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 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) form. 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) form. 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 officiant after the ceremony, and must be signed by the officiant, 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. In some instances the Agency's medical coding staff has determined that strict adherence to the automated ICD classification process would misstate the intention of the physician completing the Medical Certification of Death. In these cases the Agency deviates slightly from ICD coding for the material presented in this report. Data coded to automated ICD classification standards are maintained by the Agency for comparison to other jurisdictions or submission to Statistics Canada. Data presented in this report does not necessarily correspond to data for British Columbia published elsewhere.

Since the early 1900s, the International Classification of Diseases has been revised regularly in order to reflect advances in medical science and changes in diagnostic terminology. 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. Many changes in the codes and in the rules for selection of the underlying cause of death precluded direct comparison of data in ICD-10 with data from earlier years. Translation tables were used, and extensive manual reviews and recoding of data from ICD-9 to ICD-10 was completed in order to be able to provide trend data in this annual report.

Time Periods

This report primarily pertains to events that occurred in the calendar year 2002, but some data is presented either as a time series or aggregated for the five-year period, 1997-2001 These broader time periods provide context for the 2002 data and 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.

It should be noted that data prior to 2000 have been updated based on ICD-10 rules. Results may differ from earlier publications due to changes in the definition of diagnosis categories. Readers should treat this report as a replacement of previous publications and avoid comparisons with tables in earlier publications.

Population Data

Population estimates for incorporated communities, local health areas, and health regions were provided by BC STATS, Ministry of Management Services. 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). The Agency has used the 1991 Canadian Census population as the 'standard population' in the calculation of these age-standardized measures since 1998. Please refer to Standard Population in the Glossary for a more detailed description.

Spatial Analysis and Mapping

This report presents regional analyses using data dissemination areas used by the Ministries of Health (Health Authority, Health Service Delivery Area, and Local Health Area) and for incorporated communities. This continues the practice established in 2001 and provides Health Authorities a consistent time series of health status indicators for their governance regions. 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 and 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 statistics for all LHAs are presented in the maps, emphasis should be placed on those 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.