SCHS: Data to Action
Examples of how data at the State Center for Health Statistics is used to improve health!
The Perinatal Quality Collaborative of North Carolina (PQCNC)
The Vital Statistics team in the Statistical Services Branch provided data regarding the rising rates of Cesarean sections and preterm deliveries in North Carolina to the PQCNC. Perinatal leaders at PQCNC concluded that some scheduled early term births (either induction of labor or planned Cesarean delivery) occurring in the state might be due to non-medical or non-obstetrical indications (early-term elective delivery or EED).
EEDs carry a significantly increased risk to the baby and may place infants at greater risk of Neonatal Intensive Care Unit admissions for increased transient tachypnea of the newborn, respiratory distress syndrome, ventilator support, suspected and proven sepsis and/or newborn feeding problems.
As a result, in 2009, the PQCNC partnered with the March of Dimes to launch the Eliminating Elective Deliveries Under 39 Weeks Gestation project. The goal of the initiative was to eliminate elective delivery less than 39 weeks without documented fetal lung maturity in participating hospitals. Forty-one NC hospitals participated in the first year of the project, and the program reported that EEDs were reduced by 43 percent in these hospitals.
Examining the Completeness of Industry and Occupation Data in the North Carolina Central Cancer Registry
The North Carolina Central Cancer Registry (NC CCR) assessed the completeness of Industry and Occupation (I/O) data reported for cancer cases, which are critical for identifying occupational cancer risks and guiding public health efforts. The study evaluated 2021 cancer data for the 10 most common cancer types, finding that I/O data was often missing -- occupation data was reported for only 18% - 47% of patients and industry data for 19% - 51%. Melanoma had the highest missing occupation data (82%).
The study also explored the potential of using death certificate data, which began collecting I/O information in 2020, to enhance the completeness of cancer data. The study linked NC CCR cancer data from 1995 to 2021 with death certificate data from 2020 to 2022 using probabilistic matching software.
The study highlights the importance of improving I/O data completeness to enhance cancer surveillance and inform targeted prevention strategies.
Drive-Time Analysis for Wastewater Monitoring
The Health and Spatial Analysis Branch worked closely with the Epidemiology Section in October 2024 on identifying new wastewater (WW) monitoring sites where social vulnerability is high and where clinical surveillance methods are limited (greater distance from emergency departments). This work identified 26 potential new sites to monitor respiratory diseases through WW monitoring in North Carolina.
Women Infants and Children (WIC)
Around 2013, a NC WIC Vendor was found to be committing fraudulent actions and was removed from the WIC vendor program. That vendor sued WIC to be reinstated to the program. The reason given for the vendor to be reinstated was that WIC would not be able to serve the clients in that area of town. Through the use of GIS, it was easily demonstrated in court that there were vendors as close or sometimes located even closer to the clients than the fraudulent vendor. WIC successfully defended the decision to remove the vendor.
Monitoring prevalence of neural tube defects to help focus folic acid education programs in areas with the highest prevalence
Western North Carolina had one of the highest rates of neural tube defects in the United States, but since the mid-1990s the rate of birth defects like spina bifida has dropped almost 80 percent in that region following fortification and other folic acid promotion initiatives. Prevalence information from the Birth Defects Monitoring Program (BDMP) helped target and evaluate folic acid education efforts.
Research collaboration to identify risk factors and preventions to reduce the occurrence of birth defects
Since 2002, the Birth Defects Monitoring Program has been a collaborator on the National Birth Defects Prevention Study (NBDPS) and the Birth Defects Study to Evaluate Pregnancy exposureS (BD-STEPS), which are multistate projects aimed at identifying the causes of major birth defects. BD-STEPS extends the efforts of the NBDPS including research on dietary and nutritional factors, medications, occupational and environmental exposures and various lifestyle factors as they relate to preventable causes of birth defects.
Promoting Preconception Health in North Carolina
The North Carolina Strategic Preconception Plan was developed as part of a statewide collaborative effort among over 80 different leaders and organizations. The plan took over a year to develop and focused on two health issues in particular: healthy weight and pregnancy intendedness.
The North Carolina Preconception Health Coalition strives to be data driven both in development of its strategic plans and in monitoring the impact of preconception health activities throughout the state. The Coalition utilized the Pregnancy Risk Assessment Monitoring System (PRAMS), the Behavioral Risk Factor Surveillance System (BRFSS) and vital statistics data on women of childbearing age to develop their initial Preconception Health Strategic Plan for the state.
The Statistical Services Branch staff provided updated data from PRAMS, BRFSS and other data indicators that the Coalition used to help track the state's progress and determine the effectiveness of maternal health initiatives throughout the state.
According to the Coalition, the use of PRAMS, BRFSS, vital statistics, and census data was vitally important to the process of creating the initial 2008-2013 Preconception Health Strategic Plan and was also critical to the work to prepare the 2014-2019 Preconception Health Strategic Plan.
Systematically reviewing the data during stakeholder meetings helped inform the decisions that the Preconception Health Leadership Team made concerning funding opportunities, educational materials, social marketing, and program development. Having access to data sources helped guide strategic planning and prioritize funding decisions essential to implementing effective interventions to improve the health of women and their infants.
Last Modified: November 6, 2025