Quarterly Digest
Volume 12 - Number 3 March 2003
- Preface
- Map: B.C. Local Health Areas
- Local Health Areas(LHA) within Health Service
Delivery Area (HSDA) and Health Authority
- Vital Event Statistics - July
1, 2002 - September 30, 2002 and Year-to-date
(Population, Livebirth, Death, Marriage, Stillbirth,
Infant Deaths)
- Selected Birth Statistics -
July 1, 2002 - September 30, 2002 and Year-to-date
(Low Birthweight, Preterm, Teenage Mother, Elderly Gravida, Cesarean
Section)
- External Causes of Death - July
1, 2002 - September 30, 2002 and Year-to-date
(Accidents - [Motor Vehicle Accidents, Poisoning,
Falls, Burns/Fire, Drowning, Other], Suicide, Homicide, Other External
Causes)
- Neoplasm Deaths - July 1, 2002
- September 30, 2002 and Year-to-date
(Lung, Female Breast, Colorectal, Other G.I., Female
Reproductive, Prostate, Blood/Lymph, Other Malignancy, Nonmalignant
and Unspecified)
- Heart Disease Deaths - July
1, 2002 - September 30, 2002 and Year-to-date
(Rheumatic/Valvular, Hypertension, Ischemic, Conductive
& Dysrhythmic, Heart Failure, Congenital, Other)
- Respiratory Disease Death Statistics
- July 1, 2002 - September 30, 2002 and Year-to-date
(Emphysema, COPD, Pneumonia, Influenza, Asthma, Lung
Disease from External Agents, Pulmonary Fibrosis, Other Respiratory)
- Other Selected Death Statistics
- July 1, 2002 - September 30, 2002 and Year-to-date
(Diabetes, Alcohol-Related, AIDS, Other Infectious
Disease, Cerebral and Other Vascular, Liver Disease, Amyotrophic Lateral
Sclerosis and Multiple Sclerosis, Alzheimer's Disease, Parkinson's
Disease)
This quarter's standard tables of vital events are for the third quarter
of 2002 (July 01 to September 30), and summary "year-to-date"
data.
We remind readers that the data files used to produce these tables
are updated on a continuous basis. Therefore, data compiled by addition
of quarterly totals will not correspond exactly to year-to-date and
year-end figures. For the same reason, depending on the date data are
finalized for the Annual Report, there generally are differences between
the numbers reported in the Quarterly Digest and those eventually reported
in the Annual Report.
As always, we welcome reader comments and suggestions aimed towards
improving the value of this publication for our readers. Contact information
is available at the end of this report.
| R.J. Danderfer |
Terry Tuk |
| Chief Executive Officer |
Manager |
| British Columbia |
Information and Resource |
| Vital Statistics Agency |
Management Branch |
| |
|
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Local Health Areas within
Health Service Delivery Area & Health Authority
HA 01 Interior
HSDA
11 East Kootenay
LHA
01 Fernie
02 Cranbrook
03 Kimberley
04 Windermere
05 Creston
18 Golden HSDA
12 Kootenay Boundary
LHA
06/07 Kootenay Lake/Nelson
09 Castlegar
10 Arrow Lakes
11 Trail
12/13 Grand Forks/Kettle Valley HSDA
13 Okanagan
LHA
14 Southern Okanagan
15 Penticton
16 Keremeos
21 Armstrong-Spallumcheen
22 Vernon
23 Central Okanagan
77 Summerland
78 Enderby HSDA
14 Thompson Cariboo
LHA
19 Revelstoke
20 Salmon Arm
24 Kamloops
25 100 Mile House
26 Cariboo-Chilcotin
29 Lillooet
30 South Cariboo
31 Merritt
HA 02 Fraser
HSDA
21 Fraser Valley
LHA
32 Hope
33 Chilliwack
34 Abbotsford
75 Mission
76 Agassiz-Harrison |
HSDA
22 Simon Fraser
LHA
40 New Westminster
41 Burnaby
42 Maple Ridge
43 Coquitlam HSDA
23 South Fraser
LHA
35 Langley
36 Surrey
37 Delta
HA 03 Vancouver Coastal
HSDA
31 Richmond
LHA
38 Richmond
HSDA
32 Vancouver
LHA
161 Vancouver City Centre
162 Vancouver Downtown East Side
163 Vancouver North East
164 Vancouver West Side
165 Vancouver Midtown
166 Vancouver South
HSDA
33 North Shore Coast Garibaldi
LHA
44 North Vancouver
45 West Vancouver-Bowen Island
46 Sunshine Coast
47 Powell River
48 Howe Sound
49 Bella Coola Valley
83 Central Coast
HA 04 Vancouver Island
HSDA
41 South Vancouver Island
LHA
61 Greater Victoria
62 Sooke
63 Saanich
64 Gulf Islands
65 Cowichan
66 Lake Cowichan |
HSDA
42 Central Vancouver Island
LHA
67 Ladysmith
68 Nanaimo
69 Qualicum
70 Alberni
71 Courtenay
66 Lake Cowichan HSDA
43 North Vancouver Island
LHA
72 Campbell River
84 Vancouver Island West
85 Vancouver Island North
HA 05 Northern
HSDA
51 Northwest
LHA
50 Queen Charlotte
51 Snow Country
52 Prince Rupert
53 Upper Skeena
54 Smithers
80 Kitimat
87/94 Stikine/Telegraph Creek
88 Terrace
92 Nisga'a
HSDA
52 Northern Interior
LHA
28 Quesnel
55/93 Burns Lake/Eutsuk
56 Nechako
57 Prince George
HSDA
53 Northeast
LHA
59 Peace River South
60 Peace River North
81 Fort Nelson |
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Glossary
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 geographical locations. ASMRs in this report
are per 10,000 standard population (1991 Canada Census).
Alcohol-Related:
This category includes all deaths considered as being directly or indirectly
related to alcohol as indicated by inclusion by the certifier of selected
alcohol identifying conditions anywhere on the death record (including
"lifestyle" field). It should be noted that where alcohol
is an indirect cause of death (i.e. not UCOD) 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-10 codes: F100-F109, K700-K709, O993, P043, O354, Q860,
G312, G621, G721, I426, K292, K860, X45, X65, Y14, T510-T512, T519.
Note: now excludes acute pancreatitis, and cirrhosis not specifically
identified as alcohol induced.
Assignment of Health Service Delivery Area (HSDA) and Health Authority (HA):
Cases are assigned to Health Service Delivery Areas and Health Authorities 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. 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 (considered
accidents), homicide, legal intervention, misadventures (counted as
accident) and injury from war operations. Standard "Quarterly"
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-10 V020-V049, V090-V092, V093, V120-V149,
V190-V196, V200-V249, V260-V349, V360-V449, V460-V549, V560-V649, V660-V749,
V760-V799, V803-V805, V820-V821, V823-V839, V840-V875, V877-V8999, Y850),
poisoning (X40-X49), falls (W00-W19), burns/fire (X00-X19), drowning
(V900-V909, V920-V929, W65-W74), other accidents (V010-V019, V050-V069,
V091, V099, V100-V119, V150-V189, V198-V199, V250-V259, V350-V359, V450-V459,
V550-V559, V650-V659, V750-V759, V800-V802, V806-V819, V822, V876, V910-V919,
V930-V949, V950-V978, V98-V99, W20-W64, W75-W99, X20-X39, X50-X59, Y40-Y849,
Y859, Y86, Y880-Y883). Suicide ICD-10 codes are X60-X84, Y870; homicide
(X85-Y09, Y871); "other [external]" consists of events of
undetermined intent, legal interventions, and operations of war (Y10-Y369,
Y890-Y899).
Note: the late effects of accidental poisoning, falls, and
burns/fire are no longer identified separately for inclusion in these
categories and are now part of "other accidents"). Trains
are now considered motor vehicles in ICD-10 but for consistency, have
been excluded from MVA counts to still be considered as "other
transport".
Heart Disease:
Tables under this heading include deaths due to:
- rheumatic/valvular: (I050-I099, I340-I38)
- hypertension/hypertensive: (I10-I159)
- ischemic: (I200-I259) (Note: now includes cardiomyopathy
specified as ischemic)
- conductive & dysrythmic: (I440-I499)
- heart failure: (I500-I509)
- congenital: (Q200-Q249)
- other: pulmonary (I260-I289), inflammatory (I300-I311, I319-I339,
I400-I409, I514); cardiomyopathy (I420-I429) (Note: now excludes
ischemic); other ill-defined and unspecified heart disease (I312-I318,
I510-I513, I515-I519) (includes myocardial degeneration)
ICD-9:
The ninth revision of International Classification of Diseases,
World Health Organization, Geneva, 1977. An internationally used system
of approximately 12,000 four (and some three) 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.
ICD-10:
The tenth revision of International Classification of Diseases and
Related Health Problems, World Health Organization, 1992. In use
beginning with year 2000, update of ICD-9 revised with alpha-numeric
system and increased code detail (approximately 18,000). The BC Vital
Statistics Agency and all their provincial counterparts utilize an ICD-10
that has been modified by the National Center for Health Statistics
(NCHS) for use in the classification and analysis of medical mortality
data in the United States (October, 1998).
Infant Deaths:
Deaths of children under one year of age.
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:
- breathing;
- beating of the heart;
- pulsation of the umbilical cord; or
- unmistakable movement of voluntary muscle, whether or not the umbilical
cord has been cut or the placenta attached.
Low Birth Weight:
Any liveborn infant weighing less than 2500 grams.
Neoplasms (ICD-10 C000-D489):
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-10 breakdown used in "Neoplasm Deaths" tables
are;
- lung: includes trachea, bronchus, lung and pleura (C33, C340-C349,
C384, C450). Note: now excludes mesothelioma of lung and trachea.
- female breast: (C500-C509)
- colorectal: (C180-C218)
- other G.I.: includes esophagus, stomach, small intestine and duodenum,
liver & intrahepatic bile ducts, gallbladder and extrahepatic
ducts, pancreas, peritoneum, other and ill-defined within digestive
organs (C150-C179, C220-C269)
- female reproductive: includes uterus, cervix, placenta, ovary and
adnexa, vagina & external genitalia (C510-C58)
- prostate: C61
- blood lymph: includes lymphatic and haematopoietic tissue (C810-C969,
C463).
- 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)and ill-defined
or unspecified sites (C000-C148, C300-C449, C451-C462, C467-C499,
C600-C609, C620-C768, C5099*, C80*). Note: * codes used exclusively
by BC Vital Statistics Agency for male breast cancer and for unknown
primary site cancer.
- non-malignant & unspecified: includes benign, in-situ, and neoplasms
of uncertain or unknown behaviour (D000-D489).
Note: This neoplasm group now includes myeloproliferative disease,
thrombocythemia, monoclonal gammopathy, and lymphoproliferative disease
which were not previously considered neoplastic in ICD-9 and were
counted in other ICD chapters.
Other Selected Death Statistics:
Tables under this heading include deaths due to:
- diabetes (E100-E149).
- alcohol related - see above.
- AIDS/HIV: (B200-B24).
- other infectious and parasitic disease: (A000-B199, B250-B999) Note:
Now includes obstetrical and neonatal tetanus.
- cerebro and other vascular disease: (I600-I698, I700-I879, I950-I959,
I880-I899, I970-I979, I99). Includes cerebrovascular disease, disease
of arteries and veins, hypotension, and other circulatory system disease.
Note: "Other circulatory system disease" now includes
post procedural disorders of the circulatory system (I970-I979) which
are never selected as the UCOD. However they are confirmed by editing
and either recoded to the more specific disease (embolism, stroke,
M.I.) or double coded if the complication is confirmed.
- liver disease: (K700-K7699). Note: Now includes toxic liver
disease with cholestasis.
- ALS/MS: Amyotrophic lateral sclerosis and multiple sclerosis: (G122,
G1221, G35). Note: In order to maintain continuity with ICD-9,
unspecified motor neuron disease (G122) is included in this category
as it was previously not distinguishable from ALS.
Premature/Pre-term:
Any live born infant less than 37 weeks gestation at delivery.
Respiratory Disease Death Statistics:
Tables under this heading include deaths due to the following:
- emphysema: (J430-J439) Note: Now excludes when described
as or resulting in obstructive disease -see note at COPD.
- COPD: (J440-J449). Note: Now includes specific code within
the group for COPD when accompanied with acute lower respiratory infection,
or with acute exacerbation. This inclusion has no statistical impact
on UCOD. Also, this category now includes asthma and emphysema described
as obstructive not previously included in ICD-9.
- pneumonia: (J120-J181, J188-J189) Note: ICD-10 has a new
code for chlamydial pneumonia (J160). It is uncertain if this condition
would have previously been coded to "pneumonia due to other specified
bacteria" (ICD-9 4828) or to "other diseases due to viruses
and chlamydia" (0788), or to both. This disease is very rare
on death records so if not coded to 4828, the impact to comparison
of historical data would still be minimal. Daily VS edits have been
implemented to unsure consistent selection of pneumonia.
- influenza: (J100-J118)
- asthma: (J450-J459, J46) Note: Now excludes when described
as obstructive - see note at COPD.
- lung disease due to external agents: (J60-J709)
- pulmonary fibrosis: (J841)
- other respiratory diseases: (J00-J069, J182, J200-J42, J47, J80-J840,
J848-J9899) Note: Now includes post procedural respiratory
disorders (J950-J959) which formerly used to be injury codes. These
codes are never selected as the UCOD so their impact would only effect
multiple code analyses. The Vital Statistics Agency includes these
in daily data edits to confirm them as post procedural and to double
code for the specific respiratory condition (e.g. pneumonia). As a
result, respiratory disease statistics in BC are more consistent with
historical data.
Standardized Mortality Ratio (SMR):
The ratio of the number of deaths occurring to residents of a geographical
area (e.g. LHA) to the expected number of deaths in that area based
on provincial age specific mortality rates.
Stillbirth:
The complete expulsion or extraction from its mother after at least
twenty 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.
UCOD:
Underlying cause of death - based upon application of standard international
coding rules for determining sequential relationships of conditions
and diseases from immediate cause backwards to underlying cause.
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Contributors' Note:
The editorial staff would like to invite any researchers of health-related
topics 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, Power Point, Corel, Pagemaker, etc.). Article presentation
will be subject to space allowances and publishing deadlines.
Readers' Note:
Re: "Letters to the Editor", or mailing and distribution.
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