Introduction

The Vital Statistics Agency is responsible for the ascertainment, registration, and certification of vital events through the administration of the Vital Statistics Act, Marriage Act, and Name Act. Statistical information contained in this report is summary data provided by the Agency for use by government agencies, health planners, researchers, and the general public. In order to maintain confidentiality, the information does not disclose personally identifiable data.

Vital Event Data

Live birth, stillbirth, and death statistics in this report summarize events that occurred in the province for British Columbia residents only, and exclude events to non-residents except where specifically noted. Statistics do not include events for British Columbia residents that occurred outside the province; Statistics Canada, in its publications, makes adjustments for events that occur to Canadians outside their province of usual residence. Marriage statistics summarize all events that occurred in the province to either residents or non-residents.

Data presented in this report are based on registrations of birth, stillbirth, death, and marriage as reported to the British Columbia Vital Statistics Agency. Registration requirements for each type of event are outlined briefly as follows:

Live Births: The Vital Statistics Act prescribes the legal requirements for the registration of live births. The parent(s) of the child have the responsibility to complete the Registration of Live Birth within 30 days of the event. The physician or registered midwife who was in attendance at the birth must complete a Notice of Live Birth or Stillbirth (NOB). Other requirements must be met if the birth was not attended by a physician or registered midwife.

Stillbirths: In the event of a stillbirth, the parent(s) must complete the Registration of Stillbirth. The physician or registered midwife who was in attendance at the birth must complete a Notice of Live Birth or Stillbirth (NOB). In addition, a physician or coroner is required to complete the Medical Certification of Stillbirth portion of the Registration of Stillbirth and deliver it to the funeral director who in turn submits it to the Agency.

Deaths: The physician in attendance at the last illness of the deceased person, or the coroner conducting an inquiry into the death of the person is required to complete a Medical Certification of Death. In addition, the Registration of Death is completed by the informant with assistance from the funeral home. Funeral Directors obtain the Medical Certification of Death, issue the burial permit and submit the Medical Certification of Death and the Registration of Death documents to the Agency to complete the registration.

Marriages: The Marriage Act prescribes the legal qualifications of individuals to marry, the authorization of Religious Representatives and Marriage Commissioners to perform the marriage ceremony, and the solemnization of marriage. Under the Marriage Act, the Agency licences Religious Representatives of established religious denominations who desire the authority to solemnize marriage. The Agency recommends for appointment Marriage Licence Issuers and Marriage Commissioners to perform civil ceremonies.

Couples who meet the legal qualifications to marry must obtain a marriage licence up to 90 days before the ceremony. They can choose a civil ceremony performed by a Marriage Commissioner or a religious ceremony performed by a Religious Representative. The Registration of Marriage is completed by the officient after the ceremony, and must be signed by the officient, the bride and groom, and two witnesses.

Medical Coding

The Notice of Live Birth or Stillbirth includes information on birth weight, gestation, and mode of delivery, as well as abnormalities of the infant and complications of pregnancy, labour and delivery. The Medical Certification of Death and the Medical Certification of Stillbirth include information on the immediate cause of death or stillbirth, antecedent causes giving rise to the immediate cause, and other significant conditions contributing to the death or stillbirth. This information is processed by medically trained staff using the World Health Organization's International Classification of Diseases (ICD) coding scheme.

Since the early 1900s, the International Classification of Diseases has been modified about once every ten years in order to reflect advances in medical science and changes in diagnostic terminology. A longer interval occurred with the latest revision. The ninth revision of ICD (ICD-9) was used for medical coding of birth complications and causes of death from 1979 until 1999. Coding according to the tenth revision (ICD-10) was implemented at the beginning of the year 2000. ICD-10 is far more detailed than ICD-9, with approximately twice as many categories. As well, ICD-10 includes new disease entities, some groupings of conditions within the classification have changed, and some conditions have been assigned to different parts of the classification than they were found in ICD-9. As a result, discontinuities in trend data are expected. In some areas, these changes are so extensive that data cannot be compared until translation tables have been developed, and manual reviews and recoding of data from ICD-9 to ICD-10 have been completed.

Issue papers to be published in upcoming Quarterly Digest reports will provide more details about the impact of ICD-10. Through an editing process, the output from ICD-10 mortality coding and underlying cause of death selection was modified in British Columbia to better reflect the intent of certifiers in British Columbia and to provide greater continuity over time.

Time Periods

This report pertains to events that occurred in the calendar year 2000. Selected tables present aggregate information for the five-year period, 1995-1999. These broader time periods permit more meaningful tests of statistical significance when analyzing data at sub-provincial levels, and can smooth out random fluctuations that occur when annual numbers are small. For regional health status profiles, readers are encouraged to refer to measures of statistical significance and use data presented for the five-year aggregates.

Data for 1995-1999 have been updated and may differ from earlier publications. Readers should treat this report as a replacement of previous publications and avoid comparisons with tables in earlier publications.

It should also be noted that changes in medical coding for some of the categories of birth and death information are too extensive to allow comparison between the most recent year (in ICD-10) and earlier years (in ICD-9). In these situations, the report provides data for 2000 events only. Readers familiar with previous annual reports may lament the absence of trend information provided previously. The Vital Statistics Agency has been developing ICD-9 to ICD-10 translation tables, and has been reviewing and recoding 1986-1999 birth and death data. When these tasks have been completed, additional trend information will be available.

Population Data

Population projections for the year 2000 and population estimates for earlier years for local health areas and for health regions are from PEOPLE 25. Population estimates for incorporated communities are from Total Population Estimates Municipalities and Regional Districts. All population information is from BC STATS, Ministry of Finance.

In the mortality section of this report, a 'standard population' is used in the calculation of Age Standardized Mortality Rates (ASMR) and Potential Years Of Life Lost Standardized Rates (PYLLSR). Since the 1998 Annual Report, the Agency has used the 1991 Canadian Census population as the 'standard population' in the calculation of these age-standardized measures. Please refer to Standard Population in the Glossary for a more detailed description.

Spatial Analysis and Mapping

This report presents regional data for the Ministry of Health's standard data dissemination areas (health regions and local health areas) and incorporated communities. Vital events are allocated to these data dissemination areas by the postal codes recorded on registration documents. Marriages are assigned geographically by the postal code of the location where the marriage ceremony was performed; other vital events are assigned by the usual residence of the parents (for live births and stillbirths) or the decedent (for deaths).

The maps in this report present local health area (LHA) data ranked by quintiles and allow easy visual examination of spatial patterns. Although all LHAs are presented in the maps, emphasis should be placed on data that are statistically significant.

Terms, Methods, and Computational Examples

Readers are encouraged to refer to the glossary for explanations of terms and methodologies. In addition, the glossary provides examples of computations of measures and statistical tests.

Personal information collected by the Vital Statistics Agency is protected under the Freedom of Information and Protection of Privacy Act and is treated with confidentiality.