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Health event data

Introduction

Learning objectives: You will learn about health event data and recording of health events affecting individuals or populations. This includes the registration of births and deaths, disease registers, routine surveys of self-reported health and health activity data from primary and secondary care. The common sources are:

  • births and deaths registers
  • disease registers
  • health surveys
  • health activity data (from primary care and secondary care)

Please read the resource text below.

Resource text

Births and death registration

In the UK, registration of birth and death events is a legal requirement. Information on how registration occurs can be found at the National Statistics website.

Births data

What is on a birth certificate?

  • child's forenames
  • sex
  • date of birth
  • place of birth
  • mother's full name and maiden name
  • father's full name and occupation if married to the mother
  • name, address and relationship to child of the person who registered the birth
  • information on marital status and living arrangements of parents
  • parents' occupation
  • postcode of mother's normal place of residence

In Scotland the following additional information would be given:

  • time of birth
  • date and place of parents' marriage

Birth registration must be completed within 6 weeks of the birth. If the parents were not married then the mother cannot register the father's name (in his absence) unless he has made a statutory declaration allowing her to do so. A new birth certificate can be issued for someone who has changed gender if they have been granted a full Gender Recognition Certificate. Name changes, after the initial registration, can only be made once (forename changes may only be made once in the birth register, up to 12 months after the birth). Stillbirths also need to be registered.

Publicly accessible data on births can be found at the National Statistics website

Summary data includes information on stillbirths and can be found at the London Health Observatory.

Deaths data

Description

In England and Wales, deaths need to be reported to the local registrar within 5 days of the death occurring.

Deaths data is passed to ONS on a weekly basis. ONS provide a monthly dataset on deaths to directors of public health, including cause of death and contributing factors. Information on what is captured on the death certificate can be found at Family Records.

Data on the certificate and the data files available to public health departments include:

  • full name of deceased
  • date of death
  • address and postcode of normal place of residence
  • place of death
  • given age
  • cause of death, underlying and participatory
  • occupation (or name and occupation of husband if the deceased was a married or widowed woman)
  • name, address and family relationship (if any) of the person who reported the death.

In Scotland, the following additional information would be given:

  • marital status
  • spouse's name
  • sex
  • father's name and rank or profession
  • mother's name and maiden name

Mortality statistics publications are routinely available from the ONS. Among them are:

  • DH1 - Annual review of the Registrar General on deaths in England and Wales
  • DH2 - Deaths by cause
  • DH3 - Childhood infant and perinatal mortality
  • DH4 - Injury and poisoning

Further information on data about deaths is available at the Natonal Centre for Health Outcomes Development.

Public health mortality files contain information about deaths within different strategic health authority boundaries. It also includes details about people who died outside the strategic health authority region in which they were normally resident. These files are only available to health authorities and at a cost.

National births and deaths data are made available to regional Public Health Observatories (PHOs). Mortality data has been linked to Hospital Episode Statistics, and is in the process of being made available to PHOs. 2006/7 and historic years' extracts are available with date of death added. Discussions with ONS are ongoing to secure a regular quarterly feed of deaths data that also includes cause and place of death.

Data on stillbirths can be found on the Compendium website. The Compendium is also a good general source for data on mortality, infant mortality births, and fertility.

Public Health uses of births and deaths data

  • Health service planning, epidemiology, monitoring, and audit.
  • Screening programmes (breast and ovarian cancer, immunisation take-up), confidential enquiries and register checking.
  • Inequalities analysis.
  • The postcode enables precise geographical analysis of population and patients.
  • Assessing progress against targets e.g. on infant mortality, and life expectancy.

Strengths

  • both births and deaths data are very complete and accurate for the UK.
  • deaths data can provide very important information on health of populations.

Weaknesses

  • ethnicity is not collected for either deaths or births (though where these take place in NHS hospitals it may be derived from HES records).
  • defining the socio-economic status from the occupation recorded on birth registration records is not ideal.
  • deaths are not reliable as a picture of burden of morbidity of chronic illness, as more people are living longer with illness than in the past.
  • quality of recording cause of death varies considerably.