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Vital Records in Hawaii

Vital Records in Hawaii

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Published by Doctor Conspiracy
Hawaii Medical Journal Vol 21 No 2
November - December 1961
Hawaii Medical Journal Vol 21 No 2
November - December 1961

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Published by: Doctor Conspiracy on May 17, 2011
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07/30/2012

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Although registrationhasbeenapproximatelycomplete onlyinrecentyears, nearlyamillionrecordsare nowonfile, someof themdatingbackoverahundred years.Theoldestmarriageecordswerefiledin L84I;the oldest death recordsn1853;andheoldestbirthrecordsn 1853.Alocalregistrarn eachcountys responsibleforsupervisingheregistrationsystemTvithinhisarca andorcollectingandforwarding certificatesto theBureauofHealthStatistics.nthe countiesofHawaii,Kauai andMaui,thecountyhealthofficer actsas he local registrar;nHonolulu,thelocal registrarsa full-timeemployeewithintheBureauofHealthStatistics.Beginninginl9AL,government physiciansservedasocal registrars.n1950,achangewasmadeto county healthofficersandthe BureauofHealthStatistics'employeeonOahu,thereby re-ducing the numberofregistrarsrom35tofour.Since he centraloffice can deal moreeasilywithfour officials thanrvitha larger number,this re-ductiongreatlysimplifiedadministrationofthesystem.With present-dayommunicationacilities,the reduction innumberofregistrarsdoesnotinconveniencehepublic.TheHealth Department,hrough heBureauofHealthStatistics,also maintains agents neachcounty whoissuemariagelicenseso applicantsmeeting the necessaryegal requirements.triththe exceptionf one civil servicemployeewithinthe Bureau,heagentsare appointedbythePresi-dentofthe Boardof Health.Thereare28of themdistributedhroughouthe Territory.TheUsesofVitalRecordsIn additiontosupplyingcertified nformationto individualsandfamilies forpersonaluse, heBureauofHealthStatistics lsousesvitalrecordsto assistotheragencies.or example,heFederalBureauofInvestigationndheBureauof InternalRevenueometimeseceiveassistancensearchingforaddressesndotherinformationneededolocatendividuals;titlesearchinggenciesreas-sistedby tracinggenealogies; pon request,wel-f.are agencies and thejuvenilecourts receiveverificationsof age;immigrationofficialsobtaininformationregardingcitizenship;newspapersetlistsof currentbirths,deathsand marriagesortheircolumns;periodically,countyclerksarefur-nished noticesofdeceasedersons twenty-oneyearsofageandoverforpurging voter lists;and,foreign consulatesetnoticeof the deathsoftheirnationals.1l
VITALRECORDSN HAWAII
CHARLES G. BENNETT,M.A.,*eNo GEORGETOKUYAMA,B.A.,tHonolulutlltHEBUREAUofHealthStatistics f the Ter-lLritorialHealth Departments responsibleor
r-rlrorlal ,uealtnuepartmentts responslbletormaintaining a registration system or thecollectionofbirth,death, fetalre
death,marriageandi-vorceecordshrough-out the Territory.TheBureaupreservesheserecordsnpermanentformandfurnishescertifed informa-tionfromthemtothosewho needtforproving personalandpropertyrights.In rnostcountries fthe world the registra-tion ofvitaleventsandthepreservation f docu-mentationconcerning hemareunctionsofagov-ernmentagencypecializing nthatfield.In everystateand territory of the United StatesexceptMassachusetts,hese unctionsbelongothe healthdepartment,owingtoitsneed forvital statisticsinpublichealth and medicalwork. The reasoningis thatpublichealthagencies avethegreateststake nreliablevital statisticsnd, therefore,willdo thebestand mosteconomicalobin registra-tiontogetthem. notherwords,goodregistrationisnecessaryorgoodvitalstatistics.A certificate ofeverybirth, maniage, divorceand deathoccurringn the Territory isfiledintheBureauofHealthStatistics.nthe course f time,oneormorecopiesof acertificateertainingoanindividual mayberequiredbyhimor his family.TheBureaunowreceivesmorethan 40,000re-questsnnuallyordocumentarynformationfromvitalrecords.The Registration SystemThe registrationof vital events nthe Territoryisa far-flungprocessnvolvingseveralhousandpeopleeveryyear.They includeregistrars,hysi-cians,midwives,undertakers,ersonnelofhospi-tals, marriageicenseagents,ministers,andcourtclerks,aswell ashendividualsandheir familiesto whom the eventsertain.InL954, the Bureau egistered6,1p1births,2,95, deaths,793fetal deaths,5,362marriagesand L,27Oivorces r annulments.
*Chief of the BureauofHealthStatistics,Departmentof Health.tChiefof theRegistration andRecordsSection of the sane Bureau.Received orpublicationJulyJ,195J.
VOL. 15, No.2- NOVEMBER-DECEMBER955
MR. BENNETT
OURNAL127
 
$Tithinthe HealthDepartment,the BureausofMaternal andChildHealthandCrippled Childrenreceivedataon congenital malformations,birthinjuries,prematurebirths andmaternaldeaths;theAccidentCommitteegets details regardingfatalaccidents;heBureauof Epidemiology receivesn-formationpromptlyondeaths fromcommunicabledisease;similarly, the Bureausof Tuberculosis,Cancerand VenerealDiseaseControl receivedatarelativetotheirspecialties.Ofequalimportancewithnon-statisticalusesenumerated aboveis theproductionofvitalstatis-ticsfromvital records,such asbirth and deathrates,tabulationsshowingthe causesofdeath,theweightsofinfantsatbirth,maniageand divorcerates,etc.The use of vitalstatistics inpublic health maybesummarized bythe statement thatthey pointouthealthproblemsand measurethe resultsofpublichealthwork. It isbecauseofthe need forthem inpublichealththat vital recordsare cen-tralized in the DepartmentofHealth.Inadditiontopublichealthuse,vitalstatisticsareof great valuein other fields,suchasmedicalscience,population estimating,housingprograrns,social securityplans, studieson fertility andlifeinsurance,andconsumerresearch.Eventuallytheuseof thisclass of statistics npublichealthworkwillprobablybeovershadowedby their moregen-eraluse inotherlinesofendeavor.ConfidentialNatureDespitethevery wideuse of vital records,ahighdegreeof confidentiality ismaintainedwithregardto them.Thefiles are notopen topublicinspection;applicantsforcertifiedcopies mustshow alegitimaterightto them;andstatisticspro-duced fromthe recordsneveridentifyindividuals.Inthe caseoflegitimationsandadoptions,wherenewcertificatesaremadeout, theold ones aresealed nenvelopesthatcanbeopened only uponcourt order.The Bureau frequentlyreceivessuchqueriesasthe following:"\7ewant to knou'JohnnySmith'sbirthdateforplanningasurprisepartf, or"Iarnmostanxiousto knowwhat myneighbordiedoflast week."Theseare notacceptable reasonsfordisclosing nformationfromvitalrecords.RecordFormsIn cooperationwithotheragencies,heNationalOfficeofVitalStatistics, PublicHealthService,recommendsstandard formsfor certificatesofbirth, death, fetaldeath, marriageand divorce.Statesandterritoriesuseallof the items inthisstandard formfor theirown certificates,buttheyarenotobligatedtofollowthe same arrangementorexact wordingas the standardform, and they128
canand doincludeadditional nformation.In theTemitory ofHawaii,thelawstates hatcertificateshall contain as a minimumall itemsrecommended n thestandardormof the Na-tionalOfficeofVitalStatistics, ualified bytheprovision hatthe BoardofHealthshallapprovetheitems.Additional itemsdesiredby health andmedical agenciesre added and arrangementol-lows a uniquepattern.Alladditional tems nthebirth,death andfetal deathcertificatesre ap-proved by committees ftheHawaiiMedical As-sociationbeforehey are adopted.Majoritemson certificate orms shouldbesub-stantiallyhe same n all areas f the country.Thisisdesirableor theproductionofnationalvitalstatisticsand for securingcomparabilityof dataamonghe states nderritories.Tithoutconsider-ableuniformityinthecontentof certificateorms,wecouldnot have nationalvitalstatistics r com-parethe healthsituationnonestatewith thatinanother.Moreover,duetothe effortsofinterna-tionalorganizations, ertificateorms arebecom-irg increasinglyuniform evenamongvariouscountriesof theworld.Followingthepracticefthe NationalOffice ofVitalStatistics,erritorial formsare revisedeveryten years.Current formswere ntroducedn L949and normallyhenext revisionwouldben L9r9.Due tothe desirability ofintroducingrevisedformsnearerhemiddleofthedecennialcensusperiod,t isproposedorevisehe formsn1955for use startinginJanuary,1956 andevery tenyears hereafter.Oneadvantagefintroducingnew ormsearlieris thatreportingdifficulties will be adjustedbe-fore the nextcensus.Soon afternewpopulationdatabecomeavailables thetimewhenbest usecan bemadeoftheminthecomputation frates.The most radicalchange n any certificate ormwillbenthemedicalcertificationfthe causesffetaldeath.The new certificationwillbe similarto thecertificationrrangement owinuseonthedeathcertificate, ith whichphysiciansrealreadyfamiliar.It willprovidea w^y for determining hephysi-cian'sudgmentasto the underlying causeandincreaseshe possibilitiesor studying causesffetaldeathas anintegratedpattern-i.e.,the rela-tionshipofmaternalandfetal causes.A secondmajorchangepertainsosupplemen-tary information related opregnancy,abor anddelivery on both the livebirthand fetal deathcertificates.Although few new data willbere-quested,earlyallitemswillbearranged ncheckiist form. It is believed hat thiswillbemoreobjectiveand require esseffort onthepart ofthephysician.
BirthThebirthstheyo,orothtInlassumrnoretthisisAnrtificatetheatteandafisendstistrar.IfarcertificapitalabNeverttabirthrItwacamesumititsiareamaimeanttlandtharcludedirInI9lcensusi
ee%.r
Thertoutthec,\WarII,,ofregistlabirthceicancitiztAlmosteregisterecqulremenlaterinIiIfac)period,tlregisteritbirthprorandcertaiAfterotheHawaoftheSec:istrationsIwhencurrcompletetTosecuistrate'shrnessesestthebasisoTheTer
vol.15,
AWAIIMEDICALOURNAL
 
sthatitems:Na-rytheDroveirattdrtfol-inthereaP-alAs-resub-r.This.lvitalrf datansider-forms,
rfCOfil-
thatinnterna-becom-variousrfficeofdeverynt949nL959.revised.censustnl9)1rerytensearlierstedbe-pulationbestuseofrates.rteform:ausesf:similar;eonthe:alreadyrephysi-ruseand:ausesftherela-rplemen-aborandtaldeathllbere-in checkbemoreartofthe,OURNALBirthReportingTheattendingphysician rmidwife must reportbirths to the ocalregistrarwithinseven aysaftertheyoccur.f neitherwas nattendance,parentor other personmustreport.Inpractice,a.hospitalwhere a.birth occursassumesheresponsibilityorreporting it.Sincemorethan95%ofall births occur nhospitals,this is the usualprocedure.A nurseorclerkin the hospital illsinthe cer-tificate ormandgetshe motherto signit.Thenthe attendingphysicianntersertainmedicaldataandaffixes his signature.Finally,thehospitalsendshe completed certificateo thelocal reg-istrar.If anyquestionarises elative to items in thecertificate, theregistrarusuallyasks thehos-pitalabout t ratherthan theattendingphysician.Nevertheless,heegalresponsibilityorreportingabirthremainswiththe physician.It was notuntilL929hat birthregistrationbe-camesufficientlycompletentheTerritorytoper-mititsadmittanceotheU. S.birthregistrationareamaintainedytheBureauofthe Census.hismeanthatregistrationwasatleast90/ocompleteandthat birthdatafromHawaii wouldbein-cludednnationalstatistics.In 1950,a testnconnectioniththedecennialcensusndicated acompleteness fmorethan99%.This isbetterhan the nationalaverage.Therequirementofa birth certificatehrough-out the country oshow citizenship, uringNTorld$VarIl,gaveagreatmpetusothecompletenessofregistration.This and otherfactorshave madea birth certificatehe principaldocumentn Amer-icancitizenuses o proveegalactsabouthimself.Almost everyparent.knowshatababymustberegisteredsoonafterbirth,notonlyto meet re-quirementsofthelaw, butto protectthechildlaternlife.If achildis not registeredwithin the legalperiod,theBureauofHealthStatisticsanstillregister tanytimeup tooneyear from dateofbirthprovidedhe certificates marked"delayed"andcertaindocumentary roofsareoffered.Afterone year,abirth canberegisterednlyinthe Hawaiianbirthcertificateectionoftheofficeof theSecretary fHawaii.For themostpart,reg-istrationshereareof older peoplewho werebornwhencurrentbirthregistrationwas less nearlycompletehan today.Tosecure"Hawaiianbirth certificate"amag-istrate'shearingmayberequiredat whichwit-nessesestify, orthecertificatemaybeissuedonthebasis f documentaryvidence.TheTerritory ofHawaii sthe onlyregistrationVOL.|5,No. 2-NOVEMBER-DECEMBER955
areaof the UnitedStates n whichbirth registra-tiondutiesaredividedbetweentwogovernmentalagenciesand,withtheexception ofMassachusetts,the onlyareawhereentire authorityforbirth reg-istrationisnotvestedin the HealthDepartment.Death ReportingTheundertaker,orpersonsacting assuch,mustreporta deathwithin three days tothelocalreg-istrar,using the certificateformauthorizedbytheBoardofHealth. Theundertaker fills inpersonalparticularsof the deceasedand theattendingphysiciancertifiestothe best ofhisknowledgethe causeof death. Ifnoregularphysician wasinattendance,thecoroner'sphysiciancertifies thecauseofdeath.As soon asthelocalregistrarreceivesadeathcertificate,heissuesaburialor transit permit. Itisaseriousoffense to disposeofabodyor shipitwithoutthispermitwhich showsthat a certificateis on file identifyingthedeadpersonand indicat-ingthecause ofdeath.The medicalcertification form inthedeathcer-tificate follows theinternational recommendationof the \(odd Health Assembly madein Geneva in1918. Ithasbeenaccepted n allstatesandterri-tories ofthiscountryandinmanycountriesoftheworld.Becausehe undedying or fundamental causeofdeathisbasicin mortalitytabulations, the mostimportant feature ofthecertification form isitsemphasison the undedyingcauseas determinedbythe attendingphysician tothebest ofhisknowledgeandbelief.Thus, the physicianhas aresponsibility andagreatopportunitytomakemortality statisticsreflect thetruefrequencies ofthe underlyingcausesofdeath.Fetal Death* ReportingTheregistrationofallfetaldeaths(stillbirths)isimportantnotonly becauseofthegreatloss ofhuman life occurringin theprenataland natalperiods, butalso on accountoftherelationshipbe-tweenfetal deathsandmaternal morbidityandmortality. To minimize suchdeaths, medical andhealth agenciesmust know the magnitudeoftheproblemanditscauses.The mechanism of fetal deathreporting issimilarto that for deaths except that a dead fetusoflessthan sixteenweeksofgestationrequiresnoburialor disposalpermit.The attendingphysicianisresponsibleor completing themedicalpart ofthefetal deathcertificate,whilethe undertaker orother personincharge ofthebodyfills inotherparticularsand files thecertificatewith the localregistrar.
*Conformingto recommendations of theri(orldHealth Organiza-tion,theterm-"fetal death" isused inplaceof"stillbirth.;
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