NATIONAL CENTER 

For HEALTH STATISTICS 

VITAL and HEALTH STATISTICS


DATA FROM THE NATIONAL VITAL STATISTICS SYSTEM 

A study of infant mortality 

from linked records: 

Method of Studyand PROWRV (F;~THE ;RANCH 

Registration ~spects , [%!KIRikRY 

United States, 1960 live birth cohort 

Description of the study of 

States live birth cohort, 1960, 

of records, results of record 

study results and registration 

infant mortality among the United 

including collection and preparation 

linkage, and implications for the . 

completeness. 

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

Public Health Service


Health Services and Mental Health Administration


Washington, D-C. February 1970 
,,. 

Public Health Service Publication No. 1000-Series 20-No. 7 

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

Was bingtmr, D. C., 20402- Price fio cents 
NATIONAL CENTER FOR HEALTH Sf/iiVSTICS 

THEODORE D. WOOLSEY, Director 

PHILIP S. LAWRENCE, SC. D., Associate Direc;or 

OSWALD K. SAGEN, PH. D.,, Assistant Director /oT Health Stati~/;c3 Develo#rk&rzt 

WALT R. SIMMONS, M.A., Assistant Director for Research and Scien’~!fic Development 

ALICE M. WATERHOUSE, M. D., Medical Corzsu/t~nt 

JAMES E. KELLY, D. D. S., Dentu/ Advisor


EDWARD E. MINTY, .Execri@ue Officer


MA RGERY R. CUNNINGHAM, Irz/ormatiorz O//icer


‘i i 

OFFICE OF HEALTH STATISTICS ANALYSIS 

IWAO M. MORIYAMA, Ph. D., Director


DEAN E. KRUEGER, M.S. Depu/y ~irector


DIVISION OF VITAL STATISTICS 

ROBERT A. ISRAEL, M.S., Director 

ROBERT A. ISRAEL., M.S., Acting 

JOHN E. PATTERSON, Chief, 

LOREN E. CHANCELLOR, Chief, 

ALICE M. HETZEL, Chief, Marriage 

ARNE B. NELSON, M.A., chief, 

MICHAEL J. ZUGZDA, Chief, 

Public Health Service Publication 

Chief, Mortality Statistics Branch 

Natality .Statistics Branch 

Registration Methods Branch 

and Divorce Statistics Branch 

Vital Records Survey Branch 

statistical Resources Section 

NQ. 1000. Series 20-No. 7 

Library of Congress Catalog Card Number 73-602409 
PREFACE


This report is one of a group of analytical studies of death in the 

first year of life among infants born alive in the United States in 1960. 

The mortality data are derived from infant death records linked to live 

birth records for the same infants, representing the mortali~ experience among the 1960 cohort of livebom infants. This first report concerns itself with the record collection and registration aspects of the 

study. 

The study required the preparation of a new file of linked records, 

each of which consisted of information partly from the death record and 

partly from the live birth record for the same infant. By combining the 

data from the two records, it became possible to relate age at death and 

cause of death to characteristics such as the infant’s birth weight or the 

age of the mother, both of which are items on the live birth records but 

not on the death records. 

In the conduct of the study, use was made of procedures already 

in existence for the regular production of national vital statistics. The 

National Center for Health Statistics had microfilm copies of the original 

records and computer tapes which contained selected data taken from the 

records. The States and some cities had alphabetic indexes of births 

and deaths and were the permanent custodians of the original records. 

Although the study was carried out by the National Center for Health 

Statistics, the imperative assistance of State and city offices of vital 

records contributed substantially to the final outcome. This study of infant mortality is but one example in a long history of cooperative 

Federal-State relations in vital statistics. 

... 

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SYMBOLS 

Data not available 

Category not applicable .1. 

Quantity zero -

Quantity more than O but less than O.05---- 0.0 

Figure doesnot meet standards of 

* reliabilityor precision 

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CONTENTS


Preface _.,.-. ------

Introduction


Basic Data-----


Collection of Records


Verification of Li&age


Completion of File


Results


Color and Sex------------------------------------------------------


Age at Deati


Geographic Variation


Cause of Death -----------------------------------------------------


Age of Mother


Birth Weight and Period ofGestation


~scussion


Implications for Registration of Live Birtis


Relationship to Birth Registration Completeness


Implications for Record LinkageStudies


Implications for Infant Mortality Rates


Conclusion


References


Detailed Tables


Appendix L Technical Notes


Classification by Occurrence and Residence


Age of Mother


Race and Color


Hospital Delivery


Birth Weight---------:---------------------------------------------


Period of Gestation


Control of Errors


Sampling of Birth Records


Registration Completeness


Appendix H. Standard Certificate of Live Birth


Appendix HI. St=dard Certificate of Deati


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v 
IN THIS REPORT the method of study of infant mortality based on 

linked vitul vecords for the 1960 United States live bivth cohwt is descvibed with special attent~on to the registration aspects of the pvoblem. 

Infant movtulity is analyzed from a set of combined vecovds consisting 

of infowation obtiined pavtly from the live bivth vecovd and pavtly 

from the death vecovd for specific individuals. The infant deaths relate 

to all infants bona alive in the United States in 1960. 

The records were accumulated thvough the cooperation of the National 

Center fovHealth Statistics and the 50 Stites and a few city vital vecords 

offices, which ave the pemanent custodians of the ovi~”nal vecords. In 

all, 109,861 deaths undev 1 year of age among the 4,257,850 infants who 

ware bomt alive in 1960 wwe identified. Of the deaths, 97.4 pevcent 

weve successfully linked to the corresponding live bivth vecovds, 2.1 

pe-rcent could not be linked eithev at the Center or in the State of bivth, 

and 0.5 p.evcent weve supplied by the States but could not be found on th,e 

computev tapes at the Centev. 

The linkage of recovds was less complete for nonwhite infants (3.2 pevcent unlinked) than fov white infants (1.7 percent), but thwe was no difference by sex within the CO1OVgroups. When class~ied by age at death, 

linkage was less complete fov infants who died during the fivst houv of 

life (3.1 percent unlinked) than fov those who died dum”ng the vemaindw 

of the fivst month. Linkage was least complete as the age at daath approached the end of the first year of life—reaching 4.8 pe=rcent of vecords unlinked for those infant deaths in the age group 6-11 months. Geographically, the pvopo~tion of vecovds which wwe unlinked vavied widely 

from zero fov the State of Hawaii to 7.9 pevcent for New Mexico. 

These findings ave. important from two points of view. Fivst, they are 

us ebl in assessing the degree of understatement of movtality vates pvo ­

duced from this study. Second, they ave usefil in identifying some of the 

remaining veg”s tvation pvoblems. 

This vepovt introduces a group of reports on infant movtility among the 

1960 United States live birth cohort. The results as they relate to infant 

movtality will .be vepovted in this series in subsequent vepovts. 

vi 
A STUDY OF INFANT MORTALITY FROM LINKED RECORDS 

METHOD OF STUDY


AND REGISTRATION ASPECTS


Helen C. Chase, Dr. P. H., OjYice of Health Statistics Analysis . 

INTRODUCTION 

Infant mortality remains a problem of concern in many parts of the world. In developing 

nations, high levels of infant mortality are recognized as problems warranting serious attention. 

In more advanced countries, as well, considerable 

effort is exerted to bring newborn infants through 

the hazardous first year of life. 

In the United States, for a number of years, 

attention has been called to the failure of the infant mortality rates to maintain their former rate 

of decline. 1-3 Although this country has made 

great strides in reducing infant mortality, deaths 

among infants under 1 year of age remain an important public health problem. For example, 

there are more deaths during the first year of 

life than at ages 1-29 inclusive. 

Infant mortality can be measured by any of a 

number of techniques. In usual vital statistics 

practice, the rates are derived from two independent sets of vital records for a common time 

interval: the numerators consist of deaths under 1 

year of age derived from death records, and the 

denominators consist of live births derived from 

live birth records. Because rates are computed 

based on data obtained independently from two 

separate sets of records, they can be derived 

only for the characteristics which appear on 

both records, e.g., residence, color, and sex. 

Rates obtained by this method of computation 

have a number of disadvantages. Even under 

conditions of complete registration of live births 

and infant deaths, these rates can provide only 

estimates of the risk of infant death. In any calendar year, some of the infants who die are born 

in the preceding year. Similarly, some of the 

infants who are born in tliat calendar year do not 

die until the following year. When this method of 

calculating infant mortality rates is used, it is 

assumed that deficiencies in infant deaths in one 

direction are offset by excesses in the other. This 

assumption is not too hazardous when the numbers 

of live births are fairly constant over the years, 

but it is less acceptable when the numbers of 

live births are increasing or decreasing rapidly 

from one year to the next. 

This method has an additional disadvantage 

in that it limits the items which can be considered 

to those which appear on both the live birth and 

infant death records, and it is assumed that recorded information for these items is consistent. 

For example, responses to the sex item would be 

expected to be the same on both records. However, responses to the color item may be a little 

less consistent since it is reported differently on 

live birth and, death records. Live birth records 

require the reporting of the color of the mother 

and the father, and the color of the “infant is determined from these two items of information. 

Death records ask for the color of the deceased, 

1

$ 

which for this study is the infant. Residence may 

vary between the time of birth and the time of an 

infant’s death, and as a consequence the same 

infant may appear in different geographic areas 

in live birth and infant death tabulations. These 

rates are therefore only estimates of the risk or 

probability of infant death. 

A more direct measure of infant mortality 

can be obtained by litiing the live birth and corresponding infant death certificates for specific 

individuals, producing combined records and deriving mortality rates in relation to characteristics on the birth records. ,Such rates are termed 

“cohort” mortality rates. This method has the 

advantage of dealing with records relating to individuals rather than groups. Furthermore, rates 

obtained by this method quantify the risk of death 

among a specified group of individuals and therefore represent probabilities of infant death. For 

reliable rates, the cohort method depends on the 

success of record linkage in addition to the completeness of registration of both live births and 

infant deaths. 

A second advantage of the cohort method is 

that the number of variables available for study is 

greatly increased. In addition to place of residence, color, and sex, other pertinent variables 

such as mother’s age, order of birth, birth 

weight, and period of gestation are made available 

for study. A third advantage is that by using residence, color, and sex from the live birth records 

only, any discrepancy arising from inconsistencies between the birth and death records with regard to these variables is avoided. 

ln order to analyze infant mortality in the 

United States in greater depth, a nationwide 

cohort study was undertaken by the National 

Center for Health Statistics (NCHS) with the cooperation of the State vital statistics offices. 

Birth and death certificates were linked for each 

infant who was born in the United States in 1960 

and who died before reaching 1 year of age. By 

combining information from the live birth records 

(appendix II) and the death records (appendix III), 

raw data were provided for a study of infant 

mortality among the, cohort of infants born alive 

in the United States in 1960. The success of the 

study was predicated on the assumptions that the 

registration of live births and infant deaths was 

essentially complete and that it would be possible 

to link the birth and death records for virtually all 

infants who were born in 1960 and who died before 

reaching 1 year of age. Since the preparation of the 

linked records required that the birth certificate 

be sought for each of more than 10E$800..inf~ 

who died before age 1, an unusual opportunity was 

provided to identify a group of infants for whom 

live birth records could not be found. The unlinked records represented a functional failure in 

the registration system: either a failure to register the birth, or some other obstacle to the 

linkage operation. At best, the unlinked infant 

death records can provide leads to only a small 

portion of deficient live birth registration, since 

death occurs witbin a year for only about 2 percent of live births. 

Two nationwide studies of birth registration 

completeness were conducted in connection with 

the 1940 and 1950 Censuses of Population .4~5”In 

1950, for example, after completing the regular 

census return, census enumerators prepared 

special “Infant Cards” for all infants in the 

household who were born alive during January 

through March 1950, regardless of their survival 

to the time of the census or of their death during 

the interval between birth and the census. These 

“Infant Cards” were compared with the live birth 

certificates for the same period, and the results 

were used to measure incomplete live birth 

registration. From the 1950 study, it was estimated that about 2.1 percent of live births were 

not registered. s 

There have been no nationwide tests of registration completeness since 1950, and unfortunately, in the present study, there is no external 

source of information which can be used to measure completeness of live birth registration. The 

only segment of registration completeness which 

can be evaluated relates to those instances when 

the death certificates were available but no corresponding birth certificates could be found. Although this portion of incomplete live birth registration does rmt yield an overall estimate of incomplete birth registration, it provides insights 

into some of the factors which are associated 

with linkage failures and with functional regis ­

tration failures. 

For a few items of information, the use of 

unlinked records provides estimates of the degree 

of understatement of mortality rates which may 

2 
be due to failures in record linkage. Such estimates are possible for items which are common 

to the birth and death records _a.s.Jcm example, 

sex, color, and place of birth. However, for 

characteristics on the birth record which do not 

appear on the death record (such as age of mother, 

infant’s birth weight, and period of gestation), 

estimates of the understatement of mortality 

rates cannot be derived. 

The purpose of the present report is to describe the method of data collection used for the 

cohort study and to explore the data obtained in 

this study for leads to remaining problems of 

vital registration. The results of the study as they 

relate to infant mortality will be presented in 

other reports. 

BASIC DATA 

Original birth and death certificates arekept 

on permanent file in State offices of vital records, 

or, in a few instances, in city offices of vital 

records. Microfilm copies of birth and death 

certificates are routinely sent to the National 

Center for Health Statistics by 54 reporting areas 

(50 States and the 4 cities of Baltimore, District 

of Columbia, New Orleans, and New York City) .a 

These copies are used toproducenational natality 

and mortality statistics. The Center does not, 

however, maintain an alphabetic index of births, 

and consequently it is inefficient and uneconomical 

to attempt to create a linked set of birth and death 

records from NCHS records alone. 

Collection of Records 

To produce the infant mortality rates, two 

elements of information were needed: data for 

Iive births which occurred in 1960 and data for 

infant deaths which could be correlated with the 

birth characteristics. The data for live births, 

based on a 50-percent systematic sample, 

were already published in considerable detail in 

Volume 1 of Vital Statistics of the United States, 

1960. In order to produce comparable data for 

the infants who died, it was necessary to bring 

together the birth and infant death records for 

\ 

aRecords received from other areas such as Puerto Rico 

and the Virgin Islands are omitted for the purpose of this study. 

specific infants and to tabulate the infant death 

records according to the same characteristics 

which were already available for all live births. 

A more detailed description of the technical 

aspects of the coding and limitations of the data 

are contained in appendix I. 

At the outset of the study, the National Center 

for Health Statistics requested the 54 reporting 

areas to provide linked birth and death records 

for each infant who met the study criteria— 

namely, that the infant was born in the United 

States in 1960 and that the infant died before 

reaching 1 year of age. Since the vital records of 

the United States were to be used to identify the 

infant deaths, a further limitation of the study 

was that the birth and death occurred in the 

United States. This limitation on the data was 

felt to be a minor one for the purposes of the 

study. 

The preferred method for submitting linked 

records for the study was for the reporting areas 

to provide paired photocopies or microfilmed 

copies of the birth and death certificates for each 

infant who met the study criteria. These records 

became the base for a new set of punched cards 

which were prepared specifically for the cohort 

study. Because of differences in registration and 

record keeping systems in the reporting areas, it 

was not practical for all areas to follow the preferred method. In order to achieve coverage of 

the entire country, three methods were. actually 

used. 

The preferred method. that of providing 

paired records (either photocopies or microfilmed 

copies), was followed by 40 registration areas 

and accounted for about 54 percent of the infant 

deaths. Photocopies of linked records which were 

submitted by the reporting areas were verified 

to assure their proper linkage, and new punched 

cards were prepared for the study. A number of 

reporting areas submitted microfilm showing the 

related’ birth and death records in sequence. 

Photocopies were prepared from the microfilm, 

and after the copies were cut apart, the linkage 

of records was again verified to assure proper 

assemblage of each pair before punching. 

Some of the larger States provided the information in an alternate manner. Since a number 

of these States already had punched cards for their 

linked records, they agreed to provide the infor-
mation contained “in the cards either as lists 

or as duplicate sets of punched cards. The Center 

then proceeded to prepare the necessary copies 

from its routinely collected microfilm of birth 

and death records. This method was used by nine 

reporting areas ,“but because they were predominantly large States, their records represented 

about 39 percent of the infant deaths. New uniformly punched cards containing standard information were prepared by the Center to replace 

the cards or lists of varying format and content 

which were received from the reporting areas. 

In the initial stages of the investigation, a 

few reporting areas indicated that, for a variety 

of reasons, they could not provide linked records. 

For these areas a third method was used. The 

Center sent a copy of the appropriate death certificates showing State of birth to the reporting 

areas. After searching their alphabetic birth indexes, the State offices entered the birth certificate number on each copy and returned the records to the Center. A search was then made of 

the NCHS microfilm, and infant death study”cards 

were punched from the birth microfilm and the 

copy of the death record. This method was used 

for five States and accounted for about 7 percent 

of the infant deaths. 

Verification of Linkage 

The following items, which are common to 

both live birth and infant death records,, were the 

basis for determining whether or not a given birth 

and infant death record were for the same individual: 

Name of child


Name of father


Name of mother


Sex of child


Color (of parents, or child)


Date of birth of child


Place of birth of child


Because of inconsistencies in spelling and interpretation of certain items of information (e.g., 

color of mother and father on the birth record 

versus color of infant on the death record), an 

undetermined amount of judgment entered into 

the final reconciliation of questionable cases. 

As the linking of records progressed and the 

file of linked records was compiled; two files of 

unresolved cases were established from all available sources. One file consisted of death records 

for which no linked birth record could be found in 

the Center or in the registration office, and these 

are termed “unlinked death records” in the present study. The other unresolved file consisted 

of linked infant death and birth records supplied 

by registration offices for which ,no death record 

could be found on computer tapes at the Center. 

Completion of File 

Because of the variety of methods used in 

data collection, it was felt that a final reconciliation of the file of linked records with a master 

file of infant deaths was necessary. At this point, 

the procedure outlined in figure 1 was effected. 

The frequencies shown at various steps of the 

operation are rounded because precise counts did 

not exist at every step, and estimates are shown 

in parentheses. Actual counts are shown without 

parentheses. 

Briefly, the procedure was as follows. The 

complete Center death tapes for the years 1960 

and 1961 were reviewed, and all deaths which 

occurred among individuals under 1 year of age 

were extracted from them and converted to 

punched cards. The selection, which resulted in 

punclied cards for about 219,000 infant, deaths, 

included infants born in 1959, 1960, and 1961. 

This file was then reduced by eliminating the 

records for all infants who could nothave been 

born in 1960. The year of birfi, which was not 

part of the tape record, was estimated from the 

age at death and the month and year of death, 

which were part of the tape record. The method 

of elimination was such that only those infams 

who were definitely not born in 1960 were rejected, and all those possibly born in 1960 were 

retained. The selection procedure resulted in an 

almost equal division between “those rejected. 

(a@ut 109,500) and those retained as a master 

file for further examination (about 109,300). The, 

file of study punched cards, which had been pre4 
‘“cords’

pared earlier from linked records submitted by 

the registration areas and from ‘other sources, 

was compared with the master file of 109,300 

punched death cards, with about 102,400 agreements between the two files. 

The remaining 6,900 punched cards in the 

master file represented infant death records in the 

routinely collected records at the Center for which 

the registration areas had not submitted linked 

birth and death records for the study. These 

punched cards were listed by State of birth, and 

the lists were sent to the reporting areas for a 

final search of their alphabetic birth indexes. As 

a result, the registration offices were able to 

supply about 4,300 additional linked cases, and 

approximately 2,600 unlinked death records remained. 

In addition to the 2,600 unlinked deaths which 

remained, the Center had accumulated a file of 830 

linked records supplied by the registration offices 

which, at the time, could not be found on NCHS 

computer tape of death records. As a final crosscheck at the Center, the files of 2,600 and 830 

records were compared, and 300 additional linked 

cases were identified. The final result of all of the 

searching, linking, and cross-checking proceBorn 

in U,S. In 

960? 

p YES 

1. Copies of dmth 

certificates to Statas 

2. Direct sedrch in States 

3.	 Punched cards or lists 

(109,300) 

I 

+ 

No 

Reiects 

[109,500) 

3 

_________ .___________T 

J 1 

* Death record; no State supplied linked 

Linked death and 

G 

1


Linked records L NCHS death recoin 

1A mm -vH!!-l- ‘ ‘- ‘““h co’”” ‘ birth record records. No deoth 

I ‘“”y I state, ““ / 0 Ann\ record in NCHS 1 

w~ I w Linked records YES Link? 1 (300) 

—N --0

Deoth record; no State supplied 

Ilnkcd birth record linked records; no 

deaib record found 

in NCHS 0107,038 

1’ Linked 

filo 

2,293 (“n

Figure i. Reconc i 1 i at ion of records for the infant mortality study from 1 inked records. 

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dures was the three files shown at the bottom of 

figure 1: 

Number Percent 

Total 109,861 100.0 

Tape file of linked birth 

and death records- 107,038 97.4 

Card file of unlinked 

death records, no 

birth record found 2,293 2.1 

Card file of linked records from registration 

areas, no death record 

found in NCHS tapes - 530 0.5 

Theoretically the group of 530 linked records 

should have been added to the 107,038 linked 

records since they too represented bona fide 

records of .Mants who were born alive in the 

United States in 1960 and who died before reaching age 1. At the time of analysis, however, the 

copies of records had been destroyed, and only 

the punched cafds were available. Since some of 

the data which were punched into the cards in 

accordance with State codes were incompatible 

with the s. ‘\dy codes, the cards could not be incorporakti with the major file. Fortunately, they 

represented less than 1 percent of all infant 

deaths, and their omission could not seriously 

bias the results, 

RESULTS 

Color and Sex 

Data derived from the files of death records 

identify certain groups for which the record Iinkage was more successful than for othei=. For 

example, the linking of death records was more 

successful for white than for nonwhite infants 

(table A). Birth records could not be found for 1.7 

percent of the white and for 3.2 percent of the 

nonwhite infant deaths. For the total group and 

within each of the color groups, there was little 

difference between the two sex groups. 

Age at Death 

The distribution of infant death records by 

color, sex, and age at death is shown in table 1. 

By age at death, the proportions for which no birth 

certificates could be found were higher at the two 

ends of the age range. For deaths occurring within the first hour of life, no birth certificate could 

be found for 3.1 percent of the deaths. The rate 

declined in successive age groups to its lowest 

Table A. Number and percentage distribution of infant deaths, by sex, type of record, and color: 

United States, 1960 live birth cohort 

Type of record and color 

= 

Percentage Nwaber of infant leaths distribution 

To~;t;ecordB 109,861 - 81,610 ~onwh~ee 28,251 

Li$;~erecotda 107,038 

79,819 ~onw~i~e-------------------------------------- 27,219 

Un~iM.~;ddeath records 2,293 

1,391


Nonwhite 902


No death record found in NCHS------------------- 530 ~ite 400 

Nonwhite-==----------------------------------- 130 

63,272 46,589 100.0 100.0 100.0 

:;,;;; 34,166 100.0 100.0 100,0 > 12,423 100.0 100.0 100.0 

61,651 45,387 97.4 97.4 97.4 

46,386 33,433 97.8 97.8 97.9 

15,265 11,954 96.3 96.4 96.2 

1,315 978 2.1 2.1 2.1 

820 571 

495 407 ::; ::; ::; 

306 224 0.5 0.5 0.5


238 162 0.5 0.5 0.5


68 62 0.5 0.4 0.4


6 
level at 2 days. It increased, thereafter, reaching 

its highest level (4.8 percent) in the oldest age 

group 6-11 months. This same general pattern is 

“repeated for each sex and for each color- sex 

group. The proportions of unlinked records were 

higher for nonwhite than for white infants throughout . 

Geographic Variation 

As was mentioned earlier, the linkage of 

the birth and death records began with the identification of the infant deaths. The standard death 

certificate, after which most State certificates are 

patterned (appendix III), contains an item requiring the entry of “birthplace (State or foreign country).” The great majority of infant deaths occur in 

the same States in which the infants are born. 

However, some prospective mothers cross State 

lines at the d.rne of birth to reach the nearest 

hospital, and some infants move with their families from one State to another between birth and 

death. Thus in order to complete the set of linked 

records for this study, a certain amount of interstate searching was required. Upon completion 

of the study file of linked records, it was possible 

to identify State of birth for the linked and unlinked 

records and to identify the States with higher 

proportions of unlinked records. The geographic 

patterns of these proportions are of interest from 

two points of view. Statistically, they are of interest because of their possible effect on the 

mortality rates by geographic area. Administratively, they are of interest because they reflect 

deficiencies in functional registration. 

The presentation of mortality, rates in geo­

,	 graphic detail is generally according to the 

mother’s residence at time of the infant’s birth. 

However, this information is not part of the death 

\ record and, as a consequence, data are not available for unlinked records by mother’s residence. 

On the other hand, the death certificate includes 

the birthplace, and this information is also obtainable from live birth records. The following 

presentation is based on data by place of birth, 

and therefore relates more specifically to the 

registration than to the mortality aspects of the 

study. While the data can be used to assess the 

statistical effect of linkage failures for some 

States where residence and birthplace are highly 

correlated, in other States any such transference 

of meaning should be avoided because of the disparity between the geographic allocation of residence and place of birth. (The degree of concordance of these two variables for individual 

States is shown in table 2.) 

The results of the linkage of infant death and 

live birth records by State of birth are shown in 

table B. Among the 2,293 unlinked records there 

were 101 infant death records which failed to 

specify the State of birth and which were not 

linked by the States themselves. Of the remaining 2,192 unlinked records, the largest number of 

infants (395) was purported to have been born in 

Texas. Other States with 100 or more such events 

were also States with large populations: California 

(118), New York (165), and Pemsylvania (138). 

The percentage of unl~ed records by geographic division ranged from a low of 1.0 percent 

for the East North Central Division to a high of 

4.4 percent in the West South Central Division. 

For individual States, the percentage of unlinked 

records varied from zero for Hawaii to 7,9 percent for New Mexico (fig. 2). Birth certificates 

could not be found for 5.0 percent or more of 

the infant deaths which were stated to have been 

born in Arkansas (6.2), New Mexico (7.9), Texas 

(5.6), and Utah (5.0). 

When the States were divided into four approximately equal sized groups; the States in the 

quartile with the highest proportions of unlinked 

records were chiefly in the Southwest (Arizona, 

New Mexico, Texas) and northward east of the 

Rocky Mountains to the Canadian border (Nevadaj 

Utah, Idaho). In the highest quartile, the only 

other instance of contiguous States was Maine 

and New Hampshire in the northeast corner of 

the country. The remaining States in the highest 

quartile were geographically separated Arkansas, Kentucky, Rhode Island, South Carolina, and 

South Dakota. 

Colov. -The proportions of unlinked records 

demonstrate some interesting geographic differences by color (table C). he 530 records 

were omitted from this table because at the time 

of final analysis, they were no longer available 

for tabulation by State of birth and color. Their 

omission can, however, have lit@e ef feet on the 

7 
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Table B. Number and percentage distribution of infant	deaths, by type of record: United States, each division and State, 1960


live birth cohort


un~~*ed No death 

State of birth Total Linked death record
 records records fotind


in N(25S


Number of infant deaths Percentage distribution


United states 1109.S61	 107,038 12,2931 530 100.0 97.4 2.1 0.5 — 

Geographic division:
 New England


Middle Atlantic


East North Central
 West North Central


South Atlantic


East South Central
 West South Central
 Mountain


Pacific


New England:


Maine-------------------------------------


New Hampshire
 Vermont-------:


Massachusetts


Rhode Island


Connecticut


Middle Atlantic:


New York----------------------------------


New Jersey
 Pennsylvania


East North Centra1:
 Ohio


Indiana


Illinois


Michigan


Wisc~sin


West North Central:
 Minnesota


Iowa--------------------------------------


Missouri


North Dakota------------------------------


South Dakota------------------------------


Nebraska


Kansas


South Atlantic:
 Delaware


Maryland


District of Columbia--------------------:-


Virginia


West Virginia


North Carolina


South Carolina
 Georgia- .-----------


Florida


East South Centra1:
 Kentucky


Temeaaee


Alaba~-----------------------------------


Mississippi


West South Central:
 Arkansas


Louisiana


Oklahoma


Texas-------------------------------------


Molmta in: Montana 

Idaho


Wyoming-----------------------------------


Colorado


New Mexico--------------------------------
 Arizma


Utah--------------------------------------


Nevada


Pacific:
 Washington


Oregon


California


Alaska------------------------------------
 Hawaii------------------------------------


5>233 5,063 100.0 96.S 2.7 17,763 17,297 100.0 97.4 20,960 20,662 100.0 9S.6 M S,512 8,351 100.0 ;;,; 1.2 19,005 18,615 100.0 1.6 9>368 9,117 100.0 97:3 12,295 1;,;;; 100.0 95.3 M 4,998 100.0 95.3 3.8 11,626 11:456 100.0 9s.5 1.1 

598 579 19 100.0 96.8 345 330 14 100.O 95.7 ::: 221 216 100.0 97.7 1.8 2,W; 2>405 6; 100.0 97.1 2.4 405 15 100.0 96.4 3.6 1,173 1,12s 30 100.0 96.2 2,6 1.3 

8,660 8,431 165 100.0 97.4 3,7.12 3,034 100.0 97.5 ;:; 5,991 5,S32 1:: 100.0 97.3 2.3 

5,456 5,406 26 100.0 99.1 ;.: 0.4 2,78S 2,717 100.0 97.5 0.5 5,837 5,760 2: 100.0 9s.7 O:B 0.5 4,706 4,635 61 100.0 9s.5 0.2 2,173 2,144 17 100.0 9s.7 ::: 0.6 

y: 1,866 100.O 9s.5 0.8 0.6 1,377 100.0 99.2 :.: 0.6
 2;43S 2,377 100.0 97.5 . 0.9
 407 405 100.0 99.5 507 

767 472 

764 100.0 

100.0 ;3.: ::; 

0.4 2.; 

1,111 1,090 100.0 9s:1 1.2 0.; 

273 266 100.0 97.4 2.2 0.4 1,;9: 1,86S 100.O 98.3 1.3 0.4 

2,670 945 2,605 100.0 

100.0 

97.7 

97.6 1.8 

1.9 

0,5 

0.6 1,049 1,016 100.0 96.9 2.2 3,464 3,400 100.0 98.2 M 2,044 1,959 100.0 95.8 ::? 0.4 3,230 3,1S6 100.0 98.6 0.9 0.5 3,408 3,370 100.O 98.9 0,5 0.6 

2,030 

2,459 

1,929 

2,435 E 100.0 

100.0 95.0 

99.0 M 

0.3 

0.4 2,495 2,430 60 100.0 97.4 2.4 0.2 2,384 2,323 54 100.0 97.4 2.3 0,3 

1,105 1,026 100.0 92.9 6.2 0.9 2,827 2,770 100.0 98.0 1.s 0.2 1,278 1,245 100.0 97.4 7,085 6,671 100.0 94.2 ;:: 8:: 

419 

387 

227 

1,192 

413 

361 

223 

1,166 

1; 

1; 

100.0 

100.0 

100.0 

100.0 

98.6 

93.3 

9s.2 

97.8 

0.5 

4.9 

1.3 

1,6 939 862 74 100.0 91.s 7.9 1,096 1,051 39 100.0 95.9 3.6 516 ;.3; 26 100.0 93.4 5.0 222 7 100.0 93,2 3.2 

1,525 

904 

1,503 

893 100.0 

100.0 9S.6 

9S.8 W 

1.0 

1.0 

8,511 S,380 100.0 9s.5 1.4 0.2 294 290 100.0 98.6 0.7 392 390 100.0 99.5 ::: 

1Includes 101 infant deaths for which the place of birth was mknown or not stated.

data in this table. For the country as a whole, the 

proportion of unlinked, records was higher for 

nonwhite (3.2 percent) than for white infant deaths 

(1.7 percent). The difference was in the same 

direction for each of the geographic divisions except for New England, where the proportions for 

white and nonwhite infaht deaths were equal. The 

ratios between the percentages by color varied 

considerably from 1.0 fd? the New Engkuid Division to 3.6 for the Mountain Division. 

For the majority of the States, the proportions of unlinked records were higher for nonwhite 

than for white infant deaths, The proportions for 

white infant deaths ranged as high as 4.9 percent, 

and those for nonwhite infant deaths as high as 

23.2 percent. The highest proportions were among 

the nonwhite groups in New Mexico (23.2) and Utah 

(19..2); where American Indians form the largest 

proportion of the nonwhite group. The proportion 

for Arizona, another State which has a sizable -

Indian population, was also relatively high (8.0 

percent). 

Hospital delivew-Data derived from the 

present study, when combined with data routinely 

published in Vital Statistics of the United States, 

can be further examined for their relationship to 

the proportion of live births occurring outside 

hospitals. Table D shows the distribution of the 50 

Figure 2. Percent unl inked infant death records, by State of birth.

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Table C. Number of infant deaths and percent unlinked infant death records, by color:


United States, each division and State, 1960 live birth cohort


Division and State of birth Total


II I 

Percent unlinked
 Number of infant deaths death records


United States-------------------------------- 109,331	 B1,21O 28,121 2.1 1.7 3.2
 — — -


Geographic division:


New England- 5,205 4,866 339 2.7 2.7 2.7 

Middle Atlantic 17,663 13,870 3>793 2.1 2.0 2.5 

East North Central 20,869 17,131 3,738 1.0 0.8 1.9 

West North Central-----------?------------------- 8,452 7,438 1,014 1.2 1.0 2.7 

South Atlantic 18,910 10,336 8,574 1.6 1.0 2.2 

East South Central-------------------------------- 9,339 5,314 4,025 2.4 2.0 2.9 

West South Central 12,253 8,299 3,954 4.4 3.5 6.3 

Mountain 4,954 4,269 685 3.8 2.8 10.1 

Pacific 11,585 9,625 1,960 1.1 1.0 1.8 

New England:


Maine 598 594 4 3.2 3.2 (1)


New Hampshire 344 343 1 4.1 4.1 (1)


Vermont 220 220 1.8 1.8 ... .


Massachusetts 2,465 2,306 159 2.4 2.3 3.8


Rhode Island 420 384 36 3.6 3.9 g-


Connecticut 1,158 1,019 139 2.6 2.6 2.2 <


Middle Atlantic:


New York .........---------- ..... 8,596 6,650 1,946 1.9 2.0 1.6 

New Jersey 3,097 2,377 720 2.0 1.6 3.3 

Pennsylvania 5,970 4;843 1,127 2.3 .2.0 3.5 

East North Central: .’?,,, 

,,. 

Ohio 5,432 4,500 932 0.5 0.4 1.1 

Indiana 2,774 2;413 361 2.1 1.9 3.3 

Illinois 5,806 .4,373 1,433 0.8 0.8 0.8 

Michigan 4,696 3,839 857 1.3 0.7 ,4.2 

Wisconsin 2’,161 2,006 155 ,0.8 0.7 1.3 

West North Central:


Minnesota 1,882 1,825 57 0.9 0.8 X1.8 

Iowa--------------------------------------------- 1,380 1,342 38 0.2 0.1 ‘2.6 

Missouri 2,417 1,809 608 L*7 1.3 2.6 

North Dakota 407 377 30 0.5 0.5 2-

South Dakota 496 396 100 4.8 4.0 8.0 

Nebraska 767 710 57 0.4 0.4 2;-

Kansas --------------------------------.---------- 1,103 979 124 1.2 1.2 0.8 

See footnotes at end of table.


10

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Table C. Number of infant deaths and percent unlinked infant death records, by color:


United States, each division and State, 1960 live birth cohort-Con.


Division and State of birth
 31kE-kx= 

Percent unlinked
 Number of infant deaths death records


South Atlantic:


Delaware


Maryland


District of Columbia


Virginia


West Virginia


North Carolina


South Carolina


Georgia


Florida .-.---,---


East South Central:


Kentucky


Tennessee


Alabama


Mississippi ----------------,.-


West South Central:


Arkansas


Louisiana


Oklahoma


Texas


Mountain:


Montana


Idaho


Wyoming


Colorado


New Mexico


Arizona


Utah


Nevada


Pacific:


Washington---.-----


Oregon


California


Alaska


Hawaii --.----..------..-.------”.-
 -“-----


Not stated


l’percentnot shown; based on less than 20 deaths.


2Based on at.least 20, but less than 100 deaths.


272 167 105 2.2 2.4 1.9 

1,892 1,130 762 1.3 1.3 1.2 

962 415 547 1.8 1.0 2.4 

2,655 1,620 1,035 1.9 1.4 2.7 

1,039 976 63 2.2 1.9 26.3 

3,453 1,680 1,773 1.5 0.8 2.2 

2,035 824 1,211 3.7 1.6 5.2 

3,215 1,542 1,673 0.9 0.5 1.3 

3,387 1,982 1,405 0.5 0.4 0.6 

2,024 1,721 303 4.7 4.2 7.6


2,448 1,667 781 0.5 0.4 0.9


2,490 1,228 1,262 2.4 1.9 2.9


2,377 698 1,679 2.3 0.7 2.9


1,095 624 471 6.3 2.9 10.8


2,822 1,228 1,594 1.8 0.7 2.8


1,270 986 284 2.0 1.6 3.2


7,066 5,461 1,605 5.6 4.5 9.2


415 369 46 0.5 0.5 2. 

380 365 15 5.0 4.9 (1) 

226 212 14 1.3 1.4 (1) 

1,185 1,113 72 .1.6 1.6 2’1.4 

936 781 155 7.9 4.9 23.2 

1,090 765 325 3.6 1.7 8.0 

508 482 26 5.1 4.4 219.2 

.214 182 32 3.3 3.8 2-

1,510 1,381 129 0.5 0.4 0.8 

895 851 44 0.2 0.2 2-

8,498 7,153 1,345 1.4 1.2 2.5 

292 136 156 0.7 0.7 0.6 

390 104 286 

101 62 39 ... ... ... 

11:

States and the District of Columbia by the proportion of resident births occurring outside 

hospitals in 1960 and the percent of”unlinked 

death records in the present study. Data for place 

of birth (in or outside hospitals) are by State of 

residence, and data for unlinked records are by 

place of occurrence of birth. For the country as a 

whole, 97.5 percent of all live births to residents 

of individual States occurred in the same States, 

and only 2.5 percent occurred in other than the 

States of residence. For individual States, the percentage was over 90 percent except for Maryland 

and New Hampshire (table 2). 

The upper left quadrant of table D shows a 

concentration of States with relatively few births 

occurring outside hospitals and with relatively 

few unlinked infant death records. The two 

characteristics are not invariably associated, 

however, because the upper right quadrant of 

the table shows a smaller number of States with 

relatively few births occurring outside hospitals 

but with higherproportions of unlinked infant death 

records. Although virtually all the live births 

in the latter States occurred in hospitals, there 

was comparatively less success lifi.ing the records than in the States in the upper left quadrant. 

The States in the upper right quadrant are relatively small in population, but in each instance the 

percentage of unlinked records was based on at 

least 200 infant deaths. 

The lower left quadrant consists of States 

with higher proportions of births occurring outside hospitals, but with relatively few unlinked 

infant death records. ~is suggests that, despite 

fairly high proportions of births occurring outside 

hospitals, it is pos,sible to achieve a fairly high 

Table D. Distribution of States by percent of infants born outside hospitals and percent unlinked infant


death records: United States, 1960 live birth cohort


Unlinked death records (percent)


Number
 Percent born
 of
 outside hospitals States Less
 1.0-1.9 2.0-2.9 3.0-3.9 4.0-4.9 5.0-5.9 6.0-6.9 7.0-7.9
 than 1.0


Total----------------- 51 15 13 10 5 3 3 1 1 

Less than 1.O--------- 24 Hawaii Calif. Corm. Nevada (N.H.) Idaho 

Iowa Kansas Indiana Rhode Is. Utah 

Minn. Michigan Mass. 

Nebraska New York N.Jersey 

N.Dakota Wyoming Pa. 

Ohio


Oregon


Wash.


Wis.


1.0-1.9--------------- 9 Illinois Colorado Delaware Maine S.Dakota 

Montana D.C. Oklahoma 

Vermont 

2.0-2.9--------------- 2 g;~uri 

3.0-3.9--------------- 2 W.Va. Arizona 

4.0-4.9--------------- 1 La. 

5,0-9.9--------------- 8 Alaska N.C. Kentucky Texas N.Mex. 

Florida Virginia 

Term. 

10.0-14.9------------- 2 Georgia Arkansas 

15.0-19.9------------- 2 Alabama S.c. 

20.0 or more---------- 1 Miss. + 

NOTE: Table includes 50 States and the District of Columbia. States in parentheses have less then


90 percent of resident births occurring within the same State: Maryland (84.6 percent)and New Hampshire


(87.3 percent).


12

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---- -- -----------

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degree of record linkage of infant death and live 

birth records. 

The lower right quadrant of the table contains 

those relatively few States with higher proportions 

of live births occurring outside hospitals, and 

with high proportions of unlinked records. In 

summary, the data imply “that although regis ­

tration and record linkage are somewhat related 

to the level of hospital deliveries, other factors 

are operating also. 

llosp~tal delivery and colov.—when the geographic data are further subdivided by color, some 

of the patterns are brought even more sharply into 

focus (table 3). For white infants, the proportions 

of live births occurring outside hospitals were 

quite low for almost all States. Only three States 

had proportions higher than 5 percent: Kentucky 

(5.6), New Mexico (5.2), and Texas (5.7). In 

marked contrast, the proportions of nonwhite 

live births occurring outside hospitals were much 

higher, and in some States the proportion was 

almost 50 percent. The data in table 3 show the 

wide variation in the pattern of hospital deliveries 

for nonwhite infants and record linkage for individual States. Among the Southeastern States 

(those in the South Atlantic AndEast South Central 

Divisions, primarily), virtually all nonwhite infants were Negro (table 4). In a number of these 

States the proportion of” nonwhite infants who 

were born outside hospitals was high, but the 

deficiency in record linkage was not nearly of the 

same magnitude: 

State 

Alabama


Florida


Georgia


Kentucky


Mississippi


North Carolina


South Carolina


Tennessee


Virzinia


N;:;cm::: Unlinked 

records 

born among 

out side nonwhite 

hospitals infant 

deaths 

Percent 

;;.: 

::: 

31:9 1.3 

10*5


49.4 ;:: 

25.2 2.2 

39.9 

14.6 ::; 

24.3 2.7 

In each of these States the proportion of unlinked 

records for nonwhite infants exceeded that for 

white. .In some States, however, the proportion of 

unlinked records for nonwhite infant deaths was 

below the national average of linkage failures for 

white infants (1.7 percent). Despite the large numbers of live births occurring outside hospitals in 

these States, it seems that the records for most 

infants who died during the first year of life were 

linked. 

Among States having nonwhite populations 

which are predominantly American Indian, examplea of the reverse situation are found: 

Nonwhite Unlinked 

infants records 

born among State 

out side nonwhite 

hospitals	 infant 

deaths 

I Percent 

Arizona 8.2


New Mexi,co ---------- 5.6 2%:


Utah 5.8 19.2


The 1950 test of birth registration completeness, 

which by design included all live births which 

occurred during January-March 1950, found that 

“the Indian had the poorest record of registration 

completeness (85.1 percent). “ 5 The high proportion of unlinked records found in the present 

study for these areas was probably due, in part, 

to incomplete birth registration and, in part, to 

the structure of the American Indian names. 

In attempting to interpret the remarks made 

here with regard to registration, it must be remembered that only that small portion of live 

birth registration which relates to infant deaths 

is represented in this report. The far greater 

number of liveborn infants who survived the infant period is not included. Yet, even the limited 

data shown here demonstrate deficiencies in the 

present vital records and vital statistics system. 

13

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Cause of Death 

The distributions of the 107,038 linked and 

2,293 unlinked death records by cause of death are 

shown in table 5. Cause-of-death information is 

not available for the 530 deaths for which no record could be found in the Center’s computer tapes, 

and this group of records is omitted from the 

table. 

Unlinked records were widely distributed 

over the causes of death. In the infant and, more 

specifically, the neonatal periods, there were 

higher concentrations among unlinked records 

than among linked records of the causes associated with extrinsic rather than intrinsic factors: 

the infective and parasitic cause group (ICD cause 

numbers 001- 138); influenza, pneumonia, and 

other respiratory diseases (480-527, 763); digestive diseases (530-587, 764); and homicide (E964, 

E980-E984). The excess in the last mentioned 

group is probably associated with unidentified 

dead foundlings since 72 of the 75 deaths in this 

group were allocated to the cause number used 

for such deaths (E983, assault by other means). 

Age of Mother 

The percentage distribution of live births and 

infant deaths by color and age of mother is shown 

in table 6. In comparison with the group of linked 

records, records which could not be found in the 

Center’s computer tapes showed a somewhat 

higher concentration among mothers under 25 

years of age for both the white and nonwhite 

groups. Since the mother’s age appears on ,the 

birth record but not on the death record, no information is available for the group of 2,293 

records for which birth certificates could not be 

found, and these are omitted. There is, therefore, 

no estimate of the effect of linkage failure in 

infant mortality rates by age of mother. 

Birth Weight and Period of Gestation 

The percentage distributions of live births 

and infant deaths by color and birth weight are 

shown in table 7, and by color and gestation in 

table 8. As in the table by age of mother, there was 

no information available on the birth characteristics for the 2,293 records for which the ‘b&th 

certificates could not be found in either the Center’s computer tapes or in the purported State 

of birth. Consequently, estimates of the effect of 

linkage failures on infant mortality rates by birth 

weight or period of gestation are not available. 

Among the 530 records which could not be 

located in the Centpr’s tapes, there was a greater 

concentration of heavier babies (table 7) and of 

infants with longer gestation periods (table 8) than 

among linked records. When the data were examined by age at death (table 1), a greater concentration of deaths in the postneonatal period 

was found 

No deatk 

Linked record Age records found 

in NCHS 

Percentage

distribution 

Under 1 year---- 100.0 100.0 

Under 28 days 73.2 17.4 

28 days-n months 26.8 68.3 

Not stated w,- 14.3 

The same relationship was found for both white 

and nonwhite infants, and it was particularly 

strong for period of gestation. This suggests 

that the failure to find the 530 records in the 

Center’s computer tapes was not related to prematurity or to early postnatal death, but may be 

related to other problems such as the spelling or 

structure of names, .mobilit y of the population, or 

to delayed death registration. 

DISCUSSION 

The accumulation of the data needed to conduct the cohort infant mortality study provided an 

opportunity to examine on a nationwide scale the 

success with which the birth certificates for the 

cohort were found in a Federal-’State cooperative 

vital” statistics system. Of the total of 109,861 

eligible infant deaths which were identified by any 

14 
of the procedures which were used, live birth certificates were found for 107,038 (97.4 percent). 

Implications for Registration of Live Births 

Interest in the completeness of birth and death 

registration is twofold. Legally, it is related to the 

ability or inability to produce legal records of 

vital events when they are needed. Statistically, 

the interest revolves around the assessment of 

the quality of the statistical information produced 

from the records for cohort studies of infant 

mortality. 

One small group of linked records (530 or 0.5 

percent) was supplied by the States but couId not 

be located in the Center’s computer tapes of death 

records. Since registration functions are carried 

out at the State level, the failure to locate these 

530 records at the Center was not considered to 

be a deficiency in registration because the records 

were on file in the States, and the information 

was supplied by the regis~ation offices when it 

was needed, These records may represent a deficiency in the national statistics, but since they 

constitute less than 1 percent of the deaths, they 

‘do not seriously affect the level of the infant mortality rates. The percent of records in this group 

of 530 records Was m?t affected by sex or color 

(table A), and was affected in only afew instances 

by State of birth (table B). Age at death was not 

specified on 76 of the 530 ‘records, but since the 

State offices were able to link the records, the 

omission of age at d@h may have been a deficiency in the preparation of the study punched 

cards or the cornpyter tapes at the Center. Compared with the “linked records, this group of 

records showed slightly more mot$ers under 25 

years (table 6), greater concentrations of heavier 

infants (table 7), &ants with longer periods of 

gestation (table 8), and postneonatal deaths (table 

1). These irregularities may be asso~iated with 

delayed death registration at the State level wl_Qch 

caused the tape record to be placed on a later 

tape at the Center, or with punching errors which 

showed the age at death to be over 1 year or 

wi~ births in a year other than 1960. Because 

these records represented only 0.5 percent of the 

infant deaths, they were considered to be ~~~sw 

of a number of minor aberrations @ ~i~h~~ 

tolerable limits for the subject under ~udy. 

The group of 2,293 unlinked records may, to 

some degree, be indicative of failures in birth 

registration. Although the proportions of deaths 

which were unlinked do not represent all live 

births which were not registered, they represent 

that portion of live births which relate to infant 

death and are therefore pertinent to this study. 

The proportion of infant death records for which 

no birth record could be found was higher for 

nonwhite (3.2 percent) than for white infants (1.7 

percent), but there was no essential difference by 

sex in the total group or in either of the two major 

color groups. 

By age at death, the proportions of unlinked 

records were higher for infants who died within 

the first hour of life (3.1 percent) and during the 

intervals 28 days-5 months (3.3 percent) tid 6-11 

months of age (4.8 percent) than for those who 

died at the intermediate ages (1.0-2.5 percent). 

The percentage was lowest for infants who died 

at 2 days (1.0 percent), and it increased thereafter throughout the remainder of the age range. 

The same general pattern was evident for both 

white and nonwhite infants, but the percentage 

unlinked was higher for the nonwhite infants in 

each age group. There was no evidence of a sex 

differential within the total group or in either of 

the two major color groups. 

The elevations at the two extremes of the 

infant age scale for both white and nonwhite infants suggest that two separate sets of factors 

were operating. For infants who died within an 

hour of birth, birth certificates could not be found 

for 3.1 percent of the death records. The reasons 

are probably related to the early demise of the 

infant. About one-fifth of the unlinked death records for infants who died within an hour of birth 

appeared to be for unidentified foundlings; for 

these records, linkage failure was due to the lack 

of identity of the deceased. Other failures to link 

records may have been associated withdelivery of 

the inftit at home when registration is sometimes 

overlooked ~r with an oversight on the part of 

hospital staffs to file a birth certificate in those 

instarices when infants died very soon afterbirth. 

Optimum record linkage occurred for infants 

who survived the first hour of life, but who died 

during the remainder of the first week of life. 

Higher percentages of unlinked records also 

occurred for infants who died after the first 

15

week of life. For these infants, the proportions 

of unlinked records increased with age at death. 

After the first hour of life, the percentage of unlinked infant deaths was highest in the last 6 

months of the first year (4.8 percent). 

Registration problems associated with the 

older infant age groups are quite different from 

those associated with death in the first hour of 

life. After the first week of life, virtually all infants have left the hospital, and as they survive 

to older ages the possibilities of name changes 

due to adoption or other changes in family affiliation increase. With time, there are also changes 

in residence which may make it more difficult to 

link the death and birth records. The effect of the 

mobility of the population would be expected to 

increase as time from birth increases, and such a 

trend is suggested in the data. 

One perplexing group of records was about 500 

death records for infants who died in hospitals, at 

an early age (3 days or less) and whose birth records could not be found, Since a high proportion 

of live births occur in hospitals (96.6 percent in 

1960), it was felt that either the birth records 

should have been prepared at the hospital or that 

the hospital should have had enou~ information 

available to determine where the birth occurred. 

Because of the long delay in pursuing this aspect 

of the study, it was not feasible to contact all of 

the States on the subject. The registrars of a few 

States offered to look into the matter because they 

were particularly interested in identifying the 

source of the difficulty. 

In Mississippi, 11 such deaths were investigated. It was found that of the 11, nine of the infants were born outside hospitals (five were 

stated to have been born at home). The other two 

infants were born in hospitals, but no birth record 

had” been filed for one and neither a birth record 

nor a death record could be found at the hospital 

for the other. 

In North Carolina, the vital records were 

searched and copies of nine missing birth records 

were found which had been filed with the local 

registrars from 4 to 14 months after the deaths 

of the infants, Seven of the nine records were 

filed from 4 to 7 months after death. These records were clustered by date of filing, suggesting 

that they were identified through some Statewide 

linkage procedure and that efforts were made to 

obtain a delayed birth registration for each child. 

Among this group of nine infants, three were born 

at home and six were born in hospitals. 

In New York City only two such events were 

identified for further search: one was born at home 

and the other in a hospital. The results of these 

fragmentary investigations indicated that continued effort is needed to stimulate complete 

birth registration, and that birth registration is 

not complete for infants who are born inside as 

well as for those born outside hospitals. 

Tabulations by State of birth are particularly 

relevant to the process of registration. Tables B 

and C indicate States where some of the greatest 

deficiencies exist and where further educational 

efforts may be needed. The proportion of unliriked 

infant death records ranged from zero for the 

State of Hawaii to 7.9 percent for New Mexico. All 

of the States with perc~ntages of 5.0 percent or 

higher were among the States in the West. South 

Central and Mountain Divisions. 

The higher rates of unlinked records were not 

associated with the size of the 50 States as determined by population size, but showed some association with population density (population per 

square mile): 

0.4- 18.4--- 13 

26.6- 64.0---

67.3 -100.4--- :; 

128.9 -812.4--- 12 

Percent


uolinked Range


I 2.8 0.2-7.9” 

3.0 0.2-5.6 

1.6 0-4.7 

1.6 0.5-3.6 

The two less densely populated quartiles show, 

higher proportions of unliqlced records than the 

more densely populated quartiles. The lower 

limits of the range did not differ much, a result of approaching an irreducible minimum. 

However, the upper limits of the range decreased 

steadily with increasing population density. 

For most States, there appeared to be a 

positive association between the proportion of 

live births that occurred in hospitals and the 

success in record Iipkage (table D). Particularly 

among nonwhite infants, a number ‘OfStates with 

16

high proportions of live births outside hospitals 

had fairly low proportions of unlinked records. 

These States had large proportions of Negro births 

among the nonwhite group. A few States with low 

proportions of births outside hospitals had high 

proportions of unlinked records. Inthese States, 

the American Indians were the predominant nonwhite constituent. These patterns are consistent 

with those shown in earlier studies of birth 

registration completeness, which demonstrated 

that registration was less complete for nonwhite 

than for white infants, and poorest for American 

Indians. 5 

Registration of live births has been shown to 

be more complete for live births occurring in 

hospitals than for those occurring outside hospitals in both the 1940 and 1950 tests of registration 

completeness. 4~5From spot checks in three areas 

in the present study, it is apparent that incomplete registration still exists for infants born in 

hospitals as well as for those born outside hospitals. Routine record linkage of infant death and 

live birth records is one way of monitoring at 

least a portion of incomplete birth registration. 

Record linkage has also been useful in detecting a portion of incomplete death registration. 

A study in North Carolina linked live birth records for infants who weighed 1,500 grams or less 

at birth to the death records.G The purpose of the 

study was to determine whether there were any 

unregistered deaths among this group. Since these 

very small infants rarely survive, virtually all of 

these infants should have appeared in the death 

register, and by using hospital records, the death 

or survival of each infant was verified. The study 

demonstrated that 6.3 percent of the deaths among 

these very small infants were not registered. Such 

record linkage studies are useful in discussing 

registration comp~eteness with hospital staffs. 

However, the discussions with hospital personnel 

will have little effect on the registration of births 

which occur outside hospitals. As an example, in 

1960, 27.3 percent of the live births to residents 

of Mississippi occurred outside hospitals. In such 

States, where significant numbers of live births 

occur outside hospitals, educational efforts must 

be much more widespread to include physicians 

and midwives who attend deliveries outside hospitals as well as hospital staffs. It is generally admitted that the births which are least likely to be 

registered are those which are unattended by any 

member of the medical or paramedical gioups. 

Another problem is associated with sparsely 

populated States where the distance from place 

of birth to the registration office also presents 

deterrents to complete registration. 

In addition to the possibility of an outright 

failure to register a birth, a number of other 

‘obstacles to record linkage should be mentioned. 

If the infant’s name is not spelled consistently on 

the birth and infarit death records, it may be impossible to link the records. If the two documents 

are prepared in different settings by different 

individuals, it is easy to imagine such inconsistencies occurring. Minor deviations in spelling 

can sometimes be allowed for in searching for 

birth records, but inconsistent spelling cannot be 

overcome in all instances. In addition, the structure of the names of certain subgroups of the 

population are also known to present deterrents 

to record linkage. Indian names-because of their 

structure—present a particukr problem in record linkage for this subgroup of nonwhite infants. 

Names of Spanish origin which are often but not 

consistently compounded are frequently encountered in New Mexico and Texas and may 

contribute to the higher proportions of unlinked 

records among white infant deaths in States with 

sizable Spanish-American populations. 

Another obstacle to record linkage may be 

the improper entry of the State of birth on the 

infant death record. If the State of birth is incorrectly given on the death certificate, the birth 

record may be irretrievable unless a search is 

conducted in each of the States, a time-consuming 

operation. This possible source of difficulty is felt 

to be of some relevance among Mexicans or. 

Mexican Americans who crossed over into States 

bordering Mexico and who erroneously reported 

a State in the United States as the place of birth 

on the infant’s death certificate. 

In some cases, the legitimation or adoption 

of an infant may impede record linkage. When such 

Iegal procedures take place, it is necessary to revise or replace the birth record to reflect a 

change in’ name. If the infant dies before legal 

steps are completed and the changes have been 

reflected in the birth record, the names of the 

infant on the death and live birth records may not 

17

-----

-- ------

---

---------

------

----------

----------

-----

----------

correspond. In such instances, it may be impossible to link the records. 

Finally, there are those relatively infrequent instances illustrated by an unidentified 

dead foundling whose birth was probably not 

registered, and whose name and place of birth 

were unknown at time of discovery. It is impossible to provide linked birth records for 

such infant deaths. 

Relationship to Birth Registration 

Completeness 

It was pointed out earlier that failures in 

record linkage in ,the present study cannot be interpreted to represent overall percentages of 

incomplete birth registration for 1960. Nevertheless, in combination with the events of JanuaryMarch 1950, the data suggest that live birth registration has improved: 

Class of records Tota 1 White ~~~e 

then the registration of live births would be expetted to be more than 98.5 percent complete in 

1960. Independent estimates of birth registration 

completeness for 1960, which were prepared by 

the Division of Vital Statistics, NCHS, are as 

follows: 8 

Pevcent 

United States 98,9 

White 99.3 

Nonwhite 96.4 

Implications for Record Linkage Studies 

The data from the 1960 cohort study also 

provided insights into the possible effects of conducting linkage studies at the State level.’ A high 

proportion of infants who died before reaching age 

1 apparently were born in the same. Stat,e where 

the death occurred: nationally, the proportion was 

97.9 percent (table E). For individual States, the 

proportions were at least 94.8 percent, and in one 

instance (California) reached virtually 100 percent (table 9). If the areas of consideration are 

Table E. Number and percentage distribution of in­


fant deatha, by place of birth and place of death
 1960: and type of record: United Statea, 1960 live


Xnfant death 

Neonatal death---

January-March 1950: 

Neonatal death7 

Live births 

Percent unlinked - records 

2.1 1.7 3.2 

1.5 1.2 2.4 

2.4 2.0 4,6 

2.1 1.4 6.5 

birth cohort


Type of record


Total records-----


Linked records


Unlinked death records-­


Total records-----


Linked records
 Unlinked death records-­


Total recorda


Linked records


Unlinked death recorda--


I Born in 

Born State 

All and other 

infant died in than 

deaths same State 

State of 

death


lNmber of infant deatba


I 10;,;;: 105,229 1,809


, 1,799 494


I Percentage distribution


In the earlier study, record linkage between infant cards and vital records was a little better 

for live births (97.9 percent) than for neonatal 

deaths (97.6 percent). Over the decade, the linkage of neonatal deaths and live birth records appears to have improved. The linkage of neonatal 

deaths was 97.6 percent in the earlier study (infant cards and vital records), and 98.5 percent 

in the later study (infant death and live birth 

records). If the same relationship between live 

births and neonatal deaths which was found in 

January-March 1950 continued to exist in 1960, 

18

----------

enlarged to encompass geographic divisions, at 

least 97.2 percent of the infant deaths recorded 

in any division related to infants who were born 

in the same geographic division. 

Based on the information provided on the 

death records, the linkage of records was more 

likely to be successful if the birth and death 

occurred in the same State (98.3 percent) than if 

they occurred in different States (78.5 percent). 

An element which cannot be overlooked is the 

possibility that among the 2,293 unlinked death 

records there may have been a number of records 

with the State of birth incorrectly entered. Had 

the 2,293 unlinked death records been available 

at the time of final analysis, it would have been 

possible to search for at least a sample of them 

in all States and, thus, to estimate how of&enthe 

State of birth was incorrectly entered on the death 

records. However, since the records were no 

longer available, this avenue of investigation was 

closed. 

In any event, the linkage of infant death arid 

live birth records was largely an intrastate matter: nationwide, the State of birth and State of 

death agreed and the records were linked for 96.2 

percent of the infant deaths. For individual States, 

there was concurrence between State of birth and 

death, and the records were linked for at least 

91.7 percent of the cases. If the area of consideration is enlarged to include geographic divisions 

rather than individual States, the rate of concurrence and linkage is increased to at least 94.0 

percent. These findings are encouraging to the 

conduct of linked record studies of infant mortality 

in each of the States. At least 90 percent of this 

type of record linkage can be accomplished within 

any State’s own record system. 

Possible exceptions were thought to exist in 

the three city-State systems where separate central fiIes of vital records are maintained for a 

major city and for the remainder of the State, i.e., 

Baltimore and Maryland, New Orleans and Louisiana, New York City and Upstate New York (New 

, York State exclusive of New York City). From 

another cohort study based on linked records 

which was conducted in Upstate New York, an 

estimate of the experience in one such situation 

was obtained. 9 The study consisted of linking all 

death certificates for infants and children who died 

before reaching 5 years of age in the years 1950-

57 to the corresponding live birth records for 

births which occurred in 1950-52. With particular 

reference to the infant period, the fol&wing was 

found: 

Item


Infant deaths recorded in 

Upstate New YOrk 

Born in Upstate New York--- Certificate found-------- Certificate not found:---


Born in New York City or in
 other Statea--------------


Place of birth not stated-­


Age at death


Undar Under 1 28 days11 months year ~;B 

3,904 2,930 974


3,806 2=913 893


3,803 2,911 89:


3 2


89 10 79 

9 7 2 

f 

Live birth certificates for 97.5 percent of the 

infants who were born in Upstate N;w York during 

1950-52 and who died in that area during 1950-53 

were found within the State’s own fiIing system 

without reference to the files of New York City 

or those of other States. Even in this atypical 

situation, where two sets of permanent files of 

vit’kl records are maintained within a single State, 

a large part of record linkage between infant death 

and live birth records remains an internal matter. 

The remaining interstate records needed for 

such studies of infant mortaIity are supplied 

through a system of interstate exchange of transcripts which is conducted by the Division of Vital 

Statistics (DVS), National Center for Health Statistics. Each registration area periodically sends 

DVS a photocopy or transcript of each infant 

death certificate for infants who died before 

reaching age 1 but who were born in another 

registration area. Quarterly, the copies are sent 

to the State of birth. Using these transcripts to 

supplement their own records, interested investigators in any State can compile a set of infant 

death records which refer to the total live births 

which occurred in that State in a given year. 

A number of States have successfully instituted routine programs of record linkage of infant death records. As early as 1962, at least 

36 States were linking infant or neonatal death 

records to live birth records annually: 27 States 

19 
----------------

------------------

------------------

------------

-----------------

had programs for the infant period and the remainder for the neonatal period.l” This activity 

permits the States to prepare annual tabulations of 

infant deaths by weight at birth, period of gestation, birth order, age of mother, and other variables shown on birth certificates but not on death 

certificates. In modern vital statistics, record 

linkage of infant deaths and live births is becoming an integral part of many of the State vital 

statistics systems, 

Implications for Infant Mortality Rates 

The primary purpose of the 1960 live birth 

cohort study of infant mortality from which the 

data in this report were derived was to study infant mortality in relation to a number of characte~istics recorded on live birth records. The 

failure to link all of the infant death records will, 

in effect, under stat~?to varying degrees the mortality rates which are based on linked records. 

For example, the infant mortality rate of 25.1 

per 1,000 live ,births based on linked records 

may be as high as 25.8 per 1,000 live births if 

the rate is increased to allow for linkage failures. 

Of the total of 109,861 infant deaths which 

were identified in the study, birth certificates 

could not be found for 2.1 percent, Among the 

factors analyzed, the sex of the infant showed 

little relationship to the level of record linkage, 

while color was an important correlate. Record 

linkage was less complete for nonwhite than for 

white infant deaths: 3.2 and 1.7 percent unlinked, 

respectively, 

By age, as well, there were variations in the 

degree of unlinked records: 

Pevcent 

Under 1 hour 3.1 

1-23 hours 1.1 

1 day----------------------- 1.2 

2 days ---------------------- 1.0 

3 days ---------------------- 1.5 

4-6 days -------------------- 1.5 

7-13 days ------------------- 2.2 

14-27 days 2.5 

28 days-5 months 3.3 

6-11 months 4.8 

This same general pattern is repeated for each 

color-sex group. The proportion of unlinked retorals was higher for nonwhite than white infant 

deaths throughout the age range. 

Among the causes of death, record linkage 

was poorer for infants dying of’causes associated 

with extrinsic than intrinsic factors. However, 

this finding may reflect the higher proportions of 

unlihked records in the postneonatal periods when 

environmental factors predominate, rather than 

an association with cause jMv se. 1 

Geographically, the percent’ of infant death 

records which were unlinked varied from zero 

for the State of Hawaii to 7.9 percent for” New 

Mexico. Record linkage was poorest in States 

with relatively high proportions of American Indians. As a consequence, the infant mortality 

rates derived from this study for individual States 

are expected to be deficient to varying degrees. 

For nationwide rates, the data presented in 

this report can be used to gauge the degree to 

which linkage failures could lead to an understatement of the mortality rates. For State rates, this 

will not be universally possible. The data in this 

report are presented by the State of birth, while 

infant mortality rates are presented by place of 

mother fs residence at the time of the infant *s 

birth. Although there is usually a high degree of 

concordance between these two characteristics, 

the degree of concordance was as low as 84.6 

percent for the State of Maryland (table 2). Therefore, State data in this report should be used with 

caution in gauging the understatement of the infant 

mortality rates in the cohort study. The proportions of unlinked records should be used only as 

rough guides to assist in determining whether differences in mortality rates could possibly be accounted for on the basis of failures in record 

linkage. 

One other factor, could not be examined within the framework of the study. The proportions of 

unlinked records refer to infant death records for 

which no linked birth records could be found. However, some infant deaths go unregistered and there 

are no data available as to their number. Such 

unregistered infant deaths are not included in the 

1960 cohort study in any form. The magnitude of 

this deficiency remains unknown, but is presumed to be small on a nationwide scale. Its 

magnitude for some small geographic areas 

20 
may not be negligible, but their location and 

magnitude are unknown. 

CONCLUSION 

This report presents the background and 

study method for, ‘a study of infant mortality among 

the cohort of infants born alive in the United 

States in 1960. Included are a description of the 

data collection, the results of record linkage, and a 

discussion of the implications for. the study itself 

and for vital registration. 

The study demonstrated that ahighproportion 

of infant death records can be linked to their 

respective birth, records, thus providing an opportunity for studying infant mortality on a cohort 

basis. Mortality rates based on a cohort of live 

%oriyarna, 1, M.: Recent changes in irhrt morbality 

Lrend, Pub. HeaZth Rep. 75(5):391-405, May 19S0. 

2Shapiro, S., and Moriyama, I. M.: International trends in 

inrant mortality and their implications for the United States. 

Am.J.Pub.HeaL!h. 53:747-760, May,1963. 

3National Center for Health Statistics: International comparison of perinatal and infant mortality: The United States 

and six West,Fmropoan countries. Vital and Hea?th Statistic. 

HIS Pub. No. 1000-Series 3-No. 6. Public Health Service. 

Washington. U.S. Government Printing Office, Mar, 1967. 

4U.S. Bureau of the Censue: Studies in completeness of 

birth registration, Part I. Completeneee of birth registration 

in the United Statee, Decernher 1, 1939 to March 31, 1940, by 

& D. Grove. Vital LWa.tistic&Speoial Reports, Vol. 17, No. 18. 

M’ashington, B. C., Apr. 1943. 

5National ONice of Vital Statistics: Birth registration 

complexness in the United States and geographic areas, 

.1950, by S. Shapiro and J. Schachter, Vital Statistics-SpeciaZ 

Eeports, Vol. 39, No. 2. Public Health Service. Washington, 

L. C., Sepl,. 1954. pp. 37-93. 

6Rogers, P. B., Council, C. R., and Abernathy, J. R.: 

Testing death registration completeness in a group of premature infants. Pub.Hea?th Rep. 76(8):7.17-724, Aug. 1961. 

7.National Center for Health Statistics: Weight at birth 

and survival of the newborn, United States, early 1950. Vr2aZ 

and ii eazth Statistics. PHS Pub. No. 1000-Series 21-No. 3. 

Public lieallh Service. Washington. U.S. Government Printing 

Office, July 1965. 

births p$rmit the examination of patterns andrelationships associated with characteri~tics at 

birth which are unavailable from routinely produced data. Among these characteristics are age ,, 

of mother, birth order, birth weight, and period 

of gestation. 

The availability of direct observations in relation to these characteristics provides a powerful addition to the knowledge of factors associated 

with infant mortality. The increased knowledge 

available from such studies could be useful to 

those who are seeking to prevent infant death, 

those who are planning programs to provide care” 

for infants, and to research workers who are interested in relationships between mortality and 

birth characteristics in the general population as 

well as in the clinical setting. 

‘National Center [or IIealth Statistics: VitaZ Statistic’s of 

the Unite d States, 1960, Volume I. Public Health Service. 

Washington. U.S. Government Printing Office, 1962. 

‘Chaee, H. C.: Father’s occupation, parental age, and 

infant’s birth rank. The Rezationehip of Certain BioZogic and 

Socioeconomic Factors to FetaZ, Infant, and Earzy Chizdhood 

MOrtazity, Part I. Washington, B.C. Children’s Bureau, 1964. 

10National Vital Statistics Divisi,on: Report for ZJi.scrusion of the Str@y Group on Guide Materiaz for Comparable 

Studies on MatemaZ, PerinataZ and Postneonataz Events Reported on VitaZ ‘Records, a report by The Public Health Conference on Records and Statistics. Dec. No. 534.6. Public 

Health Service. Washington, D.C., May 1962. 

llNational Office of Vital Statistics: Part II, Coding and 

punching geographic and personal particulars. Section B, 

Births, deaths, and fetal deaths occurring in 1960. V;taz Statistics Instruction Manuaz. Public Health Service, Washington, 

D,C., Oct. 1960. 

12National Vital Statistics Division: Matched record comparison of birth certificate and ceneus information, United 

States, 1950, by J. Schachter. VitaZ Statistics-SpeciaZ Feports, Vol. 47, No. 12. Public Ilealth Service. Washington, 

B. C., Mar. 1962. 

21. 
DETAILED TABLES 

Table 1.


2.


3.


4.


5.


6.


7.


8.


9.


Number and percentage distribution of infant deatha, by type of record, color,


sex, and age at death: United States, 1960 live birth cohort~-------------------


Live birtha by place of occurrence and residence, and percent resident of and


born in same area: United States, each division and State, 1960 live birth co­


hort------------------------------------------------------"----------------------


Percent of infants born outside hospitals and percent unlinked infant death rec­


ords, by color: United States, each division and State, 1960 live birth cohort-­


Live births by specified race and sex: United States, each division and State,


1960 live birth cohort----------------------------------------------------------


Number and percentage distribution of infant death records,by 55 selected causes


of death, color, and age at death: United States, 1960 live birth cohort--------


Number and percentage distribution of live births and infant deaths, by type of


record, color, and age of mother: United States, 1960 live birth cohort---------


Number and percentage distribution of live births and infant deaths, by type of


record, color, and birth weight: United States, 1960 live birth cohort----------


Number and percentage distribution of live births and infant deaths, by type of


record, color, and period of gestation: United States, 1960 live birth cohort---


Infant deaths by place of birthplace of death, type of record; percent born and


died in same areq and percent linked records among infant deaths in area: United


States, each division and State, 1960 live birth cohort-------------------------


Page


23


26


28


30 

32 

36 

37 

38 

39 

22

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Table 1. Number and percentage distribution of infant deaths, by type of record, color, sex, and


age at death: United States, 1960 live birth cohort


Unlinked No death


Color, sex, and Total Linked death record


age at death records records found


in NCHS


TOTAL


Both’sexes Number of infant deaths Percentage distribution


All ages 109,861 107,038 2,293 530 100.0 97.4 2.1 0.5 

Under 1 hour 8,078 7,811 251 16 100.0 96.7 3.1 0.2 

1-23 hours 35,940 35,506 406 28 100.0 98.8 1.1 0.1 ~ day-. . . . . . . . . . . . . .. 11,534 11,388 11 100.0 98.7 1.2 

2 days---------------

3 days---------------

4-6 days 

7-13 days 

14-27 days-----------

7,530 

3,526 

4,489 

4,190 

4>324 

7,443 

3,469 

4,414 

4,091 

4>208 

12 

4 

8 

6 

7 

100.0 

100.0 

100.0 

100.0 

100.0 

98.8 

98.4 

98.3 

97.6 

97.3 

1.0 

1;5 

;:; 

2.5 

‘;:; 

0.1 

0.2 

0.1 

0.2 

Unknown days 1 (1) P) 

Under 28 days 79,612 78,330 1,190 100.0 98.4 1.5 0.1 

28 days-5 months 22,664 21,641 746 2% 100.0 95.5 1.2 

6-11 months 7,5;: 7,067 357 85 100.0 94”.1 ::: Not stated----------- 76 100.0 10M 

Male


All ages 63,272 61,651 1,315 306 100.0 97.4 2.1 0.5 

Under 1 hour 4,355 4.208 139 100.0 96.6 3.2 0.2 

1-23 hours 20,973 20;720 236 100.0 98.8 1.1 I day---------------- 6,843 6,754 100.0 98.7 1.2 %: 

2 days--------------- 4,531 4,483 :: 100.0 98.9 0.9 0.1 

3 days--------------- 2,125 2,094 29 100.0 98.5 1.4 0.1 

4-6 days 2,552 2,508 39 100.0 98.3 1.5 0.2 

7-13 days 

14-27 days-----------

2,319 

2,476 

2,265 

2,410 

51 

62 

100.0 

100.0 

97.7 

97.3 

2.2 

2.5 

0.1 

0.2 

Unknown days .-

Under 28 days-------- ;;,;;: 45,442 682 100.0 98.4 1.5 0.1 

28 days-5 months 12,360 436 100.0 95.3 1.3 

6-11 months 4:097 3,849 197 100.0 93.9 ::2 

Not stated----------- 33 100.0 10M 

Female


All ages 46,589 45>387 978 100.0 97.4 2.1 0.5 

Under 1 hour 3,723 3,603 112 100.0 96.8 3.0 0.2 

1-23 hours 1:,;;; 14,786 170 100.0 98.8 1.1 0.1 

1 day---------------- 4,634 100.0 98.8 1.1 0.1 

2 days 2:999 :,;%; 100.0 98.7 1.1 0.2 

3 days 1,401 100.0 98.1 1.7 0.2 

4-6 days 1,937 1:906 100.0 98.4 1.4 0.2 

7-13 days------------ 1>871 1.826 100.0 97.6 2.2 0.2 

14-27 days----------- 1,848 1;798 47 100.0 97.3 2.5 0.2 

Unknown days--------- 1 1 P) (1) 

Under 28 days-------- 33,438 32,888 508 100.0 98.4 1.5 0.1 

28 days-5 mon.ths 9,696 9,281 310 100.0 95.7 1.1 

6-11 months 3,412 3,218 160 100.0 94.3 ::; 1.0 

Not stated------------ 43 100.0 100.0 

See footnotes at end of table.


23

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----------- ---------

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-------- ----- ----------

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----------- ---------

-------- ----- ----------

-----------

Table 1. Number and percentagedistributionof infant deaths,by type of record, color, sex, and


age at death: United States, 1960 live birth cohort-Con.


Linked Unlinked No death Color,sex, and Total death record 

age at death Total E records records, in NCHS 

found


WHITE


Both sexes Number of infant deaths Percentagedistribution


All ages 81,610 79,819 1,391 100.0 97.8 1.7 0.5 

Under 1 hour--------- 6,433 6,241 178 100.0 97.0 2.8 0.2 

1-23 hours 27,925 

1 day---------------- 9,054 

27,645 

8,958 

256 100.0 

100.0 

99.0 

98.9 

0.9 

1.0 

0.1 

0:1 

2 days 6,142 6,078 X 100.0 99.0 0.9 0.1 

3 days 2,795 2,76L 31 100.0 98.8 1.1 0.1 

4-6 days 3,367 3,324 37 100.0 98.7 1.1 0.2 

7-13 days 3,039 2,980 53 100.0 98.1 1.7 0.2 

14-27 days 2,848 

Unknown days 1 

2,786 58 

L 

100.0 

(1) 

97.8 2.0 

(1) 

0.1 

Under 28 days 61,604 60,773 756 100.0 98.7 1.2 0.1 

28 days-5 months 14,913 14,282 423 100.0 95.8 ::$ 1.4 

6-11 months 5,040 4,764 212 100.0 94.5 

Not stated 53 . - 100.0 10;:; 

Male


All ages 47,444 46,386 820 100.0 97.8 1.7 0.5 ,

Under 1 hour 3,460 3,351 101 100.0 96.8 2.9 0.2


1-23 hours 16,461 16,286 161 100.0 98.9 0.1


1 day---------------- 5,407 5,344 58 100.0 98.8 R 0.1


2 days 3,721 3,687 29 100.o“ 99:1 0.8 0.1 .“


3 days 1,678 1,657 100.0 98.7 1.1


4-6 days 1,923 1,900 R 100.0 98.8 1.0 ,::;


7-13 days 1,716 1,686 100.0 98.3 1.6


14-27 days 1,665 1,626 :; 100.0 97.7 2.2 0:1


Unknown days


Under 28 days 36,031 35,537 452 100,0 98.6 1.3 0.1


28 days-5 months 8,638 8,258 248 100.0 95.6


6-11 months 2,749 2,591 120 100.0 94.3 ;:: i:;


Not stated 26 100.0 100.0


Female


All ages 34,166 33,433 571 100.0 97.9 1.7 0.5


Under 1 hour--------- 2,973 2,890 100.0 97.2 2.6 0.2 

1-23 hours 11,464 11,359 100.0 99.1 0.8 0.1 

1 day---------------- ;>:;; 3>614 100.0 99.1 0.8 0.1 

2 days 2,391 100.0 98.8 1.1 0.2 

3 days.-.-........... 1:117 1,104 100.0 98.8 1.1 0.1 

4-6 days 1,444 1,424 100.0, 98.6 1.2 0.2 

14-27 days 1,183 1,160 100.0 98.1 1.8 0.2 

Unknown days 1 P) (1) 

Under 28 days 25,573 25,236 100.0 98.7 1.2 0.1 

28 days-5 months 6,275 6,024 100.0 96.0 1.2 

6-11 months 2,291 2,173 100.0 94.8 ::: Not stated 27 100.0 . - 10;:; 

7-13 days 1,323 1,294 100.0 97.8 2.0 0.2 

See fOOtnotesat end of table.


24

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----------

Table 1. Number and percentage distribution of infant deaths, by type of record, color, sex, and


age at death: United States, 1960 live birth cohort—Con.


Color, sex, and


age at death


NONWKHE


Both sexes Number of infant deaths Percentage distribution


All ages 28,251 27,219 902 100.0 96.3 3.2 0.5 

Under 1 hour 1,645 1,570 73 100.0 95.4 4.4 0.1 

1-23 hours 8,015 7,861 150 100.0 98.1 1.9 

1 day---------------- 2,480 2,430 48 100.0 98.0 1.9 %: 

2 days 1,388 

731 

1,365 

708 

20 100.0 

100.0 

;3.; 

M 

0.2 

L:azys 1,122 1,090 % 100.0 97:1 U 

7-13 days------------ 1,151 1,111 40 100.0 96.5 ::;


14-27 days 1,476 1,422 51 100.0 96.3 3.5 O.i


Unknown days---------


Under 28 days-------- 18,008 17,557 434 100.0 97.5 0.1


28 days-5 months 7,751 7,359 323 100.0 94.9 ::: 0.9


6-11 months 2,469 2,303 145 100.0 93.3 5.9


Not stated----------- 23 100.0 10:::


Male 

All ages 15,828 15,265 495 100.0 96.4 3.1 0.4


Under 1 hour 895 857 38 100.0 95.8 4.2 

1-23 hours 4,512 4,434 100.0 98.3 1.7 0.; 

1 day---------------- 1,,436 1,410 ;; 100.0 98.2 1.7 0.1 

2 days--------------- 810 796 14 100.0 98.3 1.7 

447 437 10 100.0 97.8 

~	 L:a%ys 629 608 19 100.0 96.7 H 0.; 

7-13 days------------ 603 579 24 100.0 96.0 4.0 

14-27 days 811 784 25 100.0 96.7 3.1 0.; 

‘Unknown days


Under 28 days 10,143 9,905 230 100.0 %7.7 ~ Qd 

28 days-5 months 4,330 4,102 188 14%-0 94.7 ct.9 

6-11 months 1>348 1,258 77 100.0 93.3 5:7 1.0 

Not stated----------- 7 (1) (1) 

Female


All ages------- 12,423 11,954 407 100.0 96.2 3.3 0.5 

Under 1 hour 750 713 35 100.0 95.1 4.7 

1-23 hours 3,503 3,427 100.0 97.8 2.1 ::: ~ day---------------. 1,044 1,020 E 100.0 97.7 2.2 0.1 

2 days--------------- 3 days 

578 

284 

569 

271 

6 

12 

100.0 

100.0 

98.4 

95.4 

1.0 

4.2 

0.5 

0.4 

4-6 days 493 482 11 100.0 97.8 2.2 

7-13 days------------ 548 532 16 100.0 97.1 

14-27 days----------- 665 638 26 100.0 95.9 ;:; O.i


Unknown days
 -


Under 28 days-------- 7,865 7,652 204 100.0 ,97.3 0.1 

28 days-5 months 3,421 3,257 135 100.0 95.2 ;:; 0.8 

6-11 months 1,1:; 1,045 68 100.0 93.2 6.1 0.7 

Not stated----------- P) (1) 

lpercent not sh~; based on less than 20 deaths. 

25

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Table 2. Live birtha by place of occurrenceand residence,and percent resident of and born in
 same area: United States, each divisionand State, 1960 live birth cohort


Occurred in Resident of


specifiedarea Occurred specifiedarea Percent
 in and
 resident


Division and State of and


born in
 same area


Number of live births


United Statea 4,257,850 . . . . . . 4,257,850 ..* ..* 

Geographicdivision:


New England


Middle Atlantic


East North Central


West North Central


South Atlantic


East South Central


West South Central


Mountain


Pacific


New England:


Maine


New Hampshire


Vermont


Massachusetts


Rhode Island


Connecticut


Middle Atlantic:


New York


New Jersey


Pennsylvania


East North Central:


Ohio


Indiana


Illinois


Michigan


Wisconsin


West North Central:


Minnesota


Iowa


Missouri


North Dakota


South Dakota


Nebraska


Kansas


See footnoteat end of table.


237,882 2,372 235,510 236,758 1,248 .99.5 

731,87.0 2,916 728,954 733,294 4,340 99.4 

872,834 5,970 866,864 877,300 10,436 98.8 

371,604 6,498 365,106 368,888 3,782 99.0 

628,418 6,758 621,660 628,716 7,056 9,8.9 

297,152 7,546 289,606 294,240 4,634 98.4 

430,014 2,724 427,290 430,922 3,632 99.2 

188,112 3,854 184,258 187,062 2,804 98.5 

499,964 1,380 498,584 500,670 2,086 99.6 

23,874 1,218 22,656 23,218 562 97.6 

13,158 1,072 12,086 13,844 1,758 87.3 

9,178 494 8,684’ 9,408 724 92.3 

116,510 2,906 113,604 115,124 1,520 98.7 t 

19>294 1,644 17,650 18,396 746 95.9 

55,868 774 55,094 56,768 1,674 97.1 

361,186 4,470 356,716 359,452 2,736 99.2


127>566 1,482 126,084 132,374 6,290 95.2


243,118 5,778 237,340 241,468 4,128 98.3


230,042 3,542 226,500 230,718 4,218 98.2


113,154 3,244 109,910 112,722 2,812 97.5


236,204 3,858 232,346 238,928 6,582 97.2


194,074 1,102 192,972 195,336 2,364 98.8


99,360 1,880 97,480 99,596 2,116 97.9


87,586 2,242 85,344 87,594 2,250 9-z4---

64,806 2,450 62,356. 64,162 1,806 97.2 

101,672 6,944 94,728 97,926 3,198 96.7 

16,594 1,140 15,454 16,626 1>172 93.0 

17,630 852 16,778 17,620 842 95.2 

34,158 1,118 33,040 34,262 1,222 96.4 

49,158 2,200 46,958 50,698 3,740 92.6 

26

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-----------------------

Table 2. Live births by place of occurrence and residence, and percent resident of and born in 

same area: United States, each division and State, 1960 live birth cohort-Con. 

Division and State


South Atlantic:


Delaware


Maryland


District of Columbia


Virginia


West Virginia


North Carolina


South Carolina


Georgia


Florida


East South Central:


Kentucky


Tennessee


Alabama


Mississippi


West South Central:


Arkansas


Louisiana


Oklahoxna~--------------------


Texas


Mountain:


Montana


Idaho------------------------


Wyoming


Colorado .-.-....--------.....


New Flexico


Arizona


Utah


Nevada


Pacific:


Washington


Oregon


California------------.--y---


Alaska


Hawaii


Occurred in I Resident of Occurred specified area in and I specified area Percent 

resident
 1 “s:$- l-- of and 

Occurred born in 

Total Nonresi- specified Total else- same area
 dentl areal
 w’nere~


Number of live births


11,636 600 11,036 11,580 544 95.3 

68,738 3,326 65,412 77,350 11,938 84.6 

33,550 15,354 18,196 19,872 1,676’ 91.6 

89,186 2,012 87,174 95,534 8,360 91.2 

40,492 3,384 37,108 39,474 2,366 94.0 

109,820 1,646 108,174 109,774 1,600 98.5 

59,556 1,378 58,178 59,812 1,634 97.3 

100,942 2,786 98,156 99,750 1,594 98.4 

114,498 574 113,924 115,570 1,646 98.6 

73,724 3,872 69,852 72,208 2,356 96.7


83,576 3,722 79,854 82,036 2,182 97.3


80,180 1,468 78,712 80,846 2,134 97.4


59,672 1,510 58,162 59,150 988 98.3


40,960 1,626 39,334 40,582 1,248 96.9


90,210 1,134 89>076 90,212 i,136 98.7


50,270 820 49,450 50;986 1,536 97.0


248,574 I,7L2 246,862 249,142 2,280 99.1


17,25t 146 17,112 17,444 332 98.1


17,022 694 16,328 17,176 848 95.1


8,336 272 8,064 8,512 448 94.7


45,184 2,818 42,366 42,912 546 98.7


29 858 546 29,312 30,680 1,368 95.5


36 520 522 35,998 36,760 762 97.9


26 656 666 25,990 26,308 318 98.8


7 278 234 7,044 7,270 226 96.9


65 288 990 64,298 65>278 980 98.5


38,532 976 37,556 38,414 858 97.8


371,476 770 370,706 37.2,210 1,504 99.6


7,466 7,466 7,562 96 98.7


17,202 46 17,156 17,206 50 99.7


lTotals for the geographic divisions do not equal the sum of the individual States, because of


differences between place of birth and mother’s residence at time of birth which affected State


data but did not affect divisional data.


27

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-------------------------

Table 3. Percent of infants born outsidehospitalsand percentunlinked infant death records, by


color: United States, each divisionand State, 1960 live birth cohort


Division and State


E


United States


Geographicdivision:


New England


Middle Atlantic


East North Central


West North Central


South Atlantic


East South Central


West South Central


Mountain


Pacific


New England:


Maine


New Hampshire


Vermont


Massachusetts


Rhode Island


Connecticut


Middle Atlantic:


New York-----------------------

New Jersey 

Pennsylvania 

East North Central:


Ohio


Indiana


Illinois


Michigan


‘WiscOnain


West North Central:


Minnesota


Iowa


Missouri


North Dakota


South Dakota


Nebraska


Kansas


See Eootnoteaat end of table.


Total White Nonwhite


Born Unlinked Born Unlinked


outside death death


hospitall recordss h~;;;$l records%


Percent


3,4 2.1 1.2 1.7 15.0 3.2


0.5 2.7 0.4 2.7 0.8 2.7 

0.9 2.1 0.7 2.0 2.2 2.5 

1.0 1.0 0.7 0.8 3.4 1.9 

0.9 1.2 0.7 1.0 3*9 2.7 

7.8 1.6 1.2 1.0 23.5 2.2 

13.3 2.4 3.1 2.0 37.8 2.9 

6.3 4.4 4.0 3.5 15.2 6.3 

2.0 3.8 1.7 2.8 5.5 10.1 

0.9 1:1 0.8 1.0 2.1 1.8 

8)
 1.4 3.2 1.4 3.2 ,(


0.4 4.1 0.4 4.1 4. (a) 

“1.1 1.8 1.1 1.8 � *, � *, 

0.3 2.4 0.3 2.3 1.1 3.8 . 

0.3 3.6 0.3 3.9 0.8 4-

0;3 2.6 O*3 2.6 0.7 2.2 

O*9 1.9 0.6 2.0 2.7 1.6


0.7 2.0 0.5 1.6 2.1 3.3


0.9 2.3 0.8 2*O 1.4 3.5


0.8 0.5 0.8 0.4 0.9 1.1


0.9 2.1 0.7 1.9 2.7 3*3


1.8 0.8 1.0 0.8 6.3 0.8


0.6 1.3 0.5 0.7 i.7 4.2


0.4 0.8 0.3 O*7 2.1 1.3


0.4 0.9 0.4 0.8 2.2 41.8


0.4 0..2 0.4 0.1 1.4 “2.6


2.1 1.7 1.6 1.3 5.3 2.6


0.2 0.5 0.2 0.5 0.6 4-


l.l 4.8 0.7 4.0 5.8 8.0


0.4 0.4 0.3 0.4 1.1 4-


005 1.2 0.4 1.2 1.2 0.8


28

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------------------------

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-------------------------

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-------------------------

-------------------------

Table 3. Percent of infants born outside hospitalsand percent unlinked infant death records, by 

color: United States, each division and State, 1960 live birth cohort-Con. 

Total White Nonwhite


Division and State Born Unlinked Born Unlinked Born Unlinked
 .
 outside death outside death death


hospitall records~ hospitall recordsg h~:;:;~~ 

Irecords~


South Atlantic:


Delaware


Maryland


District of Columbia


Virgtnia


West Virginia


North Carolina


south Carolina


Georgia


Florida


East South Central:


Kentucky


Tennessee


Alabama


Mississippi


West South Central:


Arkansas


Louisiana


Oklahoma


Texas


Mountain:


Montana


Idaho


Wyoming


Colorado


New Mexico


Arizona


Utah


Nevada


Pacific:


Washington


Oregon


California


Alaska


Hawaii


Percent


1.8 2.2 0.7 2.4 6.9 1.9 

2.0 1.3 0.7 1.3 6.5 1.2 

1.5 1.8 0.5 1.0 2.0 2.4 

7.3 1.9 1.6 1.4 24.3 2.7 

3.3 2.2 3.2 1.9 6.8 46.3 

8.5 1.5 0.8 0.8 25.2 2.2 

17”.6 3.7 1.3 1.6 39.9 5.2 

12.0 0.9 1.0 0.5 31.9 1.3 

6.0 0.5 1.0 0.4 “19.5 0.6 

6.0 4.7 5.6 4.2 10.5 7.6 

5.0 0.5 2.2 0.4 14.6 0.9 

18.0 2.4 2.0 1.9 45.2 2.9 

27.3 2.3 1.2 0.7 49.4 2.9 

13.5 6.3 2.1 2.9 39.9 10.8


4.1 1.8 0.5 0.7 9.7 2.8


1.9 2.0 0.9 1.6 8.1 3.2


6.9 5.6 5.7 4.5 13.6 9.2


1.0 0.5 0.9 0.5 2.0 4-

0.8 5.0 0.8 &.g 1.8 (3) 

0.3 1.3 0.3 1.4 1.4 (3) 

1.0 1.6 1.0 1.6 1.0 41.4 

5.2 7.9 5.2 4.9 5.6 23.2 

3.1 3.6 2.2 3-.7 8.2 8,0 

0.6 5.1 0.5 4.4 5.8 419.2 

0.6 3.3 0.3 3.8 2.3 4-

0.’5 0.5 0.5 0.4 1.0 0.8


0.7 0.2 0.7 0.2 1.6 4-


0.9 1.4 0.8 1.2 1.3 2.5


8.7 0.7 1.3 0.7 24.9 0.6


0.7 . 0.3 0.8


lBy mother’sresidence at time of infant’s birth.


2By place of birth.


apercentnot shown; based on less than 20 events.


%ased on at least 20, but less than 100 events.


29

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-----------------------------------------------

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---------------------------

----------------------------------------------------

----------------------------------------------------

-----------------------------------------------------

------------------------------------------------------

-----------------------------------------------------

----------------------------------------------------------

---------------------------------------------------------

---------------------------------------------

--------------------------------------------------------- ---------------------------------

---------------------------------------------

---------------------------------------------------

--------------------------------------------------- ---------------------------------------------------- --------------------------------------------------

-------------------------------------------------------- --------------------------------

------------------------------------------------------

--------------------------------------------------------

---------------------------------------------------------

---------------------------------------------------------

-------------------------------------------------------

-------------------------------------------------------

Table 4. Live births by specified race and sex: United States, each division and State, 1960 live birth cohort


[Byplace ofresidence. Datamf.ronlytobirtbs occurring witbin W? United Stites, including A1.sks andEnwaii. Basedona 50-percent
 sample]
 . . 

All races White


Division and State


Total Male Female Male Female 

United States i.257.85C 2,179,70t	 2,078,142 1,848,19: 1,752,55:
 —


Geographic division:
 New England 236,75S 121,464 115,294 116,84( 110, s2[
 Middle Atlantic-----..---------.-------------.-,----------------- 733,294 374,936 358,358 329,97I 313,72(
 East North Central S77,30C 448,612 428,6SS 399,68! 380,25~
 West North Central 36 S,S88 1S9,480 179,40s 177> 72( 168,20(
 South Atlantic--------------------------------------------------- 628,716 321,924 306>792 228> 361 215,061
 East South Central.-.-----.-. .--------------------------- 294, 24c 150,524 143,716 107,25 I 100,50(
 West South Central 430,922 220> 566 210,356 174,35L L65,471
 Mountain--------------------------------------------------------- 187,062 95,598 91,464 88,56( 84,46f
 Pacific 500,670 256,604 244,066 225>42t 214, 04[
 New England:
 Maine--------------------------- -----. 23,218 11,948 11,270 11>79( 11,11:
 New Hampshire 13,844 7,08S 6,756 7,04: 6,706
 VemOnt ---------------------------------------------------------- 9,40s 4,792 4,616 4,78( 4,612
 Mssachusetts 115> 124 59,264 55, S60 57,0s( 53,76f
 Khode Island 1S,396 9,390 9,006 9,00( S, 64t
 Connecticut 56,76S 28,9S2 27,7S6 27,13( 25,976
 Middle Atlantic:
 New York--------------------------------------------------------- 359,452 183,932 175,520 160,71( 152,19E
 New Jersey------------------------------------------------------- 132,374 67,316 65,058 58,35[ 56,412
 Pennsylvania 241,468 123,6S8 117,780 llo,90f 105,11C
 East North Central:
 Ohio------------------------------------------------------------- 230,718 118,142 112,576 lo5,90f 100,6OC
 Indiana 112,722 57,604 55,118 52,84( 50>486
 IllinOis 238392S 122> 114 1;$,:;: 103,01[ 97,672
 Michigan--------------------------------------------------------- 195,336 99,730 S8, S7t 84,91C
 Wisconsin-------------------------------------------------------- 99,596 51,022 48;574 49,04( 46,5S6
 West North Central:


Minnesota-------------------------------------------------------- 87,594 44,916 ;$;;: 44,11E 41, s4c
 Iowa------------------------------------------------------------- 64,162 33,126 32,621 30,546
 Missouri--------------------------------------------------------- 97,926 5:,::: 47;626 43,35t 41,134
 North Dakota----------------------------------------------------- 16,626 8,140 8,18( 7,S22
 South Dakota----------------------------------------------------- 17,620 8;928 8,692 S,29C 7,988
 Nebras~--------------------------------------------------------- 34,262 1.7,742 16,520 16,97$ 15,770
 Kansas .------------- 50,698 25>982 24,716 24,2.82 23,100 South Atlantic: Delaware 11,580 5,992 5,58S 4,89C 4,556
 Maryland-.---------------------- 77>350 39>832 37,51s 31,07C 2S>960
 District of Columbia 19,872 10,206 9,666 3,20S 2,988
 Virginia-.------------------------------------.--:--------------- 95,534 48,496 47>03s 36,586 35,12S
 West Virginia---------------------------------------------------- 39,474 20,282 19,192 19,268 18,296
 North Carolina 109,774 56,316 53,45s 38,826 36,432
 South Carolina 59,812 30,672 29,140 17,962 16,622
 Georgia ...... 99,750 51,280 48,470 33,380 30,912
 Florida -----..- 115,570 58>S4S 56>722 43,174 41,170
 East South Central:
 Kentucky-................------------..................---.-...-- 72,20S 34,826 34,1S2 31,778
 Tennessee S2,036 40,140 32,876 30,988
 Alabama------------------ ........ 80,846 39,522 26,304 24,524
 Mississippi 59,150 29,228 13,894 13,210
 West South Central:
 Arbnsas --------------------------------------------------------- 40,582 20,020 14,372 13,994
 Louisiana 90,212 44,152 28,314 26,978
 Oklahom 50,986 24,770 22,670 21,240
 Texas------------------------------------------------------------ 249,142 121,414 108,998 103,262


Mountain:
 Montana---------------------------------------------------------- 17,444 S,978 S,466 8,350 7,81S
 Idaho------------------------------------------------------------ 17,176 S,766 8,410 8,630 S>216
 WyOtinS---------------------------------------------------------- 8,512 4,350 4,162 4,212 4,012
 Colorado 42,912 21, S28 21,084 21,050 20,270
 New Mexico------------------------------------------------------- 30,680 15,542 15>138 13,904 13,500
 Arizona---------------------------------------------------------- ;:,;;: 18,94B 17, S12 16,008 14,97B
 Utah------------------------------------------------------------- 13,480 12,828 13,190 12,562
 Nevada----------------------------------------------------------- 7;270 3,706 3,564 3,216 3,110


Pacific:
 Washington 65,278 33,338 31,940 31>63s 30,072 

Oregon----------------------------------------------------------- 38,414 

California 372,210 

19,590 

190,806 

18, S24 

181,404 

18,878 

16;,M~ 

18,200 

16;,;;; 

Alaska----------------------------------------------------------- 7,562 3,862 3,700 

Hawaii----------------------------------------------------------- 17,206 9,008 8,198 2;808 2;506 

lIncludes112 births ‘toAleuts and 562 births to Eskimos. (In addition,there were 38 births to Aleuts and Eskimos residing
 in other States.)


‘Includes 122 births to Aleuts and 48S births to Eskimos. (In addition there were 30 births to Aleuts and Eskimos residins
 in other States.)


‘Includes 2,498 births to Hawaiians and Part-Hawaiians. (In addition there were 356 births to Hawaiians and Part-Hawaiians
 residing in other States.)


41ncludes 2,246 births to Hawaiians and Part-Hawaiians. (In addition there were 320 births to Hawaiians and Part-Hawaiians
 residing in other States.)


Source: National Center for Health Statistics,Vital Statistics of the United States, 1960, Vol.I, Public Health Service,


Washington, U.S. Government Printing Office 1962, p. 2-7.


30 
Table 4. Live births by specified race and sex: United States, each division and State, 1960 live birth cohort—Cm.


[By PIN. of reside . . . . De.fnrefer only to births occurring within the United States, including Ak.skn snil Hawaii. BP.@ m n 50-percenC s.mple] 

Negro Indian Chinese Japanese Other races 

:ale Female Male Female Male Female Nale Female Male Female 

03.566 298,698 . 10,512 10,602 2,966 6,688 6,304 7,784 7.106 

128 136 100 

2:: 2i; 560 320 3% 354 2% 

558 528 192 412 420 214 218 

1,498 1,632 

8;; 764 1?; 

30 

20s 168 

324 312 118 

286 2% 

40 26 

1>234 1,2!: 70 2;; 1% 

4,152 4,192 

1,862 1,894 1,7% 

264 250 

4,730 4,500 

1% 1% 

6,436 5,964 

32 30 26 16 14 

; 6 6 : 

j 3i 

6 8; 

18 

7: 4?) 

10 ;2 

6 12 2$ 12 14 

206 214 436 166 172 172 120 

10 74 106 88 

22 20 50 48 62 1;: 1;: 

24 26 38 94 40 40 

4 16 26 ;2 26 26 

1:: 176 200 72 

l% 104 X 66 :: 54 

328 288 16 50 ;: 32 26 

378 426 24 30 36 38 3; 

:: 30 18 16 

1: 28 22 1: 14


256 2$: 2 12 6 4 2


604 666 2 10


124 120 2 1: 22 2:


78 66 6 98 56 28 

2; 3; 3; i: 6; 6; 31 

10 36 30 lC 36 

22 1: 10 56 66 :; 36 

72: 64; i 6: 6: 4? 30 

18	 18 16 1: 24 12 

i 36 28 2E 18 

5: 4: 18 5$ 52 22 38 

6 3E 2t If 

2 i 1: 12 11 1: 2 14 f 1[ 4 

6: 52 12 f 1: f 

2 

H 1: 

1[ 3: 

1 4 

1,1?: 

64 

1,114 

46 5; 

:! 

14f 

, 

1:; 

1: 

5( 

;: 

52 

552 58C 22 1( 11 10 

72 106 : 2[ 3( 1: 16 

82 94 Li 

9e 1; 6: 4: 4; 3: 

1,2:: 

1,908 

134 

1,192 

1,846 154 

3: 

14 

5f 

: 

4t 

G 

3( 

2: 

3: 

1[ 

3: 

12 

12C 122 4 1[ 1( [ 2 

40E 44E 24L 27( 20( 226 

216 

924 

302 

17t 

87( 

38C 

Y l,22f 

8[ 

2,33[ 

2[ 

2,2:: 1 8? 

3721 

52 1.682 

2634 

12 2( 39: 2,03: 1,8;[ 33,65( 43,370


31 
------------------

Table 5. Number and percentage distribution of infant death records, by 55 selected causes of


death, color, and age at’death: United States, 1960 live birth cohort


. 

Total


1


2


9


10 

11 

16


17


18


23


24


25


26


27


28


29


30 

31


32


38


42


— 

Cause of death Under 1 year


(Seventh Revision of the International Lists, 1955)


Linked Unlinked


records death


records


Number


All causes-------------------------------------------------- 107,038 i 23293


Percentage distribution


All causes-------------------------------------------------- 100.0 100.0 

Dysentery, all forms---------------------------------------O45-O48 0.1 0.4 

Septicemia and pyemia------------------------------------------O53 0.4 0.5 

whooping cough-------------------------------------------------O56 0.1 0.2 

Meningococcal infections---------------------------------------057 0.2 0.2 

Tetanus--------------------------------------------------------O6l 0.1 0.6 

Other infective and parasitic 

diseases 001-044,049-052,054,055,058-060,062-138 0.5 1.0 

Malignant neoplasms, including neoplasms of lymphatic and 

hematopoietic tisaues-------------------------------------l4O-2O5 

Benign neoplasms and neoplasms of unspecified nature-------2lO-239 ::; ::: 

Diseases of thymus gland---------------------------------------273 0.1 0.0 

Meningitis, except rneningococcaland tuberculous---------------34O 0.8 

Other diseases of nervous system and sense organs--330-334,341-398 0.8 ::; 

Acute upper respiratory infections-’-------------------.----47O-475 0.4 

Influenza and pneumonia,except pneumonia of newborn-480-483,490-493 8.4 1%$ 

Influenza--.---------------;--------------------------'----48O-483 0.3 0.6 

Pneumonia, except pneumonia of newborn------------------~49O-493 8.1 13.3 

Bronchitis-------------------------------------------------5OO-5O2 0.6 0.7 

Other diseases of respiratory system---------------5lO-522,525-527 1.4 

Pulmonary congestion and hypostasis--------------------------522 0.2 ::; 

Other chronic interstitial pneumonia-------------------------525 0.8 1.4 

Bronchiectasis---------------------------------------,--------526 

Other.diseases of lung and pleural cavity------------------527.2 ::: 0.1 

All other diseases of respiratory system-----------5lO-52l,527. 1 0.2 

Hernia and intestinal obstruction----------------------56O,56l,57O 0.8 0.7 

Gastritis, duodenitis, enteritis, and colitis, except 

diarrhea of newborn-----------------------------------543,57l,572 

Other diseases of digestive system---------53O-553,573-587,573-587 $2 ;:; 

Congenital mlformations-----------------------------------75O-759 13.9 12.7 

S~ina bifida and meningocele---------------------------------75l 1.0 0.9 

Congenital hydrocephalus and other congenital malformations 

of nervous system and sense organs----------------------752, 753 1.4 

Congenital malformations of circulatory system---------------754 ::: 

Other congenital malformations-----------------------75O, 755-759 4.6 ;:! 

Certain diseases of early infancy--------------------------76O-776 61.6 41.6 

Birth inj-ies-------------------------------------------76O, 761 9.4 5.8 

Without mention of immaturity (.0)---------------------------+ 3.7 3.5 

With immaturity (.5)------------------------------------------ 5.7 2.2 

Intracranial and spinal injury at birth------------------76O 2.9 1.7 

Without mention of immaturity (.0)------------------------ 1.7 

With immaturity (.5)-------------------------------------- ::: 

&her birth injury---------------------------------------76l ;:: 4.1 

Without mention of immaturity (.0)------------------------ 2.3 

With immaturity (.5)-------------------------------------- ::: 1.8 

32

5

10

15

20

25

30

. 

Table 5. Number and percentagedistribution of infant death records? by 55 selected causes of


death, color, and age at death: United States, 1960 live bnth cohort—con.


Total White Nonwhite


Under 28 days .28 days-n months Under 1 year


Linked Unlinked Linked Unlinked Linked Unlinked Linked Unlinked


death death death death
 records records records records, records records
 records records


Number


78,330I 1,190 28,708 1,103 II 79,819 1,3911 27,219 902 1


Percentagedistribution


100.0 100.0 100.0 100.0 100.0 100.0 100.0 2
 ~


0.0 0.1 0.3 7 0.1 0.4 0.6 3


1:0 ‘ 0.3 0.5 M 0.4 4


0.; 0.; ::; 0.4 0.0 0.1 :.: 0.4


0.0 0.5 0.4


0.1 1.2 0.0 M ;:: 0.1 1.5 ;


0.1 0.5 1.4 1.5 0.4 1.1 ,0.6 0.9 8


0.0 0.2 0.8 0.7 0.3 0.6 0.1 0.2 9


0.1 0.2 0.2 0.1 0.1 0.2 0.1 -


0.0 0.3 0.1 0.1 0.1 0.0 -111


0.3 0.; 2.2 2.4 0.7 0.8 1.1


0.2 0.1 2,5 1.0 K


0.1 0.1 ::2 .::! ::; 14


0.1 0.3 3::: 28.6 6.9 1::; 12.7


0.1 0.3 0.2 16


0.0 3::; 2;:: 6.8 1::: 1;:: 17


0.1 0.2 2.0 1.4 0.6 0.9 0.6 18


0.2 4.5 1.3 1.4 ::2 2.0 19


0.1 0.5 ::: 0.2 0.1 0.1 0.1


0.0 2.9 0.8 1.1 1.9 21
 ::: ::: - 22


0.; 0.7 O.i 0.2 0.1 0.3 - 23


0.1 0.3 0.2 0.1 - 24


0.8 0.3 0.8 1.0 0.9 0.8 0.5 0.4


;.; 11.4 4.2 4.5 7.6 26
 ;:: M ::2 1.0 0.6 0.6 27


12.5 17:7 12:; 16.2 17.3 7.2 5.5 28


0.7 ;:; 1.7 1.3 1.2 1.3 0.3 0.2 29


1.1 2.6 1.7 0.8 ().6


5.6 ;:; 10.2 1;:: R 3.7 2.7 31


5.1 4.2 3.2 2.7 ;:: 4.4 2.4 2.1 32


82.4 73.3 4.9 7.4 62.9 41.9 57.8 41.1 33


12.8 11.1 0.0 10.3 6.1 6.5 :.; ;:
 5.0	 6.8 0.0 3.5 3.0


4.3 0.0 H 2.7 3.4 1:6 36


.::: 3.3 0.0 3.0 1.4 2.6 2.2 37


2.3 2.4 0.0 1.2 1.4 1.4 38


0.8 H 0.2 0.8 39
 ::; 0.6 4.7 M 3.0 40


2.7 i:; ;:: 2.3 2.2 41


6.1 3.4 M 5.2 2.4 H 0.8 42


I


.-

33

-------------------------------------

Table 5. Number and percentage distribution of infant death records, by 55 selected causes of


death, color, and age at death: United States, 1960.live birth cohor’i-Con.


= 

1


2


:


2


;


9


10


11


12


13


14


15


16


17


18


%


21


22


23


24


;:


27


28


29


30


31


32


33


Cause of death


(Seventh Revision of the International Lista, 1955)


Certain diaeases of early infancy--Con.


Postnatal asphyxia and atelectasia---------------------------762


Without mention of immaturity (.0)----------------------------


With immaturity (.5)------------------------------------------


Pneumonia of newborn-----------------------------------------763


Without mention of immaturity (.0)----------------------------


With immaturity (.5)-----’


Diarrhea of newborn------------------------------------------764


Without mention of immaturity (.0)----------------------------


With immaturity (.5)------------------------------------------


Ocher infections of newborn------------------------------765-768


Without mer+ion of immaturity (.0)----------------------------


With immaturity (.5)-------------J----------------------------


Neonatal disorders arising from certain diseases of mother


during pregnancy--------------------------------------------769


Without mention of immaturity (.0-.4)-------------------------


With immaturity (.5-.9)---------------------------------------


Hemolytic diaease of newborn (erythroblastosis)--------------77O


W%thout mention of immaturity (.0-.2)-------------------------


With immaturity (.5-.7)---------------------------------------


Hemorrhagic disease of newborn-------------------------------77l


Without mention of immaturity (.0)----------------------------


With immaturity (.5)------------------------------------------


Ill-defined diseases peculiar to early infancy, including


nutritional maladjustment-------------------------------772, 773


Without mention of immaturity (.0)-------------+--------------


With immaturity (.5)------------------------------------------


Immaturity without mention of any other subsidiary condition-774


Immaturity, unqualified--------------------------------------776


Symptoms and ill-defined conditions--------------------780-7933795


All other diseases----------------------------------------Residual


Accidents------------~-----------------------------------E8OO,E'962


Inhalation and ingestion of food or other object cauaing


obstruction.or suffocation----------------------------E921,E922


Accidental mechanical suffocation in bed and cradle---------E924


Other accidental causes-----------------E800-E920,E923,E925-E962


Homicide--------------------------------------------E964,E98O-E984


Total


Under 1 year


Unlinked
 Linked
 death
 records
 records


Percentage distribution


18.0 9.3


4.8, 4.2


1;.; 5.1


3.0


?):: ::;


0.4 0.6


0.3 0.5


0.1 0.1


0.9


::; 0.7


0.2 0.2


M


0.6


2.0


:::


0.6 0.4


0.4 0.3


0.2 0.0


7.3 6.1


2.1 3.7


5.3


::;


1+:; 12.9


2.2 5.3


::: :::


1.1
 ::;
 R 

;:? 3.3


34

5

10

15

20

25

30

Table 5. Number and percentagedistribution of infant death records? by 55.selected causes Of


death, color, and age at death: United States, 1960 live bzrth cohort-Con.


= 

Total White Nonwhite


1


I


Under 28 days 28 days-n months Under 1 year


Unlinked
 Linked death Linked Unlinked Linked Unlinked Linked Unlinked


records records records records records death 

records


death 

records records death


Percentagedistribution


24.3 17.1 1.0


6.3 0.8


1:.: H 0.2


...
 3:2 ...
 1.2 ...


M ::: 0.1 

0.9 1.6 0.0 

0.6 1.3 0.0 

0.3 0.3 0.0 

1.6


0.7


0.9


1.8


1.5


0:3


0.8 0.8 

0.5 0.7 ::: 0.3 0.1 0.0 

1.3 4.3


0.5 0.8


0.7 1.6


0.4 0.4


0.3 

M 

0,1 %: 

I 1 

0.9 18.8


0.8


0.1 1::;
 ... 2.9
 ... 2.0
 ... 0.8


::;


0.1


0.1 0.6


0.1 0.4


0.2


W


0.6


0.3


0.1 ;::
 0.2 0.5


%;


0.2


5.2


4.9 ;:?


0.3 5.4


0.7


0.3 1+::


1.2
 ::;


9.5 :::


1.8 l.l


0.8


::2
 ;::


15.9 1 

3.9 

12:0 ; 

4.3 4 

3.2 

1.1 6 

;:? : 0.2 9 

0.6 0.9 1.2 

0.5 0.5 1.0 11 

0.1 0.3 0.2 12 

w :: 0.3


0.4 16


0.1 17


0.3 18


0.7 0.2 19 

0.4 0.2 

0.2 21 

5.8 22 

3.3 23 

2.6 24 

0.8 “ 

12.4 26 

2.6 2; x 5.2 3.8 29 

1.2 1.1 0.9 . 1.3. 1.1 1.2 31 

1.6 3.7 

M 0.2 2.2 :: 

3.5


—


35

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-------- ------------------------

-----------------------------------------------

Table 6. Number and percentagedistributionof live births and infant deaths, by type of record,€

color, and age of mother: United States, 1960 live birth cohort€

I Infant deatha€

Color and age of mother births€ ‘iveFT=TE 

Number€

Total€

tiite€

Nonwhite %iEIER”

Tota1 Percentagedistribution€

All ages 100.0 ioo.c 100.0 100.0 

Under 15 years 0.2 0.4 0.4 

15-19 years 13.8 18.0 18.0 19.6 

20-24 years------------------, 33.5 32.2 32.2 35.8 

25-29 years-----.---------.-------. -----.-- 25.7 22.8 22.8 21.5 

30-34-years 16.2 15.2 15.2 12.6 

35 years and over 10.7 11.4 11.4 9.6 

Not stated ... 0.0 � ., 0.8 

White€

All ages 100.0 100.O ,100.0 100.0 

Under 15 years 0.,1 0.l 0.2 

15-19"yeara---------------------------------------------= 12.7 16.1 16.1 17.8 

20-24 years 33.9 32.8 32.8 36.3 

25-29 years 26.2 23.6 23.6 21.8 

30-34 years 16.3 ,15.6 15.6 13.8 

35 years and over 10.8 11.8 11.8 9.8 

Not stated ..0 0.O ..0 0.8 

Nonwhite€

All ages 100.0 100.0 100.0 100.0 

Under 15 years 0.6 1.0 1.0 

15-19 years 19.6 23.4 23.4 25.4 

20-24 years 31.5 30.5 30.5 34.6 

25-29 years 22.9 20.7 20.7 20.8 

30-34 years-------------------------------------------7-- 15.1 14.0 14.0 9.2 

35 years and over .------- 10.2 10.3 10.4 9.2 

Not stated � *O 0.0 ... 0;8 

36€
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--------------------------------------

----------------------------------------

----------------------------------------

----------------------------------------

----------------------------------------

----------------------------------------

----------------------------------------

---------------------------------------- -------------------------------------- -----------------------------------------------

----------------------------

----------------------------- ---------------------------------------- ---------------------------------------- ---------

----------------------------------------

---------------------------------------- --------- --------- ----

----------------------------------------

---------------------------------------- ----------------------------- --------------------------------------------

----------------------------------

--------------------------------------

---------------- ------- ---------------------- --------------------------------------

----------------------------------------

----------------------------------------

----------------------------------------

----------------------------------------

---------------------------------------- -------------------------------------- -------------------------------- -------

Table,7. Number	and percentagedistributionof live births and infant deaths, by type of record,


color, and birth weight: United States, 1960 live birth cohort


Color and birth weight


Total


White


Nonwhite


Total


All birth weights


1,000 grams or Less


1,001-1,500grams-----------------------------------”-----


1,501-2,000grams


2,001-2,500grams


2,501-3,000grams


3,001-3,500grams


3,501-4,000grams


.4,001-4,500
grams


4,501-5,000grams


5,001 grams or more
 Not sta~ed


White


All birth weights ----..--


1,030 grams or less--.----.,­


l,OQ1-1,500grams


1,501-2,000grams


2,001-2,500grams-.------- .---------------------


2,501-3,000grams


3,001-3,500grams


3,501-4,000grams . . . . . . . . . . . . . . . . . .


4,001-4,500grams


4,501,.5,000
~ams
 5,001 grams or more---.-----


Not st@ed---


Nonwhite


All birth weights


1,000 grams or less


1,001-1,500grams- --.------------s


1,501-2,000grams---.-----------.--


2,001-2,500grams


2,501-3;000grams


3,001-3,500grams


3,501-4,00.0
grams


4,001-4,500grams


4,501-5,000grams


5,001 grams or more
 tiotstated ---..----


Infant deaths


Percentagedistribution


100.C 100.0 100.0 100.0 

0.6 20.8 20.9 

1*S 11.9 11.9 6.4 

J:: 

11.9 

14.0 

11.9 

14.0 

13.6 

20.2 

38.0 15*4 15.3 24.9 

26.8 8.5 8.5 15.8 

4.5 ::: M ;:2 

0:2 0.2 0.2 ::: ... 0.0 � ., 2.5 

0.7 14.2 14.2 ?: 

100.0 100.0 100.0 100.0 

0.5 20.3 20.4 4.8 

0.6 ;;.; 14.5 5.3 

12.5 

i:: 11:9 11.9 1:;: 

17.2 13.5 13.5 19,8 

38.1 1;.; 15.2 24,8 

28.2 . 8.7 1:.: 

8.0 � 

R ::: M 0.2 0.2 ::2 � �� 0.0 � *. 2.5 

100.0 100.0 100.0 100no 

1.0 22.3 22.4 6.2 

1.2 13.5 13.6 

10.2 10.2 1::: ;:: 11.9 11.8 14.6 

25.3 15.4 15.4 21.5 

37.1 15.6 15.6 2:.: 

18.9 7.8 7.8 

4.6 5:4 

i?:: ::; w 0,2 

.** ::: .*. 2.; 

37

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Table 8. Number and percentage distribution of live’births and infant deaths, by type of record,


color, and period of gestation:United States, 1960 live birth cohort


I Infant deaths


Color and period of gestation births
 ‘iveFF=TE 

Total


~ite


Nonwhite m&i


Total


All gestations


Under 20 weeks


20-27 weeks


28-31 weeks


32-35 weeks


36 weeks


37-39 weeks


40 weeks and over


Not stated


White


All gestations


Under 20 weeks


20-27 weeks


28-31 weeks


32-35 weeks


36 weeks


37-39 weeks


40 weeks and over


Not stated


Nonwhite


All gestations


Under 20 weeks


20-27’weeks


28-31 weeks


32-35 weeks


36 weeks


37-39 weeks----------------------------------------------


40 weeks and over


Not stated-----------------------------------------------


I II I i 

Number


Percentagedistribution


100.0 100.0 100.0 100.O 

0.0 l.O 1.0 0.2 

0.6 18.3 18.4 4.7 

0.8 13.2 13.3 6.2 

2.2 10.8 10.9 5.1 

3.1 5.0 5.0 4.9 

15.0 9.1 9.1 14.0 

72.5 34.6 34.5 59.4 

5.7 7.9 7.9 5.5 

100,0 100.0 100.0 100.0 

0.O 0.8 0.8 

0.5 18.3 18.4 4.5 

0.7 13.4 1304 5.5 

2.0 11.7 1107 4.8 

2.8 4.9 4;9 4.5 

15.3 9.8 9.8 15.5 

72.8 32.9 32.8 59.0 

6.1 8.1 8.1 6.3 

100.0 100.0 100.0 100.0 

0.1 1.5 1.5 0.8 

1.0 18.3 18.4 5.4 

1.5 12.8 12.8 8.5 

3.4 8.4 8.4 6.2 

5.0 5.3 5.3 6.2 

13.8 7.0 6.9 9.2 

71.2 39.5 39.4 60.8 

3.9 7.3 7*3 3.1 

38

----------

------

-------

-------------

--------------

--------

--------------

--------

---------

----------

--------

----------------

-------------

------------

------------

-----------

-----------

------------

--------

------------

--------------

Table 9. Infant deaths by place of birth, place of death, type of record; percent born ar,ddied in
 same area, and percent linked records among infant deaths in area: United States, each division and


State, 1960 live birth cohort


Linked records


Division and State Deaths Born Born
 occurring and alive in
 in died


specified in same specified
 area


United States----


Geographic division:


New England


Middle Atlantic


East North Central---


West North Central---


South Atlantic


East South Central---


West South Central---


Mountain


Pacific


New England:


Maine----------------


New Hampshire


Vermont


Massachusetts


Rhode Island


Connecticut


Middle Atlantic:


New York------------

New Jersey----------

Pennsylvania 

East North Central:


Ohio


Indiana


Illinois


Michigan


Wisconsin


West North Central:


Minnesota


Iowa----------------


Missouri


North Dakota--------


South Dakota


Nebraska


Kansas


area areal


107,038 . . .. 107,O38 

5,066 5,046 5,063


17,305 17,236 17,297


20,652 20,517 20,662


8,379 8,236 8,351


18,580 18,437 18>615


9,155 83983 9,117


11,691 11,585 11,712


4,824 4,7i3 4,765


11,386 11,353 11,456


583 574 579


337 325 330


216 212 216


2,393 2,393 2,405


407 403 405


1,130 1,122 1,128


8,425 8,373 8,431


2,992 2,949 3,034


5,888 5,800 5,832


5,429 5>356 5,406


2,699 2,649 2,717


5,754 5,648 5,760


4,633 4,603 4,635


2,137 2,107 2,144


1,906 1,843 1,866 

1,374 1,343 1,377 

2,397 2,310 2,377 

402 394 405 

448 436 472 

753 731 764 

1,099 1,068 1,090 

Unlinked death records


Deaths Born
 Born
 occurring and zlive in
 in died


specified in same ;pecified
 area
 area areal


2,293 . . . 22,293 

155 130 142 

383 331 366 

203 179 207 

126 90 101 

337 274 “295 

226 200 222 

564 518 541 

189 161 189 

110 102 129 

13 13 19


-
 14


2 1 4 

119 54 60 

7 3 15 

14 10 30 

190 142 165


66 51 63


127 118 138


27 19 26


49 44 57


48 35 46


61 58 61


18 13 17


20 12 16


4 2 3


41 32 40


5 2 2


26 21 24


9 3 3


21 9 13


Percent Percent


born linked


and records


died among


in same infant


deaths
 area
 in area


. . . . . . 

99.1 96.6


99.3 97.4


99.2 98.4


97.9 96.8


98.9 97.5


97.9 95.8


98.8 94.5


97.2 94.0


99.6 98.8


98.5 96.3


96.4 96.4


97.7 97.2


97.4 95.3


98.1 97.3


99.0 98.1


98.8 97.2


98.1 96.4


98.4 96.4


98.5 98.2


98.0 96.4


97.9 97.3


99.3 98.1


98.4 97.8


96.3 95.7


97.6 97.5


96.1 94.7


97.3 96.8


96.4 92.0


96.3 95.9


96.2 95.4


. See footnotes at end of table.


39

-------------

-------------

-------------

--------

-------

-------

--------------

--------------

-------------

------------

--------------

----------

-------------

------------

-------------

----------------

--------------

----------------

--------------

-------------

-----------

--------------

-----------------

---------------

-----------

---------------

-----------

---------------

---------------

Table 9. Infant deaths by place of birth, place of death, type of ,record;percent born and died in
 same area, and percent linked records among infant deaths in area: United States, each divisionand


State, 1960 live birth cohort—Con.


Linked records


Deaths. Born
 Division and State )ccurring and alive in


Born


in died specified
 >pecified Ln same
 area


South Atlantic:


Delaware


Maryland


District of Columbia-


Virginia


West Virginia


North Carolina


South Carolina


Georgia


Flordia


East South Central:


Kentucky


Tennessee


Alabama


Mississippi


West South Central:


Arkansas


Louisiana


Oklahoma


Texas


Mountain:


Montana


Idaho


Wyoming


Colorado


New Mexico


Arizona


Utah


Nevada


Pacific:


Washington


Oregon


California


Alaska


Hawaii


area area1


260 256 266


1,900 1,830 1,868


931 897 945


2,610 2,544 2,605


988 974 1,016


3,403 3,358 3,400


1,965 1,929 1,959


3,171 3,111 3,186


3,352 3,284 3,370


1,909 1,867 1,929


2,495 2,386 2,435


2,445 2,385 2,430


2,306 2,273 2,323


1,008 980 1,026


2,78L 2,746 2,770


1,239 1,204 1,245


6,663 6,583 6,671


414 $06 413 

360 342, 361 

221 214 223 

1,200 1,146 1,166 

885 852 862 

1,053 1,022 1,051 

484 475 482 

207 202 207 

1,503 1,474 1,503 

896 872 893 

8,303 8,302 8,380 

292 287 290 

392 389 390 

Unlinked death records


Deaths Born Born occurring and 

in died alive in 

specified Ln same specified area area areal 

4 3 6


48 22 24


24 12 17


54 37 50


22 18 23


55 47 53


80 72 76


34 22 29


16 7 17


85 78 95


29 8 13


55 51 60


57 50 54


65 56 69 

55 48 52 

28 20 25 

416 ’383 395 

4 1 2 

15 15 19 

2 3 

17 9 19 

44 34 74 

62 35 39 

34 23 26 

11 7 7 

6 3 7 

7 2 2 

95 93 118 

1 1 2 

~ . 

Percent Percent


b% Linked


records


died


in same L%%


~eaths
 area
 Ln area


98.1 97.0


95.1 93.9’


95.2 93*9


96.9 95.5


98.2 96.4


98.5 97.1


97.8 94.3


97.8 97.1


97.7 97.5


97.5 93.6


94,8 94.5


97,4 95.4


98.3 96.2


96.6 96.2


98.5 96.8


96,6 96.8


98.4 93.0


97.4 97.1


95.2 91.2


96.0 96.0


94.9 94.2,


95.4 91,7


94.8 91.7


96.1 91.7


95.9 92.7


97.9 97.7


96.8 96.6


100.0 98.9


98.3 98.0


99.0 99.0


lTotals for the geographicdivisionsdo not equal the sum of the individual States because’of dif­


ferencesb,etweenState of birth and State of deat~which affect Staee data but do not affect divisional


data,


~Includee101 infant deaths for which the place of birth was unknown or nQt stated and which are ‘ot


shown in any State total.


40

APPENDIX 1 

TECHNICAL NOTES 

The data in this report are derived from two 

sources. Data referring to all live births in 1960 are 

taken from Volume I of Vital Statistics of the United 

States, 1960. Data on birth characteristics of infants in 

the 1960 live birth cohort who died before reaching 

age 1 are derived from computer tapes prepared from 

a new set of punched cards which contained both birth 

and death information. 

The punching instructions for detailed information 

in the new set of cards corresponded to the instructions 

for preparing cards for use in Vitul Stuti.sties of the 

United States, 1960, The classification and interpretation of certain important items is discussed in the following pages. The complete rules followed in the classification of geographic and personal items for births 

are set forth in Vital Statistics Irzatvu&’on ManuaL~~ 

Classification by Occurrence and Residence 

For the 1960 statistics by place of occurrence, 

events are classified according to the place where the 

birth occurred. Place of residence in birth statistics 

refers to the geographic area which constituted the 

mother’s usual residence at time of the birth. 

For residence statistics, all events occurring within the United States (i.e., 50 States and the District of 

Columbia) are allocated to a place of residence within 

the United States. For nonresident aliens, the place of 

residence is considered to be the same as the place of 

occurrence. 

Age of Mother 

The birth certificate asks for “Age (at time of this 

birth).” Some sources of minor errors in the age data 

have been noted. A small number of records are filed 

with age unspecified, and some births are not registered. 

Measures of variation of completeness of registration 

with age of mother are available from tests of completeness in 1950 and 1940.4,5 They show that registration completeness is approximately the same for all 

ages except for the oldest age group, where it is lower. 

Race and Color 

Births in the United States in 1960 are classified 

as white, Negro, American Indian, Chinese, Japanese, 

Aleut, Eskimo, Hawaiian and Part-Hawaiian (combined), and “other nonwhite. ” 

The category “white” includes, in addition to persons reported as “white, ITthose reported as Mexican or 

Puerto Rica.m With one exception, a reported mixture of 

Negro with any other race is included in the Negro 

group; other mixed parentage is classified according 

to the race of the nonwhite parent and mixtures of 

nonwhite races to the race of the father. The exception 

refers to a mixture of Hawaiian and any other race, 

which is classified as Part-Hawaiian. In most tables a 

less detailed classification is used—’’white” and “nonwhite.” 

Completeness of birth registration in 1960 is 

estimated by the Division of Vital Statistics, National 

Center for Health Statistics, to be 99.3 percent for 

“white” births and 96.4 percent for “nonwhite” births. 

The most recent figures for other groups are from the 

1950 test which indicated registration completeness at 

that time to be 85.1 percent for American Indians and 

97.4 percent for “other races,” chiefly Chinese and 

Japanese. Both figures are probably higher for 1960, 

but later data are not available. 

A comparison of the race designation in matched 

sets of birth certificates and infant cards from the 

1950 registration completeness test indicates very 

high agreement for white and Negro infants. There 

were, however, substantially fewer American Indians 

recorded on birth records than on census records.~ 

Hospital Delivery 

Births are classified as occurring “in hospital or 

institution” on the basis of entn”es on the birth certificate. The classification is unrelated to the American 

Hospital Association (AHA) registered hospital listings. 

Birth Weight 

In practically all areas, birth weight is reported in 

terms of pounds and ounces rather than in grams. 

However, the metric system has been usedintabulating 

and presenting the statistics to facilitate comparison 

with data published by other groups in the United States. 

Period of Gestation 

In 1960, the live birth record forms for the State 

of Massachusetts and that part of Maryland outside the 

city of Baltimore did not provide for information on the 

period of gestation. These areas account for about 60 

41 
---------

---------

---------

---------

---------

percent of the records with gestation unspecified. Records with unknown gestations are shown separately and 

are not distributed in this report. 

An examination of the reported information on 

period of gestation suggests a substantial heaping at 

the interval “40 weeks and over.” This bias probably 

results from the fact that gestation period is not carefully calculated, and instead the newborn infant of normal size is assumed to have a gestation period of 40 

weeks. Such errors in reporting are minimized in 

areas where the birth certificate asks for the date of 

onset of last normal menstrual period. Places using 

this question (California, Baltimore City, the District 

of Columbia, and New York City) contributed about 14 

percent of the live birth records. 

Control of Errors 

The coding and punching of birth data for the live 

birth records for 1960 were performed simultaneously, 

and the major portion of the work was verified using a 

partial sequential sample. This procedure was used in 

verifying the work of employees whose performance (as 

indicated by complete verification) was such as to produce consistently less than 4-percent error distributed 

among all the items. For any one item, less than l-percent error would be expected under these procedures. 

A new set of punched cards, using the same procedures, was prepared for infant deaths combining the 

necessary birth and death information into one card. 

However, to preserve the consistency of the death information, once the infant death was identified, the coded 

cause-of-death information from NCHS computer tapes 

for all deaths was used. 

Published data for all live births taken from Volume 

1 of Vital Szkztistics of the United States, 1960, were 

used. For live birth characteristics of infant deaths, 

the newly created tapes were used. There are no estimates available of the degree of concordance between 

these two sources of information. Tabulating,. computing, table preparation, and all other operations subsequent to the preparation of punched cards were verified. 

Sampling of Birth Records 

In this report, birth data for 1960 have been derived 

from a 50-percent systematic sample which consists of 

only even-numbered birth records. Statistics for this 

year were obtained by multiplying the sample figures by 

z. 

The sample data represent estimates which differ 

somewhat from figures that would have been derived 

by processing all the records. However, the manner 

in which records are numbered greatly reduces the 

sampling variability of totals for geographic areas. 

With few’ exceptions, records are numbered in the 

State offices of vital statistics as they are received 

—000 

42 

from the local offices. The assignment of the last 

digit in the number is not selective, and the systematic 

sample of even-numbered records may be assumed to 

be unbiased. 

TTse extent to which residence figurzw for States 

derived from the sample differ from the totals that 

would have restilted from a complete count depends 

on the amount of nonresident interchange. (This assumes 

virtually no error in the figures on a place-of. occuxrence basis.)’ Since there is relatively little nonresident 

interchange of births among the States, the sampling 

errors for these geographic units are negligible. 

The following table shows percent errora due to 

sampling in the published birth data by other than geographic characteristics. The chances are about 2 out of 

3 that the percent difference due to sampling variability 

between the published figure based on the 50-percent 

sample and the result that would be obtained by a complete count is less than the appropriate percent error 

shown in the table. The chances are aJmtt 19 out of 20 

that the percent difference is less than twice the percent error. 

Number of Total births in area or to residents of areal births with a specified characteristic 25o 500 1,000 2,000 5,000 10,000 50,000 500,000 

1 I I ! I 1 1 

18.3 18,3 18,3


1$~ 14.1 14.1
 10.0 10.0 ... 6:2 

5oo--------- ::: 0:6 4.4 ::? !:; l,ooo ... ...1 0.01 3.0 3.1 3.2 

2,000 ... ... 2.0 2.2 2.2 

5,000 . . . . . . 1.3 1.4 

LO, BOO--------- . . . . . . N 0.9 1.0 20,000 .,. ,,8 I :::1 :::1 :::1 . . . 0.5 

50,000 . . . . . ““’l ““”l “’”l .,. 0.0 l!:: 

1 1 1 I 1 I I 1 

lAn “area” is the smallest geographic unit to which th$ figure under 

..risideration perqins. If the area is a city or county of residence 

where appreciable mnxesidettt interchange occurs, the sampling error will 

be sligbcly larger. 

Registration Completeness 

Although every State has adopted a law requiring 

the registration of births, deaths, and fetal deaths, 

these laws are not uniformly observed. In most areas 

practically all births and deaths are registered. For 

some areas, however, there is enough underregiMration to affect the use of the statistics for certain purposes. 

Nationwide tests of completeness of birth registration were made in both i940 and 1950.4~5For the United 

States as a whole, these tests indicated that birth registration was, respectively, 92.5 and 97.9 percent com ­

plete. A detailed discussion of the results of these tests 

was given in chapter 6, Volume I, Vital Statistics of 

the United States, IWO; On the basis of results of the 

1950 test, it is estimated by the Division of Vital Statistics that in 1960 birth registration completeness was 

98.9 percent for the country as a whole—99.3 for the 

white and 96.4 for the nonwhite groups, respectively. 
s APPENDIX II 

STANDARD CERTIFICATE OF LIVE BIRTH 

CERTIIWATE Or No, LIlfll BIRTH STATE OF BIRTH

1y:”;= URTH 2. U)LIALEIIE51 oENCE OF MOT”U ~W4&edma. moth,, I{.<?) 

I 

: 1b.CllY. TOW, OR LWT!O” G CITY.‘IOWN. 0, LCCAT,O” 

;

: ,, “*”E or (@u4 (. hd@d. gbe ,&cef add,,”) d. STREET ADDRSSS : _plTAL OX 

i Ins ~T~H . d.	 IS PIAC3 C$ BIRTH ltiSIDE CITY UUIT27 <. IS RESIDENCE lNS,DE CITY LIMITS, J. IS RE31DENCE ON A FARM? 

YCSIJ N’alJ YE3D mu wcl Non” 

s. 19Amlc >V,t Middle I.ul 

~~y 0, 9 

~ ,,;= 5. nils 81R7H 5b. IF TWIN OR TR8?LET. WAS CHILD E4R?I 6. :AF, ?.rOllfh Da, Ymr 

SINGLE � TWIN � TRl~E7 a 1s7 � 2D � 30 Iz BIRTH 

7. MAME Fsr,l Mm!l, L-la! 8. COLOR OR RACE 

: g 

“ 

E . 

; ~ 9. AGE (At time ,J M hi,(h) 10. BIRTI!PL4CE [.%(, w /0?4?. cot!tim) 110. USUAL WXIJPATWN Ilb. KIND OF BUSINESS OR tHDU51RY 

z

: 1 YEARSI I I . ~ 12. MAIDEN NAME Flr,t Mlddlc .&arc 13. CMOR OR RACi 

s 

a I I I % 18. MoTHERS MA,L,NG ADDW55 

z“ 

Q 

k SIUNATURE 123. A-DAM7AT B,P.T” 

I bmb, urti/” ~ thatlM! chid M. D.rJ C1.o.m MtDwFEn OTHER (Sgdm Fi ,0., torn dlu =. ,“ fk dd. I&. ADDRE52 123, OATE SKNED 

!3 dud&u. � 

s 

-s 19. OATC RECD. BY LOCAL KG. i 2V. REGISTR4R3 SIGNATURE 121. DAT2 ON WHICH GIVEN NAME ADWD 

% BY (R@/mr) 

k 

. FORC4ZD1 CAL NIO SICU.’IH USE OMLV 

~ (m8. tal.m .MUw’kplkdalq

- 2?u. LENGTH OFPREGNNCY Z& WEIGHT AT BIRTH ‘?3. LEGITIMAT3 

3 fcyy LB. 02 7330 NOIJ 

= T (5PA’X FOR ADOITION OF MCOICAI. AND HFJLlll WEMS BY INDIVIDUAL 3TATSS) 

* 

~ 

$ , 

000 

43 
-----

.

� 

� � � 

APPENDIX Ill 

STANDARD CERTIFICATE OF DEATH 

I

I b,CITY. TOWN, ORLOCATION c. LENGTH OF S7AY IN lb e. CITY, TOWN, OR LKXTIOH 

I . . Inem’kwa I 

YES � NO � ma K.13 YEsONO 3.	 Mum or Firm Mi.iih hat 4. DA’IE Month Da Yew HCUUD 

(7%x or mlno, &H 

5, SEX & COLOR OR RACC 7 MARRIED � NEVER UARRIEDO 8. DATE OF BIRTH 9, AGE (In qecr, !, u,- I VEM IIFIJULXJ 24 Hm. 

lud blrlMov) MM* h. H- M{.. 

WIDOWED � DIVORCED � l@u.	 USUAL OCCUPATION Qlm k(mfc?l!mrk done 103. KIND OF BU51NES20R IN DU2TRY II. BIRTHPLACE [.S5!. or/m4m cow!lrrl 12, cmzr.i+ w wnir cwnnw 

durlttc mwl ./work \ no 1{{<, an if rdfred) 

~~ 

J* : 13. FATHER,S PAME 14. MOTHER,S MAIDEN NAME 

. 

~~ I E : 15. WAS DECEASED EVER IN U. S, ARMED F0KE57 16, 3XIAL 3ECUR1TV NO. 17, lNMRMAMT Addrcu 

* ( Y“. “o. w .ti”o””l 111w,, d“ -r 8. old.. 01.“.!-1 

3 

~: 

2 18. cauu ov D2A’134 [fife, OIZIV one couu w lhu /or (o], (b). and (c).1 INTERVAL u~WEEN 

2’ PART 1. DEATH WAS CAUSED 8Y: 0N53T AND 0EA7B 

:J {MMEDIATE CAUSS (a) 

&g 

s%’ Cmdhnr, If anv, 

IOA{CA vane rb to DUE TO (61 -

z m .&WC came t ah 

s .% tiding lh, U71$C.. 

lrbw mule Id. t Duc m (4 

$. 

5 5 Ph!W l!, 07~ 3GNW’IUNI CCUD,,DUS ~!UJT!MO m WA,” 2UT NuT REUTEO m WE TERUUUL D!= CDNDITWM GWEN IH PAFJ !(0] 19 WAS mlmm 

~ p b PERFORMED? 

YES � NO � @ : a ; w, ACCIDENT s!JlclOE HoM ICI DE X0, DESCRIBE HOW !NJUR’I GCCURREO, (En(,r .cIw, oJ{nJvrv i“ Part 10, Po; II ,!ih 18.) 

w. . 

~ 3 

Zk. ::IMR:F F#u?r, MmI1h, DaY, Year . 

~ ~ 

m r.. m. 

k : m, ,“J”FW OCC”RREII Z&, PUCE OF INJURY (,, P,, in 0, hti k% ZOJ CITY. TOWN. OR WTION COU NIY STATE 

2 ~:; “ � H;g{:’ u J.,ml/@orv. ,1,4 oflw Ma, .~c.) 

% 

g 

k 2!. , a c*.”,+*,+ *he dm..,.d tram , c. .od Iaaf �.w ~h?r .Iive on nm 

z -=~h -=.,-d .t m on the dare .f=f-l above; �nd io *A. b-r ./my knowJod#o. zrmnz the au,., fared. 

a 22.3, StamTuRz (Dew., or MC] 72b, ADDRE55 Z?C. DATE SIGNED 

1 I I 2% mm,!!-, CRWA1!QII, 2M DATE 2%, NAME OF cEMETERY OR CREMATORY 2?.4. LCGTION (awl town. or mii.tw (sold � RE”WAL (SWC,J”) 

: 

~ 24. FUNERAL 018E~R ~ ADDRESS 75. DATE RECD. BY L&CAL REG. 26. REGISTRAR’S S(GIMTURE 

000 

fr u. s. .a.avERNMeNT PRINTING oFFIcE - 1s70 - 32+X43 F. 0. 

44 
OUTLINE OF REPORT SERIES FOR VITAL AND HEALTH STATISTICS 

Public Health Service Publication No. 1000 

Se7’ies 1. 

Series 2. 

SeTies 3. 

Series 4. 

Series 10. 

Series 11. 

Series 12. 

Series 13. 

Series 14. 

Series 20. 

SeTies 21. 

Sem”es 22. 

P~’ogYams and coL&ection pYocedu~es.— Reports which describe the general programs of the National 

Center for Health Statistics and its o~ces and divisions, data collection methods used, definitions, 

and other material necessary for understanding the data. 

Data evaluation and methods ~eseaych. —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 stua!ies.-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 jYom the Health InteYview Su~vey. —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 St.owey. —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 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. 

Data from the Institutional Population SuYveys. —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 from the Hospital DischaYge 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: manpowev and facilities. — Statistics on the numbers, geographic distribution, and characteristics of health resources including physicians, dentists, nurses, other health 

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

Data on moYtality.-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, rnarviage, anddivorce. —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 from the National Natality and klo~’tality .%oweys. —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, medical experience in the last year of 

life, characteristics of pregnancy, etc. 

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