NATIONAL CENTER Series 4 

For HEALTH STATISTICS Number 10 

VITAL and HEALTH STATISTICS 

DOCUMENTS AND COMMITTEE REPORTS 

The 1970 Censusand 

Vital andHealthStatistics 

A Study Group Report of the 

PublicHealthConferenceon 

RecordsandStatistics 

A study of the plans for the 1970 Census of Population being 

developed by the Bureau of the Census; their relation to vital 

and health statistics; and recommendations for ways to incorporate Census data in Stateand natianal statistical programs. 

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

Public Health Service 

Health Services and Mental Health Administration 

Washington, D.c. April 1969 
Public Health Service Publication No. 1000-Series 4-No. 10 

For sale by the Superintendent of Documents, U.S. Government Printing Office 

Washington, D. C., 20402- Price 30 cents 
NATIONAL CENTER FOR HEALTH STATISTICS 

THEODORE D. WC) OLSEY, DirectoT 

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

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

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

ALICE M. WATERHOUSE, M.D. Medical Consultant 

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

EDWARD E. MINTY, .Executiue O//icer 

MARGERY R. CUNNINGHAM, Irz/omnation O//icer 

OFFICE OF STATE SERVICES 

ANDERS S. LUNDE, Ph. D., Director 

JOHN MONROE, Deputy Director 

J. K. KNEE, Assistant to the Director 

Public Health Service Publication No. 1000-Series 4-No. 10 

Library of Congress Catalag Card Number 7’7-60027’1 
STUDY GROUP ON THE 1970 CENSUS AND VITAL AND HEALTH STATISTICS 

Members 

Clyde V. Kiser, Ph. D., Chairman 

Senior Member, Technical Staff 

Milbank Memorial Fund 

New York, New York 10005 

Stephanie J. Ventura, Rapporteur 

Statistician, Natality Statistics Branch 

Division of Vital Statistics 

Nat ional Center for Health Statistics* 

Washington, D.C. 20201 

Ann Dillon 

Director, Statistical Service 

Tennessee Department of Public Health 

Nashville, Tennessee 37219 

Sandra H. Kinch 

Director, Office of Biostatistics 

New York State Department of Health 

Albany, New York 12208 

Raymond D. Nashold, Ph.D. 

Supervisor, Statistical Services Unit 

Section of Vital Statistics 

Division of Health 

Wisconsin Department of Health and Social 

Services 

Madison, Wisconsin 53701 

Margaret E. Rice 

Director, Division of Public Health Statistics 

Mississippi State Board of Health 

Jackson, Mississippi 39205 

Consultants 

Paul C. Glick, Ph.D. 

Assistant Chief for Demographic and Social 

Statistics Programs 

Population Division 

Bureau of the Census 

Suitland, Maryland 20233 

Robert D. Grove, Ph.D. 

Director, Division of Vital Statistics 

National Center for Health Statistics* 

Washington, D.C. 20201 

Anders S. Lunde, Ph.D. 

Director, Office of State Services 

National Center for Health Statistics* 

Research Triangle Park, North Carolina 27709 

Oswald K. Sagen, Ph.D. 

Assistant Director for Health Statistics 

Development 

National Center for Health Statistics* 

Washington, D.C. 20201 

Henry S. Shryock, Jr., Ph.D. 

Assistant Chief for Program Development 

Population Division 

Bureau of the Census 

Suitland, Maryland 20233 

Conference Secretariat 

Frances I. Chamberlain 

Public Health Analyst 

Office of State Services 

National Center for Health Statistics* 

Washington, D.C. 20201 

Virginia L, Monroe 

Staff Assistant 

Office of State Services 

National Center for Health Statistics* 

Washington, D,C. 20201 

“Dtlpurtmont of Hmlth, Educu.tion, aud \Velfare, Public Health Service. 

iii 
THE PUBLIC HEALTH CONFERENCE ON RECORDS AND STATISTICS STANDING COMMITTEE 

Anders S. Lunde, Ph. D., Chairman 

Director, Office of State Services 

National Center for Health Statistics* 

Research Triangle Park, North Carolina 27709 

Robert D. Grove, Ph. D., Vice Chairman 

Director, Division of Vital Statistics 

National Center for Health Statistics* 

Washington, D.C. 20201 

J. K. Knee, Executive Secretary 

Assistant to the Director, Office of State Services 

National Center for Health Statistics* 

Washington, D.C. 20201 

Leland E. Aase (1968) 

Chief, Section of Vital Statistics 

Wisconsin Department of Health and Social 

Services 

Madison, Wisconsin 53701 

W. Donald Carroll (1970) 

State Registrar and Chief 

Records and Statistics Section 

Texas State Department of Health 

Austin, Texas 78701 

Marian Maloon Colby (1968) 

Director, Bureau of Vital Statistics 

Division of Public Health Services 

New Hampshire State Department of Health 

and Welfare 

Concord, New Hampshire 03301 

Carl L. Erhardt, SC.D. (1968) 

Director of Program Planning for Health 

Intelligence 

The City of New York Health Services 

Administration 

New York, New York 10013 

Theodore R. Ervin (1970) 

Associate Director for Administration 

Michigan Department of Public Health 

Lansing, Michigan 48914 

Todd M. Frazier (1970)1 

Associate Professor of Biostatistics 

Harvard School of Public Health 

Boston, Massachusetts 02120 

Paul C. Glick, Ph.D. (1968) 

Assistant Chief for Demographic and Social 

Statistics Programs 

Bureau of the Census 

Suitland, Maryland 20233 

Forrest E. Linder, Ph. D., Ex officio 2 

Professor of Biostatistics 

School of Public Health 

University of North Carolina 

Chapel Hill, North Carolina 27514 

Oswald K. Sagen, Ph. D., Ex officio 

Assistant Director for Health Statistics 

Development 

National Center for Health Statistics* 

Washington, D.C. 20201 

Edward R. Schlesinger, M.D. (1970) 

Professor of Maternal and Child Health 

Graduate School of Public Health 

University of Pittsburgh 

Pittsburgh, Pennsylvania 15213 

Strawn W. Taylor (1970) 

Director of Staff for Comprehensive 

Health Planning Commission 

Kentucky State Department of Health 

Frankfort, Kentucky 40601 

William F. Taylor, Ph.D. (1968)3 

Consultant in Charge 

Medical Statistics 

Mayo Clinic 

Rochester, Minnesota 55901 

Kerr L. White, M.D. (1970) 

Professor and Chairman 

Department of Medical Care and Hospitals 

School of Hygiene and Public Health 

The Johns Hopkins University 

Baltimore, Maryland 21205 

John C. Wilson (1968) 

Director, Office of Comprehensive Health 

Planning 

Montana State Department of Health 

Helena, Montana 59601 

%ntil August 1968 Associate Direrjtir for planning and Research, District of Columbia Department of Public HeaItb. 

2

Until August 1967 Director, National Centar for Health Statistics.* 

%_ JIItjI July 1967 A~~~ciate pmfes~or of Biosatistics, School of Public Health, university of California, Berkeley. 

NOTE: Year in parentheses refers to expiration of term. 

‘Department of Health, Education, and Welfare, Public Health Service. 

iv 
FOREWORD 

This report was prepared by the Study Group 

on the 1970 Census and Vital and Health Statistics 

under the auspices of the Public Health Conference 

on Records and Statistics. Dr. Clyde V. Kiser, 

Chairman of the Study Group, was the principal 

author of the report. He was assisted by other 

members of the Study Group. 

The central purpose of the Study Group was 

“to study the plans for the 1970 census, as being 

developed by the Bureau of the Census, to consider how the y relate to vital and health statistics, and to recommend ways to incorporate 

census data in State and national statistical 

programs.” 

It is hoped that this report will encourage 

State health officials and students of vital statistics, demography, and the social sciences to take 

advantage of the 1970 census year, or the 1969-

71 census period, to carry out studies of small 

areas and special population groups. 

For her help as rapporteur and coordinator, 

a special word of thanks to Mrs. Stephanie 

J. Ventura. 

Anders S. Lunde, Ph.D. 

Chairman, Standing Committee 

Public Health Conference on 

Records and Statistics 
CONTENTS

Page

Foreword ------------------------------------------------------------

Introduction ----------------------------------------------------------

Overview: Areas for Investigation ---------------------------------------

Findings and Recommendations -----------------------------------------

Addition of New Items Into the 1970 Census ----------------------------

Special Vital and HealthStatistics Tabulations --------------------------

Tabulations byStates ------------------------------------------------

Tabulations by NCHS------------------------------------------------

Matching Studies ---------------------------------------------------

Gaps in Uniformityof Definitions -------------------------------------

Endorsement ofComprehensiveApproach ------------------------------

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

Appendix I. Probable New Items in the 1970 Census and Their Relation to

Public Health Statistics -----------------------------------------------

New Items ---------------------------------------------------------

Results of the New Haven Pretest -------------------------------------

Field Office @erations -------------------------------------------

Mailing List for Rural Areas --------------------------------------

Subject Content --------------------------------------------------

Coverage Improvement -------------------------------------------

1968 “Dress Rehearsals''--------------------------------------------

Appendix II. Review of 1960 Matching Study of Deaths and Census Records

(Kitagawa-Hauser Study) ----------------------------------------------

Deaths Included in Study ------------------------------------------

Matching of Deaths toCorresponding Census Records ----------------

Special Sample Survey --------------------------------------------

Analysis of Data -------------------------------------------------

Results of Analysis— Education and Income Differentials -------------

Limitations of the Study Data for Analysis --------------------------

Appendix HI. Gaps in Uniformity in Census and Registration Definitions

and Procedures ------------------------------------------------------

Census -(l96O)-----------------------------------------------------

Place of Residence ----------------------------------------------

Type of Residence -----------------------------------------------

Marital Status ---------------------------------------------------

National Center for Health Statistics ----------------------------------

Place of Residence -----------------------------------------------

Type ofResidence ------------------------------------------------

Marital Status ---------------------------------------------------

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vii
IN THIS REPORT the plans for the 1970 Census of Population ave

described, their potential relationship with vital and health statistics

is considered, and ways of incorpo~ating census data in State and

national statistical programs are recommended,

The decennial Population Census offevs vich veseavch opportunities to

the public health analyst, demographer, and sociologist; and to analysts

in other related fields. The 1970 census in pm%icular will offer a number of important innmxztions, including greater provision of small ayea

data and more detailed information on the health and economic c7zavactevistics of the population.

The usefulness of vital statistics has been enhanced by the introduction

of the new s tandavd certificates. With the introduction of questions on

educational attainment to the bivth certificate, fov example, it will be

possible to calculate fertility rates by education for the total population

and for population subgroups of the 36 States which have items on educational attainment on theiv birth certificates.

Plans by State and local health departments fov using the 1970 census

data in combination with their own vitul statistics data are described

and recommendations are made fov additional tabulations both on the

national and the State or local level.

Matching operations using census and vitul statistics data ave discussed

and recommendations made concerning them.

It is uvged thnt existing diflwences in definitions between the National

Center for Health Statistics and the Bureau of the Census be eliminated

as soon as possible.

Finally, the concept of an integrated and comprehensive approach to the

critical questions of population dynamics in velation to health is endovsed.

viii
THE 1970 CENSUS

AND VITAL AND HEALTH STATISTICS

INTRODUCTION

The forthcoming decennial census, scheduled

for April 1970, will make possible a great variety

of research projects in health and demographic

fields. Federal government interest and participation in health programs operated at the local

government level has had an important impact on

the special innovations proposed for the 1970

census. Of particular interest to public health

authorities and demographers alike is the greater

provision for small area data. This will permit,

particularly with reference to the census year or

census period, detailed analyses of health problems at the local level and demographic analyses

of small areas and special population groups.

Other important innovations planned for the

25-, 20-, or 5-percent samples of the 1970

census include (1) obtaining additional information on place of work by detailed area to learn

more about commuting patterns; (2) obtaining

information on activity 5 years ago; (3) some expansion of income data to obtain more information

on sources of income; and (4) obtaining information on presence and duration of a “health or

physical condition which limits the kind or

amount of work’! a person can do at a job, and on

whether the condition kept him from working at

all. Clearly, the 1970 census offers rich research

opportunities to the public health analyst, demographer, and sociologist, and to those in related

fields.

AREAS

OVERVIEW:

FOR INVESTIGATION

In 1967, the Public Health Conference on

Records and Statistics established a Study Group

to investigate these opportunities:

to study the plans for the 1970 census, as being developed by

the Bureau of the Census, to consider how they relate to vital

and health statistics, and to recommend ways to incorporate

census data in State and nstional statistical programs.

Three specific proposals were originally suggested, as follows:

Consider new items being proposed for inclusion

in the census, or to propose such items, and

make recommendations concerning them as related to the field of public health statistics.

Consider and xecommend special vital statistics

and health tabulations to be prepared for the

census year and around the census year. Also,

consider special tabulations of population data

from the census.

Consider and recommend special studies matching vital records with census records.

In addition, the Study Group agreed to add a fourth

proposal:

Consider the gaps in uniformity of census and

registration definitions and procedures, and make

recommendations concerning them.

1
Provision for a decennial census was written

into our Constitution at the beginning of our

Nation’s history. It arose from the need to have

a periodic reassessment of the number of congressional representatives to which the several

States were entitled. Still serving this purpose,

the census also has become our chief method and

source of periodic inventory of the changing size,

distribution, and characteristics of our population. Collectively, the Censuses of Population

and Housing and those of Agriculture and Manufacture, provide periodic assessment of our

economic and social resources. Of particular

relevance here, the census provides the population bases or denominators needed to compute

our annual series of vital and health statistics.

The central theme of this report is to urge

State health officials and students of vital statistics, demography, and the social sciences

to take advantage of the 1970 census year or the

1969-71 census period to carry out studies of

small areas and special population groups. It

is during the census period that solid population

data are available. At other times intercensal

estimates must be relied upon.

Furthermore, although those planning the

1970 census probably have received more requests for special data and special tabulations

than any of their predecessors, they continue to

show a commendable sensitivity to the needs of

the States for population data for small areas

and special population groups a’ndfor denominators for vital and health stat istics.

In a paper “Planning the 1970 Censuses to

Meet State and Local Needs,” 1 A. Ross Eckler,

Director, Bureau of the Census, stated: “Statistics for small areas are a unique contribution of

a census and this feature is receiving special

attention as the Census Bureau prepares for the

1970 Censuses of Population and Housing. In a

series of 22 regional meetings held with groups

of representative users of census data about a

year ago there was a strong expression of interest

in data for small areas, reflecting State and local

interest in the many legislative programs relating

to economic opportunity, economic development,

transportation, housing, and health programs.

“A mail population and housing census requires a complete file of residential addresses

coded to reflect the geographical detail to be

observed in the census. A major advance of the

1970 censuses will be the geographic coding

system being developed which will permit us to

account for all the addresses located on each

side of each city block.

“For assigning geographic codes in the major

urban areas, we are preparing computerized address coding guides which will include street

names, block face identification, intersecting

streets, the range of address numbers for each

block face according to census tract and zip

code area, afid the area identification codes required for census tabulations.”

However, it may be well to differentiate

between what will be available and what will be

published in the way of population data for small

areas. Also, whereas population counts will be

available for small areas, the detail regarding

population characteristics will naturally decrease

with the size of the area considered. Dr. Henry

S. Shryock, Jr., Assistant Chief, Population

Division, Bureau of the Census, stated the attitude

of the Bureau of the Census on this matter as

followss !!~e Bureau is putting a high pranitttn

on speed of publication and on simplifying the

programming and table preparation in the computer. Thus, we have tried to simplify the overall pattern of the reports, recognizing only a few

different levels of detail and dropping a good

many historical figures and percent distributions

that were carried in 1960. There still remains

more detail for States than for their component

areas; but, at a number of points, we postponed

the presentation of further State detail until

Series P-D. Individual SMSA’S, urbanized areas,

and places of 25,000 or more, as well as counties,

are given the same type of treatment. Less detail is given for urban places of fewer than

25,000 inhabitants and the rural-farm and ruralnonfarm parts of counties, In the last few censuses, the cutting score for this differential

treatment of cities had been at 10,000 rather

than at 25,000, but the number of urban places

has been growing and there are competing needs

for space for additional subject matter. Moreover, after Series P-A, we are proposing dropping

published data for Minor Civil Divisions.” 2

2
FINDINGS

AND RECOMMENDATIONS

Addition of New Items Into the 1970 Census

With respect to the first specific charge to

the Study Group, only a few new items will be

introduced into the 1970 census. Of perhaps

main interest is the likelihood of a question on

presence and duration of a “health or physical

condition which limits the kind or amount of work

a person can do at a job,” and on whether the condition kept him from working at all. This question

probably will be asked of persons 14-64 years old

in the 5-percent sample. Other items scheduled

for the 5-percent sample are whether married

more than once, date of first marriage, whether

first marriage ended because of death of the

husband (or wife), occupation- industry 5 years

ago, citizenship, vocational training completed,

and year of immigration of foreign-born persons.

(See appendix 1.)

Among the new housing items tentatively

scheduled for the 100-percent sample is one concerning the presence of “complete kitchen faciliries.lt There are related questions in the proposed

5-percent sample about washing machines, dishwashers, and ownership of a “second home. ”

These and other housing items might be of value

in relating health conditions to housing. They

also provide some measure of the level of living.

Special Vital and Health Statistics

Tabulations

In general, the special relevance of the 1970

census for vital statistics consists not so much

in new items as in greater provision for small

area detail. Systematic sets of tabulations on

counties, census tracts, and other small areas will

probably be made and published for each State.

It is likely that some unpublished tabulations

will also be available, for the cost of reproduction.

Other tabulations may be available at the costs

involved in getting them produced. Those who

wish population bases or denominators for studies

of vital events for small areas, for special

population groups, or for specific subdivisions

of the population should communicate with the

Census Bureau’ and inquire about the possibility

of securing appropriate population bases from

the 1970 census. In some cases it is possible that

complete tabulations of the desired detail will be

published. In other cases, the Census Bureau may

suggest that the consumer modify the detail in

the numerators in order to accommodate them to

the available denominators. In still other cases,

other arrangements or compromises may be

indicated.

Whatever the final nSture of the tabulations,

the 1970 census probably will produce a greater

volume of small area data at an earlier date

than any previous census. The availability of

these data presents an excellent opportunity

for those who are responsible for vital records

systems to produce complementary data necessary for health planning, demography, and general

social research. For many States and cities this

will require expanded place coding of vital

events. Tabulations for places above 2,500 population and balance of county will not be adequate.

Tabulations should be extended at least to villages beyond a certain size (perhaps 500 or more

population). For areas that are census- tracted,

births, deaths, marriages, and divorces should

be tabulated from vital records by census tract

for 1969-71. This is of particular value for programs focusing on poverty areas. Vital records

systems can provide data quickly for these areas

and reduce the need for more time-consuming

special surveys. This is of special importance

to persons primarily interested in action programs.

For small areas of low population density

the number of events is likely to be too small to

calculate meaningful rates, but small areas can

be combined to provide regional data that are

more sensitive to a particular need. The current

stress in public health on local, regional, and

comprehensive health planning and on the delivery of services emphasizes the need for such

small area data.

The 1970 census should provide more and

better data for small areas as early as late 1970.

aDr. Henry S. ‘Shryock and Dr. Paul C. Gtick of the Population Division, Bureau of the Census, were consultants to

the “Study Group. Inquiries regarding data availability may be

directed to either of them.
In particular, the Bureau of the Census has given

much attention to improving poverty area data. If

vital statistics show similar improvement, maximum benefits can be obtained in combining data

from the two sources.

Because of the small frequency problem it

may generally be impractical to tabulate mortality

for small areas by detailed cause, but this does

not preclude the use of a few major causes such

as heart disease, cancer, stroke, accidents, and

all other causes; or the system used in Alaska

which groups deaths into four broad classifications: Preventable-those causes which show a

rapid decline with concerted medical and public

health attention; Violent --accidents, suicides,

homicide and alcoholism; Chronic and Old Age—

those deaths for which the age- specific rate rises

very rapidly with advancing age; and All Othw

Causes. 3

Such cause groupings along with perinatal

and infant death data should also be tabulated by

race or color for small areas having appreciable

nonwhite populations. If rates become too variable

for comparative analysis it may be advisable to

combine areas or to extend the analysis to 3

years centered on the census year. Birth and

death data by race or color should also be

tabulated to show patterns of hospital usc and to

determine whether births and deaths are concentrated according to color in particular hospitals

serving an area. Similarly, studies can be conducted on relative proportion of births occurring

in hospitals, attendance at birth by a physician,

prenatal care, prematurity, cause of death, and a

number of other topics.

Demographers have long recognized the

value of census and vital statistics data in combination. If a vital records system provides birth

and death data for small areas within a State, it

becomes possible to determine natural increase

or decrease for the area, and it becomes more

feasible to attempt population estimates and

projections for individual or, at least, for grouped

areas. When such data are available from two

successive decennial censuses, imputed net migration can also be calculated for the decade by

combining data from the two sources.

The introduction of the new standard birth

certificate provides additional opportunities for

demographic research, particularly in combination with census data. The new standard birth

certificate, adopted as of January 1968, contains

a question on education of mother and father

with response categories that conform to census

population groupings. Education is a variable of

great interest to demographers in fertility research. For a large segment of the national

population and for population subgroups, it will

become possible to calculate fertility rates on an

annual basis by education, thus supplementing the

data by education on the number of children ever

born which is available from the census. Possibly special arrangements for tabulations of all

women and married women of childbearing age

by age and educational attainment will be needed

if age-specific birth rates by educational attainment are to be computed for the 36 States which

have this item on their birth certificates.

Tabulations by States

The State health offices vary greatly in the

extent to which they have planned special studies

during the census period. Replies to a brief inquiry sent to the State offices indicated a range

from virtually no plan to very extensive plans,

For instance, extensive plans for special studies

are being made by Robert Dyar in California,

Franklin D. Yoder and Clyde A. Bridger in

Illinois, Robert A. Calhoun in Indiana, Sandra

H. Kinch in New York State and Carl L. Erhardt

in New York City, Glenn A. Flinchum in North

Carolina, R. H. Hutcheson and Ann Dillon in

Tennessee, Donald J. Davids in Colorado, Marian

M. Colby in -New Hampshire, Raymond D.

Nashold in Wisconsin, and Margaret E, Rice

in Mississippi.

Dr. Dyar~s description of California’s previous experience may be chosen as an example

I!For earlier census years of extensive activity:

we have calculated all vital rates for the State

in great detail; cause-specific rates, rates by

race, etc. For 1959-61 deaths, a study of occupational mortality by county is still underway,

for which unpublished denominator data were

purchased from the [Bureau of the] Census.

“In addition, life tables, on a State and

county basis, by single years of age as well as

five-year groups have been developed for each

census year. ”

4
Dr. Dyaw’s suggestions of needs for the

future are also of interest: IIFor comprehensive

health planning there are several kinds of areas

for which data for planning are needed. These

are: cities of 100,000 or more; counties; regions—

i.e., groupings of counties; metropolitan areas;

urban areas; central cities; cities of areas with

concentrations of Negro and Spanish American

populations; and areas where unusual poverty

exists. These are needed both to describe populations of concern as well as for denominator use.

!!In addition there is hlCr&lShIg illtelXXt in

data for subparts of counties, e.g., tracts, groups

of tracts, and health districts. We know of at

least eleven local health departments which

tabulate at least part of their data by census

tract on an ongoing basis;

“In order to fulfill our program needs we

are hoping for additional types of data than those

which were available in 1960.”

Dr. Dyar lists as examples of specific

tabulations needed for California:

a. Data on each of the nonwhite groups

separately--down to city and county level.

b. More cross-classifications of race with

socioeconomic variables, especially for areas

involved in antipoverty programs.

c. Place of work versus place of residence

is needed for occupational health studies.

d. Separation of public and private water

systems.

e. Additional data which would be useful

include:

1.

2.

3.

4.

5.

6.

7.

8,

Manpower in relation to education and

occupation.

Per capita income.

Ethnicity.

Historical changes of census tract boundaries.

More cross-tabulations by income, education. and age, by county.

Data related to family planning and patterns of living, e.g., number of children

by age of mother, women working by

age, place of birth by age.

Place ot migration in relation to socioeconomic variables.

Address coding guides

the State as possible.

for as much of

Most of the census-related studies described

above by Dr. Dyar were also mentioned by respondents from other States. Several additional

comments by others are of interest. Dr. Calhoun

of Indiana stated: “Perhaps one of our most important activities was the organization of the

Indiana Census - Vital Statistics Committee in

1960. This group consisted of membership essentially from the State Board of Health and”

State Universities . . . . This group met on a

quarterly basis from 1960 through 1962 and we

plan to reactivate it next year.”

Dr. Erhardt of New York City stated: “In

1950, we embarked on some studies of vital

statistics utilizing health areas ranked by economic status (an index number) for analysis of

data. We should like to pursue this idea further

when 1970 population data become available.

This need would require that we have population

and family characteristics by health area and

comparable accumulative data for health districts

for 1970. We hope that the Bureau of the Census

can be prevailed upon to produce these materials

and to publish them for New York City in addition

to census tract data which are very costly for us

to use in the manner described.”

Mr. Davids of Colorado stated: “We will use

the age and sex data for age- and sex- specific and

adjusted rates. There is demand for fertility rates

and both natality and mortality data by socioeconomic status by census tract and county as

well as by State; much of our data will be analyz’ed

by socioeconomic status and census tract, especially for the Denver Metropolitan area. Also

there will be demand for vital statistics data by

race and [for persons of] Spanish surname and

census data will provide the denominators for

these data.”

Mrs. Colby of New Hampshire said: “We

plan to use the 1970 data in preparing all of our

vital statistics rates and the data will be invaluable for use in the regional medical programs

and in supporting programs concerned with comprehensive health planning.”

From Florida came a report by Mr. Oliver

H. Boorde: “We also use the decennial census

data to adjust inter- censal crude birth rates,

crude death rates, age- race- sex-cause specific

death rates, and birth rates by age of mother for

State and counties, which are initially based on

population estimates.

5
“In addition to the above, for 1970 we plan

to compute age-adjusted birth rates and total

and cause- specific death rates for this State and

counties. These latter computations are now

practical because of the added capability provided

by the 1401 computer which has been installed

since the 1960 Census.”

Finally, a paragraph from E. L. Wittenborn

and Mr. Bridger of Illinois may be noted: “What

we specifically need from the 1970 census is

summarized in this excerpt from our 1963

Annual Report: ‘The principal population characteristics needed in public health planning are

age, sex, color, education and income. In addition, occupation, industry and marital status

are needed for some programs. Data on income

cross-classified by education, age, sex, and

color are generally not available in sufficient

detail for effective planning. The presence in

Illinois of nearly a million persons 65 years of

age and over, many of them widows with small

income, and the presence of nearly a million

nonwhite persons, many of them with educational

attainments too 10-wto compete effectively in the

labor market, underscore the problems in just

two of the many areas where health programs

must be tailored to fit the needs.’”

Tabulations by NCHS

The National Center for Health Statistics

has frequently conducted various types of special

studies during the census year or period. For

example, in 1960 it cooperated with the University

of Chicago and the Bureau of the Census in

planning the matching of death certificates with

census data for the deceased persons. The Center

assumed responsibility for the detailed mortality

tabulations and special tabulations of divorce for

the census period 1959-61 for the American Public

Health Association (APHA) Vitul and Health Statistics Mongvaphs. NCHS also made some special

mortality tabulations for the Public Health Service, and it prepared the decennial life tables for

1959-61. The birth registration tests of the 2

previous census years were not repeated, but the

Center began a matching of death and birth certificates for infants born in 1960 for a study of infant

mortality.

The Study Group has made a number of

recommendations

6

to the Center concerning special

tabulations and studies that should be made, taking

special advantage of opportunities offered by the

1970 census. Some of these recommendations

have already been adopted by NCHS. For example,

the Study Group recommended that NCHSprepare

life tables for the Nation and for the States for

the period 1969-71, in the same detail as used in

the 1959-61 census period. The Division of Vital

Statistics has already made plans to implement

this recommendation.

The Study Group also recommended a comparison of causes of death as classified by the

Seventh and Eighth Revisions of the Intonational

Classification of Diseases. Such a comparison,

similar to one carried out in 1950, is urgently

needed because of changes in the Eighth Revision.

The Division of Vital Statistics has already completed a preliminary investigation of the comparability of the two revisions based on a sample

of deaths. The results of this studywere reported

in a recent issue of the Monthly Vital Statistics

Repovt. 4 The Division expects to conduct a more

detailed study of the comparability of the two

revisions in the future.

Mortality rates, age-specific and age-adjusted, from the total of all causes and from selected specific causes by sex and race for the

United States, geographic regions, and States

should be calculated for the census period 1969-

71. Tables of this type were made for 1949-51

and are of great value to the States.

Since marriage and divorce data, especially

the latter, need improvement in coverage, advantage should be taken of the census period to

demonstrate the potential value of these data.

Studies of marriages and divorces for States in

the registration areas, specific for color, age,

and education should be made. Cooperation between the Center and the Bureau of the Census was

important in producing the APHA monograph on

marriage and divorce based on the 1960 census

period; further cooperation of this kind is to be

encouraged.

Likewise, continued cooperation of these two

agencies for the collection and utilization of

natality and fertility data is desirable. Fertility

rates by color, age, and education should be

computed for all women and for married women

for the United States, regions, and States. Again, a

pattern for this type of cooperation was set by the

APHA Monograph Series.
Some type of repetition of the APHA Vital

and Health Statistics Monographs is recommended. It is not necessarily advisable that the

exact format be duplicated. For example, the detailed analyses of 12 separate causes of death

might be postponed for another decade. Also,

some other method of funding and recruitment of

authors might be considered. However, in view

of the rapid changes taking place in marriage,

fertility, and in morbidity and mortality from

Wrtain causes, it would seem well to have a series

of at least a half dozen monographs on vital and

health statistics based upon the 1970 census

period.

Matching Studies

The Kitagawa-Hauser study (discussed in

some detail in appendix II) has demonstrated that

a valid analysis of mortality differentials can be

carried out from a carefully planned and executed

matching operation of death and census records.

However, such a matching operation is lengthy

and es~ensive, particularly in view of the sampling

design of the census. The analysis must await

the matching operation; thus the results are not

available to users of the data until an even later

date.

New techniques for matching records by computer have been designed by the Bureau of the

Census and are described in “Data Access

Descriptions. ft~ These techniques hold promise

of si~mificantly reducing the time and cost of

such operations. Although the method described

will not in itself yield all of the detail desired in

a study of mortality differentials, it should be

explored as an aid in such studies.

The inclusion of the Social Security Number

in the census for persons 14 years and older would

assist the matching operation for deaths in that

population, However, it has been decided not to

include the Social Security Number in the 1970

census. Some of the States added the Social

Security Number of the mother to the revised

birth certificate and of the bride and groom to

the revised marriage certificate for use in

matching records for analysis. These studies are

encouraged.

Results of matching studies, such as the

Kitagawa-Hauser Study, are of great interest

and value to the States. It is recommended that

they be distributed to the State health departments by the National Center for Health Statistics if not by the contract agency.

Although a nationwide birth registration test

similar to those of 1940 and 1950 is not recommended, such a test for nonwhite births would

be advisable in the 1970 census period. However,

in lieu of a full birth registration test during the

census period, it has been decided to conduct a

limited test in 1969 in conjunction with the Current Population Survey. It is planned to sample an

equal number of births in the white and nonwhite

population, thus effect ively oversampling the

nonwhite population.

Gaps in Uniformity of Definitions

There are a few differences in definitions

between the National Center for Health Statistics

and the Bureau of the Census; these should be

eliminated as soon as possible. There are troublesome differences relating to the assignment of

residence of military personnel, crews of vessels

of the U.S. Navy and Merchant Marine, and inmates of institutions. Another area of inconsistency relates to assignment of residence of

students of colleges and prep schools. (For a

more detailed discussion, see appendix III.) A

third inconsistency is the assignment of marital

status to persons whose only marriage was

annulled; these persons are regarded by the

Bureau of the Census in the strict legal sense as

never married, but they are combined with the

divorced in vital statistics. This is a minor inconsistency which will probably become even

less of a problem now that New York has relaxed

its divorce laws, and annulments there are expected to decline.

The Bureau of the Census maintains a strict

urban-rural dichotomy, but the National Center

for Health Statistics does not. The Study Group

suggests that attention be given to the possibility

of having the geographic-area coding specify

whether an address outside incorporated limits

is urban or rural. Vital statistics data continue to

be available for individual cities and other urban

places of 10,000 or more population. (For more

detail, see appendix 111.)

7
Endorsement of C~mprehensive Approach

Finally, in addition to the several specific

recommendations given in this report, the Study

Group wishes to endorse enthusiastically the

related recommendations of the Subcommittee

on Migration and Health of the National Committee

on Vital and Health Statistics. The Subcommittee,

under the Chairmanship of Dr. Irene B. Taeuber,

has pointed up the need for an integrated and

comprehensive approach to the many critical

questions of population dynamics in relation to

health. Emphasizing that States are the collection

agencies for registration data and that some of

the States collect materials beyond those required

for membership in the registration area, the

Subcommittee urged the States to take advantage oi

the census period to develop the full potential oi

their data. It also urged that States be amply

represented in any planning for a comprehensive

approach on a national basis. As a result of the

Subcommittee’s report, “the Executive Secretary

of the National Committee on Vital and Health

Statistics was directed to prepare a memorandum

to the Surgeon General describing the proposed

program of special activities in relation to 1970

data and proposing that he ask the Bureau of the

Census, the National Center for Health Statistics,

and the National Institutes of Health to form a

group to plan and carry out these activities.”6

Work has begun on this activity and plans are

being developed for a monograph series.

REFERENCES

lEckler, A. R.: Planning the 1970 Censuses to Meet “State

and Local Needs. Paper delivered at the Conference of the

Association of ‘State Planning and Development Agencies.

Washington, D.C. March 29, 1967. Unpublished.

2Population Division, U.’S, Bureau of the Census: Personal communication to Dr. Clyde V. Kker, May 3,1968.

3Bran~h Of’statistical “Services: Alaska’s vital StatistiC.Q,

Alaska State Department of Health and Welfare, Juneau,

Alaska, 1966. pp. 3, 45.

‘%ational Center for Health Statistics: Monthly Vr%atStatistics f?,eport, Vol. 17, No. 8, ‘Supplement. Public Health

‘Service. Washington. U.S. Government Printing Office, Oct.

1968.

5U.’S. Bureau of the Census: Matching ‘Studies ‘Series.

MS- 1. Washington. U.S. Government Printing Office, March

1967.

6U.S; National Committee on Health and ‘Vital ‘Statistics:

Minutes of meeting, March 7-8, 1968. Washington, D.C. p. 6.

‘7.U.S. Bureau of the Censue: Current Population Reports,

Speciat Ceneuses. ‘Series P-28, No. 1459. Washington. U.S.

Government Printing Office, Dec. 1967.

‘Guralnick, L., and Nam, C. B.: Censue-NOVS etudy of

death certificates matched to Census records. Mizbank .Mem.

Fund Qua~t. XXXVII(2), April 1959.

‘Kitagawa, E. M., and Hauser, P. M.: Methods used in a

current study of social and economic differentials in mortality.

Emerging Tech_niques,in Population Research. Milbank Memorial Fund. New York, 1963.

10Kitagawa, E. M., and Hauser, P. M.: Education and Income Differentials in Mortality, United States, 1960. Paper

delivered at 1966 annual meeting of the Population Association of America. Revised, March 1967.

Ilsirken, M. G., and Brown, M. L.: Quality of data elicited by successive mailings ‘in mail surveys. Proceedings q]

the Sociat Statistics. Section, 1962. American ‘Statistical Ak.

sociation. Washington, D. C., 1963. p. 120.

12U.S. Bureau of the Ceneus: U.S. Cenwe of Poprdation,

1960, DetaiZed Population Characteristic, United State8 Sum.

maq. Final Report P C(l)-1 D, Introduction. Washington. U.”S

Government Printing Office, 196%

13National Center for Health Statistics: FuneraZ Directors’

Handbook on Death and Fetat Death Registration. Public(

Health ‘Service. Washington. U.S. Government Printing Office,

1967.

l?National Center for Health Statistics: Vital Statistics o ~

the U.S. 1960, Vol. I, Natality, Technical Appendix. Publif!

Health ‘Service. Washington. U.”S. Government Printing Office,

1962.

l~ational Center for Health ‘Statistics: Vitaz stat~stiu$ of

the U.S. 1964, Vol. I, Natality, Technical Appendix. Publi ~

Health Service. Washington, U.S. Government Printing Office,

1966.
APPENDIX I

PROBABLE NEW ITEMS IN THE 1970 CENSUS AND THEIR RELATION TO

PUBLIC HEALTH STATISTICS

NEW ITEMS

In planning content for the 1970 census, the Bureau

of the Census made intensive efforts to obtain suggestions and comments for new items for inclusion in the

census schedule.

From among the many elicited, only a limited

number could be chosen. Among criteria for selection

of an item were:

It must be in the broad public interest.

It must not be too complex or too personal.

It must be appropriate for the large scale coverage implicit in the census rather than for a national sample survey.

The entire schedule must fall within the limits of

available resources and not impose an unreasonable burden on the respondent.

The final schedule of items for 1970 does not

differ strikingly from the 1960 items. The dominant

theme in 1970 is greater exploration of existing

subjects and provision of additional data for small

arw.s.

New material includes:

Population Items

Activity 5 years ago------------------

Occupation-industry 5 years ago-------

Citizenship --------------------------

Year of immigration -----------------

Vocational training completed ---------

Presence and duration of disability ----

Parts of the following questions:

Income lastyear ---------------------

(Self- employment income was a single

item in 1%0; in 1970 there will be a two

way separation by farm-nonfarm income. “Other income” was a single

itcm in 1960; in 1970, there will be a

3-way separation of this item—by Soc ia 1 Sccurit y, public welfare, and all

other sources. )

Sample Rate

Percent

25

5

5

5

5

5

25

Housing Items

Number of units at this address ------- 100

Complete kitchen facilities ----- ------ 100

Second home ------------------------ 5

Dishwasher ------------------- ------ 5

Parts of the following questions have been changed also:

Native language

Marital history

The Social Security Number, proposed to facilitate

matching studies, was finally eliminated because of

great concern for protection of the confidentiality aspects of the census.

The new items on activity (working, attending

college, and/or serving in the Army) and occupationindustry 5 years ago may provide useful data for health

activities. The year of immigration may be helpful

in estimating the migration component of the population.

The presence and duration of disability will provide

a useful measure of this serious health, and economic

problem in the general population. At present the incidence of disability is one of the many health unknowns.

In general, however, most of the new items finally

selected do not provide very much useful new material

for public health statistics.

,

RESULTS OF

THE NEW HAVEN PRETEST

At the present time data from the New Haven pretest are not available in a single document. (Statistics

on the color and sex of the population of the SMSA and

its central City of New Haven were published as a

regular report.)7 Some of the highlights were presented by David Kaplan (1970 Census Coordinator,

Bureau of the Census) at the 1967 American Statistical

Association meeting. They are abstracted below:

Field Office Operations

“The essential purpose of the New Haven pretest

was to refine further the mail-out/mail-back system

which will be used for the collection of information

from a majority of the population in 1970. . . . The

9
New Haven experience emphasized very forcefully

that the regional staff must be prepared for close and

frequent contact with the local office and that our

staffing and budgetary plans should be adjusted accordingly. . . .

“The New Haven experience showed that the

administrative complexities of the centralized technique

used for handling the mail returns outweighed its

anticipated advantages except in very large local

offices . . . . Plans for 1970 now call for the centralized

New Haven-type of mail census to be used in only

about 40 of the largest offices and the decentralized

Louisville-type approach to be used in the remaining

150 or so mail census offices . . . .

Mailing List for Rural Areas

t!

. . . the mailing addresses for rural areas were

obtained through a special listing by the rural carriers.

One of the objectives of the New Haven test was to

help determine whether this approach was more desirable than having census employees do a special

canvas s.... The New Haven experience confirmed the

growing belief that using census employees would be

more desirable. There are a number of important

advantages in using the letter carrier but they are

outweighed by such difficulties as relating carrier

routes to census areas and the administrative complexities of interrelating the operations . . . .

Subiect Content

11. . .an expanded [questionnaire] approach was taken

to try to meet the demands of census users. On the 25

percent questionnaire were added social security number, vocational training, college degree, marital history, a considerably expanded set of income questions,

employment activity five years ago, and facilities included in rent . . ..

“As a result of the New Haven experience and

certain associated factors, the content of the longform questionnaire now planned for 1970 has been

reduced so that its scope is only slightly greater

than the 1960 level. For example, social security

number and facilities included in rent were dropped,

and the expansion in income detail cut back. However, to accommodate the most pressing demands

for information on additional subjects, the 25-percent sample has been split into two panels: 20 percent and 5 percent. . . . This technique adds to

operational complexities and does not permit crosstabulation between the 20-percent and 5-percent items.

But it does allow us to cover more subjects without adding to the burden on the respondent, an issue

which the New Haven experience indicated might

become a serious obstacle in conducting a successful 1970 census . . . .

Coverage Improvement

“The findings of two coverage-improvement experiments performed in New Haven can be reported at

this time, although further analyses are still being

made.

“One technique involves the use of lists of tmmes

of people who appear to have an above-average chance

of being missed . . . . the checklist technique appears to

be a costly and time-consuming operation for the small

amount of coverage improvement it actually yields.

“Another coverage- improvement procedure tried

out operationally fcm the first time in New Haven (after

some evaluative experiments in Louisville and Cleveland) involved the use of the post office change-ofaddress cards. . . . The impact on the population count

was an increase of ahcmt 0.2 percent. . . . However, the

operation is a complex and costly one, and there are

a number of technical questions about the validity of

the procedure. An intensive review of this procedure

is being undertaken to determine whether it should

be utilized in 1970 if the funds are available.”

These tests incorporate the experience of the

New Haven pretest.

1968 “DRESS REHEARSALS”

The “dress rehearsal” program for the 1970 census included three test censuses conducted during 1968

in Dane County, Wisconsin (the Madison SMSA); Trenton City, New Jersey; and Chesterfield and Sumter

Counties, South Carolina. The first two dress rehearsals utilized the mail-out/mail-back procedure

with addresses maintained in an address register.

Under one mail-out/mail-back procedure, edit and

followup was decentralized; that is, enumerators

working from their homes edited questionnaires and

followed up for incomplete information and nonresponse. In the centralized mail-out/mail-back procedure office personnel edited and followed up for

incomplete information. Enumerators were responsible

only for visiting households from which a questionnaire was not received or where a personal visit

followup was necessary to collect additional information.

The third dress rehearsal utilized “conventional”

enumeration procedures in which a short-form questiomaire was left at each household prior to census

day. The respondent was asked to complete the form

and hold it until the enumerator’s visit. At that time,

the enumerator either picked up the completed questionnaire or, if necessary, completed one. At every

fourth household, the enumerator conducted a longform interview. (Four out of every five sample households were enumerated on the 20-percent schedule; one

out of every five sample households was enumerated

on the 5-percent schedule.) By this means the Bureau

of the Census hopes to obtain more extensive data

without making the questionnaire any longer.

10 ooo —
APPENDIX II

REVIEW OF 1960 MATCHING STUDY OF DEATHS AND CENSUS RECORDS

(Kitagawa-Hauser Study)

Nationwide information on mortality differentials

by important social and economic characteristics has

been restricted, due to the limited information contained on death certificates. In addition, the occupation

item which formerly appeared on the death certificate

did not correspond by definition with that item as

collected on census records, thus the usefulness of

the occupation item for analysis was limited. There

are other items subject to lack of correspondence

or to difficulty in matching the death-certificate information to the proper census classification, for example,

residence and allocation of address as urban or rural.

In order to assess the possibility of circumventing

these difficulties by matching death certificates with

the corresponding census records, a pilot study was

carried out in Memphis, Tennessee at the time of a

special census as of January 31, 1958. This study 8

yielded a match rate of 83 percent. It was concluded

that a large-scale study of mortality according to

characteristics of the decedent as given in the census

enumeration record was feasible, provided the study

design included a means for estimating the characteristics of the unmatched decedents.

Accordingly, plans were made for such a study

following the 1960 census. The study is being conducted

through the Population Research and Training Center

of the University of Chicago with the cooperation

of the National Vital Statistics Division (currently

the Division of Vital Statistics of the National Center

for Health Statistics) and the Bureau of the Census.

Following is a brief review of the study and preliminary results as taken from two published papors. !’,lo

Deaths Included in Study

Those occurring May-August, 1960, selected by

;lge and race as follows:

White: All decedents under 65 years of age

50 percent of those 65-74 years of age

20 percent of those 75 years and older

Nonwhite: All decedents regardless of age

Clf the 536,000 deaths which occurred during the

4 months of May-August, 1960, some 340,000 were

included in the study and searched in the 1960 census

records,

Matching of Deaths to Correspanding Census

Retards

The matching operation was conducted in two

stages.

Stuge I (100-pwcent enumeration). —The deaths

were searched in these records using Census Enumeration District codes assigned to addresses listed on the

death certificates to guide the search. Of the 340,000

records, 263,000 or 77 percent were matched. The

percentage of match failures varied by race with

about 30 percent for nonwhite and about 20 percent for

white. Also, the percentage of failures was slightly

higher for males than for females in bath white and

nonwhite deaths.

Stage II (zS-percent sample). —’. he decedents that

were matched in Stage I and codt 1 on the census

records as in the 25-percent sample w re then searched

in those records. This sample conta .ned more of the

socioeconomic data collected in the census. Of the

263,000 decedents matched in Stage 1, 62,400 were

located in the 25- percent sample. This was some

2,000 less than expected.

The matching procedures were completed during

the summer of 1962 and produced four sets of data:

A deck of 263,000 mortality punchcards to which data

from the 100-percent census enumeration records were

added.

A magnetic tape duplicating census data from the 25-

percent sample for the 62,400 decedents located in the

sample.

A magnetic tape collating selected data from the above

tape and from the mortality punchcards for the 62,400

decedents.

A deck of 77,000 unmatched mortality punchcards to

which census urban-rural geographic codes had been

assigned.

Special Sample Survey

This survey was designed to provide information

on the social and economic characteristics of a sample

of the unmatched decedents. A sample of 9,500 decedents was selected at random from the Current Mortality

11
Sample for the same months as the study, May-August,

1960. Questionnaires containing items similar to those

in the cens,us, requesting information regarding the

decedent, his family and the household, were sent to

informants listed on the death certificate. The survey

was initiated in the summer of 1960 and completed

in June 1961. Thus, the survey was carried out on

a sample of all deaths included in the Study, both

matched and unmatched.

The response rate was 88 percent from the mail

survey and increased to 94 percent after followup by

personal interview. There were higher response rates

for the questionnaires concerning white decedents and

female decedents than for those concerning nonwhite

decedents and male decedents.

Reporting of various items on the questionnaire

was not uniform. For decedents 25 years and older,

the education item was completed on 82 percent of the

questionnaires returned; family status of the decedent

was indicated on 93 percent of the questionnaires; and

some information on family income was reported for

96 percent of the decedents who were classified as

family members. In each instance the item completion

was higher for white decedents than for nonwhite

decedents. The apparently high response for family

income was tempered by further analysis which indicated that the income section of the questionnaire

was “least often adequately completed. ” 11

Measures of “match bias” showed that the proportions of decedents whose death records were not

matched with census records were substantially higher

for those 25-44 years of age than for older persons.

Men with low family incomes tended to have high “nonmatch” rates. For women, the proportion not matched

was higher for those with less education, particularly

after age 65. The wide variation found in nonmatch rates

substantiated the need to estimate the social and

economic characteristics of unmatched decedents in

order to measure mortality differentials by such

characteristics.

The sample survey produced the following sets of

data: For matched decedents, data from death certificates, census records, and survey questionnaires; and

for unmatched decedents, data from death certificates

with census geographic codes and survey questionnaires.

In addition to providing a basis for estimating the

social and economic characteristics of the unmatched

decedents, the survey allows comparison of response

to the same questions on census and survey questionnaires for the matched decedents. Thus, some evaluation of the adequacy of the survey data as a substitute

for census data will be available.

Analysis of Data

The matched deaths will be inflated to “total deaths

in 1960” by use of ratio-estimation procedures controlled for color, sex, age, cause of death, and geographic area. This will tend to minimize the sampling

variance.

Mortality measures based on tabulations of matched

deaths will be adjusted for two sources of bias: the

social and economic characteristics of the unmatched

decedents and the seasonality of the deaths included

in the study.

Mortality differentials will be determined on the

basis of age-adjusted measures, using indirectly

standardized mortality ratios. Separate analyses are

planned for three age groups, 25-44 years, 45-64 years,

and 65 years and over.

Results of Analys~s— Education and Income

Differentials

Estimates of white mortality differentials by education and family income as reported in the second

of the two papers are summarized as follows:

Education and income were inversely related to mortality in the white population.

Education differentials in mortality were larger than

income differentials for women, but the opposite appeared true for men.

Both income and education differentials were much

greater prior to age 65 than after age 65.

In the judgment of the authors, in this country in 1960,

education differentials were better than income differentials as indicators of socioeconomic differentials

in mortality.

Estimates in the process of preparation for the

white population include the following factors:

Major occupation groups (males)

Marital status (population 25 years and older)

Nativity and parentage

Country of origin (for foreign stock)

Number of children ever born (for ever-married

women)

Separate estimates for the nonwhite population

will be made insofar as the quantity and quality of the

data permit.

limitations of the Study Data for Analysis

Incompleteness of the data, both in matching the

two sets of records and in the data contained on the

records, poses problems. The special sample survey

compensated for some of these difficulties, but not

for all of them.

The sampling design of the 1960 census, in whicl

most of the social and economic data were collectec

on a 25-percent sample basis, depleted greatly the

number of records available for analysis in certair

categories, There was no way to compensate for this

The restricted time period from which the deatk

records were taken also required adjustment of tht!

data.

12 —000
APPENDIX Ill

GAPS IN UNIFORMITY IN CENSUS AND REGISTRATION DEFINITIONS

AND PROCEDURES

CENSUS-(1960)12

Place of Residence

Mllitavy.-Persons in the Armed Forces quartered

on military installations were enumerated as residents

of the States, counties, and minor civil divisions in

which their installations were located. Members of their

families were enumerated where they actually resided.

The crews of vessels of the U.S. Navy and the American

Merchant Marines in harbors of the United States were

counted as part of the population of the ports in which

their vessels were berthed on April 1, 1960.

Institution. -Inmates of institutions, who ordinarily

live there for long periods of time, were counted as

inhabitants of the place in which the institution was

located,

Type of Residence

Urban definition, 1960.—The urban population

comprises all persons living in (a) places of 2,500

inhabitants or more incorporated as cities, boroughs,

villages, and towns (except towns in New England, New

York, and Wisconsin); (b) the densely settled urban

fringe, whether incorporated or unincorporated, of

urbanized areas; (c) towns in New England and townships in New Jersey and Pennsylvania which contain

no incorporated municipalities as subdivisions and have

either 25,000 inhabitants or more or a population of

2,500 to 25,000 and a density of 1,500 persons or more

per square mile; (d) counties in States other than the

New England States, New Jersey, and Pennsylvania

thot have no incorporated municipalities within their

boundaries and have a density of 1,500 persons or

more per square mile; and (e) unincorporated places

of 2,500 inhabitants or more. The Bureau of the

Census delineated boundaries for unincorporated places.

Rural definition, 1960. —The population not classified as urban constitutes the rural population.

Marital Status

Data on marital status were based on replies to

the question, “Is this person married, widowed, divorced, separated, or single (never married)?” Persons classified as “married” comprised, therefore,

both those who had been married only once and those

who had remarried after having been widowed or

divorced. Persons reported as separated (either legally

separated or otherwise absent from the spouse because of marital discord) were classified as a subcategory of married persons. The enumerators were

instructed to report persons in common-law marriages

as married and persons whose only marriage had been

annulled as single.

NATIONAL CENTER FOR HEALTH STATISTICS

Place of Residence13

The item showing length of stay was deleted from

the Standard Certificate of Death in January 1968.

The Funeral Divectovs’ Handbook on Death and Fetal

Death Re@”styation Specifies that “Residence of the

deceased is the place where he or she usually slept.

This is not necessarily the same as ‘Home State,’

‘Voting Residence,’ or ‘Legal Residence.’ Never enter

a temporary residence such as one used during a

visit, business trip, or a vacation. Place of residence during a tour of military duty or during attendance at college is not considered as temporary.

If deceased lived in a hospital, sanatorium, nursingconvalescent home, or other institution at the time of

death, the place of residence before admission is reported. If deceased is a child, residence is given as

that of the mother, legal guardian, or custodian. ”

Although the above rules were first published in

1968, they have been in effect since 1961.

13
Type of Reside nce14,15

Wran definition, 1960-1963.—Consists of inb.abitantsresidingin the following places: Eachincorporated

city, borough, village, and town of 2,500 inhabitants

or more (except towns in New England, New York, and

Wisconsin). Each town in New England and each township in New Jersey and Pennsylvania that had no incorporated municipality as a subdivision and had

either 25,000 inhabitants or more, or a population of

2,500 to 25,000 and a density of 1,500 persons or more

per square mile. Each county, in States other than the

New England States, New Jersey, and Pemsylvania,

that had no incorporated municipality within its lmundary and had a density of 1,500 persons or more per

square mile.

Urban definition, 1964.—Changes made in 1964

eliminate the classification of vital statistics into ‘‘urban” and “rural” categories. Vital statistics are now

classified into population-size groups. Begiming in

1964, the group of cities and other urban places of 2,500

to 10,000 population has not been separately identified,

but has been included with areas formerly classified

as rural. Data are still available for the individual

cities and other urban places of 10,000 population or

more.

Urban places other than incorporated cities for

which vital statistics data are still shown include: Each

town in New England and each township in New Jersey

and Pennsylvania that had no incorporated municipality

as a subdivision and had either 25,000 inhabitants or

more, or a population of 10,000 to 25,000 and a density

of 1,500 persons or more per square mile. Each county,

in States other than the New England States, New Jersey, and Pennsylvania, that had no incorporated municipality within its boundary and had a density of 1,500

persons or more-per square mile. (Arlington County,

Virginia is the only county classified as urban under

this rule.)

Ruval definition. —Consists of inhabitants residing

in places not classified as urban.

Marital Status12

Enter the marital status of the deceased at time

of death. Specify one of the following: married, never

married, widowed, or divorced.

—000

f? U. S. GOVERNMENT PRINTING OFFICE: 1969—342047146

14
OUTLINE OF REPORT SERIES FOR VITAL AND HEALTH STATISTICS

Public Health Service Publication No. 1000

SeYies 1.

Series 2.

Series 3.

SeVies 4.

Se)’ies 10.

Sevies 11.

~

Sevies 12.

Series 13.

Series 14.

SeTies 20.

Sevies 21.

SeVies 22.

Prog~ams and collection pvocedures.— 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.

Data evaluation and methods reseaych. —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.

Analytical studies. —Reports presenting analytical or interpretive studies based on vital and health

statistics, carrying the analysis further than the expository types of reports in the other series.

Documents and committee reports. — 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.

Data f~om the Health lntevview Suvvey. —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.

Data from the Health Examination Survey .- Data from direct examination, testing, and measurement of national samples of the population provide the basis for two types of reports: (1) estimates

of the medically defined prevalence of specific diseases in the United States and tbe distributions of

the population with respect to physical, physiological, and psychological characteristics; and (2)

.malysis of relationships among the various measurements without reference to an explicit finite

universe of persons.

Data fvom the Institutional Population .%vveys. — Statistics relating to the health characteristics of

persons in institutions, and on medical, nursing, and personal care received, based on national

samples of establishments providing these services and samples of the residents or patients.

Data fvom the Hospital Discha?ge Survey. —Statistics relating to discharged patients in short-stay

hospitals, based on a sample of patient records in a national sample of hospitals.

Data on health vesources: manpower and facilities.—Statistics on the numbers, geographic distribution, and characteristics of health resources including physicians, dentists, nurses, other health

manpower occupations, hospitals, nursinrz homes, and outpatient and other inpatient facilities.

Data on mortality. -Various statistics on mortality other than as included in annual or monthly

reports — special analyses by cause of death, age, and other demographic variables, also geographic

and time series analyses.

Data on natality, marriage, and divorce. —Various statistics on natality, marriage, and divorce other

than as included in annual or monthly reports— special analyses by demographic variables, also

geographic and time series analyses, studies of fertility.

Data fvom the National Natality and Mortality Suvveys. —Statistics on characteristics of births and

deaths not available from the vital records, b&ed on ‘sample surveys stemming from these records,

including such topics as mortality by socioeconomic class, medical experience in the last year of

life, characteristics of pregnanc17. f’t~.

For a list of titles of reports published in these series, write to: Office of Information

National Center for Health Statistics

U.S. Public Health Service

Washington, D.C. 20201