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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 2003.  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 affect 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 at birth.  The published                         
tables of infant death data are all based on residence at birth.  Fetal deaths in 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 1965-2003 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 of 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 filed 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.                                       
                                                                                                              
                                                                                                              
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 infant deaths in a given calendar year by the number of births                      
in that 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.                                      
                                                                                                              
                                                                                                              
                                                                                                              
                                                                                                              
                                                                                                              
                                                                                                              
                                                                                                              
                                                                                                              
                                                                                                              
                                                                                                              
                                                                                                              
                                                                                                              
                                                                                                              
                                                                                                              
                                                                                                              
                                                                                                              
                                                                                                              
                                                                                                              
                                                                                                              
 
 
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