General Release Notes

2019 Birth

New Primary Care Service Area Dimension

We have added a new geographic dimension to the Birth Module to cover primary care service areas. Primary care service areas were created to describe the delivery of primary health services in the State of Hawai'i through participation of multiple stakeholders in the early 1990's. The rural health associations of the Hawai'i, Maui and Kauai Counties delineated rational service areas under their respective jurisdictions. Neighborhoods were clustered into primary care service areas to provide information below the county or island level with demarcation between adjacent neighborhoods. Census tracts were used in defining these areas due to their availability in census and vital statistic data.

Here is a link to a document containing the Hawai'i-IBIS Census Tract to Primary Care Service Area Crosswalk:

• Hawai'i-IBIS Census Tract to Primary Care Service Area Crosswalk

2018 Birth

New Cell Suppression Criteria

Cell suppression criteria have changed. In accordance with data use restrictions set forth by Hawai'i State Department of Health (DOH) and the National Center for Health Statistics (NCHS), cell counts of fewer than 9 events and rates based on counts of 9 or fewer will be suppressed, and rates based on counts of less than 20 will be regarded as unreliable and will also be suppressed. Suppressed data is denoted with a double asterisk (**).

2014 Birth

Changes to the Birth Certificate

A new birth certificate data collection form was implemented in Hawai'i in 2014. This new form and some procedural changes in how some data elements are captured resulted in discernable differences in some of these data elements before and after the change. In prior years, infant gestational age at birth was calculated based on the date of last menstrual period as reported by the mother. As of 2014, gestational age is based on the health care provider's assessment; therefore, dimensions based on gestational age cannot be trended. Accordingly, HHDW has created two new dimensions starting in 2014:

• Infant's Gestational Age (2014+)
• Trimester Prenatal Care Began (2014+)

Birth method data (Birth Type) has also been impacted by this data collection change. We are working with the Office of Health Status Monitoring at DOH to determine the best way to handle these changes. In the meantime, analysis by birth method is limited to 2000-2013.

All Years

Population Estimates for Population-based Rates

Annual population estimates are extracted each year from the U.S. Census, Population Division, Annual County Resident Population Estimates. These estimates change each year and provide the denominator for the crude birth rates, fertility rates and teen birth rates, by age, sex and census race, for the years 2000-2019.

However, population estimates for Hawai'i-specific race/ethnicities (DOH Race/Ethnicity) are not reportable for individual years, so a special 5 year aggregate population estimate file was created for Hawai'i, by the Data Products Development Branch, American Community Survey Office, U.S. Census Bureau. This 5 year aggregate (2010-2014) file was used to create a single average annual population estimate, which does not change and is used for all population-based rates by DOH Race/Ethnicity for the years 2010-2019.

Because HHDW uses two different population estimate files, birth rates may vary slightly depending on which category you select your birth rate indicator from - Rates by Census Race vs Rates by DOH Race/Ethnicity. Census Race and DOH Race/Ethnicity rates should not be compared directly.

Residence

Data can be analyzed geographically by mother's residence or infant's place of birth. Mother's residence is based on the address provided on the birth certificate as the place where the mother resided at the time of the birth. Military members and dependents who live in Hawai'i at the time are classified as residents. Visitors who give birth while in Hawai'i but do not reside in Hawai'i will not appear in queries by Mother's residence.

There are two measures for capturing geography in the Birth Record - zip code and census tract. School complex and community are based on zip code and primary care service area is based on census tract.

Infant's birth location includes all live born infants in Hawai'i regardless of the mother's place of residence. Infant's birth location will not always correspond to the mother's place of residence; for example, an infant can be born in Honolulu to a mother who resides in Kauai.

Race/Ethnicity Data

The birth certificate allows for up to 4 race/ethnicities to be captured for both the mother and the father. The DOH Office of Health Status Monitoring (OHSM) uses the following algorithm to code a single race/ethnicity for each individual. Ethnicity of the child is based on the ethnicity of the father. It is based on the ethnicity of the mother when the ethnicity of the father is unknown.

Only one ethnicity is coded from the actual certificates. If more than one ethnicity is listed on the certificate, the following rules apply:

1. If Hawaiian is one of the multiple ethnicities listed, Part-Hawaiian is coded.
2. If a non-Caucasian ethnicity is listed with a Caucasian ethnicity, the non-Caucasian ethnicity is coded.
3. If there is more than one non-Caucasian ethnicity listed, the first one is coded.
4. If there is more than one Caucasian ethnicity listed, the first one is coded.

In IBIS, the most granular level is the program race/ethnicity (PRG) which rolls up into the DOH standard race/ethnicity (DOH), which rolls up into Census race reporting categories (Census). The table below illustrates how the data is aggregated.

Race/Ethnicity Classifications
Source Race/Ethnicity	Program Race/Ethnicity (PRG)	DOH Race/Ethnicity (DOH)	Census Race (Census)
Asian Indian	Asian Indian	Other Asian	Asian
Black	Black	Black	Black or African American
Caucasian	Caucasian	Caucasian	Caucasian
Chinese	Chinese	Chinese	Asian
Cuban	Cuban	Other	Other
Filipino	Filipino	Filipino	Asian
Guamanian	Guamanian	Other Pacific Islander	Native Hawaiian and Other Pacific Islander
Hawaiian	Hawaiian	Native Hawaiian	Native Hawaiian and Other Pacific Islander
Part Hawaiian	Part Hawaiian	Native Hawaiian	Native Hawaiian and Other Pacific Islander
Indian	Indian	Native Alaskan/American Indian	Native Alaskan/American Indian
Japanese	Japanese	Japanese	Asian
Korean	Korean	Other Asian	Asian
Mexican	Mexican	Other	Other
Portuguese	Portuguese	Caucasian	Caucasian
Puerto Rican	Puerto Rican	Other	Other
Samoan	Samoan	Other Pacific Islander	Native Hawaiian and Other Pacific Islander