Such an observation is perhaps not

unexpected. It complements the data from New

York State3 which show that previous fetal death

is an even better predictor of late fetal death than

of early infant death.

‘Ike wide variety of causes of death that are

associated with previous fetal or infant death suggests that many mechanisms are involved. previous fetal or infant deaths are indexes of families

whose infants are at high risk of death and for any

particular family, the mechanism may be social,

biological, or both.

Finding a lower infant mortality rate in first

than in subsequent birth orders was somewhat

unexpected, since most previous studies have suggested that the mortality rate is higher in first

Table B. Infant toortality rates by birth

order and age at death: England and

Wales, 1949-50

A&a;:

at death

Less than 1

week ----------

1-4 weeks ------

1 ❑onth-1 yearBirth order

~

Rate per 1,000

live births

than in second births. In the United States in 1950,

neonatal death rates (deaths up to age 28 days) for

the first, second, and third birth orders were

19.1, 17.8, and 19.7 per 1,000, respectively.2 In

England and Wales at the same time, overall infant

mortality rates were 25.2,23.9, and 29.6 per 1,000

in the first three birth orders.i Separated by age

at death, as in table B, the British data showed

that the high mortality rate for first births was a

consequence of high rates in the early neonatal

period.

However, a study of United States live births

in 1960 showed neonatal mortality rates of 16.4,

17.4, and 17.1 in the first three birth orders. 5 As

in the present data, the favorable experience of

first births was more marked for white than for

black infants. The fact that the rate for first births

is relatively lower in the present study than in the

1960 study may result from the exclusion of illegitimate infants, since illegitimate infants have

high infant mortality rates and are disproportionately represented among first births. Illegitimate e

infants were included in the 1960 and 1950 United

States studies but, like the present study, the

British study was based on legitimate single-born

infants. It seems likeIy that a greater decline in

mortality rates for first-born infants than for

later-born infants accounts for at least part of

the difference between the earIier and the two

more recent studies. The present data indicate

that relatively favorabIe experience of first births

is not limited to the neonatal period.

7
REFERENCES

lMacMahon, B,; Kovar, M.G.; and Feldman, J.J.: In&nt

mortality rates by socioeconomic status. United States,

1964-66. Vital and Health Statistics. Series 22-No. 14, DHEW

Pub. No. (HSM) 72-1044, Washington. U.S. Government

Printing Office, Mar. 1972.

2Loeb, J.: Weight at birth and survival of newborn, by

age of mother and total-birth order: United States, early

1950. Vita 1 Statistics4pecial Reports, vol. 42, No. 2.

Public Health Service. Washington, D.C., Aug. 1958.

3Shapiro, S.; Schlesinger, E.R.; and Nesbitt, E.L., Jr.:

Infant and perinatal mortality in the United States. Vital and

Health Statistics. Public Health Service. Washington. PHS pub.

No. 1000-Series 3-No. 4, U.S. Gwernment Printing Office, Oct.

1965.

4Heady, J.A. and Heasman, M.A.: Social and Biological

Factors in Infant Mortality. Studies in Me&cd and Population

Subjects No. 15. General Register Office. London. Her Majesty’s Stationery Office, 1959.

5Chase, H.C,: A study of infant mortality from linked

records. Comparison of neonatal mortality from two cohort

studies. Vital and Health Statistics. Series 20-No. 13, DHEW

Pub. No. (HSM) 72-1056, Washington. U.S. Government

Printing Office, June 1972.

000
Table 1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

LIST OF DETAILED TABLES

Estimated average annual number of live births and infant deaths per 1,000 live

births according to whether a previous infant death was reported for the mother,

and percent of mothers of live births with a previous infant death, by live-birth

order and race of infant: United States, 1964-66 legitimate, single births-------

Estimated average annual number of live births and infant deaths per 1,000 live

births according to whether a previous infant death was reported for the ❑other,

and percent of mothers of live births with a previous infsnt death, by age of

mother and race of infant: United States, 1964-66 legitimate, single births------

Estimated average annual number of live births and infant deaths per 1,000 live

births according to whether a previous infant death was reported for the mother,

and percent of mothers of live births with a previous infant death, by family income and race of infant: United States, 1964-66 legitimate, single births--------

Estimated average annual number of live births and infant deaths per 1,000 live

births according to whether a previous infant death was reported for the mother,

and percent of mothers of live births with a previous infant death, by education

of mother and race of infant: United States, 1964-66 legitimate, single births---

Estimated average annual number of live births

births according to whether a previous

and infant deaths per 1,000 live

infant death was reported for the mother,

and percent of mothers of live births with a previous infant death, by education

of father and race of infant: United States, 1964-66 legitimate, single births---

Estimated infant deaths per 1,000 live births for white infants,by cause of death

and whether a previous infant death was reported for the mother: United States,

1964-66 legitimate, single births------------------------------------------------

Estimated infant deaths per 1,000 live births for white infants, by age at death

of sample child and whether a previous infant death was reported for the mother:

United States, 1964-66 legitimate, single births---------------------------------

Estimated average annual number of live births and infant deaths per 1,000 live

births for white infants according to whether a previous infant death was reported

for the ❑other,and percent of mothersof live births with a previous infant death,

by birth weight: United States, 1964-66 legitimate, single births----------------

Estimated average annual number of live births and infant deaths per 1,000 live

births according to whether a previous fetal death was reported for the mother,

and percent of mothers of live births with a previous fetal death, by live-birth

order and race of infant: United States, 1964-66 legitimate, single births-------

Estimated average annual number of live births and

births according to whether a previous

infant deaths per 1,000 live

fetal death was reported for the mother,

and percent of ❑others of live births with a previous fetal death, by age of

❑other and race of infant: United States, 1964-66 legitimate, single births------

Estimated average annual number of live births and infant deaths per 1,000 live

births according to whether a previous fetal death was reported for the mother,

and percent of mothers of live births with a previous fetal death, by family income and race of infant: United States, 1964-66 legitimate, single births--------

Estimated average annual number of live births and infant deaths per 1,000 live

births according to whether a Pr$vious fetal death was reported for the ❑other,

and percent of mothers of live broths with a previous fetal death: by education

of mother and race of infant: United States, 1964-66 legitimate, srngle births---

Estimated average annual number of live births and

births according to whether a previous

infant deaths per 1,000 live

fetal death was reported for the mother,

and percent of ❑others of live births with a previous fetal death, by education

of father and race of infant: United States, 1964-66 legitimate, single births---

Page

11

12

13

14

15

16

17

17

18

19

20

21

22

9
LIST OF DETAIL TABLES-Crm. -.-——— -----

Table 14.

15.

16.

17.

18.

19.

20.

21.

22.

23.

24.

Estimated infsnt desths per 1,000 live births for white infants, by cause of

death and number of previous fetal deaths reported for the mother:UnitedStatea,

1964-65 legitimate,single b&ths -----------------------------------------------

Estimated infant deaths per 1,000 live births for white infants, by age at death

of sample child and number of previous fetal deaths reported for the mother:

United States, 1964-66 legitimate,single births-------------------------------’-’

Estimated average annual number of live births and infant deaths per 1,000 live

births for white infants according to whether a previous fetal deathwas reported

forthemother, and percentof mothers of live births with a previous fetal death,

by birth weight: United States, 1964-65 legitimate,single births---------------

Estimated average annual number of live births and infant deaths per 1,000 live

births, by live-birthorder, family income, and race of infant: United States,

1964-66 legitimate,single births--------------------------------------------.

Estimated average annual number of live births and infant deatha per 1,000 live

births, by live-birthorder, education of mother, and race of infant: United

States, 1964-66 legitimate,single birthe-------------------------------------

~.’c’cted average annual number of live births and infant deaths per 1,000 live

by live-birthorder, education of father, and race of infant: United

States~ 1964-66 legitimate,single births---------------------------------------

Estimated infant deaths per 1,000 births for white infants, by live-birthorder

and cause of death: United States, 1964-66 legitimate,single births------------

Estimated infant deaths per 1,000 live births for white infants, by live-birth

order and age at death: United States, 1964-66 legitimate,single births--------

Estimated average annual number of live births and infant deaths per 1,000 live

births, by age of mother, live-birthorder, and race of infant: United States,

1964-66 legitimate,single births---------------------------------------------

Estimated infant deaths per 1,000 live births for white infants, b

and cause of death: United States,

{ ageof mother

1964-66 legitimate,single birt s------------

Estimated infant deaths per 1,000 live births for white infants, by age ofmother

and age st death: United States, 1964-66 legitimate,single births--------------

Page

23

24

24

25

26

27

28

28

29

30

30

10
Table 1. Estimated average annual number of live births and infant deaths per 1,000

live births accordingtowhether a previous infant death was reported for the mother,

and percent of ❑others of live births with a previous in~ant death, by live-birth

order and race of infant: United States, 1964-66 legitimate, single births

Live births

T

Previous inAll fant death

fants

‘n- T

Infant deaths

All

f:ts

Previous infant death

Percent

with

previous

infant

death

Race and live-birth order

No

I

Yes

Rate per 1,000

live births All races Number in thousands

All birth orders---------- 3,417 3,232 185 5.4 21.; 20.1 50.9

First----------------.----------

Second--------------------------

Third---------------------------

Fourth--------------------------

Fifth--------.--.-----.--.,------

Sixth or ❑ ore-------------------

1,004

857

610

392

228

326

2,961

1,004

845

575

356

199

254

2,823

18.1

22.C

22.1

21.2

25.2

29.7

19.5

18.0

20.8

19.9

19.5

24.0

23.9

18.1

12

35

36

29

72

138

1.4

5.8

9.1

12,8

22.1

4.7

*

59.7

37.8

33,4

50.3

49.2

White

All birth orders----------

First---------.--.-.”--------.-.

Second----------.---------------

Third----------------------------

Fourth--------------------------

Fifth---------------------------

Sixth or more-------------------

907

759

536

342

191

226

402

907

748

504

312

169

183

360

16.3

20.1

20.1

19.5

20.5

28,8

37.6

16,3

19.1

18.0

17.6

19.5

22.7

35.7

11

31

31

22

43

43

1.4

5.9

9.0

11.3

19.1

10.6

*

53.0

38.0

*

54.4

53.4

Black

All birth orders----------

First-------..----------.-------

Second----------------.---”-----

Third--------------.--------.-.-

Fourth------”-------------------

Fifth-..---.-.-----..,-----------

Sixth or ❑ ore-------------------

83

81

66

45

33

94

83

80

63

41

26

68

38.1

39.4

39.5

34.2

51.4

31.1

38.1

36.2

36.3

33,7

51.4

27.1

*

*

5

7

26

*

*

10.5

21.0

27.5

*

*

*

*

41.6

11
Table 2. Estimated average annual number of live births and infant deaths per 1,000

live births according towhether a previous infant death was reported for the mother,

and percent of mothers of live births with a previous infant death, by age of mother

and race of infant: United States, 1964-66 legitimate, single births

Race of infant and

age of mother

All races

All ages -------------------

Under 20 years -------------------

20-24 years ----------------------

25-29 years ----------------------

30-34 years ----------------------

35 years and over ----------------

White

All ages-------------------

Under 20 years -------------------

20-24 years ----------------------

25-29 years ----------------------

30-34 years ----------------------

35 years and over----------------

Black

All ages -------------------

Under 20 years -------------------

20-24 years----------------------

25-29 years ----------------------

30-34 years ----------------------

35 years and over ----------------

All

f:ts

Live births

L

Previous infant death

No Yes

Number in thousands

3,417

468

1,237

878

494

340

2,961

393

1>082

771

425

290

402

70

136

91

59

45

3,232

462

1,194

823

452

300

2,823

389

1,048

729

396

261

360

69

128

78

48

36

185

5

43

55

42

40

138

*

34

42

29

29

43

%

9

13

11

9

Per -

cent

with

previous

infant

death

5.4

1.2

3.5

6.2

8.4

11.7

4.7

*

3.1

5.4

6.9

10.0

10.6

*

6.2

14.0

18.7

19.1

Infant deaths

T

Previous inAll fant dei~th

f::ts

No Yes

Rate per 1,000

live births

21.7

28.0

19.5

20.0

21.5

26.3

19.5

23.6

17.8

17.8

20.3

24.1

37.6

52.0

33.0

39.0

29.5

37.0

20.1

26.3

18.1

18.4

19.8

23.3

18.1

22.1

16.7

16.8

18.1

21.3

35.7

50.0

30.0

33.9

32.4

37.3

50.9

*

56.9

43.8

39.9

48.4

49.2

——

*

52.2

34.1,

50.0

49.4

53.4

*

*

*

*

*

12
Table 3. Estimated average annual number of live births and infant deaths per 1,000

live births accordingtowhether a previous infant death was reported for the mother,

and percent of mothers of live births with a previous infant death, by family income

and race of infant: United States, 1964-66 legitimate,single births

Race and family income

All races

All incomes----------------

Less than $3,000-----------------

$3,000-$4,999--------------------

$5,000-$6,999--------------------

$7,000-$9,999--------------------

$10,000 or more------------------

White

All incomes----------------

Less than $3,000-----------------

$3,000-$4,999--------------------

$5,000-$6,999--------------------

$7,000-$9,999--------------------

$10,000 or more------------------

Black

All

Less than

incomes----------------

$3,000-----------------

$3,000-$4,999--------------------

$5,000-$6,999--------------------

$7,000-$9,999--------------------

$10,000 or more------------------

All

f%s

Live births

Previous infant death

Number in thousands

3,417

679

767

871

701

399

2,961

461

660

794

666

381

402

202

94

67

27

12

3,232

627

723

826

675

380

2,823

439

624

754

643

364

360

175

88

62

24

11

185

52

44

45

26

18

138

22

36

40

23

17

43

27

7

5

*

*

Percent

with

previous

infant

death

5.4

7.6

5.7

5.2

3.7

4.6

4.7

4.8

5.5

5.0

3.4

4.5

10.6

13.3

7.4

6.8

*

*

Infant deaths

All .

f%s

Previous infant death

T

Rate per 1,000

live births

21.7

30.5

23.7

17.2

18.7

18.3

19.5

26.0

28.0

16.9

18.0

17.7

37.6

40.4

44.6

20.9

36.1

*

20.1

28.0

21.9

15.8

17.6

17.2

18.1

23.9

19.4

15.4

16.9

16.6

35.7

38.2

40.3

21.8

*

*

50.9

61.1

54.4

41.7

47.5

*

49.2

*

44.3

45.3

*

*

53.4

54.7

*

*

*

*

13
Table 4. Estimated average annual number of live births and infant deaths per 1,000

live births according towhether a previous infant death was reported for the mother,

and percent of mothers of live births with a previous infant death, by education of

mother and race of infant: United States, 1964-66 legitimate, single births

Live births Infant deaths

Al1

f%s

Per -

cent

with

previous

infant

death

5.4

Previous in

fant death L

Previous inAll fant death

.

f::ts

No Yes

Rate per 1,000

live births

Race of infant and

education of mother

E-PI

All races Number in thousands

All levels ----------------- 3,417 185 21.7 20.1 50.9

8 years or less------------------

9-11 years -----------------------

12 years -------------------------

13-15 years ----------------------

16 years or more -----------------

White

All levels -----------------

8 years or less------------------

9-11 years -----------------------

12 years -------------------------

13-15 years ----------------------

16 years or more -----------------

Black

415

851

1,495

419

235

2,961

360

799

L,440

405

228

!,823

-

283

655

.,302

.372

212

360

69

131

123

25

12

55

53

55

15

7

138

32

38

48

14

7

43

21

14

7

*

*

13.2

6.2

3.7

3.5

3.2

4.7

10.2

5.4

3.5

3.5

3.1

10.6

23.4

9.4

5.1

*

*

32.9

26.7

18.3

14.4

18.9

19.5

29.8

23.7

16.9

13.6

18.8

37.6

29.6

24.2

17.3

13.9

18.9

18.1

54.6

63.9

44.9

*

*

49.2

26.2

21.5

16.0

13.2

18.7

35.7

61.2

62.1

41.2

*

*

53.4

315

693

1,349

386

219

402

90

145

130

26

12

All levels-----------------

8 years or less------------------

9-11 years -----------------------

12 years -------------------------

13-15 years ----------------------

16 years or more -----------------

44.0

40.5

32.9

27.5

*

45.1

37.5

31.2

27.1

*

14
Table 5. Estimated average annual number of live births and infant deaths per 1,000

live births accordingti whether a previous infant death was reported for the mother,

and percent of mothers of live births with a previous infant death, by education of

father and race of infant: United States, 1964-66 legitimate, single births

Live births Infant deaths

All

.

f%s

Percent

with

previous

infant

death

5.4

Race of infant and

education of father

Previous infant death

__k__kL No

I

Yes

All races

All levels-----------------

8 years or less------------------

9-11 years-----------------------

12 years-------------------------

13-15 years----------------------

16 years or more-----------------

White

All levels-----------------

8 years or less------------------

9-11 years-----------------------

12 years-------------------------

13-15 years----------------------

16 years or more-----------------

Black

All levels-----------------

8 years or less------------------

9-11 years-----------------------

12 years-------------------------

13-15 years----------------------

16 years or more-----------------

Rate per 1,000

live births Number in thousands

3,417 3,232 185 21.7 20.1 50.9

558

718

1,241

416

483

2,961

503

666

1,190

407

467

2,823

56

52

51

9

17

138

10.0

7.2

4.1

2.2

3.5

4.7

30.8

26.5

18.0

19.1

16.0

19.5

27.7

24.9

16.7

17.5

15.8

18.1

58.2

46.5

50.0

*

*

49.2

424

590

1,108

379

459

402

392

553

1,064

371

443

360

100

103

112

30

16

33

37

44

8

16

43

7.7

6.3

4.0

2.1

3.5

10.6

28.5

23.1

16.6

17.4

15.7

37.6

25.2

21.9

15.3

16.1

15.4

35.7

67.4

41.3

46.5

*

*

53.4

121

116

118

31

16

22

13

6

*

*

17.8

11.4

5.3

*

*

39.3

43.2

31.4

36.8

*

38.9

41.4

29.3

31.6

*

*

*

*

*

*

15
Table 6. Estimated infant deaths per 1,000 live births for white infants, by cause of

death and whether aprevious infant death was reported for the mother: United States,

1964-66 legitimate, single births

Cause of death

All causes--------------------------------------

Infective and parasitic diseases ------------(001-138)

Influenza, pneumonia and all other diseases of the

respiratory system------ (470-475,480-493,500-527,763)

Gastritis, duodenitis and all other diseases of the

digestive system----------------------------(53O-587)

Congenital ❑a”lformations--------------------- (750-759)

Birth injuries------------------------------- (760-761)

Postnatal asphyxia and atelectasis --------------- (762)

Hemolytic disease of newborn --------------------- (770)

Immaturity, unqualified -------------------------- (776)

Certain diseases of early infancyl-- (765,769, 771-774)

Accidents ---------------------------------- (E800-E962)

Residual------------------------------All other causes

No Yes

Rate per 1,000 live births

19.5

0.2

2.4

0.5

3.7

1.8

3.3

0.4

2.6

3.0

0.8

1.0

18.1

0.1

2.3

0.5

3.5

1.7

2.9

0.3

2.4

2.8

0.8

0.9

49.2

=-

0.5

4.3

0.8

6.7

3.8

11.6

2.1

6.4

9.0

1.3

2.7

——

lIncludes neonatal disorders arising from certain diseases of the mother during pregnancy; ill-defined diseases peculiar to early infancy; immaturity with mention of other

subsidiary condition; and other diseases peculiar to early infancy not already shown.

Ill-defined diseases peculiar to early infancy account for about 60 percent of these

deaths.

16
Table 7. Estimated infant deaths per 1,000 live births for white infants, by age at

death ofsample child and whether aprevious infant death was reported for the mother:

United States, 1964-66 legitimate, single births

I II

Previous infant death

Age at death All infant

deaths

No Yes

I

Rate per 1,000 live births

Less than 1 year-----------------------

Less than 1 day---------------- --------------

l%)+=

1-6 days---.---- ----------------------------- I

5.0 I4.7 10.6

7-27 days------------------------------------ 1.4 II 1.41 2.4

1-5 months ----------------------------------- I 3.4 I 3.2 7.4

6-11 months ---------------- ---------------- -- I

1.5 I1.4 3.2

Table 8. Estimated average annual number of live births and infant deaths per 1,000

live births for white infants according to whether a previous infant death was reported for the mother, and percent of mothers of live births with a previous infant

death, by birth weight: United States, 1964-65 legitimate, single births

Birth weight in grams

All weights ----------------

2,500 grams or less--------------

2,501-3,000 grams----------------

3,001-4,000 grams----------------

4,001 grams or more --------------

Al 1 .

fxts

Live births

Previous infant death

No Yes

Number in thousands

3,037 2,886 I

I

188 169

510 482

2,051 1,965

289 271

151

20

28

86

18

Percent

with

preTious

infant

~eath

5.0

10.5

5.4

4.2

6.2

Infant deaths

All

infants

Previous infant death

I

No

I

Yes

II 1

Rate per 1,000

live births

20.0

192.4

18.3

6.3

7.6

18.6 f

187.1

18.0

5.8

7.0

46.9

*

24.3

16.9

*

17
Table 9. Estimated average annual number of live births and infant deaths per 1.,()()1)

live births according to whether a previous fetal death was reported for the mother,

and percent of mothers of live births with a previous fetal death, by live-birth

order and race of infant: United States, 1964-66 legitimate, single births

Live births Infant deaths

All

.

f::ts

Percent

with

previous

fetal

death

Previous fetal death

Race and live-birth order k-Previous feAll tal death .

f;:ts

No l!es

Rate per 1,00C)

live births

No

I

Yes

All races Number in thousands

All birth orders----------- 3,417 2,647 769 22.5 21.7 18.3

15.3

18.8

20.0

18.2

24.0

22.6

16.5

33.5

——.—

41.5

34.9

28.4

28.2

27.4

39.7

30.3

First---.------------------------

Second---------------------------

Third----------------------------

Fourth---------------------------

Fifth---------.--m-------..------

1,004

857

610

392

228

326

900

689

450

276

143

189

2,315

104

168

160

115

85

136

646

10.4

19.6

26.3

29.5

37.4

41.9

21.8

18.1

22.0

22.2

21.2

25.2

29.7

19.5

Sixth or more --------------------

L2,961

White

All birth orders-----------

First----------------------------

Second---------------.-----------

Third----------------------------

Fourth---------------------------

Fifth----------------------------

907

759

536

342

191

226

816

611

396

239

120

134

287

73

63

47

33

19

51

91

148

140

103

71

92

115

10

18

19

12

13

43

10.0

19.5

26.1

30.1

37*3

40.9

28.7

12.1

22.3

28.4

27.6

40.4

45.4

16.3

20.1

20.1

19.5

20.5

28.8

37.6

38.1

39.4

39.5

34.2

51.4

31.1

14.2

17,4

17.8

16.1

19.6

21.4

32.6

28.6

32.6

38.4

34.0

7’r

25.0

35.5

30.9

26.6

27.4

22,2

39.3

49.9

——

*

>&

*

*

*

38.3

Sixth or more --------------------

Black

All birth orders-----------

First----------------------------

Second---------------------------

Third---------------- ------------

Fourth---------------------------

Fifth----------------------------

Sixth or more --------------------

402

83

81

66

45

33

94

18
Table 10. Estimated average annual number of live births and infant deaths per 1,000”

live births according to whether a previous fetal death was reported for the mother,

and percent of mothers of live births with a previous fetal death, by age of mother

and race of infant: United States, 1964-66 legitimate, single births

Live births Infant deaths

I

Previous feAll tal death

“-

f::ts

No Yes

Rate per 1,000

live births

All .

f%s

Percent

with

previous

fetal

death

Previous fetal death

Race of infant and

age of mother

T

All races

All ages-------------------

Under 20 years-------------------

20-24 years----------------------

25-29 years----------------------

30-34 years ----------------------

35 years and over----------------

White

Number in thousands

3,417

468

1,237

878

494

340

2,961

2,647 769

35

190

242

158

144

646

22.5

7.6

15.4

27.6

32.0

42.3

21.8

21.7 18.3 33.5

433

1,047

636

336

196

2,315

28.0

19.5

20.0

21.5

26.3

19.5

24.5

17.1

16.9

16.3

19.1

16.5

70.5

32.6

28.0

32.4

35.9

All ages------------------- 30.3

Under 20 years-------------------

20-24 years ----------------------

25-29 years----------------------

30-34 years----------------------

35 years and over----------------

Black

All ages-------------------

Under 20 years-------------------

20-24 years----------------------

25-29 years----------------------

30-34 years----------------------

35 years and over----------------

393

13082

771

425

290

402

365

925

565

292

168

287

28

157

206

133

121

115

7.1

14.2

26.7

31.3

41.9

28.7

23.6

17.8

17.8

20.3

24.1

37.6

20.7

15.7

15.4

16.3

16.6

32.6

61.4

30.4

24.4

29.0

34.6

49.9

70

136

91

59

45

64

106

57

36

24

7

30

34

24

21

9.9

22.1

36.9

40.2

46.2

52.0

33.0

39.0

29.5

37.0

46.2

29.4

31.3

17.9

*

*

45.6

52.0

*

*

1.9
Table 11. Estimated average annual number of live births and infant deaths per IL,000

live births according to whethera previous fetal death was reported for the mother,

and percent of mothers of live births with a previous fetal death, by family income

and race of infant: United States, 1964-66 legitimate, single births

Live births Infant deatha

Percent

with

previous

fetal

death

22.5

19.5

21.6

21.5

26.1

25.3

21.8

Previous fetal death

Previous fetal death Race and family income All

f:t s

No

I

Yes No

I

Yes

11 I

Rate per 1,00ID

live births Number in thousands

All races

All incomes--------------- 3,417 2,647 769 21.7 18.3 33.5

Less than $3,000----------------

$3,000-$4,999-------------------

$5,000-$6,999-------------------

$7,000-$9,999-------------------

$10,000 or ❑ ore-----------------

679

767

871

701

399

2,961

547

601

684

518

298

2,315

133

166

188

183

101

646

30.5

23.7

17.2

18.7

18.3

19.5

26.6

20.4

14.2

14.9

14.3

16.5

46.9

35.7

27.8

29.4

29.9

30.3

White

All incomes---------------

Less than $3,000----------------

$3,000-$4,999-------------------

$5,000-$6,999-------------------

$7,000-$9,999-------------------

$10,000 or more-----------------

461

660

794

666

381

402

391

524

625

492

283

287

15.1

20.6

21.3

26.0

25.6

28.7

26.0

20.8

16.9

18.0

17.7

37.6

22.6

18.2

14.1

14.4

14.3

32.6

45.4

30.8

27.3

28.5

27.4

49.9

.—

48.1

57.0

*

*

*

70

136

169

173

97

115

Black

All incomes---------------

Less than $3,000----------------

$3,000-$4,999-------------------

$5,000-$6,999-------------------

$7,000-$9,999-------------------

$10,000 or more-----------------

202

94

67

27

12

141

66

51

19

10

60

28

16

8

$<

29.9

30.1

24.1

30.9

*

40.4

44.6

20.9

36.1

*

37.1

39.2

15.6

*

*

20
Table 12. Estimated average annual number of live births and infant deaths per 1,000

live births according to whether a previous fetal death was reported for the mother,

and percent of mothers of live births with a previous fetal death, by education of

mother and race of infant: United States, 1964-66 legitimate, single births

Live births Infant deaths

Percent

with

pre -

vious

fetal

death

Race of infant and

education of mother h

Previous feAll tal death

f:ts

No Yes

All

f%s

Previous fetal death

No Yes

Rate per 1,000

live births All races Number in thousands

3,417 2,647 769 22.5 21.7 18.3 33.5

27.1

23.6

21.5

21.5

18.7

21.8

All levels-----------------

415

851

1,495

419

235

2,961

303

650

1,;;:

191

2,315

113

201

321

90

44

646

32.9

26.7

18.3

14.4

18.9

19.5

27.5

23.3

15.3

11.9

16.6

16.5

47.5

37.9

29.2

23.5

29.2

30.3

8 years or less------------------

9-11 years -----------------------

12 years -------------------------

13-15 years ----------------------

16 years or more -----------------

White

All levels-----------------

8 years of less------------------

9-11 years-----------------------

12 years -------------------------

13-15 years ----------------------

16 years or more -----------------

315

693

1,349

386

219

402

1:;

130

26

12

236

535

1,065

303

177

287

1:;

95

20

11

25.0

22.7

21.1

21.6

19.2

28.7

29.8

23.7

16.9

13.6

18.8

37.6

24.1

20.2

14.3

11.8

17.2

32.6

46.7

35.6

26.5

20.3

25.3

49.9

Black

All levels-----------------

8 years or less------------------

9-11 years -----------------------

12 years-------------------------

13-15 years ----------------------

16 years or more -----------------

36.5

28.4

26.5

21.7

*

44.0

40.5

32.9

27.5

*

42.0

38.7

26.7

*

*

47.5

;;.;

“*

*

21
Table 13. Estimated average annual number of live births and infant deaths per 1,000

live births according to whether a previous fetal death was reported for the ❑other,

and percent of mothers of live births with a previous fetal death, by education of

father and race of infant: United States, 1964-66 legitimate, single births

Live births Infant deaths

All

“-

f%s

Percent

with

previous

fetal

death

Race of infant and

education of father

- L

Previous feAll tal death .

f::ts

Previous fetal death

*

II No I

Yes

Rate per 1,000

live births All races Number in thousands

All levels----------------- 3,417 2,647 :33.5

1[558 399

718 565

1,241 973

416 329

483 381

2,961 2,315

769 22.5 21.7 18.3

28.5

21.3

21.6

20.8

21.2

21.8

30.8

26.5

18.0

19.1

16.0

19.5

26.9

22.6

15.1

16.2

13.3

16.5

40. fj

/}1 .1

2!8.8

30.0

26.1

30.3

8 years or less=-----------------

9-11 years-----------------------

12 years-------------------------

13-15 years----------------------

16 years or ❑ ore-----------------

159

153

268

87

103

646

White

All levels-----------------

424 316

590 464

1,108 875

379 298

459 361

402 287

121 72

116 91

118 86

31 26

8 years or less------------------

9-11 years-----------------------

12 years-------------------------

13-15 years----------------------

16 years or ❑ ore-----------------

109

126

233

81

97

115

49

25

32

5

9<

25.6

21.4

21.0

21.3

21.2

28.7

28.5

23.1

16.6

17.4

15.7

37.6

24.1

19.8

13.8

15.1

13.4

32.6

41.0

35*1

26.8

26.3

23.9

49.9

Black

All levels-----------------

8 years or less------------------

9-11 years-----------------------

12 years-------------------------

13-15 years----------------------

16 years or ❑ ore-----------------

40.7

21.9

26.9

16.6

9:

39.3

43.2

31.4

36.8

9<

40.5

35.8

27.0

27.3

?<

37.5

69.8

43.4

*

*

22
Table 14. Estimated infant deaths per 1,000 live births for white infants, by cause of

death and number ofprevious fetal deaths reportedfor the mother: United States,1964-

66 legitimate, single births

Cause of death

AU causes ---------------------------------

Infective and parasitic diseases --------(OOl-l38)

Influenza? pneumonia and all other diseases of

the respmatory

system ---------- (470-475, 480-493, 500-527, 763)

Gastritis, duodenitis and all other diseases of

the digestive system-------------------(53O-587)

Congenital malformations ----------------(750-759)

Birth injuries--------------------------(76O-76l)

Postnatal asphyxia and atelectasis----------(762)

Hemolytic disease of newborn----------------(77O)

Immaturity, unqualified---------------------(776)

Certain diseases of early

infancyl ---------------------(765, 769, 771-774)

Accidents -----------------------------(E800-E962)

Residual -------------------------All other causes

All

infants

Number of previous

fetal deaths

E

Rate per 1,000 live births

19.5

0.2

2.4

0.5

3.7

1.8

3.3

0.4

2.6

3.0

0.8

1.0

.— —

16.5

0.1

2.2

0.5

3.4

1.5

2.4

0.3

2.1

2.2

0.8

1.0

27.4

0.2

2.6

0.3

4.1

2.5

5.6

0.5

3.5

6.0

1.2

1.1

36.9

0.2

3.4

0.4

6.1

3.5

8.2

1.1

6.8

6.3

0.2

0.9

lIncludes neonatal disorders arising from certain diseases of the mother during pregnancy; ill-defined diseases peculiar to early infancy; immaturity with mention of other

subsidiary condition; and other diseases peculiar to early infancy not already shown.

$LL;$fined diseases peculiar to early infancy account for about 60 percent of these

.

23
Table 15. Estimated infant deaths per 1,000 live births for white infants, by age at

death of sample child and number of previous fetal deaths reported for the mother:

United States, 1964-66 legitimate, single births

1 II

Number of previous

fetal deaths

Age at death Al 1

infants

None One Two or

more

Rate per 1,000 live births

Less than 1 year--------------------- 19.5 16.5 27.4 36..9

Less than 1 day------------------------ ---- 8.4 6.5 13.4 1901

1-6 days----------------------------------- 5.0 4.3 6.6 9.1

7-27 days------------------------ ---------- 1.4 1.3 1.6 2.2

1-5 months --------------------- ------------ 3.4 3.1 4.5 4.3

6-11 months ------------------------ -------- 1.5 1.4 1.2 2.2

Table 16. Estimated average annual number of live births and infant deaths per 1.,000

live births for white infants according to whether a previous fetal death was reported for the mother, and p“ercentof mothers of live births with a previous fetal

death, by birth weight: United States, 1964-65 legitimate, single births

Birth weight in grams r

All

f%s

Live births

Previous fetal death

I

Number in thousands

All weights --------------- 3,037

2,500 grams or less------------- 188

2,501-3,000 grams--------------- 510

3,001-4,000 grams--------------- 2,051

4,001 grams or more ------------- 289 1

2,357 681

137 51

403 106

1,610 440

206 82

Percent

with

previous

fetal

death

22.4

27.2

20.8

21.5

28.6

Infant deaths

All

.

f::ts

Previous fetal dea!th

3

No Yes

Rate per 1,00CI

live births

1

20.0 17.0 30.3

192.4 167.8 258.1

18.3 14.7 32.1

6.3 6.0 7.4

7.6 7.1 8.8

24
Table 17. Estimated average annual number of live births and infant deaths per 1,000 live births,

bv live-birth order. familv income. and race of infant: United States. 1964-66 legitimate.

single births

Race and livebirth order

All races

All birth orders-------

First------------------------

Second-----------------------

Third------------------------

Fourth -----------------------

Fifth ------------------------

Sixth or more----------------

~e

All birth orders-------

First------------------------

Second-----------------------

Third------------------------

Fourth-----------------------

Fifth------------------------

Sixth or more----------------

Black

All birth orders-------

First------------------------

Second-----------------------

Third------------------------

Fourth-----------------------

Fifth ------------------------

Sixth or more----------------

Live births

All

--

f:t s

3,417

1,004

857

610

392

228

326

2,961

907

759

536

342

191

226

402

83

81

66

45

33

94

Family income

Number in thousands

679

247

146

87

58

44

98

461

205

103

56

33

25

39

202

40

39

28

23

17

55

767

230

201

139

86

48

64

660

210

176

118

70

43

43

94

19

19

17

14

5

20

1,971

526

51C

385

248

136

165

1,840

492

480

362

239

123

144

106

25

22

20

8

11

19

Infant deatha

II Family income

All I ,

.-

f::ts g:: $3,000- $5;:00

$3,000 $4,999 more

II I 1

Rate per 1,000 live birtha

21.7

18.1

22.0

22.2

21.2

25.2

29.7

19.5

16.3

20.1

20.1

19.5

20.5

28.8

37.6

38.1

39.4

39.5

34.2

51.4

31.1

30.5

22.9

32.6

40.2

26.7

33.9

38.8

26.0

20.5

25.0

36.3

19.1

22.4

51.0

40.4

36.0

49.2

45.5

*

*

32.3

23.7

18.4

23.9

25.9

.23.4

25.9

36.4

20.8

15.4

23.3

22.6

21.9

17.1

34.0

44.6

*

*

*

*

*

*

17.9

15.6

18.2

16.8

19.1

22.2

21.8

17.5

15.0

17.8

16.7

18.8

21.4

21.1

26.1

31.4

*

*

*

*

*

25
Table 18. Estimated average annual number of live births and infant deaths per 1,000 live births,

by live-birthorder. educationofmother, and race of infant: United States, 1964-66 legitimate,

single births

Live births Infant deaths

All

f:ts

Education of mother

2:’ w

fants

Education of mother

II

~~e Grades ~~~

less 9-11more

Race and live-birthorder

All races

All birth orders--------------

Number in thoushds Rate per 1,000 live births

26.7

22.3

30.7

26.3

22.7

25.8

35.1

23.7

3,417 415 2,150 21.7 32.9 17.6

29.9

29.6

36.0

29.1

26.2

39.7

29.8

851

- -

First-------------------------------

Second----------------....-..-.....-

Third------------.------------------

Fourth------------------------------

Fifth-----------------------------

Sixth or more-----------------------

1,004

857

610

392

228

326

2,961

907

759

536

342

191

226

402

61

73

65

58

46

112

315

224

200

166

105

69

86

693

719

584

379

228

113

128

1.,954

18.1

22.0

22.2

21.2

25.2

29.7

19.5

15.7

18.0

18.1

18.4

24.5

17.4

16.4

White

All birth orders--------------

First------------------.------------

Second------------------------------

Third-------------------------------

Fourth------------------------------

Fifth----------------------.-----~--

Sixth or more-----------------------

55

60

54

47

35

63

90

194

165

143

86

52

52

145

658

534

338

209

104

111

167

16.3

20.1

20.1

19.5

20.5

28.8

37.6

27.5

23.8

29.6

26.6

20.6

45.0

44.0

19.4

28.3

21.6

21.2

21.2

37.3

40.5

44.4

44.9

*

*

*

33.4

14.5

17.1

17.9

17.2

20.2

15.5

31.6

32.6

28.9

22.3

*

*

*

Black

All birth orders--------------

First-------------------------------

Second------------------------------

Third----------------.--------------

Fourth------------------------------

Fifth-------------------------------

Sixth or more-----------------------

83

81

66

45

33

94

5

11

10

10

8

45

26

31

21

18

16

33

52

39

35

17

8

16

38.1

39.4

39.5

34.2

51.4

31.1

*

*

*

*

*

30.9

26
Table 19. Estimatedaverage annual number of live births and infant deaths per 1,000 live births,

by live-birthorder. education offather, and race of infant: United States, 1964-66 legitimate,

s~ngle births

Live births Infant deaths

All

infants

All

“-

f%s

Educationof father

w

Educationof father

!EEEllE

Race and live-birth order

All races

AM birth orders--------------

Number in thousands Rate per 1,000 live births

3,417 17.8

1,004

857

610

392

228

326

2,961

907

759

536

342

191

226

402

2,141

717

573

380

234

110

126

1,946

658

520

343

213

101

110

165

718

196

177

135

82

57

70

590

167

147

114

71

46

45

116

21.7 30.8 26.5

24.8

25.6

22.5

28.2

27.3

38.6

23.1

558

First -------------------------------

Second------------------------------

Third--------------------------- ----

Fourth------------------------------

Fifth-------------------------------

Sixth or more-----------------------

90

107

95

76

60

129

424

81

92

78

58

44

71

121

18.1

22.0

22.2

21.2

25.2

29.7

19.5

16.3

20.1

20.1

19.5

20.5

28.8

37.6

33.8

32.8

29.8

21.3

27.7

34.7

28.5

14.2

18.9

20.2

18.7

22.9

19.7

16.5

White

AU birth orders--------------

32.4

28.8

26.4

21.4

20.7

36.5

39.3

21.8

22.1

18.3

26.3

21.0

40.4

43.2

12.9

18.0

19.2

16.7

20.3

19.0

32.4

First-------------------------------

Second------------------------------

Third-------------------------------

Fourth----.-------------------.---.-

Sixth or more-----------------------

Black

AU birth orders--------------

First-------------------------------

Second------------------------------

Third---.---------------------------

Fourth------------------------------

Fifth-------------------------------

Sixth or more-----------------------

83

81

66

45

33

94

8

12

15

17

14

55

27

26

19

10

11

24

48

43

32

19

8

15

38.1

39.4

39.5

34.2

51.4

31.1

43.9

43.7

*

*

*

*

32.3

27.8

30.5

*

*

*

*

*

*

*

*

31.4

27
Table 20. Estimated infant deaths per 1,000 live births for white infants, by live-birth cinder

and cause of death: United States, 1964-66 legitimate, single births

Cause of death

All causes---------------------------

Infective and parasitic

diseases-------------------------(001-138)

Influenza, pneumonia and all other

diseases of the respiratory

system---(470-475, 480-493, 500-527, 763)

Gastritis, duodenitis and all other

diseases of the digestive

system---------------------------(530-587)

Congenital malformations----------(75O-759)

Birth injuries--------------------(76O-76l)

Pos&atal asphyxia and atelectasis----(762)

Hemolytic disease of nawborn----------(77O)

Immaturity, unqualified---------------(776)

Certain diseases of early

inFancy~---------------(765, 769, 771-774)

Accidents-----------------------(E800-E962)

Residual-------------------All other causes

II Live-birth order

Rate per 1,000 live births

19.5

0.2

2.4

0.5

3.7

1.8

3.3

0.4

2.6

3.0

0.6

1.2

16.3

0.1

1.7

0.5

3.2

1.5

2.5

0.0

2.6

2.6

0.6

3

I

20.1

0.1

2.8

0.3

3.6

1.5

3.5

0.4

2.8

3.3

0.5

1.2

20.1

0.2

2.8

0.4

4.3

1.6

3.0

0.6

2.3

3.0

0.9

1.0

19.5

0.1

2.2

0.5

2.6

2.5

3.7

0.6

3.0

2.5

0.4

1.3

20.5

0.4

2.1

0.2

3.3

1.7

3.9

1.1

2.5

2.9

0.2

2.3

28.8

.———

0.2

2.9

1.3

6.2

2.9

5.2

0.3

2.4

5.0

1.0

1.3

——

lI~clude5 neonatal disorders arising from certain diseases of the mother during pregnanC~,illdefined diseases peculiar to early infanc~ immaturity with mention of other subsidiary condition;

and other diseases peculiar to early infancy not already shown. Ill-defined diseases peculia:rto

early infancy account for about 60 percent of these deaths.

Table 21. Estimated infant deaths per 1,000 live births for white infants, by live-birth order

and age at death: United States, 1964-66 legitimate, single births

Live-birth order

All birth orders-------------

First------------------------------

Second-----------------------------

Third------------------------------

Fourth-----------------------------

Fifth------------------------------

Sixth or more----------------------

.—

Age at death

—

Less Less

than than 1-6 7-27 1-5 6-11.

1 year 1 day days days months months

—

Rate per 1,000 live births

19.5

16.3

20.1

20.1

19.5

20.5

28.8

8.4

6.7

9.3

7.8

8.2

9.8

12.6

5.0

4.9

4.6

5.1

5.1

4.4

6.0

1.4

1.3

1.3

1.5

1.4

1.0

2.5

3.4

2.4

3.7

3.6

3.5

3.4

4.9

1.5

——

1.0

1.2

2.1

1.3

1.9

2.8

28
Table 22. Estimated average annual number of live births and infant deaths per l-~00 live births, by sge of

mother, live-birth order, and race of infant: United States, 19b4-00 legitimate, single Dirths

Race and livebirth order

All races

AU birth

order s---------

First-----------------

Second ----------------

!Third-----------------

Fourth ----------------

Fifth -----------------

Sixth or more ---------

White

A1.;d&h

-..------

First -----------------

Second ----------------

Third -----------------

Fourth ----------------

Fifth -----------------

Sixth or more ---------

Black

All birth

orders ---------

Firat -----------------

First----------------Second----------------

Third -----------------

Fourth ----------------

Fifth -----------------

Sixth or more ---------

Live birtha

Age of mother in years

Number in thousanda

3,417

1,004

857

610

392

228

326

2.961

907

759

536

342

191

226

402

S3

81

66

45

33

94

468

335

107

21

5

*

*

393

295

82

13

*

*

*

70

39

22

8

*

*

*

1,237 878

478 135

424 223

215 218

81 147

26 75

12 81

L,082 771

438 125

380 206

180 198

61 132

17 62

6 47

136 91

33 8

39 11

32 17

19 13

9 11

5 32

494

38

72

105

98

73

108

425

35

64

97

89

67

74

59

*

6

6

7

5

32

340

17

31

52

62

43

125

290

15

27

47

58

45

98

45

*

*

*

*

8

25

Infant deaths

Age of mother in years

Rate per 1,000 live births

21.7 28.0

18.1 21.7

22.0 39.0

22.2 *

21.2 *

25.2 *

29.7 *

19.5 23.6

16.3 20.1

20.1 30.5

20.1 *

19.5 *

20.5 *

28.8 *

37.6 52.0

38.1 34.0

39.4 *

39.5 *

34.2 *

51.4 *

31.1 *

19.5

15.1

20.4

23.3

23.9

31.4

*

17.8

14.1

19.5

21.4

22.3

*

*

33.0

31.4

27.6

36.5

*

*

*

20.0

14.4

17.0

20.6

20.1

26.8

29.3

17.8

11.7

16.7

18.7

18.8

18.9

30.1

39.0

*

*

*

*

*

28.1

21.5]

27.3

19.0

16.9

20.1

21.3

26.3

20.3

25.6

17.3

17.5

19.2

18.5

26:8

29.5

*

*

*

*

*

25.5

26.3

=

*

28.5

21.1

16.9

24.2

31.7

24.1

*

29.0

17.1

16.7

26.4

29.2

37.0

*

*

*

*

*

36.0

29
Table 23. Estimated infant deaths per 1,000 live births for white infants, by age of

mother and cause of death: United States, 1964-66 legitimate, single births

Csuse of death

All causes---------------------------

Infective and parasitic diseases--(OOl-l38)

Influenza, pneumonia and all other diseases

of the respiratory

system-------(470-475.480-493,500-527.764)

Gastritis, duodenitis and all other diseases of the digestive system ---(530-587)

Congenital malformations----------(750-759)

Birth injuries--------------------(760-761)

Postnatal asphyxia and atelectasis----(762)

Hemolytic disease of newborn----------(77O)

Immaturity, unqualified---------------(776)

Certain diseases of early

infancy~-----------------(765,769,771-774)

Accidents-----------------------(E800-E962)

Residual-------------------Allother causes

II Age of mother in years

Rate per 1,000 live births

19.5

0.2

2.4

0.5

3.7

1.8

3.3

0.4

2.6

3.0

0.6

1.2

23.6

0.4

4.0

0.8

3.9

1.4

4.4

0.1

4.0

3.1

0.6

0.9

17.8

0.1

2.1

0.4

3*3

1.6

2.7

0.4

2.2

2.8

0,8

1.5

17.8

0.2

2.5

0.2

3.4

1.8

2.6

0.2

2.4

3.0

0.6

1.1

20.3

0.1

2.0

0.8

3*9

1.8

3.9

0.5

2.5

3.4

0.4

1.1

24.1

0,0

1.4

0.6

5.2

2.8

4.7

1.0

3.2

3.8

0.6

0.8

lIncludesneonatal disorders arising from certain diseases ofthe ❑otherduring pregnancy; ill-defineddiseasea peculiar to early infancy; immaturity with mention of o“ther

subsidiary condition; and other diseases peculiar to early infancy not already shown.

Ill-defined diseases peculiar to early infancy

deaths.

account for about 60 percent of these

Table 24. Estimated infant deaths per 1,000 live births for white infants, by age of

mother and age at death: United States, 1964-66 legitimate, single births

Age of mother

All ages-----------------------------

Under 20 years-----------------------------

20-24 years--------------------------------

25-29 years--------------------------------

30-34 years--------------------------------

35 years and over--------------------------

Age at death

aEEEEIz

Rate per 1,000 live births

19.5 8.4 5.0 1.4 3.4 1.5

23.6 9.2 5.9 1.5 1.7

17.8 7.7 4.5 1.2 u 1.5

17.8 7.7 4.1 1.5 3.3

20.3 5.6 1.5

24.1

M

1!:: 6.6 1.8 H 1.5

30
APPENDIX I

SOURCES AND LIMITATIONS OF DATA

Background of This Report

This report presents data on infant mortality

rates for 1964-66 for legitimate infants. Ordinarily, infant mortality ratesbased on all births and

infant deaths registered in.the United States are

published in Vital Statistics of the United

States. 3 These regularly published statistics are

limited to the amount of information recorded

and coded on the birth and death certificates.

This report presents data on infant deaths

classified by family income and completed

education of the mother and father—variables

not available in the regularly’ published statistics.

The data were collected as part of the 1964-66

NationaI Infant Mortality Survey (NIMS) and

the 1964-66 National Natality Survey (NNS).

The survey design of the latter precluded obtaining information on illegitimate births.

Sources of Data

The first sources of data for the survey were

the death certificates and the birth certificates

of infants. From the death certificate, information such as age of deceased, sex, race, place

of death, usual place of residence, and cause of

death was obtained. From the birth certificate,

information such as sex of child, residence of

father and mother, age of father and mother,

and race of father and mother was obtained.

The second sources of data were mail questionnaires. For infant deaths, questionnaires

were mailed to the persons who provided the

funeral director with personal information about

the deceased infant for recording on” the death

certificate. This was usually the mother. For

births, the questionnaires were mailed to the

mothers.

In the NIMS. for those deaths occurring in

1964 and 1965, a form was also sent to hospitals

and institutions in which infants died, to hospitals where infants were born, and to any other

hospitals or institutions at which the infants

received medical care. If infants died in hospitals

or institutions, the name of the hospital or

institution in which death occurred was recorded on the death certificate. The name of the

hospital where an infant was born and the names

of hospitals or institutions where an infant

received medical care were derived from responses on the informant questionnaire. Hospitals or institutions to which a form had been

sent also provided the names of other hospitals

or institutions in which the infant had received

medical care in some instances.

Sample Design

The sampling frame for the 1964-66 NIMS

was the Current Mortalky Sample (CMS)–a

10-percent systematic sample of death certificates received each month by the National

Center for Health Statistics from the 54 registration areas in the United States. The sample for

the 1964-66 NIMS was a probability sample of 1

out of every 11 deaths under 1 year of age

included in the CMS in 1964, 1965, and 1966.

This procedure yielded an overall selection rate

of approximate] y 1 out of every 110 infant

deaths registered in the United States. Of a total

of 2,490 infant deaths in the 1964-66 NIMS,

2,160 were inferred to be legitimate. In the case

of infant deaths, legitimacy status is not recorded on the death certificate; legitimacy status

was inferred from information on the death

certificate and on the questionnaire. The

31
method of making such inferences, as it pertains

to infant deaths, is further defined and explained in appendix II. Table I shows the number of deaths of all infants and the number of

deaths of legitimate infants included in the

1964-66 NIMS.

The sampling frame for the 1964-66 NNS was

the file of microfilm birth certificates received

each month by the National Center for Health

Statistics from the 54 registration areas in the

United States. As a general rule, each registration area assigns a number to each certificate

prior to or during the filming of the birth

record. The certificates are numbered consecutively from the first to the last birth occurring

during the year.

The sampling for the survey was based on a

probability design which made use of these

ns.u%bers on the birth records. Each 1,000

records constituted a primary sampling unit.

Within each 1,000 records, one record was

chosen at random. Thus, a sample of 1 out of

every 1,000 births was selected from the records

for each registration area.

The , national sample included a total of

11,331 births. Of these, 647 were reported as

illegitimate in the 36 registration areas which

record legitimacy status, and 289 others in the

19 areas which do not record legitimacy status

were inferred to be illegitimate. The mothers of

these 936 illegitimate births were not sent

questionnaires. A total of 10,395 legitimate

Table 1. Total number of infant deaths in the Unitad States and

the number of infant deaths in the National Infant Mortality

Survey, 1964-66

Number of

infant deaths

Total count of infant

deaths in the

United States’ . .

Number of infant

deaths selected in

the sample . . . .

Number of deaths

of legitimate

infants . . . . . .

1See reference 3.

Total

278165

2,490

2,160

1964

99,783

888

764

Year

1965

92,866

830

733

1966

85,516

772

633

births were therefore included in the survey.

Questionnaires were not ,sent to 70 additional

mothers because the birth was registered in the

State of New Mexico which did not participate

in the survey, to 9 mothers because the birth

was registered in the State of California and they

were already in the sample of a State survey, and

to 10 mothers either because their residence was

outside the United States or because no mailing

address was obtainable. Thus, a final sample of

mothers to whom questionnaires were mailed

numbered 10,306.

Table 11 shows the total number of births

registered in the United States and the number

in the 1964-66 NNS.

The Death Certificate, the Birth Certif ilcate, the

Questionnaire, and the Hospital Form

As mentioned previously, the death certificate

and the birth certificate were the first scmrces of

data for this report. Although not all States use

the exact Standard Certificate of Death or the

Standard Certificate of Live Birth, lboth of

which are shown in appendix III, all States do

include on their certificates items requesting the

basic information used in this report. There were

no sample cases for which information was

missing for the items on the death certificates

which were used in this report. In most (cases, alI

items on the birth certificates were answered

adequately. There wefi, however, some birth

certificates chosen for the 1964-66 NNS for

which information was missing for certain items.

Table 111 shows the number and percentage of

birth certificates on which certain items were

not answered.

As already noted, in addition to data derived

from the death certificates and from the birth

certificates, data used in this report were derived

from questionnaires sent to persons who provided the funeral director with personal information about the deceased infant (the death

certificate informant) and from questionnaires

sent to mothers.

The questionnaire sent to the death certificate

informant asked for information about the

infant who died, information about other children born to the mother, a listing of other

members of the household who usually lived

with the mother at the time of birth of the

deceased infant, employment of mother during

32
Table II. Total number of births in the United States and the number of bitths in the National Natality Survey,

Number of births

Total count of births in the

United States . . . . . . . . . . . . . . . .

Number of births selected in

thesample . . . . . . . . . . . . . . . . . .

Number of illegitimate births excluded

from survey . . . . . . . . . . . . . . . . . .

Number of legitimate births in

survey . . . . . . . . . . . . . . . . . . . . .

Number of births from New Mexico

and California . . . . . . . . . . . . . . . . .

Other . . . . . . . . . . . . . . . . . . . . . . .

Number of births for which questionnaire was sailed . . . . . . . . . . . . . . .

1964-66

Year

Total

11,393,000

11,331

936

10,395

79

Icl

10,306

Table II 1. Numbt r anj percentage of birth certificates on which

cartain items were not answered in the National Nataiity Survay, 1964-66

Item Number Percentage

Age of mother . . . . . . . . . . . .

Race of mother . . . . . . . . . . . .

Race of father . . . . . . . . . . . . .

Raceofchild . . . . . . . . . . . . .

Sexofchild . . . . . . . . . . . . . .

Number of children born alive:

Non living . . . . . . . . . . .

Nowdead . . . . . . . . . . .

Previous fetal deaths . . . . . . . .

Completed weeks of pregnahcy . . . .

Birth weight”. . . . . . . . . . . .

3

7

49

9

1

43

199

310

678

25

.0

.1

.5

.1

.0

.4

1.9

3.0

6.5

.2

NOTE–Base: 10,395 legitimate live births.

preg~iancy, family income during the previous

calendar year, education of mother and of

father, and information on health insurance

coverage for maternity care.

1964

4,027,000

4,025

282

3,743

26

3,717

1965

3,760,000

3,702

345

3,357

22

3

3,332

1966

3,606,000

3,604

309

3,295

31

7

3,257

The cwestionnaire sent to the mother of a

legitimate birth asked questions identical to

those on the NIMS, so that comparable data on

these items were obtained from both surveys. In

addition, information was sought on the

mother’s expected future fertility.

For the NINE, the form sent to the hospitals

and institutions in 1964 and 1965 asked for

information on length of pregnancy and weight

of baby at birth, specific details regarding

episodes of care provided by that hospital or

institution for the infant (such as cause and

duration of illness), and for the names and

addresses of any other hospitals in which the

infant might have been a patient.

Collection of Data

For both the 1964-66 NIMS and the 1964-66

NNS, the principal method of data collection

was a mail survey.

33
For the 1964-66 NIMS, the primary source of

information was the person who provided the

funeral director with the personal information

about the deceased for recording on the death

certificate (the death certificate informant). The

mailing address of the death record informant is

usually reported on the death certificate. For

infant deaths, the informant is usually the

mother; however, information was accepted

from the father, maternal grandmother, and

paternal grandmother (in that order) if the

mother was not available to complete the

questionnaire. For those cases where the name

or address of the informant was not available on

the death certificate or additional sources of

information were required, a letter was sent to

the funeral director requesting the address of the

informant and/or names and addresses of other

relatives of the deceased infant to whom a

questionnaire might be sent.

For the 1964-66 NNS, questionnaires were

mailed to the mothers of legitimate infants,

using the address of the mother recorded as her

usual place of residence. Information was

accepted from other respondents only if there

was no possibility of obtaining it from the

mother.

For both surveys, there we~e followup procedures when there was no response to the

original queries. If after 2 to 3 weeks no

response was received from a death certificate

informant, a funeral director, or a mother of a

legitimate live birth, the first followup mailing

was sent by certified mail. If no response was

received to the first followup mailing within 3

weeks, a second followup occurred by regular

mail; however, no second followup mai@g was

made to funeral directors. If no response was

received from the second followup mailing,

there was additional provision for collecting

information by use of telephone or by personal

intexview carried out by the U.S. Bureau of the

Census if the person resided in one of the

primary sampling units designated by the Bureau

of the Census.

For the 2,160 legitimate infant deaths in the

1964-66 NLMS, the response rate was 88 percent. For the 10,395 legitimate births in the

1964-66 NNS, the response rate was 89 percent.

Table IV shows the number and percent of

respondents to the questionnaires sent to death

certificate informants by selected characteristics

of legitimate infants who died in 1964-65.

Response rates by characteristics of deceased

infants could not be calculated for 19616 because

the information was not coded.

Table V shows the number of mot’hers of

legitimate births in the survey and the percent

responding to the questionnaire by selected

characteristics of the mothers of Iegitima te

births.

Nonresponse and 1reputation for Missing Data

A “nonresponse” represents a major problem

in any survey. Nonresponse in the 1964-66

NIMS was defined to include those cases for

which an informant was not identified from the

death certificate and the funeral dire(ctor was

unable to provide names and addresses of

relatives of the deceased infant to whom a

questionnaire might be sent, those cases for

which questionnaires were returned but were

uncodable, those cases for which there was no

response at all by mail or by interview, those

cases for which the informant was not queried

for other reasons, and those cases fc)r which

there was a refusal to answer the questionnaire.

Nonresponse in the 1964-66 NNS was defined

to include those cases for which no cluestionnaire was mailed if the birth certificate was filed

in New Mexico, those cases for which no

questionnaires were mailed because no usable

mailing address was obtained, the mothers resided outside the United States or were included

in the California survey, those cases fen- which

no questionnaire was returned after all followup

procedures had been completed, and those cases

for which questionnaires were returned but were

not usable.

AH of the above cases for which no information from the questionnaires was available or

usable are referred to as “unit nonreqponses.”

Imputation was carried out for “unit nonresponses” according to the following specifications.

Data in the 1964-66 NIMS were adjusted for

unit nonresponse by imputing for a decedent for

whom no questionnaire was returned the data

for a decedent for whom a questionnaire was

returned. The imputation was carried out in the

following manner. Four subgroups were defined:

34
Table IV. Number and percent responding to informant questionnaire by selected characteristics of deceased legitimate infants in the National Infant Mortality Survey, 1964-66

Characteristics of

deceased infants

Total

number of

legitimate

infants,

1964-66

Total

number of

legitimate

infants,

1964-65

Percent of

1964-65 infants

on which response

was receiveo

Total . .

White . . . . . .

Black . . . . . .

Other races . . .

Northeast

North Centr~l . :

South

West.:::::

Metropolitan . .

Nonmetropolitan

. . . . . . . . . . . . . . . . . . 2,160 1,497 87.9

Race

1,707

418

35

1,164

302

31

88.7

86.4

71.0

. . . . . . . . . . .

. . . . . . . . . . .

. . . . . . . . . . .

. .

. .

. .

. . . . .

. . . . .

. . . . .

Region

450 302

439

515

241

90.7

89.5

89.3

78.4

. . . . . . . . . . .

. . . . . . . . . . .

. . . . . . . . . . .

. . . . . . . . . . .

. .

. .

. .

. .

. . . . .

. . . . .

. . . . .

. . . . .

626

749

335

Metropolitan status

1,330

830

907

590

88.9

86.4

. . . . . . . . . . .

. . . . . . . . . . .

. .

. .

. . . . .

. . . . .

Causeof death

Infective and parasitic

diseases . . . . . . . . . . . . . .

Influenza and pneumonia, except

pneumonia of newborn . . . . . .

Other diseasesof respiratory

001-138

480-493

15

230

48

10

173

33

35

13

232

135

244

22

231

224

36

52

57

90.0

87.3

97.0

. .

. .

system 510-522,525-527

Gastritis; du~d;n%;e;t~r;t;s,” -

and colitis, except diarrhea of

newborn . . . . . . . . . ...543.571. 572

Other diseasesof digestive

system . . . . . . 530-542,544-553,573-587

Congenital malformations . . . . . . . . 750-759

Birth injuries . . . . . . . . . . . . ...760.761

Postnatal asphyxia and atelectasis . . . . . . 762

Hemolytic diseaseof newborn

(erythroblastosis) . . . . . . . . . . . . . 770

Immaturity, unqualified . . . . . . . . . . . 776

Certain diseasesof early

infancy . . . . . . . . . . . . . ...760-776

Symptoms and ill-defined

‘conditions . . . . . . . . . . . 780-793, 795

Accidents . . E800-E962

Residual.::::::::::::. . . . . . . . .

45 80.0

3%

180

358

92.3

92.7

92.6

84.8

81.8

89.2

335 84.8

53

75

83

83.3

78.8

91.2

Age at death

Under lay . . . . . . . . . . . . . . . . . . . .

l-6days . . . . . . . . . . . . . . . . . . . . . .

7-27days . . . . . . . . . . . . . . . . . . . . . .

28days-5months . . . . . . . . . . . . . . . . .

6-n months . . . . . . . . . . . . . . . . . . . .

917

525

155

400

163

613

361

105

293

125

88.3

89.5

85.7

87.4

84.8

35
Table V. Number and percent responding by selected characteristics of mothers in the National Natality Survey, 1964-66

Characteristic of mother

Total . . . . . . . . . . . . . .

Age —

Under 20 years . . . . . . . . . . . .

20-24 years . . . . . . . . . . . . . .

25-29 years . . . . . . . . . . . . . .

30-34 years . . . . . . . . . . . . . .

35 years and over . . . . . . . . .

Color

White . . . . . . . . . . . . . . . . .

Another . . . . . . . . . . . . . . .

Live-birth order

First . . . . . . . . . . . . . . . . .

Second . . . . . . . . . . . . . . . .

Third . . . . . . . . . . . . . . . . .

Fourth . . . . . . . . . . . . . . . .

Fifthorhigher . . . . . . . . . . . .

Region of residence

Northeast . . . . . . . . . . . . . . .

North Central . . . . . . . . . . . . .

South . . . . . . . . . . . . . . . . .

West . . . . . . . . . . . . . . . .

Metropol Itan status

lnsideSMSA . . . . . . . . . . . . .

OutsideSMSA . . . . . . . . . . . . .

Number

in

survey

10,385

1,466

3,698

2,617

1,562

1,052

9,086

1,299

3,009

2,596

1,852

1,208

1,730

2,445

2,968

3,246

1,736

6,682

3,713

Percent

responding

88.8

82.5

88.7

90.7

90.7

90.5

89.5

84.0

88.7

89.4

89.4

89.1

87.2

92.8

91.4

87.1

82.0

90.4

85.9

white males. white females, all other males, and

all other females. The data required to assign a

case to one of these four groups were complete

on all death certificates selected for the 1964-66

NIMS, regardless of whether there was a response to the mail questionnaire. After the close

of the survey, the complete file of records of

infant deaths was put in random order. This file

included those records which were unit responses as well as those records which were unit

nonresponses. Imputation was carried out by

imputing to a nonresponse record the values

found for the last previous record for which

there was a response and which fell into the

same one of the four imputation groups.

36

For the 1964-66 NNS, imputation of information in instances of unit nonresponse was carried

out through a similar procedure, except that

(1) only legitimate infants were included, and

(2) there were 24 imputation classes based on

age of mother, live-birth order, and color of

mother. These characteristics are recorded on

the birth certificate and were therefore available

for all sample cases whether a questionnaire was

returned or not. The 24 im~utation classes were

defined as follows:

,

Group

1 . . . . . . . . . . . .

2 . . . . . . . . . . . .

3 . . . . . . . . . . . .

4 . . . . . . . . . . . .

5 . . . . . . . . . . . .

6 . . . . . . . . . . . .

7 . . . . . . . . . . . .

8 . . . . . . . . . . . .

9 . . . . . . . . . . . .

lo . . . . . . . . . . .

11 . . . . . . . . . . .

12 . . . . . . . . . . .

13 . . . . . . . . . . .

14 . . . . . . . . . . .

15 . . . . . . . . . . .

16 . . . . . . . . . . .

17 . . . . . . . . . . .

18 . . . . . . . . . . .

19 . . . . . . . . . . .

20 . . . . . . . . . . .

21 . . . . . . . . . . .

22 . . . . . . . . . . .

23 . . . . . . . . . . .

24 . . . . . . . . . . .

Color and age

White

Under 20 years

Under 20 years

20-24 years

20-24 years

20-24 years

25-28 years

25-29 years

25-29 years

25-29 years

30-34 years

30-34 years

30-34 years

35 years and over

35 years and over

All other

,Under 20 years

Under 20 years

20-24 years

20-24 years

25-29 years

25-29 years

25-29 years

30-34 years

30-34 years

35 years and over

Live-birth order

1

2+

1

2

3+

1

2

34

5i1-2

3-4

5+

14

5+

1

2+

1-2

3+

1-2

34

5+

1-4

5+

All

Besides those cases referred to als “unit

nonresponses,” there were cases for which questionnaires were returned but certain infcn-mation

was missing. The missing information is referred

to as “item nonresponse.” o
For the 1964-66 NIMS, there were several

possible actions when item nonresponse occurred. These included editing-in the information on the missing items if it could be obtained

from another part of the questionnaire, other

forms, letters accompanying forms, or the death

certificate; sending a special letter to the person

who answered the questionnaire asking for the

missing information; or referring the case to the

study director for review, after which either a

special letter was se~t asking for the missing

information; a phone call or personal interview

was carried out by the Bureau of the Census, a

form was sent to the funeral director asking for

the names and addresses of relatives of the

deceased infant to whom informant questionnaires might be sent, or the case was closed.

If a special letter was sent asking for the

missing information and it was not returned or

was returned but the information asked for Was

not provided, the case wag also referred to the

study direct& for review, whereupon either a

phone call or personal interview was carried out

by the Bureau of the Census, a form was sent to

the funeral director asking for the names and

addresses of relatives of the deceased so new

informants could be queried, or the case was

closed.

For the 1964-66 NNS, actions taken when

item nonresponse occurred included editing-in

the missing information if it could be supplied

from another p,m’t of the questionnaire or the

birth certificate; sending a special letter to the

person tvho answered the questionnaire asking

for the missing information; or referring the case

to the study director for review after which

either a special letter was sent asking for the

missing information, a phone caI.I or persoryd

interview was carried out by the Bureau of the

Census, or the case was closed.

fiata iri the 1964-66 NIMS were adjusted for

item nonresponse in a manner +fferent from

that applied to unit rionresponse. Imputation for

item nonresponse was carried out by taking into

consideration the information y-o~ded for

other items on the questionna~e which was

pertinent to the missing information. kor example, if there was missing infcmnation for tli~

question on family income in the last calenddr

year previous to the year of death, information

given by the informant on the household listing

and information provided OR education of the

father would be considered if it were available.

In such a qase, the last previous questionnaire

for which the responses for household listings

and for education of father were coded in.the

same categories as those on the questionnaire

with the missing information was chosen. The

value for the item on which there was missing

information was then taken from this last

previous record and imputed to the item where

there was missing information. This method of

imputation was carried out for each case of item

nonreiponse. It should be emphasized that

household listing and education of father were

not the only items considered when imputation

was carried out for a missing item nof were they

the otdy items used to impute family income for

all cases for which information was missing on

farhily income. Rather, for item tionresponse

each item of each case for which there was

missihg information was considered individualI~.

Possible bias in selecting the last previous record

was avoided by the random ordering of the

records which was done between each step of

the imputation procedure.

Table VI shows the nonresponse rates fck

some items from the 1964-65 NIMS questionnaire. Nonresponse rates are for 1964-65 only

because, as mentioned previously, in 1966

whether there was or was not a response to the

questionnaire for each irdvidtial case was not

coded. As can be seen in table VI, the item for

which nonresponse rates were highest was fainily

income (information not dbtained for 7.3 percent of the respondents to the questionnaire).

Table W. Item nonresponse rates for selected items on the

National Infant Mortality Survey, 1964-65

Family income . . . .. . . . . . . . . . .

Yearofbirth of mother . . . . . . , . .

Educational attahw%snt of father . . . . .

Yearoffirst merriage . . . . . . . . . . .

Educational attainment of mother . . . .

Previous fetal deaths . . . . . . . . . . .

Employment during pregnancy . . . . . .

Total children ever born aliva . . . , . .

Tbtal children not now alive. . . . . . . .

96 7.3

45 3.4

29. 2.2

26 2.0

8 0.7

9 0.7

5 0.4

0.1

1 0.2

NOTE.-Base: 1,316 unit responses,legitimate births only.

37
For the 1964-66 NNS, item nonresponse rates

were generally low—usually less than 1 percent.

Most of the item nonresponses were imputed on

the basis of information available elsewhere on

the birth certificate or questionnaire. For example, mother’s age as recorded on the birth

certificate was used to impute her year of birth

when she had not completed that questionnaire

item. Other items with very low nonresponse

rates (less than 0.5 percent) were imputed

arbitrarily. Five items with fairly high nonresponse rates were-imputed in the computer by

procedures similar to those used for unit imputation on the basis of matrices designed specifically for each item. For example, education of

father was imputed by using age of father and

education of mother; family income was imputed by using age of father and education of

father.

Table VII shows the nonresponse rates for

some items from the 1964-66 NNS questionnaire.

Weighting Procedures for National Estimates

Statistics on infant deaths and births in this

report are national estimates prepared by use of

a postsurvey, stratified ratio estimation procedure. This estimation procedure, which takes

into account the total number of registered

infant deaths for the 1964-66 NIMS and the

total number ,of registered births estimated from

a 50-percent sample for the 1964-66 NNS,

reduces the sampling error by making the sample

more representative of the population of all

infant deaths or of all births than would be

expected to occur by random sampling alone.

Table VI 1. Item non response ratas for selected items on the

National Natality Survey, 1964-66

Itern ] Number I Percent

Age of father . . . . . . . . . . . . . . .

Educational attainment of father . . . . .

Educational attainment of mothar . . . .

Year of first marriage . . . . . . . . . . .

Employment during pregnancy . . . . . .

Family income . . . . . . . . . . . . . .

61

78

15

35

13

231

.7

.8

.2

.4

.1

2.5

NOTE. –Base: 9,232 unit responses, legitimate births only.

38

For the 1964-66 NIMS, for each of the four

groups that were used for imputation, the

national count of all registered infant deaths for

the appropriate year was obtained from Vital

Statistics of the United States. 3 A weight for

each group was then calculated by dividing the

number of sample deaths in each group into the

number of registered deaths in each group for

each year of the survey. The product of the

weight and the sample count equals the riational

total of infant deaths for that group.

For the 1964-66 NNS, for each c~f the 24

groups that were used for imputation, the

national count of registered births estimated

from a 50-percent sample was obtained from

Vital Statistics of the United States.4 A weight

for each group was then calculated by dividing

the number of sample births in each group into

the number of registered births in each group for

each year of the survey. The product of the

weight and the sample count equals the national

total of births for that group.

The effect of these weighting procedures is to

make the estimates from the 1964-(66 NIMS

sample more consistent with the estimates of the

total number of registered infant deatlhs and to

make the estimates from the 1964-66 NNS more

consistent with the estimates of births based on

the 5 O-percent sample, for each of the groups

used in the estimation procedure. However,

since data in this report refer only to deaths and

births of legitimate infants, the estimates in this

report are not comparable to the total number$

of births and infant deaths reported in Vital

Statistics of the United States, since the latter

include all deaths and births, legitimate and

illegitimate.

Estimates of characteristics are lproduced

from a sample using the following formulas:

1964-66 National Infant Mortality Survey

1964-66 National Natality Survey
where

X; is the estimate of the number of deaths or

births with a particular characteristic in

group i,

xi is the count of sample deaths or births

with the characteristic in group i,

y; is the count of all sample deaths or births -.

in group Z,and

Yi is the total number of

in group i, or the total

tered births in group

50-percent sample.

Reliability of Estimates

registered deaths

number of regisi based on the

Since the statistics derived from a survey are

estimates based on a sample, they may differ

from the figures that would have been obtained

had a total count been made using the same

questionnaire and procedures.

The probability design of the sample for these

surveys makes possible the calculation of sampling errors. The standard error is a measure of

the sampling variation that occurs by chance

because only a sample rather than entire population is surveyed. The chances are about 68 out

of 100 that an estimate from the sample’differs

from the value for the entire population by. less

than the standard error. The chances are about

95 out of 100 that the difference is less than

twi& the standard error and about 99 out of

100 that the difference is less than three times

the standard error.

Estimates of sampling variability for the

statistics derived from each survey were based

on 20 random half-sample replications. This

technique yields overall variability through observation of variability among random subsamples of the total sample. It reflects both the

error that arises from sampling and a part of the

measurement error, but it does not measure zmy

systematic biases in the data. A general discussion of the development and evaluation of a

replication technique for estimating variance has

been published elsewhere.s However, the procedures and computations required to estimate

variances by this method are briefly described

below.

For both surveys, each record from the entire

fiie of records in the survey was assigned

systematically to a random group between 1 and

40. Twenty pairs of random groups were created

from these groups. A half sample was formed by

randomly selecting one group from each of the

20 pairs. This process was repeated until 20

“replicate half samples” were formed from

which variance estimates were derived. The

composition of the 20 half samples was determined by an orthogonal plan.

After the composition of each of the half

samples was determined, all the estimation

procedures used to produce the final estimates

for the entire sample were applied separately to

each of the resulting half sam les.

1 An estimated variance S%1 of an estimated

statistic x‘ of the parameter X is obtained by

applying the following formula:

20

s:, = $

I

(x; - X’)2

i=1

where

x‘ is the estimate of X based on the entire

sample, and

x” is the estimate of X based on half sample

i.

Rules to determine the approximate standard

errors for aggregates and for rates presented in

this report are as follows:

1. Estimates of agpegates: Approximate

standard errors for estimates of aggregates

which are not derived from the groups used

in ratio estimation, such as the number of

infant deaths or births to families where

the father was a high school graduate, are

given in table VIII if the estimate refers to

deaths and in table IX if the estimate refers

to births. There are no standard errors for

estimates of aggregates if the estimates are

derived from the groups used in ratio

estimation.

39
Table Vlll. Approximate standard errors for estimated numbers shown in this report, 1964-66 National Infant

Mortality Survey

Size of estimate

250 . . . . . . . . . . . . . . . . . . . . . .

500 . . . . . . . . . . . . . . . . . . . . . .

1,000 . . . . . . . . . . . . . . . . . . . . .

1,500 . . . . . . . . . . . . . . . . . . . . .

2,000 . . . . . . . . . . . . . . . . . . . . .

3,000 . . . . . . . . . . . . . . . . . . . . .

4,000 . . . . . . . . . . . . . . . . . . . . .

5,000 . . . . . . . . . . . . . . . . . . . . .

10,000 . . . . . . . . . . . . . . . . . . . .

15,000 . . . . . . . . . . . . . . . . . . . .

20,000 . . . . . . . . . . . . . . . . . . . .

30,000 . . . . . . . . . . . . . . . . . . . .

1964-65

Standard

error

110

165

230

270

310

385

455

485

630

700

800

960

Relative

standard

error

44.0

33.0

23.0

18.0

15.5

12.8

11.4

9.7

6.3

4.7

4.0

3.2

1964-66

Standard

error

98

142

181

233

260

320

380

405

466

533

600

767

Relative

standard

error

—

39.2

28.4

18.1

15.5

13.0

10.7

9.5

8.1

47

3.6

3.0

2.6

Table IX. Approximate standard errors for estimated numbers shown in this report, 1964-66 National Natality

Survey

Size of estimate

5,000 . . . . . . . . . . . . . . . . . . . .

10,000 . . . . . . . . . . . . . . . . . . . .

15,000 . . . . . . . . . . . . . . . . . . . .

20,000 . . . . . . . . . . . . . . . . . . . .

25,000 . . . . . . . . . . . . . . . . . . . .

50,000 . . . . . . . . . . . . . . . . . . . .

75,000 . . . . . . . . . . . . . . . . . . . .

100,000 . . . . . . . . . . . . . . . . . . . .

150,000 . . . . . . . . . . . . . . . . . . . .

200,000 . . . . . . . . . . . . . . . . . . . .

250,000 . . . . . . . . . . . . . . . . . . . .

300,000 . . . . . . . . . . . . . . . . . . . .

500,000 . . . . . . . . . . . . . . . . . . . .

700,000 . . . . . . . . . . . . . . . . . . . .

1,000,000 . . . . . . . . . . . . . . . . . . .

1964-65

Standard

error

1,800

2,368

2,682

2,948

3,293

4,531

5,437

5,933

7,069

7,975

8,670

9,171

12,204

15,309

15,950

Relative

standard

error

36.0

23.7

17.9

14.7

13.2

9,1

7.2

5.9

4,.7

4.0

3.5

3.1

2.4

2.2

1.6

1964-66

Standard

error

1,490

1,960

2,220

2,440

2,725

3,750

4,500

4,910

5,850

6,600

7,175

7,590

10,100

12,670

13,200

Relative

standard

error

129.8

19.6

14.8

12.2

10.9

7.5

6.0

4.9

3.9

3.3

2.9

2.5

2.0

1.8

1.3

40
2. Estimates of rates: Approximate standard

errors for estimated rates, such as the

number of infant deaths to the number of

births, are determined in the following

way. When the rate is an estimate which

was not derived from the classes used in

ratio estimation, such as the infant mortality rate for families with incomes of under

$3,000, the approximate standard errors

are given in table X when the rate was

based on 2 years of data, and in table XI

when the rate was based on 3 years of data.

When the rate is an estimate which was

derived from the classes used in ratio

estimation, such as the infant mortality

rate for white infants, there are no standard

errors.

3. Difference between two sample estimates: The standard error of a difference

between two sample estimates is approximately the square root of the sum of the

squares of the standard error of the two

estimates. This formula wHl represent the

actual standard error quite accurately for

the difference between separate and uncorrelated characteristics, although it is only a

rough approximation in cases where the

characteristics are correlated.

In addition to sampling errors, survey results

are subject to errors in conceptual formulation,

ambiguities and misinterpretations arising from

the wording of the questions, biases due to

nonresponse or incomplete response, and errors

in coding, editing, and tabulation. There is no

way of computing the magnitude of these errors.

Errors in conceptual formulation and ambiguities of the 1964-66 NNS were reduced by

pretesting the questionnaire before initiating the

survey. The steps taken to reduce biases due to

nonresponse in each survey were discussed in the

section of this appendix, “Nonresponse and

Imputation for Missing Data.” Errors in tabulation were reduced, if not eliminated, by crosschecking the tabulations and by comparing data

from each survey with data from other sources

when available.

Rounding of Numbers

In this report, estimates of aggregates are

rounded to the nearest thousand. The original

Table X. Approximate standard errom of infant mortality rates based on 2 years of data

Average annual

number of live births

Io,ooo . . . . . . . . . . . . . .

15,000 . . . . . . . . . . . . . .

25,000 . . . . . . . . . . . . . .

50,000 . . . . . . . . . . . . . .

100,000 . . . . . . . . . . . . .

150,000 . . . . . . . . . . . . .

250,000 . . . . . . . . . . . . . .

500,000 . . . . . . . . . . . . .

1,000,000 . . . . . . . . . . . .

Infant mortality rate per 1,000 live births

5 10 20 30 40 50 60 7(I 80 90 100

Standard error expressed as rate

2.3

1.7

1.2

1.0

.9

.5

—

4.9

3.6

2.3

1.8

1.5

1.0

.6

7.3

4.9

3.4

2.8

2.1

1.2

.9

11.6

8.6

6.1

4.3

3.4

2.4

1.5

1.1

14.8

10.5

7.3

5.3

3.9

2.7

2.2

1.5

15.6

12.0

8.5

5.8

4.3

2.9

2.4

18.1

13.6

9.6

6.2

4.7

3.3

2.4

20.3

15.3

10.7

6.7

5.0

3.7

2.7

27.3

21.8

16.7

11.9

7.2

5.5

4.0

3.1

29.6

24.0

18.1

12.2

7.7

5.9

4.5

32.5

25.8

19.6

13.6

8.6

6.9

5.0

NOTE.-Numerator: 186465 National Infant Mortality Survey; Denominator: 18W65 National Natality Survey.

41
Table Xl. Approximate standard errors of infant mortality rates based on 3 years of data

Average annual

number of live births

10,000 . . . . . . . . . . . . . . .

15,000 . . . . . . . . . . . . . . .

;5,000 . . . . . . . . . . . . . . .

50,000 . . . . . . . . . . . . . . .

100,000 . . . . . . . . . . . . . .

150,000 . . . . . . . . . . . . . .

250,000 . . . . . . . . . . . . . .

500,000 . . . . . . . . . . . . . .

1,000,000 . . . . . . . . . . . . .

Infant mortality rate perl,OOO live births

5 10 20 30 40 50 60 70 80 go

1

100

Standard error expressed as rate

1.9

1.4

1.0

0.8

0.7

0.4

4.0

2.9

1.9

1.5

1.2

0.8

0.5

6.0

4.0

2.8

2.3

1.7

1.0

0.7

9.5

7.0

5.0

3.5

2.8

2.0

1.2

0.9

12.1

8.6

6.0

4.3

3.2

2.2

1.8

1.2

12.7

9.8

6.9

4.7

3.5

2.4

2.0

14.8

11.1

7.8

5.1

3.8

2.7

2.0

16.6

12.5

8.7

5.5

4.1

3.0

2.2

22.3

17.8

13.6

9.7

5.9

4.5

3.3

2.5

NOTE. -Numerator: 1964-66 National infant Mortality Suwey; Denominator: 1964-66 National Nataiity Survey.

tabulations on which this report is based, however, show figures to the nearest whole unit and

all totals, percentages, ratios, and averages in this

report were computed using these unrounded

—o

24.2

19.6

14.8

10.()

6.3

4.8

3.7

—-

26.5

21.1

16.0

11.1

7.0

5.6

4.1

figures. The reader should be cautioned that in

recomputing these totals, percentages, ratios,

and averages by use of the rounded figures,

exactly the same result may not occur.

o o—

42
DEFINITIONS OF CERTAIN TERMS USED IN THIS REPORT

Education of &thw.— In both surveys, data on education of father were derived from the questionnaires

which asked for the highest grade of school attended and

whether or not that grade was completed. Education of

father refers to the highest grade of regular school

completed. Regular school consists of elementary, high

school, and college or university, but does not include

trade or business schools.

Education of mother. -Education of mother also refers to the highest grade of regular school completed.

Data on education of mother were derived in the same

manner as were data on education of father.

Family income .—In both surveys, family income

refers to the total of all income received during the

calendar year prior to the year during which the birth

or the death occurred. Family income was defined to

include all income received by the mother and all persons related to the mother by blood, marriage, or adoption, and living in the same household at the time of

birth or death. Income from all sources such as wages,

salaries, unemployment compensation, rent, interest,

dividends, help from relatives, profits and feea from

own business or farm, welfare payments, social security

payments, and insurance proceeds was asked for.

Age of mothw .—In the NNS, age for mother was

recorded or derived from entries on the birth certificate. In the NIMS, age of mother was derived from

questionnaires which asked for the date of birth of the

mother. Age in this report refers to age at last birthday.

Bivth wei~ht. —In the NNS, birth weight was recorded or derived from the birth certificate. In the

NIMS, birth weight was derived from forms sent to

hospitals which had provided care to the deceased

infant. This included the hospital at which the birth

occurred, other hospitals at which the infant had a

period of care, and the hospital at which death occurred,

if the death occurred in a hospital. Data on birth weight

of deceased infants was available only for infants who

died during 1964 and 1965.

In almost all cases, birth weight was recorded in

pounds and ounces. It was converted into grams by taking

1 pound equal to 454 grams.

Le@”timacy stutus.-In the NNS, for the 36 areas

reporting legitimacy on the birth record, legitimacy of

the infant was recorded or derived from the entiy on the

birth certificate. For areas not reporting legitimacy on

the birth record, it was inferred from other evidence on

the certificate as, for example, mother, father, and infant all with the same last name, and mother’s maiden

name is different. In a few cases a reported legitimate

birth was changed to an illegitimate birth when the

mother stated on the questionnaire that she had never

been married. In the NIMS, legitimacy of the infant was

inferred by using information on the death certificate

and on the questionnaire. If mother, father, and infant

all had the same last name, and if mother’s maiden

name was different from the infant’s name on the death

certificate, the child was inferred to be legitimate.

Legitimacy was also inferred if on a questionnaire the

mother was listed as being married, the date of marriage was before or equal to the date of birth of the child,

and the father was accounted for in the household listing.

On the other hand, if the cbildhad the same last name as

the mother and if the father’s name was different or not

given on the death certificate, illegitimacy was inferred.

The child was also inferred as being illegitimate if the

mother reported her marital status as single and if no

date of marriage was given on the returned questionnaire.

.Live biVth.-In the NNS, a certificate of live birth

was filed when it met the requirements of the foIlowing

definition adopted by the World Health Organization: A

live birth is the complete expulsion or e=action IYom

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 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 attache~, each product of such a birth is considered liveborn and a certificate of live birth should be filed.

Previous live births.— In Mb surveys, data on

previous live births to the mother were derived from

the questionnaire.

43
Single bivth .—In the NNS, a live birth was identified as a single, twin, or triplet from the item on the

certificate of live birth. In the NIMS, the number at

birth was derived from the entries on the questionnaires.

In 1964 and 1965 the information provided by the mother

was supplemented and checked against that provided by

the hospital; in 1966 no hospital information was available.

Live-birth ordw .—In both surveys, live-birth

order was derived from the questionnaires. It refers to

the number of children born alive to this mother including the sample child.

Previous fetal deaths. —In both surveys, data on

previous fetal deaths were derived from the questionnaires. The number of infants born dead and the number of miscarriages were summed to obtain the number

of fetal deaths.

In.nt death .—An infant death is the death of an infant under 1 year of age.

Age of death .—In the NIMS, the age of the infant at

the time of death was recorded or derived from the death

certificate.

pvevious infant deaths .-h both surveys, data on

previous infant deaths were derived from the questionnaires. If the interval in months between date c~fbirth

and date of death for any previous child born alive to

this mother was less than 12, that infant was coded as

an infant death.

Cause of death .—Cause of death was recorded or

derived from entries on the death certificate. The coding

of cause of death from the entry on the death certificate

was in accordance with the specifications of the Manual

of the Internatwnal S@tistical Cfussification of Diseases, Injuries, and Causes of Death, World Health Organization, Vol. I, 1957 (Seventh Revision).

Race .—In the NIMS, race was recorded or derived

from entries on the death certificate. The category

“white” includes those decedents classified as white,

Mexican, or Puerto Rican. The category “black” includes only those decedents reported as Negro. The

category “other races” includes decedents reported as

Japanese, Aleut, Eskimo, Hawaiian, or Part-hawaiian.

In the NNS, race was recorded or derived from entries of the race of the parents on the birth certificate

and then classified into the same categories.

000

44
APPENDIX Ill

SOURCE FORMS

Standard Certificate of Live Birth

STATi OF

Form .pe.rwed

Bttdmt Buruu No. M-R374.s.

CERTIFICATE OF LIVE BIRTII

n,.’r” hi,.

“0,. ,” ,.”,

1 PLACEor BIRTH .2. USUAL N2SI02SSCE OF MOTHER (When dor~ mother tits{)

a. WUlbN a. sTATS b. COUNTY

b. CITY. TOWN. OR LOCATION c. CITY, TOWN. OR LOCATION

1

c. !bAME OF (Ijnot in h&pitaS, gwe #frcct addrcu)

HOSPITAL OR

d. STREET ADDRESS

lNsr ,nETlotb

I

d. IS PLACE OF BIRTH 1?4S10SCITY LIMITS1 C. 1S RESIDENCE INSIDE CITY LIMITS? f f. IS RESIDHbCE ON A FARM?

YESO NOD I

YESO mu YES ❑ ~a

3. NAME First Midd/r

~ %%”’

LUJE

z

u 4. SEX Su, THIS BIRTH 5b IF TWIN OR TRIPLET. WAS CWLO WRN 6. DATE Month Dar Yea?

SINGLE ❑ TWIN ❑ TRIPLET ❑ 1ST ❑ 20 ❑ 30 fJ B!%

7. NAME Fsrat hfiddk .&uf

g

8. -R OR RACE

z

: 9 AGE (At Iinu of this blrlh) 10. BIRTHPLACE (Sitit or foreign countr#) 1la. USUAL DCCUPATIOM t lb. KNLO OF WS1NE6S OR INDUSTRY

4 YEARS I I

12, MAIDE!I ?bAME

a

Fir!t. Middle Llul 13. COLOR OR RACE

*

1-

g 14 AGE (At time of Ihia birth) 15, BIRTHPLACE (State or /orti#m cDuntr#) 16. PREVKXJS DELIvERIEs TO MOTHER (2)D Nor I#cSudt tkb$irfh)

VEARS . . Jfnw -“” b, Mow wm. OTHER cAAlOrnm *,1*8!!

H- -., kfd &lh,

17. INFORMANT .“ “@uH“”* 1- .fl- .-M**,*)?

I

16 MOTHER3 MAILING ADORESS

I&. SlaNATURI

1 Aertby ccrtifs I&.ATTENDANT AT BIRTH

::; g C4h: M. 0.0 0.0. ❑ MIOWIFE ~

(h date

OTHER (SPScif#)

l.% ADORESS 18d OATS SIGNEO

%&d abDss.

1 I

19, DATE RECD. BY LOCAL REG. 20, REGISTRAR% SIGNATURE 21. OATE ON WHICH GIVEN NAME AO~D

I I ●Y (Rqisfm?)

FORAACOMXL AND HSALTIA USC ONLY

(ThiJ#ecSionMum k @Led w4)

22u. LENGTH Of PREGNANCY F2b. WEIGNT AT BIRTH 23. LEGITIMATE

CDMFLE7E0

wEEKs LB. oz. YESU NOn

(SPACE FOR ADDITION OF MEDICAL ANO HEALTN ITEMS BY INOIWWAL STATES)

45
Standard Certificate of Death

CERTIFICATE OF DEATH F.. .Mnr,vd .

BIRTH No, STATE OF

B.dmt But_u NO.6s-rva7.5.2,

STATE FILE No.

I PLACE OF DSATIE 2, ~S&~\ERESIOENCE(Wkcd_dli~b f/;;;;lIom:R&mA14ini~

a. COUNTY

I

b. CITY, TOWN, OR LCCATlON t. LENGTH OF STAY IN lb c. CITY. TOWN. OR LOCATION

r

d. NAME OF (If w In Ampitd, gine#treeladdrem) d. STREET ADDRESS

HOSPITAL OR

INSTITUTION

e. IS PLACE OF OEATH INSIOE CITY LIMITS? C. IS RESIDENCE INSIOE CITY LIMITSF IY. IS RESIOEVSCEON A FARM?

YES ❑ NO ❑ I

YESD ?kon I

YESD NOD

3 NAME OF Fiml MiddJe La#t DECEASED 4. DATE

(Twc or PTinl)

h4Dnth Dav Pear

E%l

5. SEX 6 COLOR OR RACE 7 MARRIEo ❑ NEVER MARRIEOO 8 oATE oF BIRTH 9. AGE(Zn VCar# w UNDSR I Yms uNmEl 2A Nn3.

lad bMAday) M-w D.m

WIOOWEO ❑ OIVORCEO C

I&z. usuALcccuPATloN (Qluekindo/work done lob, KlN00F8u51NEss0R lNDu3TRY 11, BIRTHPucE (StieorfOre~c mtir#) ~“=

during moatoj working I#je,eveniJ ret{red)

12.CITIEVNW Wnw

1 I

13. FATHERS NAME 14, MOTHERS MAIOEN NAME

15, WAS DECEASED EvER IN U S, ARMED FORCES?

(s’.,. w.m”nAnO-, , (,,w..,mcw.mmti, o,,cnw,

16, 20CIAL SECURITY NO. 17, IMFORMAMT Addrew

1 I 1

I CAUSA or DcaTsv [Enter on2y one caua per NIW fnr (a), (b), and (c).]

PART 1, DEATH WAS CAUSED Wt.

IN7ERVAL Efl~

ONSST AMO tJEATN

IM MEDIATE CAUSE <a) _

Ccmdition#,if wzv,

which owe ru &l

}

OUE TO (b) _

Dbcsu Cawe fa),

atacing the un&r. Ivingcmwe lad, O(JE 70 (c)

PART II, OTHER SIGNIFICANT CDNOIIIONS @tnnlsuFING m LWAIH EWCNOT RELATED10 Tllll TESMINAL O+SSASZCONDITION GWEN IN PART l(r) !9

“~E%mA#MET 1

h. ACCIDENT SUICIDE

YES ❑ NO [Q

HOMICIDE 20b DESCRIBE HOW INJURY OCCURRED, (a(er w2we ofinjwy in Part i or Part 11oJStcm18.)

❑ o ❑

DC~;~~n;F Hour Mrmth, Dar, Year

a, m.

p. m,

bd INJURY OCCURRED =, PLACE OF INJURY (e. o., in or dwmt honw, ZQf. CITY, TOWN. OR LOCAT~N COUNTY STATE

;~[f AT ❑ NOTW40T:E❑ farm, Jactorv,ttreet, ofice bldp., etc.)

I I attended the deceased from , to ●nd last ●aw him‘*r aIiv* on

Death oocurred at m on the date #tat*d ●bove; ●nd tothebest of my knc.wledie, from the cauna stat.d.

2a, SleNATURC (Dcv7eeor Nfk) ~, ADORESS 22s, OATS !$IGNEO

1 1

3URIAL. CREIAATION, 23b OATS

*EMOVAL [.S$XC:JVI

& NAME OF CEMETERY OR CREMATORY 22d. LOCATION (~#, SOW%. 07 CDU~#) (SvaAsl1 I

24 FUNERAL DIRECTOR ADDRESS =. DATE RECO, BY LDCAL REG. 26. REGISTRARS SiGNATURE

46
1964-1966 National Natality Survey Questionnaire

@

#P*” “%.,

.’ ;

5:’ DEPARTMENT OF HEALTH. EDUCATION, AND WELFARE

“* ,$: PUBLIC HEALTH SERVICE

. . .

wASHINGTON. 0.C. -1

NATIONAL CCNTCR FOP

MT.ALTU $TA’TISTICS

1-

L

~ U. s. PublicHealth Setice is conductinga naticmal.study of femilies

havingbabies during 1966. In this study,m? am particularlyinterested

In lemming about the size and types of these families,as well as about

other familycharacteristics.This informationis needed in order to

better understandthe grovthand changestak~ place in our populatim.

Detailedand accurateinformationof this t= is essentialfor inteM3.gent

planningof programsto improvethe Nationrs healbh and welfare.

!Chlsnationalstudywill be based cm infonmtion obtainedfran families

which were selectedas a samplefran among the 4 millionfamilieshaving a

baby during 1966. Your fsmilywas one of those selected. Please answer

the qpesticason the followingpages end returnthis fom in the enclosed

postage-freeenvelope.

As you might expect, statisticalaccuracyzqpires that we z=eceiveyour

reply and those of all of the other familiesin the study. You may be

assuredthat all infommticm which you reportabout yonreeu and your femlly

will be kept canpletelyconfidential,in accomlancewith regulaticmsof the

U. S. FublicHealthService. Your coopemtion In this study,which seeks

informticm of importancefor the general.welfare,is appreciated.

~Y~y’ u..>

4

.,

roe G. S2rked,Ph. D.

Chief,Ditilionof Health

RecordsStatistics

NsmeofChild

Me ofDirtb FileNumbsr

66M

47
CDMFIDEHTIALITY has bmn ●murcd tho individual ● Pub{ kskd in tho Fodwd Rtoictor May 20, 19s9

NATIONAL BIRTH SURVEY

Ayml .4pp*c.vd

Bud#. tBur..,, h%,68- .?823

PART 1. INFORMATION ABOUT YOUR CHILDREN

I

Inthispavt, ws are interested inkm”ngabout all of

the children which have evev bees born to yen, even if

they were by a&rem”ous mamizge.

Howmany babies have you ever had? (Count all 4. Have youever had any babies that were born

those that were born alive to you at any time.) &ad?

l-Jl ❑ 4 IJ7 •l 10 or more

1

❑ NO

02 ❑ 5 ❑ 8 Nu@er

❑ YES--How many have you ever hay

03 ❑ 6 ❑ 9

Number

Have you ever had any children who have died?

(Do not count miscarriages or babies that were

5. Have youever hada miscarriage?

born~ead.) a NO

O NO D YES-HOW many have you ever had?

D YES-Please list below the name, sex, date

I

Number

of birth, and date of death of each

such child.

1

Name of child Sex Date of Date of 6. After each birth, some couples feel that their

Birth Death families are completed, while others expect more

chil&en. In your case, do you expect to have

more children ?

lJ Definitely yes

1

How manyrmore

- children clnyou

3. Were any of your children living away from you (J Probably yes think you will

when your last baby was born ? (For example,

Cl Probably no

probably have ?

in the Armed Forces, living with relatives, etc.) I

❑ NO ❑ Definitely no E

Number

❑ YES-Please list below the name, sex, and

date of birth of each such child.

+

Date of

Name of child Sex Birth

.——. —. —J

PUS- 442>-19 (Pan= 2)

Ri+v. 3/66

(00 ON TO PART II) -

48
PART Il. INFORMATION ABOUT YOUR FAMILY I

In this part, information is asked about the members of the fmiiy who

lived w“thyou when your Last baby was bonz,

L List below everyone who usually lived in your household at the time your last baby was bory. Be sure

to list yourself, your husband (if he lived at home) and your newborn baby, as well as other children I

and relatives living with you. Unrelated persons who lived with you, and-children who were away at

school or college, should be listed. Do not include persons who lived away. (For example, persons

in the Armed Forces). Also, _ include persons who were only visiting temporarily at the time

your baby was born.

Enter your name on the first line; For each pe rson, provide the information requested below.

enter the names of every other Relationship to you Marital Status (for

person who lived with you, including (husband, daughter, Date of birth persons 14 years

your newborn baby, on the following son, father-in-law, and older).

lines. nephew, stepson, Married Divorced

adopted daughter, Month-Day-Year Widowed Separated

(First name) (Last mme) etc.) Single (never married]

Yourse Lf

(If mme space is needed, please continue on separate skeet)

[

2. Who was the head of your

household?

❑ Your husband

❑ Another person

I

Name of head

1s-4425-19(P*e 3)

w. 3/66

3. What was the total income of your fsmfly during 1965?

(Include all income of all members of the fatqily listed above even

if they were not living together during 1965. Include income from

all sources such as wages, salaries, unemployment compensation,

help from relatives, profita and fees from own business or farm,

welfare payments, Social Security payments, etc.)

❑ None ❑ $4000-$4999

❑ Under $1000 ❑ $5000-$6999

❑ $1000-$1999 a $7000-$9999

❑ $2000-$2999 •1 $10,000-$14,999

c1 $3000-$3999 ❑ $15,QO0 or over,

(GO ONTO PART III) -

49
>ART Ill. INFORMATION ABOUT YOURSELF

AND YOUR HUSBAND

PART Ill. Con.

In this part, information is reqaested about 4. What was the highest grade (or year) of regular

you and your husband. school that your husband ever attended?

1. Is this your first marriage?

(Circle highest grade attended)

❑ YES =

Please give the date of None -------------------- 0

your marriage. Elementary -------------- 1 2 3 4 5 6 7 8

* 4a”2:-:::’;;:64-”N0

PART IV. INFORMATION ON

❑ NO

/

HEALTH INSURANCE

In this pa~t, we are interested in jimiin.g out wizethev

‘ =

you were covered by health insurance atany time duriw Your recent PreW@W Please repovt on eachkind

of health insuvance protection which you had, whether

or not the insurance was used.

1. During your recent pregnancy, did you have healtt

Please give the date of insurance to pay for doctor’s bi 11s for office

present marriage. visits or horn e calls ?

~ careatti~t~ofdeliv~y~ –

2. Did you have health insurance to pay for hospital

!. Were you employed outside your home at any

time during your recent pregnancy? ❑ YES ❑ NO

•1 YES _ When did you stop working before 3. Did you have health insurance to pay for the

your baby was born ? doctor’s bill for delivery of your baby?

“N” +’ PARTD;SON~~;PLET,N<~

1. What was the highest grade (or year) of regular THIS FORM

school that you ever attended?

(Circle highest grade attended)

Name of person completing this form

None -------------------- o

—

Address

Elemenbry -------------- 1 2 3 4 5 6 7 8

High School -------------- 1 2 3 4

College ------------------ 1 2 3 4 5 6+

—

Telephone

—

la. Did you finish this grade ? ❑ YES D NO

Number

OMMENTS:

-

.4425 -19mu, m

,. 3/66-’” - -

GPO 905-4,6

50
1964-1966National Infant Mortality Survey Questionnaire

DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

PUBLIC HEALTH SERVICE

WASHINOTON, D.C. .XW1

NATIONAL CENTER FOR

HEALTH STATISTICS

r

L

The U. S. Public Health SerwLce is conductinga survey to obtain inf’ormaticn

about Mcints who died during 1965. We realize that this is a difficult

time; however, your help Is needed in dealing with an hnportantproblem.

Loss of life abmng infants,especiallyin the first few hours or dzqw of

life ma beccanea matter of Increasingconcern smong public health workers

in the ~ited States. The purpose of this survey is to collect infonnatian

about the childbearingexperiencesof mothers who have lost their babies,

about the udical facts relatedto these deaths, and about the personal

circ-t=nces of the parents of these wants. TMs im?ormticm is behg

obtainedror cm out of evexy 110 infant deaths occurringthroughoutthe

Countly.

This survey is desi~d to provide facts urgently needed in me&Lcal and

piblic health research,tbe results of which my contributeto saving the

I.lvesof babies being born in yobr own ccmmnmity.

Please ccqpletethis I’oxmand m?tu?m it within the next five days. A self.

addres8ed envelopewhich requiresno postage has been provided for your

ccmentence. If you do not have the exact“answerto a question,please

give your best es$imate.

Illetnfoz?mxktcmyou providetill be given ccnfi*ntial treatmentand will be

used for statL8ticalpurposes only. Any publlshed summarywill be presented

In such a manner that no Individualprson or family cau be identified.

Thank you fcw yvur cooperation.

g~~&k

Rec&as statistics

51
C.. fidenci.lity h.. been .sm.ted the i.di.idu.l . . published i. the Fed.ml Register My 20, 1959

.

DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

Public Health S.,,,., - NCHS

W..hi. #ton, D.C. 20201

1965 INFANT MORTALITY SAMPLE SURVEY

F.am App,wed

B.B. No. 68-R783

PART I. INFORMAlTON ABOUT THE INFANT WHO DIED

Was the baby in a hospital at the time of death? 3. Please list each hoEpitql in which the baby received care,

❑ Yes u No

~ ~r: only for a brief period. (Write in name and

oca 1 n of each place; kclude hospitals in which birth

and death took place.)

Was tke behy bo~n in a hospital?

•l Yes ❑ No Name of Hospital City and State

PART IL INFORMATION ABOUT OTHER CHILDREN

In this part, we are interested itz knowing abont all of the childwn

which have ever been born to you, including the infant who died.

How many babies have you ever bad, including tbe 3. Have you ever had any babies that were born dead?

baby wbo died? (Count all those that were born alive

to you at asy time.) ❑ No El Yes

01 ❑ 4 ❑ 7 IJ 10 or more

i

El

Number

How many have you ever had?

❑ 2 ❑ 5 ❑ 8

❑ 3 ❑ 6 ❑ 9

&

4. Have you ever had a miscarriage?

Q No ❑ Yes

Were any of your children Iiving away from you at I

E,

Number

the time of birth of the baby who died? (For example, How many have you ever had?

livbfg with relatives, etc.)

5. Have you ever had any other children who have died?

❑ No •l Yes (Do not count miscarriages or babies that were born

1

dead~

Please list below the name, sex, ❑ No •l Yes and date of birtb of each child

living away from you. 1

I

Please list below the name, sex,

date of birth and date of death of

Name of Child Sex Date of Birth each such child.

Month-Day-Year

Name of sex Date of Birth Date of Death

Child Month-Day-Year Month-Day-Yt

PHs.4670-15 (p*g= 2)

n... 2-65

52
PAHT III. INFORMATION ABOUT YOUR FAMfLY

In this part, information is asked about tke membevs of tie fmily

who lived with yow at the time of birth of the baby who died.

LL?tbelow everyone who usually lived in your homehold at the time your baby was born. Be sure to list yourself,

your husband (if he lived =me~ well as ofier children and relatives living with YOU. Unrelsted persons who

3ived with You, and children who wel e temporarily away at school or college. should be Usted. Z?.QLX.?!iIIChK@ Persons

who 3ived away. (For example, do not include persons in the Armed Forces.) Also, do not include persons who were

only visiting temporarily at the time your baby was born.

.—

For each person, provide the information requested below

Relationstdp to the Marital Status Date of first

nter your name on tbe second line; dead child (father, fkte of Birth (for persone 14 marriage for

nter the name of each person who sister, aunt, couefn, years and older) each person

,ved with you on the following 3ines grandfather, lodger, Married Divorced who was ever

etc.) Widewed Separated married.

(Last Name)

Single (never

(First Name) Month-Day-Year married) Month-Day-Year

Deceased Infant

MOTHER

(IF MORE SPACE IS NEEDED, PLEASE CONTINUE ON EACK PAGE)

. Who was the head of this household? 4. What was the total income of your family during

❑ The child’s father

1964? (Include all fncome such as wages, sakaries,

unemployment compensation, help from relatives, etc.,

•l Another person

received by Ji members of the family you have

\

listed above.)

Name of head ❑ None •1 $4,000-$4,999

4 ❑ Under $1,000 ❑ $5,000-$6,999

Have you been married more than once?

•1 $1,000-$1,999 ❑ $7,000-$9,999

❑ No ❑ Yes _ Write in date of

-t marriage. ❑ $2,000-$2,999 •1 $10,000-$14,999

Month Day Year

cl $3,000-$3,999 ❑ $15,000 or more

PLEASE CONTINUE ON BACK PAGE

PHS4670-7 (page 3)

Rev. 2.65

53
PART V. INFORMATION ON

HEALTH INSURANCE

PART IV. INFORMATK3N ABOUT THE

INFANT’S MOTHER AND FATHER

Inthispavt, we ave interested in finding out whethev

youwerecoveved byhealthinsurance atany ti?neduringyour vecentjwegnancy. Please repovto neaohhind

of health insurance protection which you had, whethev

1. Were you employed outside your home at any

ov notthe insurance was used.

time during your recent pregnancy ?

❑ YES

1. During your recent pregnancy, did you have health

_ When did you stop working before insurance to pay for doctor’s bills for office

your baby was born ?

I

visits or home calls?

❑ NO

Month Day Year ❑ YES ❑ NO

2. Did you have health insurance to pay for hospital

2. What was the highest grade (or year) of regufar care at the time of delivery?

school that you ever attended?

o YES ❑ NO

(Circle highest grade Attended)

None -------------------- O

3. Did you have health insurance to pay for the

Elementary -------------- 1 2 3 4 5 6 7 8

doctor’s bill for delivery of your baby?

High School -------------- 1 2 3 4

College ----------------- 1 2 3 4 5 6+ •1 YEs H NO

2a. Did you finish this grade? ❑ YES o NO

PART V1. PERSON Completing

THIS FORM

3. What was the highest grade (or year) of regular :

school that the child’s father ever attended?

Name of person completing this form

(Circle highest grade attended)

None -------------------- O

Address

Elementary -------------- 1 2 3 4 5 6 7 8

High School -------------- 1 2 3 4

College ------------------ I 2 3 4 5 6+ Telephone Number

3a. Did he finish this grade? ❑ YES ❑ NO

COMMENTS

PHS-4670- 15 (page 4)

Rev. ?-65

54
F... AP. r.w<d

B.d.$, B.,..,. No. 68-R7:3

1964-1965 National Infant Mottality Survey Hospital Form

CONFIDENTIALITY I!.* been . . ..rcd the individml .s published in the Fed.rsl Register M.y 2S, 1959

nWARIMtNT OF HEALTH, EDuc.4m0tJ, AND WELFARE

Public Health S..vIc. - NCNS

V.sh’”g,.., n, c. 20201

NATIONAL MORTALITY SAMPLE SURVEY - 1965

Hospital Report on Infant Death

Name of deceased infant File Number

Date of birth Date of dsatb

Name of infant’s mother

Residence of mother

Hospital or institution to

which request directed

(Name) (Imation)

—

PART I. INFORMATION ON DECEASED INFANT FROM HOSPITAL WHICH PROVfDED CARE

A. The birth of the infanti Please provide the following information about the birth of the infant if available from your records.

1. Length of pregnancy completed weeks (OR. Eate of last menses )

Month, Day, Year

2. Weight at birth lb. oz. (OR Grams)

B. Periods of care of the infanti Please complete a section below for each episode of care atthis hospital. IF BIRTH

DID NOT OCCUR IN THIS HOSPITAL. CHECK HERE ❑ and be@n with episode 1

Periods

of Care

(Bi~th

Episode)

m

PMWG7C-23

R,”. 2.6>

Admitted

on

Birth date

fiontb

)sy

fear

Iontb

)ay

rear

Discharged

on

❑ CHECK IF discharge by death; OR

specify date

Month

Day

Year

Iontb

lay

“ear

fionth

)ay

[ear

PI

Final Diagnoses

l_J CHECR IF newborn without

immaturity, birth injury, defec~

or disease

WE TURN PAGE

below.

Operations

Performed

Check if nose ❑

Check if none ❑

Check if none ❑

55
PART II. CARE OF THE DECEASED INFANT fN OTHER HOSPITAU OR MEDICAL FACILITIES

According to your records or to your personal knowledge, was the decea8ed fnfant a patient in any other hospital or medical

institution during its life span? (The birth episode is of particular importmrce, if this dld not occur at your hospital.)

❑ YES ❑ No ❑ Unknown

1

Please list bslow each other hospital or restitution m which the deceased infant received care.

OTHER HOSPITAU OR MEDICAL FACILITIES IN WHICH

THE DECEASED CHILD wAS A PATIENT

L Name of Hospital or institution

Street Address

City or P12ce State

Approximate Discharge Date

2. Name of Hospital or Institution

Street Address

City or Place State

Approximate Discharge Date

REMARKS

Signature of person completing this form

Name of this “hospltil or institution

Your position in this hospital or institution

PHW47Cb23 (Pa.. 2)

56

000

* U. S. GOVERNMENT P~G OFFICE :1973 515-212/44
VITAL AND HEALTH STATISTICS PUBLICATION SERIES

originally Public Health Service publication No. 1000

Series 1. Pro~ams and collection pyoceduyes. — Reports which describe the general programs of the National

Center for Health Statistics and its offices and divisions, data collection methods used, definitions,

and other material necessary for understanding the data.

Sevies 2. Data et.nluation and methods research. —Studies of new statistical methodology including: experimental tests of new survey methods, studies of vital statistics collection methods, new analytical

techniques, objective evaluations of reliability of collected data, contributions to statistical theory.

Sa+es 3. Analytical studies. —Reports presenting analytical or interpretive studies based on vital and health

statistics, carrying the analysis further than the es~ository types of reports in the other series.

Series 4. Documents and committee vepo~ts.— Final reports of major committees concerned with vital and

health statistics, and documents such as recommended model vital registration laws and revised

birth and death certificates.

Series 10. Data from the Health Intemiew Suvvev. —Statistics on illness, accidental injuries, disability, use

of hospital, medical, dental, and other services, and other health-related topics, based on data

collected in a continuing national household interview survey.

Sem.es 11. Data j&om the Health Examination Su?wey. —Data from direct examination, testing, and measurement of national samples of the civilian, noninstitutional population provide the basis for two types

of reports: (1) estimates of the medically defined prevalence of specific diseases in the United

States and the distributions of the population with respect to physical, physiological, and psychological characteristics; and (2) analysis of relationships among the various measurements without

reference to an explicit finite universe of persons.

Series 12. Data jkom the Institutional Popukztion Suneys —Statistics relating to the health characteristics of

persons in institutions, and their medical, nursing, and personal care received, based on national

samples of establishments providing these services and samples of the residents or patients.

Series 13. Dati from the Hospital Discharge SuYvey.—Statistics relating to discharged patients in short-sray

hospitals, based on a sample of patient records in a national sample of hospitals.

Swies 14. Data on health vesomces: manpoww and facilities. —Statistics on the numbers, geographic dismibution, and characteristics of health resources including physicians, dentists, nurses, other health

occupations, hospitals, nursing homes, and outpatient facilities.

Series 20. Data on moYtality.— Various statistics on mortality other than as included in regular annual or

monthly reports— special analyses by cause of death, age, and other demographic variables, also

geographic and time series analyses.

Series 21. Data on natality, mawiage, and divcwce. —Various statistics on natality, marriage, and divorce

other than as included in regular annual or monthly reports-special analyses by demographic

variables, also geographic and time series analyses, studies of fertility.

Sevies 22. Data porn the National Natality and Mortality Suvveys. — Statistics on characteristics of births

and deaths not available from the vital records, based on sample surveys stemming from these

records, including such topics as mortality by socioeconomic class, hospital experience in the

last year of life, medical care during pregnancy, health insurance coverage, etc.

For a list of titles of reports published in these series, write to: Gffice of Information

Nat ional Center for Health Statistics

Public Health Service, HSMHA

Rockville, Md. 20S52
U.S. DEPART

HEALTH, ED

Public Health

HEALTH SERVIC

5600 Fishers Lai

Rockvi I Ie, Maryla

OFFICIAL BUS

Penalty for Prw