Birth certificates, CDC WONDER natality files, PRAMS, BRFSS and County Health Rankings are weighed against one another for Cordell, a composite rural county, in this NU465 Unit 2 review. Searches like "nu 465 unit 2 assignment example", "nu465 unit 2 sample" and "nu465 unit 2 example" land here.
Five Sources, Five Answers: A Data Source Review for Smoking in Pregnancy in Cordell County
[Student Name]
Purdue University Global
NU465: Public Health Nursing - Evidence for Practice
Unit 2 Assignment
[Instructor Name]
[Date]
Composite county written as a model document. Data years and lags are bracketed because they change with each release.
Comparison Table
Birth certificates, state vital records. Measures: cigarette smoking before and during each trimester. Reported by: the mother, through a worksheet at delivery. Smallest geography: county. Latest year: [year]. Lag: about [one] year. Known bias: undercounts compared with other measures.
CDC WONDER natality files. Measures: the same certificate items, national. Reported by: states. Smallest geography: counties of 100,000 or more; smaller counties are grouped (Centers for Disease Control and Prevention, n.d.-a). Latest year: [year]. Bias: same as certificates; cannot isolate Cordell.
Pregnancy Risk Assessment Monitoring System. Measures: smoking before, during and after pregnancy, asked a few months after birth. Reported by: sampled mothers. Smallest geography: state (Centers for Disease Control and Prevention, n.d.-b). Latest year: [year]. Lag: about [two] years. Bias: nonresponse; but questions after birth reduce the pressure to underreport.
Behavioral Risk Factor Surveillance System. Measures: current smoking among adults, including women of reproductive age. Smallest geography: state, with some modeled county estimates (Centers for Disease Control and Prevention, n.d.-c). Bias: not specific to pregnancy.
County Health Rankings. Measures: adult smoking and low birth weight for Cordell. Smallest geography: county (County Health Rankings & Roadmaps, n.d.). Bias: modeled and multi-year estimates; no pregnancy smoking measure.
Why the Figures Differ
A national comparison found that estimates of smoking during pregnancy from birth certificates were lower than those from PRAMS in the same states, consistent with underreporting on the certificate (Tong et al., 2013). The certificate is the only source that names Cordell's pregnant residents, and it is also the one most likely to undercount them. PRAMS checks that undercount but only at the state level, so it can tell Cordell that its figure is probably low, not by how much. BRFSS and County Health Rankings describe the adults around these pregnancies rather than the pregnancies themselves.
Which Source Anchors the Problem
The birth certificate figure, 17.7 percent, anchors the later problem statement, because it is the only county-level measure of smoking in pregnancy. The statement will note that the true figure is likely higher, citing the PRAMS comparison, and will use County Health Rankings for adult smoking and low birth weight as context. The figures are not averaged, because they measure different things in different ways. Averaging a county certificate figure with a statewide survey estimate would produce a number that describes no real population.
References
Centers for Disease Control and Prevention. (n.d.-a). CDC WONDER: Natality information. Centers for Disease Control and Prevention.
Centers for Disease Control and Prevention. (n.d.-b). Pregnancy Risk Assessment Monitoring System (PRAMS). Centers for Disease Control and Prevention.
Centers for Disease Control and Prevention. (n.d.-c). Behavioral Risk Factor Surveillance System. Centers for Disease Control and Prevention.
County Health Rankings & Roadmaps. (n.d.). County health rankings. University of Wisconsin Population Health Institute.
Tong, V. T., Dietz, P. M., Farr, S. L., D'Angelo, D. V., & England, L. J. (2013). Estimates of smoking before and during pregnancy, and smoking cessation during pregnancy: Comparing two population-based data sources. Public Health Reports, 128(3), 179-188. https://doi.org/10.1177/003335491312800308
How this NU465 Unit 2 example is structured
Sources run in order of how closely each describes Cordell's pregnant residents. Birth certificates lead because they alone name those women by county, and the review states their weakness at once: a checkbox completed near delivery, often from a worksheet, that tends to undercount when compared with biochemical measures. The national natality files follow, useful for trend and comparison but blind below the 100,000 threshold. PRAMS comes next as the check on undercounting, since its questions arrive after birth and ask about the final three months of pregnancy; its limit is geography. BRFSS and County Health Rankings close the tour as context, describing the adults around those pregnancies rather than the pregnancies themselves. A last section reconciles the figures instead of averaging them, explaining why each differs and which one the later problem statement will cite.
Get an NU465 Unit 2 example written to your instructions
Data source assignments vary in how many sources they require and whether the population is assigned or chosen. Tell the desk which applies to your section, attach the Unit 2 instructions and rubric, and a review built to that list, with each source's limits stated, arrives in 24-48h; nothing is charged the first time. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
NU465 Unit 2 questions, answered
Why not use CDC WONDER for a small county's figure?
Because the natality files group counties with fewer than 100,000 residents into an unidentified category for each state, so a small county cannot be pulled out by itself. The state vital records office usually publishes county tables from the same certificates. CDC WONDER still earns a place for national trend and comparison, and saying why it stops short shows the marker you understand the tool.
Is County Health Rankings enough on its own?
Rarely for this assignment. It is convenient and county-specific, but several of its measures are modeled estimates, and it may not carry the measure a given problem needs; smoking in pregnancy is one example. Most rubrics expect at least one source closer to the problem. Use the rankings for context and cite the release year, since measures and methods change between editions.
Are the sample's figures real county data?
They are invented for a composite county, though every source named is real and described as it actually works. In your own review the numbers have to come from the live tables for your chosen place, with query settings and access dates recorded, since each figure should be reproducible from your citation alone.