The Nuts and Bolts of Vital Statistics ACCOLEDS

The Nuts and Bolts of Vital Statistics ACCOLEDS 2011 Valérie Gaston

Outline § § § § § 2 Overview of vital statistics databases What is the NRS Medical coding Demography versus vital statistics Data dissemination Canadian Coroner and Medical Examiner Database Data access Recent improvements Future improvements Statistics Canada • Statistique Canada 2020 -09 -25

HATCH, HITCH, DITCH, and DISPATCH 3 Statistics Canada • Statistique Canada 2020 -09 -25

Overview of vital statistics databases Administrative data from : • Census of 13 vital statistics registrars • Calendar year (Jan. to Dec. ) • Births, stillbirths and deaths: by place of residence • Approximate number of registrations processed per year: § Births: 340, 000 § Marriages: 147, 000 § Deaths: 229, 000 4 Statistics Canada • Statistique Canada 2020 -09 -25

Data processing 5 Statistics Canada • Statistique Canada 2020 -09 -25

Data processing § Receiving bulk data (quarterly, yearly) from p/t’s in electronic format, paper, and NRS § Files processed yearly, manual resolution of edit failures. § Cause of death coding done at SC and in provs § Internal preliminary file used to produce verification tables sent to p/t’s for validation § Master file used by analysts for dissemination § Access limited to website, custom tabulations, microdata files to partners 6 Statistics Canada • Statistique Canada 2020 -09 -25

What is the NRS? • Distribution system for vital event data which represents a fundamental change in the way data are transferred between data providers and data consumers (SC and other government agencies) • The traditional bulk file transfer of accumulated records is replaced by a messaging system that transmits record level data. All messages are standards-based: technical and data • A new registration, amendment or cancellation 7 recorded in a data provider’s database creates a trigger that performs an extraction, transformation, encryption and outgoing message to authorized data users March 2011 Statistics Canada • Statistique Canada

Medical coding § British Columbia, Québec and Ontario code the underlying cause of death. Stat Can codes the data for the remaining p/t’s. § The underlying cause of death and stillbirth data are checked by Patricia Wood, our expert nosologist. Previous classifications: ICD-3 (1921 -1930), ICD-4 (1931 -1940), ICD-5 (1941 -1949), ICD-6 (1950 -1957), ICD-7 (1958 -1968), ICD-8 (1969 -1978), ICD-9 (1979 -1999) 8 Statistics Canada • Statistique Canada 2020 -09 -25

Underlying Cause of Death • Defined by the World Health Organization (WHO) in the Tenth Revision of the International Classification of Diseases (ICD-10) and earlier revisions as: • “(a) the disease or injury which initiated the train of events leading directly to death, or (b) the circumstances of the accident or violence which produced the fatal injury. ” 9 Statistics Canada • Statistique Canada 2020 -09 -25

The medical certificate of cause of death 10 Statistics Canada • Statistique Canada 2020 -09 -25

Demography vs Vital Statistics § Demography • Estimates of births & deaths for most recent year • From July 1 to June 30 • Total counts § example. : Births, estimated, by province and territory § Vital Statistics • Actual counts of births & deaths • From January to December • Breakdown by characteristics 11 Statistics Canada • Statistique Canada 2020 -09 -25

Data dissemination § Analysts within the Health Statistics Division use the data for publication of annual counts and CANSIM tables released through The Daily. § There are several users within Statistics Canada, for example, the Demography division uses the data to produce population estimates. § Several requests for the data are also made by outside clients for research and record linkages. 12 Statistics Canada • Statistique Canada 2020 -09 -25

Birth & Stillbirth Databases Surveys: 3231 (births) & 3234 (stillbirths) CANSIM tables: 102 -4501 to 102 -4516 (~≥ 1991) Publication: 84 F 0210 X (full smart pub) http: //www. statcan. gc. ca/pub/84 f 021 0 x/84 f 0210 x 2007000 -eng. htm Last release: April 27, 2011 for 2008 data Next release: December 2011 for 2009 data 13 Statistics Canada • Statistique Canada 2020 -09 -25

Births & stillbirths variables Live Births (15 tables): tables) § Canada • age & marital status of mother • age & parity of mother • birth weight indicators by characteristics of mother (age, marital status, parity, birthplace) & child (sex, type, weeks of gestation) • weeks of gestation indicators by characteristics of mother (age, marital status, parity, birthplace) & child (sex, type, weeks of gestation) 14 Statistics Canada • Statistique Canada 2020 -09 -25

Births & stillbirths variables Live Births (15 tables): § Canada, provinces & territories • month, age of mother, marital status of mother, birth weight & sex, weeks of gestation & sex, type (single, multiple), place of birth (hospital, non hospital) • mean age of mother, crude birth rate, age-specific rate, total fertility rate, mean & median birth weight • place of residence of mother and place of occurrence 15 Statistics Canada • Statistique Canada 2020 -09 -25

Births & stillbirths variables Stillbirths (fetal deaths) (3 tables): § Canada, provinces and territories • fetal deaths (≥ 20 weeks of gestation), late fetal deaths (≥ 28 weeks of gestation) • type of birth (single, multiple) • place of birth (hospital, non-hospital) 16 Statistics Canada • Statistique Canada 2020 -09 -25

Deaths Survey: 3233 CANSIM tables: 102 -0501 to 102 -0510 & 102 -0512 (≥ 1991 ) 102 -0521 to 102 -0538, 102 -0540 &102 -0542 (≥ 2000) Publication: 84 F 0211 X (full smart pub) http: //www. statcan. gc. ca/pub/84 f 0211 x 2007000 -eng. htm 84 -208 -X (no pdf) http: //www. statcan. gc. ca/pub/84 -208 -x 2010002 -eng. htm Last release: Sept. 27, 2011 for 2008 data Next release: Spring 2012 for 2009 data 17 Statistics Canada • Statistique Canada 2020 -09 -25

Death variables Deaths (11 tables): § Canada • infant deaths (less than 1 year) by age group & sex • Infant mortality rates by age group & sex 18 Statistics Canada • Statistique Canada 2020 -09 -25

Death variables Deaths (11 tables): § Canada, provinces and territories • month, age & sex, marital status & age-group & sex, hospital and elsewhere, subject to autopsy • mortality rates by age group & sex • place of residence and place of occurrence • life expectancy at birth and at age 65 (3 territories together) • infant mortality by age group • Infant mortality by sex • perinatal mortality and components (late & early) 19 Statistics Canada • Statistique Canada 2020 -09 -25

Causes of Death variables Causes of death (20 tables of detailed causes by chapter- ICD-10): Canada age-group & sex Mortality: Summary List of Causes § CANSIM tables: 102 -0551 & 102 -0552 (≥ 2000) § Publication: 84 F 0209 X (full smart pub) http: //www. statcan. gc. ca/pub/84 f 0209 x 2007000 -eng. htm § Last release: October 18, 2010 for 2008 data § Next releases: Spring 2012 for 2009 data 20 Statistics Canada • Statistique Canada 2020 -09 -25

Causes of Death variables Mortality- summary list of causes (2 tables- ICD-10): § Canada • selected grouped causes by age-group & sex (number & age-specific rate) § Canada, provinces and territories • Selected grouped causes and sex (number, crude mortality rate, age-standardized mortality rate) 21 Statistics Canada • Statistique Canada 2020 -09 -25

Death Database Leading Causes of Deaths § CANSIM tables: 102 -0561 to 102 -0563 (≥ 2000) § Publication: 84 -215 -X (partial smart pub) http: //www. statcan. gc. ca/pub/84 -215 -x 2010001 -eng. htm § Last release: November 1, 2011 for 2008 data § Next release: Spring 2012 for 2009 data 22 Statistics Canada • Statistique Canada 2020 -09 -25

Causes of Death variables Leading causes of death (3 tables- ICD-10): § Canada • age-group & sex (rank, number of death, age-specific rate) § Canada, provinces & territories • sex (rank, number of death, age-standardized mortality rate) § Canada- Infant mortality • sex (rank, number of infant death, infant mortality rate) 23 Statistics Canada • Statistique Canada 2020 -09 -25

Marriages and Divorces • Statistics Canada and 16 other government departments underwent a strategic review in 2008. In the wake of the Strategic Review exercise, Statistics Canada made the decision to discontinue the collection and dissemination of national marriage and divorce data. • The Department of Justice Canada is responsible for collecting the divorce data through the Central Registry of Divorce Proceedings and, as such, has the divorce data. No national body has the marriage data as these data are collected by the provincial/territorial vital statistics registrars. 24 Statistics Canada • Statistique Canada 2020 -09 -25

Marriages and divorces (terminated in 2008) Marriages § Survey 3232 § CANSIM tables: 101 -1001 to 101 -1002, 1011004 to 101 -1009, 101 -1011 to 101 -1013 Divorces § Survey : 3235 § CANSIM tables: 053 -0002 (1970 -2003), 101 -6501 to 101 -6520 (≥ 2004) § Last release: August 9, 2011 25 Statistics Canada • Statistique Canada 2020 -09 -25

Canadian Coroner and Medical Examiner Database (CCMED) 26 Statistics Canada • Statistique Canada 2020 -09 -25

Canadian Coroner and Medical Examiner Database (CCMED) § Subset of deaths, mainly sudden unexpected deaths. § Provide circumstances in which deaths investigated by c/mes occur. § First annual report 2006 – 2008 to be released January 23, 2012. § Currently contains over 80, 000 cases. Statistics Canada • Statistique Canada 27 2020 -09 -25

Data access § Link to Statistics Canada Health in Canada Web site: http: //www 4. statcan. gc. ca/health-sante/index-eng. htm § Data providers • Custom tabulation requests through Client Services (613)951 -1746 hd-ds@statcan. gc. ca v. Supression for small cells v. Verification for residual disclosure 28 Statistics Canada • Statistique Canada 2020 -09 -25

Data access § § Microdata files to PHAC and HC Deemed employee Adding births and deaths data on CANSIM Pilot project in Research Data Centers • Births and deaths 1974 – 2008 § Real time remote access 29 Statistics Canada • Statistique Canada 2020 -09 -25

Recent improvements § § 30 Geography – place of residence postal code Historical file (1974 onward) Multiple cause database (2000 onwards) Documentation Statistics Canada • Statistique Canada 2020 -09 -25

Future improvements § All provinces using NRS by 2013 § Quarterly data quality monitoring § Release data within 6 to 9 months of end of year • Align with other programs • Greater unknowns § Agency use of common processing tools § Future use of EBR and EDR by p/t’s (3 provs) § Increased data access 31 Statistics Canada • Statistique Canada 2020 -09 -25

Contact information Valérie Gaston Statistics Canada 150 Tunney's Pasture Driveway, Ottawa ON K 1 A 0 T 6 Valerie. Gaston@statcan. gc. ca Telephone 613 -951 -4394 Facsimile 613 -951 -0792 32 Statistics Canada • Statistique Canada 2020 -09 -25