Data Modernization Initiative & NCHS Updates

The CDC Data Modernization Initiative, or DMI, is a multi-year, multi-billion-dollar effort to modernize data across the federal and state public health landscape.

The ultimate goal of DMI is to get better, faster, actionable insights for decision-making at all levels of public health.

NCHS is fully engaged in this initiative.  One major activity NCHS has a leadership role in is the Vital Statistics Modernization Community of Practice, which is a virtual forum for sharing ideas, technical tools, resources, and promising practices to improve birth and death data. This initiative is targeted towards all jurisdictions and partners interested in modernizing the vital records system, at any level of experience.

This diverse and growing community is designed to bring together: State vital records offices; Medical examiners and coroners (ME/C); Hospitals and health care organizations; State and national organizations of ME/Cs and vital records; Those working with public health surveillance systems that interoperate with vital records (e.g. cancer registries, etc.); IT vendors and informatics consultants working with Electronic Health Records, Electronic Death Registration Systems, ME/C Case Management Systems, and Electronic Birth Registration Systems.

Grounded in experience and based on strategies that have already proven successful, the community focuses its guiding principles on six main building blocks for modernization: Connection; Innovation; Guidance; Sharing; Policy; Vision.   Stay tuned for more future updates on NCHS’s DMI activities.

MUSICAL BRIDGE

HOST:  On the first day of December, new data on health insurance coverage from the National Health Interview Survey was released.  From January through June 2022, 27.4 million people of all ages – or 8.3% of the country – were uninsured.

Another report in early December focused on twin births in the U.S.  The report shows the number of twin births fell by 7% from 2019 to 2020, compared with a 3% decline in the number of single births. The twin birth rate declined by 3%. From 2020 to 2021 the total number of twin births rose by 2%. Another illustration of significant data changes during the first year of the pandemic

On December 8, NCHS released two new reports featuring data from the 2020 National Post-acute and Long-term Care Study.

One report looked at participants in nonprofit adult day services centers vs. those in centers for-profit.  This report also documented that there were 11,719 COVID-19 cases among participants in any of these centers from January 2020 through July 2021.  31% of these cases – or 3,246 particpants – resulted in hospitalization and 14% or 1,522 resulted in a death.

The other report looked at residential care community residents.  In 2020, a greater percentage of residents in residential care communities with 26 beds or more were aged 85 and over compared with smaller communities.  The presence of selected medical conditions among these participants, including Alzheimer disease and heart disease, varied by community size.

On December 14, NCHS released the first analysis of death certificates in the United States by the condition known as “long COVID.”  The analysis identified 4,055 deaths in the United States from January 1, 2020–June 30, 2022 that mentioned long COVID key terms and coded to U07.1, which is the code used for tracking COVID-19 deaths. The percent of COVID-19 deaths with long COVID peaked in June 2021 (1.2%) and again in April 2022 (3.8%). The death rate for long COVID was 6.3 deaths per million population for the 12-month period ending in June 2022. The long COVID death rate from July 1, 2021 through June 30, 2022 was highest among adults age 85 years and over, and also among American Indian or Alaska Native people who were not Hispanic.  Asian non-Hispanic people had the lowest death rates.  And Males had higher death rates than females.

The growth charts for the United States were originally developed in 1977 by NCHS.  NCHS and CDC updated the charts in 2000, and they have been a key tool in tracking children and adolescents height and weight over the decades.  The charts feature sloped curves or percentiles for parents and pediatricians to plot children’s growth.

With severe obesity among children more than five times as prevalent now compared with the early 1970’s, NCHS and CDC set out to modify the existing Body Mass Index charts.  This allows for parents and clinicians to more accurately plot growth trends among those with the highest level of obesity– those whose BMI is above the 95^th percentile.

On December 15, NCHS unveiled these changes to the existing growth charts.  Note that the remaining charts for under the 95^th percentile remain unchanged.

NCHS wrapped up 2022 with the release of final death data for 2021.  Though much of these data have been already released in provisional or preliminary form, the new report released on December 22 shows life expectancy for the U.S. adjusted up to 76.4 years in 2021 which is slightly higher than last summer’s preliminary estimate but still 0.6 years lower than in 2020, reflecting the continued impact on COVID-19 on longevity in the U.S.

Another factor in declining life expectancy is the multi-decades rise in drug overdose deaths in the country.  There were 106,700 drug overdose deaths in 2021, a rate of 32.4 deaths per 100,000 population.  The rate of deaths involving synthetic opioids – mainly fentanyl – increased 22% from 2020 to 2021.