1. Vital Statistics
Institute for Implementation Science In population health at cuNY
CUNY Graduate School of Public Health and Health Policy
June 2016
Disclaimer: The information in this slide set was assembled by the The Institute for Implementation Science in Population Health at CUNY to inform the work of the NYC DSRIP HIV projects. The content of these slides is based on publicly available information as of June 2016.
For detailed Vital Statistics inquiries, see the resources and contact information slides.

2. OUTLINE
Background
Content
How to use the data
Limitations
Resources

3. Background

4. BACKGROUND (2) What are Vital Statistics?
The Bureau of Vital Statistics of the NYC Department of Health and Mental Hygiene (DOHMH) collect annual data on all live births and deaths recorded in the city of New York.
Vital statistics provide data on premature mortality, life expectancy, infant mortality and leading causes of death, and can be used to provide a measure of AIDS mortality.
Mortality data (death data) are derived from death certificates, which contain demographic information and the underlying cause of death, as defined by the International Classification of Diseases (ICD-10)

5. BACKGROUND (3) Population and geography New York City:
Bronx, Brooklyn, Manhattan, Queens, Staten Island
All recorded deaths in NYC:
2014: 53,034
2013: 53,409
2012: 52,455
Deaths due to HIV in NYC:
2014: 523
2013: 579
2012: 609

6. BACKGROUND (4) Timeframe of available data Accessibility of data
1984 – present
AIDS first listed as a cause of death in the 1984 NYC Vital Statistics Summary
NYC DOHMH holds all records dating back to Death records prior to 1949 found in the Municipal Archives of the NYC Dept. of Records.
Accessibility of data
Annual summary reports publicly available on NYC DOHMH website
Counts, percentages and rates not found on the publicly available Annual Summaries or the web-based EpiQuery module may be made available from DOHMH by request

7. CONTENT What’s in vital statistics data set? HIV-related indicators
Selected underlying cause of death (as defined by the ICD-10)
Demographic variables for each death reported:
Sex, race/ethnicity, age group, most current address
HIV-related indicators
All codes from the block B20-B24 of the ICD-10 signify HIV as underlying cause of death
B20: HIV disease resulting in infectious and parasitic diseases
B24: Unspecified HIV disease

8. HOW TO USE THE DATA Examples of how data has been used in the past
Trends of age-specific death rates by sex ( )
City of New York, Summary of Vital Statistics, 2013

9. HOW TO USE THE DATA (2)
- Age-adjusted HIV death rates by race/ethnicity ( )
City of New York, Summary of Vital Statistics, 2013

10. HOW TO USE THE DATA (3)
- Age-adjusted HIV death rates by borough of residence, 2014
NYC DOHMH EpiQuery System

11. HOW TO USE THE DATA (3)
- HIV deaths by borough of residence ( )
NYC DOHMH
EpiQuery System

12. HOW TO USE THE DATA (4)
Age-adjusted death rates among persons with HIV in NYC,
Match between vital statistics and HIV surveillance data to compare all-cause deaths with HIV-related among PLWHA

13. HOW TO USE THE DATA (5)
Potential use of vital statistics to further DSRIP PPS work
Examine trends in HIV death rates by geographic area (borough/UHF neighborhood) or by demographic subgroup
Compare vital statistics (HIV as leading cause of death) to HIV Surveillance data on all deaths among persons who were living with HIV
Analysis of vital statistics data with HIV surveillance may point to some common diseases that seemed unrelated to HIV infection but in fact PLWHA have a higher risk of death from those conditions (e.g. liver and kidney disease) Whiteside, et al., 2015

14. LIMITATIONS What to keep in mind:
Misclassification of cause of death on death certificates
Increasing proportion of deaths of PLWHA attributable to causes not considered HIV related
HIV deaths caused by a variety of factors
Statistics on multiple causes of death can provide a more comprehensive and ultimately insightful view of mortality patterns than single underlying cause-of-death statistics.

15. STRENGTHS Aggregate data is publically accessible and free
Citywide aggregate data can be stratified by geographic level (borough, UHF) as well as demographic subgroup
Available historical data allows for trend analysis
Routinely matched with NYC HIV surveillance registry data (NYC HARS)

16. RESOURCES Publications and reports
Summary of Vital Statistics 2014, City of New York
Summary of Vital Statistics, historical annual reports
Kim JH., et al. (2013) All-cause mortality in hospitalized HIV-infected patients at an acute tertiary care hospital with a comprehensive outpatient HIV care program in New York City in the era of highly active antiretroviral therapy (HAART). Infection, (2):
Lim S., et al., (2015). All-Cause, Drug-Related, and HIV-Related Mortality Risk by Trajectories of Jail Incarceration and Homelessness Among Adults in New York City American Journal of Epidemiology, 181:
National (not NYC specific)
Whiteside YO., et al. (2015). Comparison of Rates of Death Having any Death-Certificate Mention of Heart, Kidney, or Liver Disease Among Persons Diagnosed with HIV Infection with those in the General US Population, Open AIDS Journal, 9,
Ingle SM., et al. (2014). Impact of Risk Factors for Specific Causes of Death in the First and Subsequent Years of Antiretroviral Therapy Among HIV-Infected Patients. Clinical Infectious Diseases,  59(2), 287–297.
Guides/guidelines and general information
Summary of Vital Statistics
EpiQuery Mortality Module
General info – National Vital Statistics System, MMWWR

17. CONTACT INFORMATION
Office of Vital Records, Bureau of Vital Statistics
Phone:

18. CUNY Institute for Implementation Science IN population health
Thank you!
CUNY Institute for Implementation Science IN population health
cunyisph.org