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Ministry of Health

Quartely Digest
Volume 6 - Number 2 October 1996

Preface

This Quarterly Digest's standard tables of vital event statistical information are for the second quarter and first six months of 1996 and are provided in the usual format by Local Health Areas (LHA) and Regional Health Boards (RHB/HB).

Due to the fact that Vital Statistics Agency files are continually being updated, totals compiled by addition of the annual quarters will not correspond exactly to year-end figures. For the same reason, depending on the date the data are extracted, there will be differences in numbers presented in this year's Quarterly Digests and those eventually reported in the Vital Statistics 1996 Annual Report. Therefore, the numbers provided in this publication should be considered provisional. Finally, the usual cautions regarding random fluctuations in values, particularly those involving small numbers, must be noted.

Structural changes in the family (e.g. age of couple, number of children, legal status) relate to many social, economic, and health issues. This issue's feature article examines social changes in childbearing and marriage habits by comparing historical vital event data through the decades from the 1930s into the 90s.

Wherever possible, changes such as additional cause of death categories, percentage, or year-to-date totals have been added to the Quarterly Digest as requested by our readers. Suggestions for article topics or contributions are also welcome. Your support and input into this publication is greatly appreciated.

R.F Cronin
Assistant Deputy Minister
Corporate Services
Ministry of Health
and Ministry Responsible for Seniors
R.J. Danderfer
Executive Director
Vital Statistics Agency
Ministry of Health and
Ministry Responsible for Seniors

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British Columbia
Local Health Areas



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British Columbia
Local Health Areas (LHA)
within Regional Health Boards (RHB)

01 East Kootenay RHB
LHA
01 Fernie
02 Cranbrook
03 Kimberley
04 Windermere
05 Creston
18 Golden

02 West Kootenay - Boundary RHB
LHA
06 Kootenay Lake
07 Nelson
09 Castlegar
10 Arrow Lakes
11 Trail
12 Grand Forks
13 Kettle Valley

03 North Okanagan RHB
LHA
19 Revelstoke
20 Salmon Arm
21 Armstrong-Spallumcheen
22 Vernon
78 Enderby

04 South Okanagan Similkameen HB
LHA
14 Southern Okanagan
15 Penticton
16 Keremeos
17 Princeton
23 Central Okanagan
77 Summerland

05 Thompson RHB
LHA
24 Kamloops
26 North Thompson
29 Lillooet
30 South Cariboo
31 Merritt

06 Fraser Valley RHB
LHA
32 Hope
33 Chilliwack
34 Abbotsford
75 Mission
76 Aggassiz-Harrison

07 South Fraser Valley RHB
LHA
35 Langley
36 Surrey
37 Delta

08 Simon Fraser HB
LHA
40 New Westminster
42 Maple Ridge
43 Coquitlam

09 Coast Garibaldi RHB
LHA
46 Sechelt
47 Powell River
48 Howe Sound

10 Central Vancouver Island RHB
LHA
65 Cowichan
66 Lake Cowichan
67 Ladysmith
68 Nanaimo
69 Qualicum
70 Alberni

11 Upper Island / Central Coast RHB
LHA
71 Courtenay
72 Campbell River
84 Vanouver Island West
85 Vancouver Island North

12 Cariboo RHB
LHA
27 Cariboo-Chilcotin
28 Quesnel
49 Central Coast
93 Eutsuk

13 North West RHB
LHA
50 Queen Charlotte
52 Prince Rupert
54 Smithers
80 Kitimat
87 Stikine
88 Terrace
92 Nishga
94 Telegraph Creek

14 Peace Liard RHB
LHA
59 Peace River South
60 Peace River North
81 Fort Nelson

15 Northern Interior RHB
LHA
55 Burns Lake
56 Nechako
57 Prince George

16 Vancouver HB
LHA
39 Vancouver

17 Burnaby HB
LHA
41 Burnaby

18 North Shore HB
LHA
44 North Vancouver
45 West Vancouver-Bowen Island

19 Richmond HB
LHA
38 Richmond

20 Capital HB
LHA
61 Greater Victoria
62 Sooke
63 Saanich
64 Gulf Islands

Marriage and Family in British Columbia: 1931-1994

by Z. Kashaninia
The structure of families has changed dramatically in the past few decades in British Columbia. Over the years, social, political and economic events have resulted in shifts in the attitudes of individuals towards marriage and family. Consequently, there has been a significant change in the number of marriages, the age of couples at the time of marriage and the number of children per family. By examining these changes and their possible causes over time, we will be able to learn more about the changing patterns of these vital events and have a better understanding of the intricate social structure of families in British Columbia.

Crude Rates of Live Birth and Marriages
British Columbia, 1931 to 1994

MarriagesLive BirthsMarriagesLive BirthsMarriagesLive Births
YearNumberRateNumberRateYearNumberRateNumberRateYearNumberRateNumberRate
19313,8795.610,40415.0195211,0819.229,82724.8197421,7349.235,45014.9
19323,6045.110,21414.5195311,2989.131,74625.4197521,8249.036,28114.9
19334,0485.79,58313.4195410,9918.532,94625.4197621,5368.735,84814.5
19344,7716.69,81313.5195511,0118.234,13825.4197721,1568.536,69114.7
19355,0346.810,01313.6195611,9508.536,24125.9197821,3888.437,23114.6
19365,4517.310,57114.2195712,6208.538,74426.1197922,0878.538,43214.8
19376,1918.211,27914.9195812,0947.939,57725.7198023,8308.940,10415.0
19386,1357.912,47616.1195911,9107.639,97125.5198124,6999.041,83515.2
19397,8629.912,37315.6196011,2037.040,11625.0198223,8318.643,09115.5
19409,62412.013,83017.2196110,9356.738,59123.7198323,6928.443,25615.4
19419,76912.015,03818.4196211,1966.738,12823.0198423,3948.244,07315.5
194210,82712.416,80819.3196311,6776.937,47822.1198522,2707.842,96015.0
19439,38510.418,80820.9196412,1587.038,89722.3198621,8197.641,80414.5
19448,4349.118,99920.4196513,6397.633,66918.7198723,3778.041,62814.2
19459,2629.818,87719.9196614,6827.832,50217.4198824,4698.242,86814.4
194611,76211.722,60922.5196716,0268.232,89916.9198925,1548.343,59414.3
194711,85211.426,28625.2196816,9148.433,68716.8199025,1858.145,36314.2
194811,71810.825,98424.0196918,2848.935,38317.2199123,6487.445,31214.1
194911,37610.227,30124.5197020,0209.436,86117.3199223,7337.045,71013.6
195011,1109.827,11623.9197120,3899.334,85216.0199323,4406.845,98913.3
195011,1109.827,11623.9197220,6599.234,56315.4199423,7346.546,92412.9
195111,2729.728,07724.1197321,3039.334,35214.9
Note: Rate per 1,000 population in the specified year
Source: British Columbia Vital Statistics Agency, British Columbia Ministry of Health and Ministry Responsible for Seniors.

Over the past 60 years, the institution of marriage has shown to be less popular than before. In 1994, the crude rate for all marriages in B.C. was 6.5 per one thousand population, the lowest rate since 1934. In fact, it is no longer surprising to find more couples in younger age groups in common-law relationships as opposed to formal marriages. In 1991, more than half of families (55.1 percent) under the age of 24 in British Columbia were living in common-law relationships.(1) The crude rates for live births have been similar to marriages. In 1940, the crude rate for live births was 17.2 per one thousand population while by 1994 this rate had dropped to an all time low of 12.9 per one thousand population. This low birth rate has many implications for British Columbia. For the most part, the Province will not be able to rely on natural growth to increase its population and must rely on immigration and migration. This will result in significant changes in the province's social, health and educational programs in order to support the needs of the changing population.

Crude Rates of Live Birth and Marriages
British Columbia, 1931 to 1994

Crude Rates of Birth and Marriages
This article will discuss the changing trends of marriages and births from 1931 to 1991 in British Columbia. In addition, some of the possible social, economical and political reasons for these changing trends will be discussed.

Marriage

In the last 60 years, there has been a number of changes in the pattern of marriages in B.C. Many men and women have been postponing marriage until they are well into their 20's and even 30's. In 1931, only 8 percent of all women married were between 30 and 34 years of age while this figure more than doubled in 1991 for the same age group (18%). In addition, the number of brides between the ages of 25-29 also increased from 21 percent to 30 percent for the same years. It is interesting to note that the opposite trends hold for both the age groups of 15-19 (from 19% to 5%) and 20-24 (from 43% to 30%) for 1931 and 1991 respectively.

Marriages by Age of Bride
British Columbia, 1931 and 1991

Marriages by Age of Bride
Although slightly less notable, the same trend can be observed for males. In 1931, 16 percent of all men who were married were between the ages of 30-34 while this figure increased to 23 percent in 1991. Proportionately, more men were married between the ages of 15-19 and 20-24 in 1931 than in 1991. Therefore, men have also been shown to postpone marriage and family until their late 20's and 30's. In 1951, 43 percent of those married were between 20 and 24 as opposed to only 20 percent in 1991. In addition, only 8 percent of those men married in 1951 were between 35 and 39 while forty years later this number increased to 23 percent.

Marriages by Age of Groom
British Columbia, 1931 and 1991

Marriages by Age of Groom
Generally, we can observe from the figures that the proportion of those married in the age groups of 15-19 and 20-24 has decreased dramatically from 1931 to 1991 for both men and women. Many different factors have contributed to this change. While it can not be proven which one factor is more important; a combination of factors has been responsible for the changes that have occurred in the decrease in the proportion of marriages in lower age groups and the increase in the proportion of marriages in the higher age groups for both men and women.

Participation of Women in Labour Force
British Columbia, 1931 to 1991

Participation of Women in Labour Force
One important factor has been the change in the role of women in society. In recent years more women have entered the work force than ever before. In 1991, participation of labour for women in the work force was measured at 59.7 percent as opposed to only 14.2 percent in 1931 and 28.3 percent in 1961. In addition, the number of females who earned university bachelor degrees has also increased dramatically. In 1991, 48 percent of those graduated with a university degree in B.C. were female as opposed to only 30 percent in 1961. Clearly, more women tend to put education and career as their priority in their 20's and postpone marriage and family until their late twenties and even thirties.

Males and Females with Bachelor Degrees
British Columbia, 1961 and 1991

Males and Females with Bachelor Degrees
One other factor responsible for the decline in marriages, particularly in the last twenty years is common-law relationships. In 1991, one out of every ten couples was living in a common-law relationship in B.C. There is a tendency for younger couples to live in common-law relationships than to get married. As mentioned before, more than half of families with husbands and wives under 24 years of age were living in common-law relationships in 1991. (2)The trend of living in common-law relationships is likely to continue as this social arrangement becomes more accepted even in the older age groups.

Another possible explanation for the changing trends in marriage is economic stability. Increasingly, men and women tend to postpone marriage until they have the desired economic security. With the change in standard of living, couples tend to focus their time and energy on their education, career and the building of financial security before committing to marriage and family.

Births

There have been many changes in the number of births per family over the past 60 years. The changes in the age of parents have been significant, particularly for mothers. With the exceptions of 1941 and 1971, there has been an increase in the number of babies born to women in the higher age groups. In 1931, only 28 percent of women who gave birth were between the ages of 25-29 as opposed to 35 percent in 1991. In contrast, more women aged 20-24 had newborns in 1931 than in 1991 (29 percent as opposed to 20 percent).

Percentage of Live Births by Age of Mother
British Columbia, 1931 to 1991

Percentage of Live Births by Age of Mother
As illustrated, there was a sharp increase in the percentages of live births for mothers between the ages of 20-24 and 25-29 in 1941 and 1971. The increase in the number of children in 1941 may have been the result of the social and political uncertainties of World War II that encouraged earlier marriages and children in the younger age groups. Also, the 1940s characterized the post depression era and the start of new economic activity. This economic stability may have encouraged the decision to get married and have children at a younger age. Many couples started their families before the soldiers went to war between 1939 and 1940, resulting in a large number of babies born to young mothers in 1941. The end of war and the return of soldiers were possible reasons for the sharp increase in the number of marriages and number of babies born in 1944 and 1945. This trend continued well into the 1950s which was characterized as the "baby boom " era.

Live Births by Age of Mother
British Columbia, 1931 and 1991

Live Birth by Age of Mother
The reason for the sharp increase in the proportion of births to women in the lower age groups in 1971 might be attributed to the large number of baby boomers in the particular age groups. By the 1970s, the number of female population in B.C. in their 20's was significant enough to explain the increase in the number of children born to these women. Another explanation could be the lower rate of unemployment and confidence in economic prosperity that resulted in the decision of the younger generation to marry and start a family.

First Births by Age of Mother
British Columbia, 1952 and 1991

First Births by Age of Mother
Another interesting trend is the postponement of initial child bearing. The first available data on first births by the age of mother appeared in the 1952 Vital Statistics Annual Report. By looking at the years 1952 and 1991, it can be seen that changes have been occurring in timing of the birth patterns, particularly the first births. In 1952, the majority of women had their first child between the ages of 20 and 24 (41%). However, in 1991, the majority of women had their first child between the ages of 25 and 29 (35%). What is also important is the differences in the younger age groups in 1952 compared to 1991. For both age groups 15-19 and 20-24, there was a remarkable decrease in the number of first borns from 1952 to 1991. From the figures, it is apparent that in 1991, more women had their first child in their late 20's. This also explains why there were less children per family in 1991 since the later women start their families the less likely it is for them to have more than two or three children in their life time.

In addition, it can be observed from the following chart that the proportion of third and fourth births have decreased dramatically since 1950s and early 1960s. The gap between the proportion of first and second births has widened since late 1960s meaning that the proportion of women giving birth for the first time has been steadily increasing for the most part in the past thirty years (from 31 percent in 1952 to 45 percent in 1994). Although there has been a similar increase for the second births in the same period (from 20 percent in 1952 to 34 percent in 1994); it is the third and fourth births that have shown a significant decrease (from 20 percent in 1952 to 14 percent in 1994 and 10 percent in 1952 to 4 percent in 1994 for third and fourths births respectively). With the majority of births being first or second (78 percent in 1991 and 79 percent in 1994), it is clear to see why there is smaller families of two or less children in the 1990s.

Proportion of Birth Order
British Columbia, 1952 and 1994

Proportion of Birth Order

Percentage of Live Births by Age of Father
British Columbia, 1931 to 1991

Percentage of Live Births
To a lesser degree, the family pattern for men has been similar to women. Generally, there has been an increase in the number of young men who postpone fatherhood until their late 20's and 30's. Overall, there is a tendency for both men and women to have less children at much later stages in their lives than ever before. The large families of the past are no longer seen as most couples tend to have two or less children or in some cases none at all. The start of this phenomenon is related to the availability and prevalence of birth control methods that was introduced in Canada in 1960. Today more couples are using highly effective birth control techniques that would prevent unwanted pregnancies and would give them the options and the flexibility of postponing a family until a desired time in their lives. Many couples that have decided to remain childless have opted for permanent contraception practices such as voluntary sterilization. In addition, the enactment of the 1969 bill on therapeutic abortions (which made abortions legal under special conditions) brought significant changes for women and families. These methods dramatically reduced unintended or unwanted pregnancies and contributed largely to the decision of couples to plan and start a family at their desired time.(3)

In addition, the change in the status of women was another phenomenon responsible for the dramatic changes in the birth patterns. Today, more women tend to focus on their education and careers in their 20's and postpone marriage and family until their late 20's or early 30's. For many women, there is a definite trade off between family and their career. With the high ideals of a better standard of living as well as gaining a higher social status, many women tend to concentrate on their career when they are younger and start their families with fewer children at the later stages of their lives. In addition, the economic recessions with period of inflation since the mid 1970s have made "two income" families a necessity in the 1990s.

The shift on the emphasis on family values has also been responsible for the change in fertility patterns. More couples tend to take the time to plan for their children's education and their future even before they decide to have children. More couples opt to have fewer children in order to provide them with better opportunities and higher aspirations.

The last sixty years have introduced significant changes in the structure of our families in British Columbia. It is clear that the traditional concepts of marriage and family are no longer valid. With more couples seeking higher standards of living , women pursuing their careers as well as the availability of better and more effective birth control, a trend towards late marriages, older first time parents and fewer children seems to be prevalent for the present in British Columbia.

1. Census 91 Fast Facts, BC Stats, Ministry of Finance and Corporate Relations, British Columbia, 1993.(back to text)

2. Census 91 Fast Facts, BC Stats, Ministry of Finance and Corporate Relations, British Columbia, 1993.(back to text)

3. Romaniuc, A. Fertility in Canada: From Baby-Boom to Baby-Bust. Ottawa: Ministry of Supply and Services Canada, 1984, p.42(back to text)

References

Romaniuc, A. 1984. Fertility in Canada: From Baby-Boom to Baby-Bust. Ottawa: Ministry of Supply and Services Canada

Grindstaff, Carl F. 1981. Population and Society: A Sociological Perspective. West Hanover: The Christopher Publishing House

Sauve, Roger. 1990. Canadian People Patterns. Saskatoon: Western Producer Prairie Books

Trovato, F. & Grindstaff, Carl. 1994. Perspectives on Canada's Population. Toronto: Oxford University Press

Baker, Maureen. 1984. The Family: Changing Trends in Canada. Toronto: McGraw-Hill Ryerson Limited

Glossary

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Alcohol-Related:
This category includes all deaths stated as being directly or indirectly related to alcohol. It should be noted that where alcohol is an indirect cause of death (i.e. not primary) and the direct underlying cause of death falls within one of our selected causes (e.g. motor vehicle accidents), then this death may be counted in both columns. That is, not all of "alcohol related" are exclusive. This category includes ICD-9 codes - 291, 303, 305.0, 357.5, 425.5, 535.3,571.0-571.3, 571.5, 577.1, 648.4, 760.7, E860, 790.3.

Assignment of Regional Health Board(RHB/HB):
Cases are assigned to RHB by the aggregation of appropriate LHAs.

Assignment of Local Health Area (LHA):
Allocation of LHA, in the case of births and deaths is based upon the usual residence (by postal code) of the mother and deceased respectively. Marriages are assigned to LHAs according to the place of event. Standard Geographical Code (SGC), derived from community name, is used in the absence of postal code.

Elderly Gravida:
Any mother who was 35 years of age or older at the time of delivery of a live born infant.

External Causes of Death:
Deaths due to environmental events, circumstances and conditions as the cause of injury, poisoning, and other adverse effects. Broad categories include accidents, suicide, medical or abnormal reactions, homicide, legal intervention, misadventures and injury from war operations. Standard tables under this heading include deaths due to accidents, suicide, homicide and other. Accidents are subdivided by the following categories; motor vehicle accidents (MVA) (ICD E810-E825, E929.0), poisoning (E850-869, E929.2), falls (E880-E888, E929.3), burns/fire (E890-899, E924, E929.4), drowning (E830, E832, E910), other accidents - all codes from E800-E949 not already noted. Suicide ICD-9 codes are E950-E959; homicide (E960-969); "other" consists of legal intervention (E970-978), undetermined if accidental or purposely inflicted (E980-989) and war operations (E990-999).

Heart Disease:
Tables under this heading include deaths due to:

  • rheumatic/valvular: 391-398, 424
  • hypertension: 401-405
  • ischemic: 410-414, 429.2
  • conductive & dysrythmic: 426-427
  • heart failure: 428
  • congenital: 745-746
  • other: pulmonary - 415-417, inflammatory - 420-423, 429.0, cardiomyopathy - 425, 429.3, degenerative - 429.1, other, ill-defined or unspecified - 429.4-429.9
ICD-9:
The ninth revision of International Classification of Diseases, World Health Organization, Geneva, 1977. An internationally used system of approximately 12,000 four digit numbers representing a system of categories to which morbid entities are assigned according to an established criteria. ICD provides a common basis of disease and injury classification that facilitates storage, retrieval, and tabulation of statistical data.

Infant Deaths:
Deaths of children under one year of age.

Low Birth Weight:
Any liveborn infant weighing less than 2500 grams.

Neoplasms (ICD-9 140-239):
Although the vast majority of deaths in this category are due to malignant cancer, also included are benign, in-situ, and unspecified "tumours". Detailed ICD-9 breakdown used in "Neoplasm Deaths" tables are;

  • lung: includes trachea, bronchus, lung (ICD-162) and pleura (163)
  • female breast: (ICD-174)
  • colorectal: includes colon (ICD-153) and rectum, rectosigmoid junction and anus (154) other G.I. (Gastrointestinal): includes esophagus (ICD-150), stomach (151), small intestine and duodenum (152), liver & intrahepatic bile ducts (155), gallbladder and extra-hepatic ducts (156), pancreas (157), peritoneum (158), other and ill-defined within digestive organs (159).
  • female reproductive: includes uterus (ICD-179), cervix (180, 182), placenta (181), ovary and adnexa (183), vagina & external genitalia (184).
  • male reproductive: includes prostate (ICD-185), testis (186), penis & other genitalia (187).
  • blood lymph: includes lymphatic and haematopoietic tissue (200-208).
  • other malignancy: includes malignant neoplasms of other (e.g. lip, oral cavity, pharynx, nose, ear, larynx, heart, bone and connective tissue, urinary tract, eye, brain, endocrine glands), ill-defined or unspecified sites (140- 149, 160, 161, 164, 165, 170-173, 175, 188-189, 190-199).
  • non-malignant & unspecified: includes benign (210-229), in-situ (230-234), and neoplasms of unspecified nature (e.g. "tumor" - 239).

Other Selected Death Statistics:
Tables under this heading inlcude deaths due to:
  • respiratory disease with four sub-categories of emphysema (ICD-492), chronic obstructive pulmonary disease (COPD) (496), pneumonia/influenza (480-487), and other respiratory diseases (ICD-460-478, 490-491, 493-495, 500-519).
  • diabetes (250)
  • alcohol related - see above.
  • AIDS: includes AIDS and HIV infections (ICD-042-044).
  • cerebro and other vascular: includes cerebrovascular disease (ICD-430-438), disease of arteries and veins (440-456), hypotension (458), and other circulatory system disease (459).
  • liver disease: ICD-570-573.

Premature / Pre-term:
Any live born infant less than 37 weeks gestation at delivery.

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 expulsion or extraction, there is no breathing, beating of the heart, pulsation of the umbilical cord or unmistakable movement of voluntary muscle.

Teenage Mother:
Any mother who was age 19 or less at the time of delivery.

Contributors' Note:

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The editorial staff would like to invite any readers who wish to contribute an article or paper summary for publication in this Quarterly Digest to contact the Information and Resource Management Branch of the British Columbia Vital Statistics Agency. Articles should focus on health status issues in British Columbia. It is preferable that submissions be in "electronic media" format (e.g. Word, Word Perfect, Excel, Lotus 123, Power Point, Corel Draw, etc.). Article presentation will be subject to space allowances and publishing deadlines.

Readers' Note:

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