Glossary
Acquired Immunodeficiency Syndrome (AIDS)
In 1987, the World Health Organization, in recognition of AIDS and the human immunodeficiency virus (HIV) that causes AIDS as important health concerns, added new codes to the International Classification of Diseases, Ninth Revision (ICD-9) which allowed AIDS (042) and HIV (043-044) to be identified as unique causes of death and also provided differentiation among the complications of AIDS.
Age Specific Fertility Rate (ASFR)
The number of live births per 1,000 women in a specific age group. This is a more detailed measure than the crude birth rate, as it reflects variations in the birth rate by age groups of the female population.
Age Specific Mortality Rate (ASR)
The number of deaths expressed as a rate per 10,000 population for each specified age and gender group.
Age Standardization
Various measures are age standardized to account for compositional differences in populations, in order that more meaningful comparisons can be made between different time periods or geographic areas. Such measures may be calculated for both genders combined or separately by gender. The major age-standardized measures employed in this publication are Age Standardized Mortality Rate (ASMR) and Potential Years of Life Lost (PYLL) Standardized Rate.
Age Standardized Mortality Rate (ASMR)
A summary of age adjusted death rates by gender which have been standardized to a specific population for the purpose of rate comparisons of different time periods or different geographic locations. In this report, the 1991 Canada Census total population (both genders combined) was used as the standard population; earlier reports used the 1971 Canada census male and female populations. Consequently, the standardized rates in this report cannot be compared to those published earlier by the Agency.
The ASMR is an important analysis tool when comparing the Status Indian population with the BC population, since these populations have very different age structures. The ASMR reflects the pattern of death at different ages and estimates the number of deaths (per 10,000 population) that would occur if the population had the same age structure as the standard population.
AIDS
See Acquired Immunodeficiency Syndrome
Alcohol-Related Deaths
Alcohol-related deaths are based on the ICD9 diagnostic categories listed below, for which the resulting deaths are directly or indirectly attributed to the use or abuse of alcohol.
| ICD9 Code(s) | Diagnostic Category |
| 291 | Alcohol psychoses |
| 303 | Alcohol dependence syndrome |
| 305.0 | Non-dependent abuse of alcohol |
| 357.5 | Alcoholic polyneuropathy |
| 425.5 | Alcoholic cardiomyopathy |
| 535.3 | Alcoholic gastritis |
| 571.0 | Alcoholic fatty liver |
| 571.1 | Acute alcoholic hepatitis |
| 571.2 | Alcoholic cirrhosis of liver |
| 571.3 | Alcoholic liver damage, unspecified |
| 571.5 | Cirrhosis of liver without mention of alcohol |
| 571.9 | Unspecified chronic liver disease without mention of alcohol |
| 577.1 | Chronic pancreatitis |
| 648.4 | "Alcohol and pregnancy" |
| 760.7 | "Fetal Alcohol Syndrome" |
| 790.3 | Excessive blood level of alcohol |
| E860 | Accidental alcohol poisoning |
Alcohol is considered to be a direct cause of death if one of the above conditions is listed as the underlying cause of death on the medical certificate of death. If, however, any of the above conditions are listed on the certificate as antecedent causes giving rise to the underlying cause or other significant conditions contributing to the death, the death is considered to be indirectly related to alcohol. In 1993, the Medical Certification of Death was revised to include a box where the physician or coroner could note environmental, occupational and lifestyle factors, including pesticides, asbestos and abuse of alcohol/tobacco. This has resulted in increased reporting of deaths indirectly related to alcohol. Alcohol-related deaths can be viewed as a measure of the health status of the population.
All Others
See Areas
ASMR
See Age Standardized Mortality Rate
Areas
This report presents information by the four administrative areas in B.C. used by Medical Services Branch, Health Canada. Data were converted to these areas based on the Local Health Areas (LHA) boundaries used by the Ministry of Health. A list of LHAs in each area is presented in Appendix 3 at the very end of this report. For the province and each area, information is presented for the Status Indian residents and other area residents (labeled All Others or All Other Residents in tables, maps and charts).
Birth Weight
The first weight of the fetus or newborn after birth. For live births this weight should be measured within the first hour of life before significant postnatal weight loss has occurred. For statistical and risk assessment purposes, birth weights are grouped as:
| Extremely Low Birth Weight | less than 500 grams |
| Very Low Birth Weight | less than 1500 grams |
| Low Birth Weight (LBW) | less than 2500 grams |
| "Normal" Birth Weight | 2500 to 4499 grams |
| High Birth Weight | 4500 grams or more |
Cesarean Section (C-Section)
A delivery involving the surgical incision of the abdomen and uterine walls.
Congenital Anomalies
Physical defects that existed or date from birth.
Crude Rates
For live births: the number of births divided by the mid-year population and converted to a rate per 1,000 population.
For birth-related statistics (teenage mother, elderly gravida, C-section, low birth weight, and preterm): the number of these births divided by the number of live births and converted to a rate per 1,000 live births.
For stillbirths: the number of stillbirths divided by the number of total births (live births plus stillbirths) and converted to a rate per 1,000 total births.
For infant deaths: the number of infant deaths divided by the number of live births and converted to a rate per 1,000 live births.
Dependency Ratio
A dependency ratio is a measure used to compare different age distributions; it is a theoretical estimate of the number of dependents (defined as children under 15 and the older group 65 or older) supported by each person in the 'working age' population (defined as between the ages of 15 and 64). It is calculated in the following way:
Drug-Induced Deaths
Deaths due to drug-induced causes such as drug dependence, accidental poisonings, and suicides involving drugs. This category is limited to deaths where the underlying cause reflects drug use or abuse. The causes of death classified as being drug-induced are based on those used by the National Center for Health Statistics (National Center for Health Statistics (1993). Technical notes. Monthly Vital Statistics Report. 41(Suppl. 7), 48), and include the following:
| ICD9 Code(s) | Diagnostic Category |
| 292 | Drug psychoses |
| 304 | Drug dependence |
| 305.2-305.9 | Nondependent use of drugs, not including alcohol and tobacco |
| E850-E858 | Accidental poisoning by drugs, medicaments, and biologicals |
| E930-E949 | Adverse effects of drugs, medicaments, and biologicals in therapeutic use |
| E950.0-E950.5 | Suicide by drugs, medicaments, and biologicals |
| E962.0 | Assault from poisoning by drugs and medicaments |
| E980.0-E980.5 | Poisoning by drugs, medicaments, and biologicals |
Early Neonatal Death
Death of an infant under seven days of age.
Elderly Gravida
Any woman who was 35 years of age or older at the time of delivery of a live born infant.
External Causes of Death (ICD9 Codes E800-E999)
Deaths due to accidents and violence including environmental events, circumstances and conditions as the cause of injury, poisoning, and other adverse effects. Broad categories include accidents, suicides, medical misadventures or abnormal reactions, homicide, legal intervention, and injury from war operations.
Gestational Age
Fetal age or duration of pregnancy measured from the first day of the last normal menstrual period. Gestational age is expressed in completed days or completed weeks (e.g. events occurring 280 to 286 days after the onset of the last menstrual period are considered to have occurred at 40 weeks of gestation). Measurements of fetal growth are expressed in relation to a specific week of gestational age as follows:
| Extremely premature | | gestational age of less than 28 weeks |
| Moderately premature | | gestational age of 28 to 36 weeks |
| Pre-term/Premature | | age less than 37 weeks of gestation |
| Term | | gestational age of 37 to 41 weeks |
| Post-term/Postmature | | gestational age of 42 weeks or more |
ICD9 Codes
Codes from International Classification of Diseases, 9th Revision, established by the World Health Organization in 1977 for classification of morbidity and mortality.
Infant Death/Mortality
Death of a child under one year of age.
Infant Mortality Rate
The number of deaths of children under one year of age expressed as a rate per 1,000 live births. The infant mortality rate is an internationally accepted indicator of the health status of a population.
Live Birth
The complete expulsion or extraction from its mother, irrespective of the duration of the pregnancy, of a product of conception in which, after the expulsion or extraction, there is:
(a) breathing;
(b) beating of the heart;
(c) pulsation of the umbilical cord; or
(d) unmistakable movement of voluntary muscle, whether or not the umbilical cord has been cut or the placenta is attached.
Low Birth Weight (LBW)
see Birth Weight
Neonatal Death
Death of a child under 28 days of age.
Perinatal Conditions
Includes conditions of the fetus or newborn which have their origin in the perinatal period even though death or morbidity may occur later.
Post Neonatal Death
Death of a child between the ages of 28 days and less than one year.
Potential Years of Life Lost (PYLL)
The number of years of life lost when a person dies before a specified age (e.g. 75 years). In this report, all deaths are assumed to occur at the mid-point of five-year age groups.
Potential Years of Life Lost Standardized Rate (PYLLSR)
An age-standardized measure of Potential Years of Life Lost expressed in terms of a rate per 1,000 population, adjusted to a standard population. In this report, the 1991 Canada Census total population was used as the standard population. Since earlier reports used the 1971 Canada census population, the PYLL standardized rates in this report cannot be compared to those in other reports published by the Agency.
Premature or Pre-Term Birth
see Gestational Age
SIDS
Sudden Infant Death Syndrome.
Smoking Attributable Mortality (SAM)
Since death certifications do not systematically collect complete data on smoking as a contributing factor to the cause of death, an alternate method is required to estimate the extent of smoking attributable deaths. The method used here is based on the concept of attributable risk. The number of adult (35+ years of age) smoking deaths were estimated for the disease categories listed below and weighted by a SAM percentage reflecting the proportion of these deaths which are attributed to smoking:
| ICD9 Code(s) | Diagnostic Category |
| 140-149 | Malignant neoplasms of lip, oral cavity, and pharynx |
| 150 | Malignant neoplasm of esophagus |
| 157 | Malignant neoplasm of pancreas |
| 161 | Malignant neoplasm of larynx |
| 162 | Malignant neoplasm of trachea, lung, and bronchus |
| 180 | Malignant neoplasm of cervix uteri |
| 188 | Malignant neoplasm of urinary bladder |
| 189 | Malignant neoplasm of kidney and other urinary organs |
| 401-404 | Hypertension |
| 410-414 | Ischaemic heart disease |
| 415-417, 420-429, 390-398 | Other heart diseases |
| 430-438 | Cerebrovascular disease |
| 440 | Atherosclerosis |
| 441 | Aortic aneurysm |
| 442-448 | Other arterial disease |
| 480-487 | Pneumonia and influenza |
| 491-492 | Bronchitis and emphysema |
| 493, 010-012 | Other respiratory diseases |
| 496 | Chronic obstructive pulmonary disease |
In 1997, provincial prevalence rates for smoking from the Tobacco Use in BC (1997) survey (which can be found on the Ministry of Health's web page at
(http://www.hlth.gov.bc.ca/program.html) were used to update the Smoking Attributable Mortality (SAM) used in the calculation of the number of smoking attributable deaths. Comparison should not be made to earlier reports due to this change in methodology. Further information on the methodology can be found in Centres for Disease Control 1990 publication Smoking and health: A national status report. (DHSS publication no. (CDC) 87-8396). 2nd Edition. Rockville, MD: U.S. Department of Health and Human Services.
Standard Population
A reference population of known age distribution and/or rates used to adjust for variations in population age structures in different geographic areas or time periods to allow for more meaningful comparisons of various measures. In this report, the ASMR and PYLLSR use the 1991 Canada Census population. Since earlier reports used the 1971 Canada census population, the standardized rates in this report cannot be compared to those published earlier by the Agency.
Stillbirth
The complete expulsion or extraction from its mother after at least 20 weeks of pregnancy, or after attaining a weight of at least 500 grams, of a product of conception in which, after the expulsion or extraction, there is no breathing, beating of the heart, pulsation of the umbilical cord, or unmistakable movement of voluntary muscle.
Stillbirth Rate
The number of stillbirths expressed as a rate per 1,000 total births (live births plus stillbirths).
Teenage Mother
Any mother who was age 19 or less at the time of delivery.
Total Fertility Rate (TFR)
The rate is calculated by summing all of the age-specific birth rates multiplied by the number of years by which the age-specific birth rates are grouped (this assumes the same number of women in each age group). "The total fertility rate indicates the number of births that a group of 1,000 women would have if they experienced, during their childbearing years (age 15 to 44), the age-specific birth rates observed in a given calendar year. It is a hypothetical measure that shows the implications of current levels of fertility by age for completed family size." (National Centre for Health Statistics, 1990, p.5).
Total PYLL
The total number of years of life lost prior to an established cut-off point of 75 years.
Underlying Cause of Death (UCOD)
The underlying cause of death is the disease which triggered the chain of events leading directly to the death or the description of the accident or violence that produced the fatality (World Health Organization, 1977).
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