“From the 1840s onward, there was constant agitation to tackle community health problems… the sanitary survey proved the most useful tool for the purpose.”
– George Rosen, A Historymam of Public Health, 1958
Vital statistics emerged in public health in the United States in the mid-nineteenth century. Statistics, such as population, had been collected by the federal government, but they were primarily used for economic purposes. Public health reformers began collecting statistics regarding life expectancy and infant mortality. The establishment of the American Statistical Association in 1839 helped advance the use of vital statistics in public health. The founding of the American Medical Association eight years later further promoted the collection of statistics among physicians.
When the Oregon State Board of Health was established in 1903, its charges included the collection of vital statistics. In 1907 the United States Census Bureau passed the Model State Vital Statistics Act (also known as the Model Law), to coordinate the collection of vital statistics (namely births and deaths) at the federal and state levels. The act has since been revised multiple times, to include marriages and divorces as well as to implement centralized state systems for collecting, processing, registering, and certifying vital statistics. The Census Bureau continued to be responsible for national mortality statistics until 1946, when the task was transferred to the United States Public Health Service.
Influenced by the Model Law, the Oregon Legislature passed measures in 1915 to enhance the collection of vital statistics. They divided the state into registration districts and created the office of State Registrar within the State Board of Health, charged with supervising and enforcing the documentation of vital statistics.
In Portland, the municipal Board of Health collected and maintained vital statistics for births, deaths, and communicable diseases. A standardized system of certificates and cards was used to record this data and physicians were required to fill out the appropriate form and submit it to the Board of Health. In 1919, the city passed an ordinance giving the city health officer the authority to impose penalties on those physicians who neglected to submit vital statistics. The penalties included a $500 fine or six months in jail. At the end of every week, a report was sent to both the State Board of Health and the United States Public Health Service.
By 1930, in Oregon cities with population’s over 2,000, the local health officer acted as the registrar and collected vital statistics. For smaller communities and rural areas of the state, registrars were appointed. Statistics collected included: births, deaths, cause of death, age, race, and gender. Local health officers were also responsible for reporting all communicable diseases, filed in weekly reports. By 1934 approximately 90 percent of the physicians in Oregon submitted weekly reports to the Oregon State Board of Health.