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INTRODUCTION                                                             
                                                                                                              
This report summarizes information about the natality, mortality, and morbidity of mothers,                   
children, and youth.  Indicators have been selected for their relevancy to the Maternal and Child             
Health (MCH) programs administered by the Arkansas Department of Health for the delivery of                   
comprehensive maternal, child, and adolescent health services.  Thus, their selection reflects                
priorities established for the Arkansas MCH program.  This report also takes into consideration               
national and international studies that have attempted to delineate health risk factors for mothers           
and children.  This report contains data for many indicators used in other studies; however, the              
indicators examined here are by no means exhaustive.  It is designed to make these indicators                 
easily accessible, while at the same time allowing flexibility to users in their selection.  To               
accomplish this, the frequencies of particular events or conditions, along with rates or percentages          
are presented in concise tables.                                                                              
                                                                                                              
The primary time focus of this report is calendar year 2000.  Data are presented for the state as a           
whole to satisfy the needs of planners, policy makers, and providers of health services at the                
regional and local levels.                                                                                    
                                                                                                              
Data from birth certificates measuring the demographic, socioeconomic, and health status of the               
mother as they may effect the health and survival of the infant are tabulated.  These variables               
include race, age, education, and marital status of the mother; birth order; prenatal care; maternal          
tobacco use and weight gain during pregnancy; medical risk factors affiliated with the pregnancy;             
and complications of labor and delivery.  Outcome data on birthweight, Apgar scores, and                      
congenital anomalies, as well as fetal, neonatal, perinatal, postneonatal, and infant mortality are           
also tabulated by several measures of demographic and socioeconomic status of mother.  The                    
reader should be aware that outcome data for neonatal, perinatal, postneonatal, and infant                    
mortality are derived from the matched birth-infant death record.  Therefore, total number for these          
items are not representative numbers from the birth totals.                                                   
                                                                                                              
All birth certificate data are by place of residence, unless otherwise specified.  This means that            
events have been assigned to the area where the person lives (usually legal residence) regardless of          
where the events occurred.  For births and infant deaths, the reference is to the residence of the            
mother.  For infant deaths, the place of residence at death may differ from the place of residence a          
birth.  The published tables of infant death data are all based on residence at birth.  Fetal deaths          
this report are usually by place of residence of the mother.                                                  
                                                                                                              
Sources of Data                                                                           
                                                                                                              
The main source of the statistics in this report is the vital records system maintained by the                
Arkansas Division of Vital Records.  Three specific files are used:                                           
                                                                                                              
The Birth Certificate File containing information reported on live birth certificates.                        
                                                                                                              
The Fetal Death Certificate File containing information from the fetal death certificate.                     
                                                                                                              
The Death Certificate File containing information reported on death certificates.                             
                                                                                                              
Summary tables using United States data and Arkansas data for years 1965-2000 are found in                    
publications produced by the National Center for Health Statistics.                                           
                                                                                                              
Limitations and Caveats                                                                   
                                                                                                              
The vital records data files provide an opportunity for studying the characteristics and                      
problems of the health of mothers and infants so that health planners and administrators                      
can better direct programs to address problems. The vital records registration system                         
provides an effective means for measuring health outcomes by place over time. However,                        
this information has a number of limitations, including completeness, accuracy, and                           
timeliness of registration, in addition to quality control and classification problems                        
for variables such as medical complications of labor and/or delivery. The reporting of live                   
births and infant deaths is considered to be essentially complete for births occurring in                     
Arkansas. Fetal deaths are considered as under-registered, but to an unknown extent.                          
                                                                                                              
Errors occasionally occur in coding and keypunching large numbers of records.  Extensive                      
computer edits and manual reviews of records are performed as this report is prepared.  Identified            
errors are corrected when found.                                                                              
                                                                                                              
A certain degree of loss of timeliness is an inevitable structural limitation of the vital records            
system.  There are delays between the occurrence of a vital event and the completion o f the legal            
document, between completion of the legal document and its filing, and between its filing and the             
completion of the computer processing.  In addition, calendar intervals such as months or years               
must elapse and all records for that interval must be files and processed before an analysis of all           
data for that interval can be conducted.  For example, this publication focuses on events                     
which occurred in a given calendar year. A birth or infant death happening in January will                    
not be analyzed for a year or more whereas one taking place in December will be considered in                 
only a few months.                                                                                            
                                                                                                              
Note that in certain places, such as 'Selected Live Birth Characteristics by Race of Mother'                  
or 'Selected Live Birth Characteristics by Sex of Child', column values may not equal the                     
total due to records in which the value of the by-variables is unknown.                                       
                                                                                                              
Sample copies of the current certificates of live birth, fetal death and death are included as                
appendices to this report                                                                                     
                                                                                                              
Notes                                                                                     
                                                                                                              
There are two ways of calculating infant mortality rates: (1) period-based, and (2) cohort-based.             
                                                                                                              
Period-based rates are much more convenient and timely to calculate. They are done by dividing the            
number of infants deaths in a given calendar year by the number of births in the year and                     
multiplying by 1,000.                                                                                         
                                                                                                              
The cohort-based rate is calculated by following each infant born in a given year. The number                 
of deaths to these infants before their first birthday are counted, regardless of which                       
calendar year the death takes place.                                                                          
                                                                                                              
The disadvantage of the cohort-based rate is that it requires a full year elapse after the birth              
of the last infant on December 31 before the rate can be calculated. A serious problem with the               
period-based rates may arise in areas experiencing extensive immigration, emigration or rapid                 
changes in infant mortality. Many of the deaths that happen in the early part of a calendar year              
befall infants born late in the previous year; thus the more recent year is credited with events              
that transpired in the foregoing year.                                                                        
                                                                                                              
This report uses the standard technique of period-based mortality rates.                                      
                                                                                                              
The birth rates for 1995-1999 on page 1-4 and 1-5 differ from those in earlier publications.                  
With the release of the 2000 census figures the estimated populations for these years                         
have been updated.                                                                                            
                                                                                                              
 
 
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