September 2018 Vital Records News

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Vital Records News

September 2018

Birth Records Help Minnesota Understand More about Young Children

three stick figure children holding hands

Did you know that the children of mothers who receive no, or inadequate prenatal care tend to have the poorest third grade school attendance? Or, that mothers who are between the ages of 30 and 39 at the time of their child’s birth tend to have children who are more likely to be proficient in reading by third grade? Or, that low birth weight babies have similar school engagement by third grade as do children who were normal weight babies?

These are just a few examples of the new information now available from Minnesota Early Childhood Longitudinal Data System, or ECLDS (http://eclds.mn.gov/). The ECLDS combines data from the departments of Education, Health, and Human Services. Each department contributes multiple program data sources. Birth records are part of the ECLDS and Minnesota is one of five states in the nation to have successfully launched an early childhood integrated data system with federal funding. All data on the public-facing site are aggregated and de-identified to protect privacy at all times.

We are learning new things about children as they enter school and the earliest grades that are helpful to multiple programs and jurisdictions. State and local programs use the ECLDS to do community planning, complete needs assessments and retrospectively see the impacts of policy and practice changes. Some of the most frequent users are school district early childhood programs, Head Start programs and county agencies.

Minnesota’s birth records are an essential contribution to our understanding of how children in our state fare over time. High quality birth record data provides a foundation for nearly everything we offer in the ECLDS. Visit the site and see how we maximize the use of the data for planning and be sure to subscribe to our updates.

The author, Anita Larson, is with the Minnesota Department of Education


Birth Records and Perinatal Hepatitis B

For over 25 years, the Minnesota Department of Health’s (MDH) Perinatal Hepatitis B Prevention Program has worked to prevent mother-to-child transmission of hepatitis B by identifying and treating infants born to women who have hepatitis B. Hepatitis B can easily be transmitted to a baby during childbirth when they are exposed to their mother’s blood. Without intervention, up to 85 percent of infants become infected at birth. Of these infants, up to 90 percent develop a chronic (life-long) hepatitis B infection. Infants that develop chronic hepatitis B infection have a 15 to 25 percent risk of death due to liver failure, liver cirrhosis, or liver cancer.

With proper treatment, infants born to mothers who have hepatitis B can avoid these long-term health consequences. All infants are recommended to get a dose of hepatitis B vaccine within 24 hours of birth. This is called the birth dose. Infants born to women who have hepatitis B are given the birth dose and hepatitis B immune globulin (HBIG) within 12 hours of birth. The combination of hepatitis B vaccine and HBIG at birth, followed by a complete hepatitis B vaccine series, is 99 percent effective in preventing perinatal hepatitis B transmission. Hepatitis B vaccination of all infants acts as a safety net in case a mother with hepatitis B is undiagnosed or misdiagnosed.  

More than 400 babies are born to women who have hepatitis B in Minnesota each year, but only five cases of mother-to-child transmission have been documented in the last five years. This success is due to the vital partnerships we have with local public health and delivery hospitals, and the information we get from vital records. From the start of the pregnancy, local public health agencies work with the mother to offer education, resources, and make sure the infant receives timely hepatitis B vaccine and testing. Due to the diligence of delivery hospitals, over 99 percent of at-risk infants receive appropriate treatment at birth to prevent hepatitis B transmission.

We also rely heavily on birth record data to do our work. Birth records include information about maternal hepatitis B status, as well as information about the infant’s hepatitis B vaccine and HBIG administration. We use the maternal hepatitis B status on birth records to identify women not reported as hepatitis B-positive during their pregnancies and enroll the infants in our program. HBIG administration noted on the birth record can also be an indicator that the mother may have been hepatitis B-positive. Birth record data, such as the infant’s name, birth weight, and vaccine and HBIG administration, help to limit the amount of information that needs to be collected from the delivery hospital and confirms that infants born to women with hepatitis B are treated properly and in the correct timeframe.

Programs like the Perinatal Hepatitis B Prevention Program provide an essential service and work to protect, maintain, and improve the health of all Minnesotans. Access to clear and accurate data makes it easier and faster for this program to identify and treat infants born to hepatitis B-positive women. Birth records data provided by the Office of Vital Records is an indispensable resource for this program.

Genny Grilli, the author, is with the Perinatal Hepatitis B Prevention Program at MDH


Reduce fraud, protect identities

Accurate and timely death information not only allows families to get the certificates they need, it can be a tool in fraud prevention. The death registration information that you collect, and that the Office of Vital Records (OVR) sends to various state and federal agencies, helps prevent fraud, waste and abuse.

When the fact of death (legal) portion of a death record files, OVR sends a subset of that information to the Social Security Administration (SSA). SSA deactivates the social security number (SSN) of the deceased individual and ends any benefits the deceased individual receives. If this process is not accurate or timely, it can have significant impact. When SSA adds the death information to its records, it shares that information with nine other benefit-paying agencies, such as the Internal Revenue Service and the Centers for Medicare & Medicaid Services. SSA receives approximately 2.5 million death records each year. Even with a low error rate, files containing death record information that are inaccurate or not received in a timely manner can lead to incorrect processing of benefits. That can add up to millions of dollars.    

Another way that fact of death information prevents fraud and identity theft is by linking a deceased individual’s death information to that individual’s birth certificate. In fact, for the security of the vital records system, Minnesota law requires OVR to protect records by matching them. When death information links to a birth record, the birth record is marked ‘Deceased’. Although birth certificates may be issued even after they are marked “Deceased,” individuals cannot use the certificates to open bank accounts, apply for benefits, or obtain licenses and identification cards. OVR shares with and receives death information from other vital records offices across the United States via the State and Territorial Exchange of Vital Events (STEVE). STEVE is a tool developed by the National Association for Public Health Statistics and Information Systems (NAPHSIS) that allows secure sharing of vital event information for this and other purposes.

The continued partnership between MR&C users and OVR, as well as the exchange and sharing of data, has a significant role in reducing fraud and protecting identities.


Sometimes “unknown” is okay

Everyone involved in vital event registration collects a lot of information when we register births, deaths and fetal deaths. We gather this information from parents and families, others, and medical records and we enter this information as data into the Minnesota Registration and Certification (MR&C) System.

Most of the time we are able to collect all the data necessary to complete the required fields in MR&C. Sometimes however, we exhaust our efforts because the source does not have the data. Sometimes the appropriate answer is “unknown.” There are situations when a whole section on a record might be marked “unknown” such as the medical data for a surrogate mother on a birth record, a court order directing the registration of a record or for an unidentified body held by a medical examiner.

When “unknown” is a valid answer, enter it on the record. Some data fields in MR&C offer “unknown” as a drop-down menu choice. Other data items have text fields in MR&C where it might be appropriate to type in ‘“unknown”.

Enter “unknown” in a data field in MR&C only when there is no other answer. OVR reviews records and data marked as ‘unknown’ to assess the quality of Minnesota’s data. Sometimes OVR staff may follow up with you to verify and confirm the “unknown” response. Please know that if health information becomes available later you may update the record in MR&C or contact OVR. Updated information is valuable and shared with NCHS regularly.

The Office of Vital Records (OVR) shares death data and de-identified birth data with the National Center for Health Statistics (NCHS) to become part of our national statistics. National vital records data is available to researchers at Public-Use Data Files and Documentation (CDC and NCHS).

The work you do as our partners in collecting information about vital events is very important. Vital records data has more uses than just documenting an individual’s birth, death or fetal death. The data you collect informs public health and improves lives both locally and nationally. Thank you for the important work you do.


NAPHSIS Identity & Security Conference

 

The National Association for Public Health Statistics and Information Systems (NAPHSIS), the professional membership organization for vital records and vital statistics programs, is hosting its first-ever Identity& Security Conference in Washington D.C., November 15 and 16, 2018.

The pace of technological change has quickened. This conference will provide an opportunity for a national conversation on the rapidly changing intersection of identity and security, as related to vital records. Participants will learn about new trends in fraud prevention, secure data exchange services, biometrics, and identity management, among other topics.

The Office of Vital Records encourages managers, supervisors, and staff at county vital records offices to consider the event. “You are the frontline securing Minnesota records and identities,” said Molly Crawford, State Registrar. “This event is aimed at vital records professionals who issue certificates and check identification. This is a great professional development opportunity that puts you in touch with others across the country and in the industry who face the same challenges as you do.”

For program tracks, registration and hotel information, see 2018 Identity & Security Conference.


OFFICE OF VITAL RECORDS CONTACTS

http://www.health.state.mn.us/divs/chs/osr/contacts.html