Occurrence versus Residence
Most vital statistics gathered by the Indiana State Department of Health are reported by county of residence. This includes births, deaths and terminated pregnancies. Marriages are reported by county of occurrence, which is where the event happened.
Some counties have questioned differences between their vital statistics and those reported by the ISDH. Most counties do not have reciprocity, which means, for example, that a mother from Johnson County that delivers her baby in Marion County will not have that information sent back to Johnson County. Also, women who reside in a county without a hospital must travel to a hospital in another county to deliver their infants, and the county of residence does not get that data back from those hospitals. However, all counties must report births to the ISDH, which in turn is able to report the number of births by county (and state) of residence of the mother.
Counties cannot always sort their data by county or state of residence. Using births for an example again, for large, populated counties on the borders with other states, this may mean that women from these adjacent states give birth in an Indiana border county. For the counties where these out-of-state births are occurring, their number of births may be much higher than what ISDH reports, since ISDH would not have those out-of-state births counted as a resident birth for that county. Occurrent birth information is available from ISDH, and is helpful for hospitals discussing plans to enlarge birth centers.
The reporting problem also happens to the ISDH. It is difficult to get 100% of the records from births and deaths of Indiana residents that happened outside of the state, even though there are reciprocity agreements. This is the reason why reports from the National Center for Health Statistics (NCHS) may have different numbers from those reported by the ISDH. Even though copies of the records may not have been sent back to Indiana, the records would be forwarded to NCHS.