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Ministry of Health

Quartely Digest
Volume 6 - Number 3 January 1997

Preface

This Quarterly Digest's standard tables of vital event statistical information are for the second quarter and nine months of 1996 and are provided in the usual format by Local Health Areas (LHA) and twenty 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-to-date and 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 Digest and those eventually reported in the 1996 Vital Statistics' 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.

This issue's feature article is the introductory section of a comprehensive Vital Statistics report which will be available February/March of 1997. This detailed report examines all accidental death in British Columbia from 1987 to 1995. In addition to a complete break-down of accident categories that considers age, gender, Aboriginal, regional differences etc., Vital Statistics' mortality data is presented in many ways not previously provided. For example, motor vehicle accident fatalities that include non-residents, by the location of the event, or air transport deaths that consider the number of events as well as the number of victims. The introductory section reproduced for this issue, is an overview of accidental death in BC that provides, to highlight, counts, age specific rates, provincial comparisons, major accident category contribution to total deaths, potential years of life lost to fatal accidents, and overall regional standard mortality ratios.

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.J. Danderfer
Director
Vital Statistics Agency
Ministry of Health and
Ministry Responsible for Seniors

Soo-Hong Uh
Manager
Information and Resource Management Branch
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

The following review of accidental death in British Columbia is the introductory chapter of a soon to be available comprehensive report that examines various types of accidental death in considerable detail.

The remaining report sections focus individually on motor vehicle traffic accidents, falls, poisonings, drownings, other transport accidents (e.g. air, water, rail, off-road), death from fires, untoward results of medical treatment, deaths from natural and environmental factors, and other less frequent (e.g. shooting, electrocution, machinery) manners of accidental death. Most of these sub-chapters examine age, gender and regional differences. In addition, for many of the accident types, other characteristics such as the nature of the injury incurred, Native vs. non-Native differences, the nature of the individual killed (e.g. driver, pedestrian, motorcyclist) and certain multiple victim accidents are also examined. The complete report is expected to be available by March, 1997.

Accident Fatality in British Columbia, 1987 - 1995

by E. Demaere

Introduction

In 1995, accidental deaths were the fourth leading cause of death in British Columbia. Between 1987 and 1995, 5.9% of the total deaths in British Columbia were attributable to accidents. Although accidents represent a small percentage of deaths, the reality is that a large number of accidents can be prevented.

A 1991 Statistics Canada Report entitled Accidents in Canada, in which 9,870 Canadians were surveyed, found that 52% of the survey respondents viewed their accidents as being a result of carelessness or unsafe activity. The other 48% of the respondents indicated that the accident could not have been predicted or avoided at all. Identifying the types of fatal accidents that occur, the age and gender distributions of the decedents, and the regional distribution of where the accidents took place could be helpful for those involved in prevention programs.

This report will focus on accidental deaths that occurred in British Columbia between 1987 and 1995. A national overview will be given to put BC's situation in perspective. Age, gender, and regional issues will be looked at to identify groups at risk and in certain cases British Columbia's First Nations Peoples will be compared to the rest of the BC population to see if special issues exist there as well.

Between 1987 and 1995, motor vehicle traffic accidents (MVTAs) were the leading cause of accidental deaths in British Columbia followed by accidental falls and accidental poisonings. Males were generally more likely to die an accidental death than females. People living in the Peace Liard, Northern Interior, Thompson, and Vancouver Regions were all more likely to die an accidental death than other residents while those living in the lower mainland regions (Abbotsford, Surrey, Delta, Richmond, Burnaby, Maple Ridge, Coquitlam, North Vancouver, and West Vancouver) and the Capital Region (Greater Victoria, Sooke, and Saanich) were all less likely to die an accidental death. Furthermore, those aged 75 years and older had rates that were significantly higher than the rest of the population. Natives were more likely to die an accidental death than non-Natives.

Objectives

  • Compare BC's rates of accidental deaths with other provincial and national rates.
  • Within each accident type, determine if significant age, gender, and regional differences exist. For the main accident types, look at differences that might exist between the Native and non-Native populations in British Columbia.
  • For MVTAs, drownings, air transport accidents, nontraffic accidents, water transport accidents, railway accidents, fires, and natural/environmental accidents determine where the accidents took place.
  • For MVTAs look at the nature of the injuries.
  • Identify age and gender issues in motorcycle and bicycle accidental deaths.
  • For air transport accidents and fires look at the number of accidents as well as the number of deaths that took place.

Methodology

British Columbia mortality data for 1987 to 1995 were extracted from Registrations/Certifications of Death (including non BC residents) filed with the British Columbia Vital Statistics Agency where the underlying cause of death (UCOD)* was indicated by the following ICD-9* codes:

Motor Vehicle Traffic AccidentsE810-E819 and E9290
FallsE880-E888 and E9293
Accidental PoisoningE850-E869 and E9292
DrowningE830, E832, E910
Fire, Flames, BurnsE890-E899, E924 and E9294
Medical misadventure & untoward adverse effectsE870-E879, E930-E949
Air Transport AccidentsE840-E845
Natural/environmental factorsE900-E909 and E9295
Motor Non-traffic off-road E820-E829, E846-E848
Water TransportE831, E833-E838
RailwayE800-E807
Accidental ShootingE922
All OtherE911-E921, E923, E925-E928, E9291,
E9298, and E9299
It is important to note that accidental deaths are assigned to the above categories based on the external event (the type of accident) that caused the death. Therefore, the manner of death is not indicated by the external cause code identifying the event that caused the death. For example, a person may be killed in a motor vehicle traffic accident in which a car ends up off the road in a body of water and the individual actually drowns. The death is coded as being caused by a motor vehicle traffic accident and another code, the nature of injury code, would indicate that the person died by drowning.

The numbers of deaths reported here may not match previous Vital Statistics Annual Reports as they are based on information which included late registrations and recent amendments.

The identification of Status Native death files for this report was based on the results of probabilistic record linkage techniques on three different data sets for 1987 to 1994. The data used are from the BC Vital Statistic Agency's death files, Registration and Premium/Billing files and the Registered Indian Status Verification file from the Medical Services Branch (originating from the Indian Registry), Health Canada. The identified Status Native population used in this report, therefore, does not represent all Aboriginal Peoples in BC. The use of the term "Native" in this report refers to the Status Native population identified through record linkage.

Typically regional analysis involves using the decedent's Local Health Area (LHA) of residence. The main advantage of doing this is that statistical testing can be employed to determine which regions have a relatively higher incidence of a particular death type. With MVTAs, drownings, air transport accidents, nontraffic accidents, water transport accidents, railway accidents, fires, and natural/environmental factors causing an accident it was useful to look at where the accidents occurred to determine if regional patterns exist. This was done by converting the place of death (typically a city) into a LHA. It was therefore assumed that if an individual did not die at the scene of the accident, but died later in hospital, that the hospital would most likely be in the same LHA that the accident occurred in. However, this may not always hold true, particularly for LHAs in the lower mainland.

Sometimes it is useful to look at situations in which an accident causes multiple deaths as could be the case in air transport accidents and fires. Therefore, it was possible to derive the number of accidents that occurred within these two categories of accidental deaths by looking at the dates and locations of where the accidents took place.

In some cases original Registrations of Death were examined to determine details that do not exist in the ICD codes. This was done, for example, to determine the types of off-road vehicles that were involved in non-traffic accidental deaths.

Accidental Death: Overview

Inter-provincial comparisons for all accidental deaths were not possible because age standardized mortality rates were not available.

National and Provinical Comparisons - Figures 1 - 3

Figure 1
Motor Vehicle Accidents - Age Standardized Mortality Rates (ASMR)*
by Province, 1994

Figure 1

Note:
*Rate Age Standardized Mortality Rate per 100,000 gender specific standard population (1991 Canada Census).
Includes both traffic and non-traffic accidents.
Source: Statistics Canada, Mortality - Summary List of Causes, 1994.
Motor vehicle accidents (MVAs) include deaths from traffic as well as non-traffic accidents that involve motorized vehicles.

  • Apart from the Yukon, which had the highest age standardized MVA mortality rates for both males (75.8 per 100,000 standard male population) and females (22.4 per 100,000 standard female population) in Canada, the highest rate of any other province or territory was observed in Saskatchewan for both males ( 21.6 per 100,000) and females (9.1 per 100,000).
  • British Columbia males had the seventh highest rate in the country (16.8 per 100,000) while females ranked third (8.4 per 100,000). Both BC males and females were slighly higher than the National rate.
  • Newfoundland had the lowest age standardized mortality rates (ASMR)* for males (11.6 per 100,000) and females (2.4 per 100,000) of any province or territory.

Figure 2
Accidental Falls - Age Standardized Mortality Rates (ASMR)*
by Province, 1994

Figure 2

Note:
*Rate Age Standardized Mortality Rate per 100,000 gender specific standard population (1991 Canada Census).
Source: Statistics Canada, Mortality - Summary List of Causes, 1994.
  • Apart from northern Canada, which had the highest ASMRs* for accidental falls for both males and females, the highest rate for males was observed in Ontario (11.0 per 100,000 male standard population) and the highest rate for females was observed in New Brunswick (7.5 per 100,000 female standard population).
  • British Columbia males had the ninth (tied with Manitoba) highest rate (8.0 per 100,000) in the country while females ranked sixth (tied with PEI at 6.3 per 100,000). BC males were lower than the National rate while BC females had a rate equal to the National rate.
  • Prince Edward Island had the lowest age standardized mortality rates for males (5.8 per 100,000) and the lowest female rate (3.9 per 100,000) was observed in Manitoba.

Figure 3
Accidental Poisonings - Crude Death Rates
by Province, 1992 to 1994

Figure 3

Note:
Rate* per 100,000 gender specific population.
Source: Statistics Canada, Mortality - Summary List of Causes, 1994.
Note that the use of crude rates does not take into consideration different population age and gender distributions that may exist between provinces.

  • Of the ten provinces, British Columbia consistently had the highest accidental poisoning death rates remaining well above the national rates in 1992, 1993, and 1994.
  • British Columbia was the only province that experienced a dramatic increase in rates from 1992 to 1993 (5.0 per 100,000 in 1992 to 10.5 per 100,000 in 1993). In fact, 8 of the 10 provinces actually had rates that decreased or remained the same from 1992 to 1993. PEI had a decrease in their rates from 1992 to 1993 (4.6 to 0.8 per 100,000).
  • Of the ten provinces, Newfoundland had the lowest rates in 1992 (1.2 per 100,000), 1993 (0.5 per 100,000), and 1994 (0.7 per 100,000 tied with PEI).

British Columbia Accidental Death Overview: Figure 4 - 7, and Tables 1 & 2

Figure 4
Accidental Deaths
in British Columbia, 1987 - 1995

Figure 4

Note:
Includes non - B. C. residents.
  • Between 1987 and 1995, accidental deaths accounted for 5.9% of all deaths that occurred in British Columbia.
  • Motor Vehicle Traffic Accidents (MVTAs) accounted for 37.3% of all accidental deaths that occurred in the province over the time period.
  • The next most common cause of accidental death was falls, which accounted for 21.1% of all accidental deaths, followed by accidental poisoning deaths at 14.7%.

Accidental Deaths - Gender Comparison, British Columbia, 1987 to 1995

Table 1
Accidental Deaths - Type of Accident by Year
British Columbia, 1987 to 1995

Table 1

Note:
*Total includes non - B. C. residents.
+Rank based on total.
  • There were a total of 12,941 accidental deaths, including 827 non BC residents, in British Columbia between 1987 and 1995. Males accounted for 8,805 deaths while females accounted for 4,136 deaths.
  • Every year between 1987 and 1995 the ratio of male and female accidental deaths remained fairly constant ranging from 1.9 to 2.1 times more male deaths than female deaths.
  • The accident types with the greatest male/female discrepancies were accidental shooting deaths where males had 22.5 times more deaths than females and accidental drownings where males had 5.0 times more deaths than females.
  • There were only two accident categories where females had greater numbers than males: females had 13 more deaths in the medical misadventure and untoward adverse effects category and 19 more deaths than males in the accidental falls category.

Figure 5
Accidental Deaths, Gender Comparison
British Columbia, 1987 - 1995

Figure 5

Note:
Includes non - B. C. residents.
  • Motor Vehicle Traffic Accidents (MVTAs) had the highest death toll among males (38.4%) followed by accidental poisonings (16.3%), and accidental falls (15.4%).
  • Females also had a high number of MVTAs (34.9%) with accidental falls close behind (33.2%), and accidental poisonings third overall (11.2%).

Age and Gender Differences: Table 2 and Figures 6 & 7

Table 2
Accidental Deaths - Counts and Age Specific Rates (ASR)
British Columbia, 1987 - 1995

AgeMaleFemaleTotal
GroupCountsASRCountsASRCountsASR
<14019.23015.27017.2
1-412214.58010.020212.3
5-9999.4505.01497.2
10-1411010.9454.61557.8
15-1964562.722222.586743.1
20-2483974.520118.21,04046.6
25-2984965.522017.31,06941.6
30-3484061.121715.91,05738.5
35-3980761.920816.01,01539.0
40-4460650.917014.777633.0
45-4948049.112112.960131.4
50-5434544.613418.147931.6
55-5933147.312218.145333.0
60-6430045.316023.946034.5
65-6927647.218227.545836.8
70-7427359.319233.546545.0
75-79330103.427162.760180.0
80-84336181.1343121.9679145.4
85+550485.7967421.51,517442.5
Total8,1783,93512,113

Note:
Age Specific Rates per 100,000 age and gender specific population.
There was one male accidental death of unknown age.

Notes to Table 2 & Figure 6

  • The highest risk of accidental death was found among elderly British Columbians age 75+ and particularly those 85+.
  • Among children age 14 and less, highest age specific accidental death rates (ASR) occurred in infants (<1) then declined to age 9 and increased very slightly in the 10-14 age group. Still, overall, children under age 15 had the lowest rates of all five-year groups.
  • The ASR increased sharply at age 15. Those age 15 to 19 were 5 to 6 times more likely to die accidentally than were children 10 to 14.

Figure 6
Accidental Deaths - Age Specific Rates (ASR)
British Columbia, 1987 - 1995

Figure 6

Note:
Age Specific Rate per 100,000 age and gender specific population.

Notes to Table 2 & Figure 6

  • The increase in ASR after age 14 extended to the 20-24 age group and then declined to the lowest rate among adults in their late 40s and early 50s.
  • From the 55-59 age group there was an initially slow increase progressing to the highest rates for accidental deaths in the 85+ age group. The rates for the 85+ age group was significantly higher (at least 3 times higher) than any other age group.
  • Males had higher rates than females in every age group and the discrepancy ranged from 1.2 times greater in the 85+ age group to 4.1 times greater in the 20-24 age group.

Figure 7
Accidental Deaths - Age Standardized Mortality Rates
British Columbia, 1987 to 1995

Figure 7

Note:
Age Standardized Mortality Rates per 100,000 standard population (1971Canada Census).
Non-residents are excluded.
  • Overall, between 1987 and 1995, rates (ASMR) for accidental deaths appeared to be gradually dropping. The only exceptions are in 1990 and in 1993 where the rates increased slightly from the prior year.
  • Rates for males appeared to show a slight downward trend over the time period while female rates tended to remain more constant. The relatively high male rates in 1993 and 1994 were largely due to increased deaths from accidental poisonings in those years. In 1987, the ASMR for male accidental deaths was 53.1 per 100,000 standard population. The rate declined to 38.4 in 1995, a 27.7% decrease over the time period.

Accidental Death in BC Status Native Population

Figure 8
Age Specific Rates of Accidental Death, Native vs. Rest of BC by Gender
British Columbia, 1987 - 1994

Figure 8

Note:
Rate per 100,000 specified age and gender groups.
Numbers above columns are total accidental deaths in each age group.
  • Between 1987 and 1994, 978 BC Natives died an accidental death while for non-Natives there were 9,873 deaths.
  • Age specific rates of accidental deaths for both Native males and females were considerably higher than for the rest of the BC population across all age groups.
  • There were varying degrees of differences between Native and non-Native age specific rates. In the <1 age group, Native males had rates that were 2.2 times greater than non-Natives while in the 50-59 age group Native males had rates that were 8.7 times greater than non-Natives.
  • In the 60+ age group, Native females had rates that were 2.6 times greater than non-Natives while in the 30-39 age group Native females had rates that were 8.1 times greater than non-Natives.
  • Of the 65 infants who died an accidental death in BC over 1987 to 1995, 14 (21.5%) were Native although the Native population of BC is slightly less than 3% of the total population. Of the 27 infant girls that died accidentaly, one third were Native.

Figure 9
Accidental Deaths - Native vs. Non-Native Age Standardized Mortality Rates (ASMR)
British Columbia, 1987 to 1994

Figure 9

Note:
ASMR - Age Standardized Mortality Rates per 100,000 standard population (1971 Canada Census).
  • Between 1987 and 1994, the age standardized mortality rates for Natives have constantly been higher (between 3.5 and 4.8 times) than those of non-Natives.

Fatal Accidents, Regional Differences

Table 3
Accidental Deaths-Standardized Mortality
Ratios, by Local Health Areas
British Columbia, 1987 - 1995

LHAObservedExpectedSMRLower*Upper*
01Fernie4050.800.790.561.07
02Cranbrook6474.830.860.661.09
03Kimberley3530.981.130.791.57
04Windermere2424.570.980.631.45
05Creston5544.271.240.941.62
06Kootenay Lake2311.981.921.222.88
07Nelson9979.561.241.011.51
09Castlegar3342.710.770.531.08
10Arrow Lakes2118.401.140.711.74
11Trail7977.331.020.811.27
12Grand Forks3330.341.090.751.53
13Kettle Valley1511.481.310.732.15
14Southern Okanagan7864.501.210.961.51
15Penticton138143.730.960.811.13
16Keremeos2315.761.460.922.19
17Princeton3516.932.071.442.87
18Golden2322.771.010.641.52
19Revelstoke4129.191.401.011.91
20Salmon Arm134101.741.321.101.56
21Armstrong-Spallumcheen4529.591.521.112.03
22Vernon198183.631.080.931.24
23Central Okanagan414434.860.950.861.05
24Kamloops367281.981.301.171.44
26North Thompson3514.712.381.663.31
27Cariboo-Chilcotin224122.371.831.602.09
28Quesnel9875.551.301.051.58
29Lillooet4215.602.691.943.64
30South Cariboo7725.712.992.363.74
31Merritt6533.991.911.482.44
32Hope5426.852.011.512.62
33Chilliwack205205.531.000.871.14
34Abbotsford230320.650.720.630.82
35Langley273295.400.920.821.04
36Surrey731908.180.800.750.87
37Delta164294.420.560.480.65
38Richmond272433.180.630.560.71
39Vancouver2,1061,955.821.081.031.12
40New Westminster190188.611.010.871.16
41Burnaby446627.750.710.650.78
42Maple Ridge160200.130.800.680.93
43Coquitlam335462.760.720.650.81
44North Vancouver247405.460.610.540.69
45West Vancouver-Bowen Is.131186.430.700.590.83
46Sechelt7877.501.010.801.26
47Powell River6070.050.860.651.10
48Howe Sound9765.251.491.211.81
49Central Coast2711.242.401.583.50
50Queen Charlotte2817.711.581.052.28
52Prince Rupert9959.091.681.362.04
54Smithers8048.881.641.302.04
55Burns Lake5423.372.311.743.02
56Nechako12350.422.442.032.91
57Prince George414282.831.461.331.61
59Peace River South11890.921.301.071.55
60Peace River North12580.141.561.301.86
61Greater Victoria741864.010.860.800.92
62Sooke120147.230.820.680.97
63Saanich120190.770.630.520.75
64Gulf Islands4244.630.940.681.27
65Cowichan149149.980.990.841.17
66Lake Cowichan2117.951.170.721.79
67Ladysmith6851.371.321.031.68
68Nanaimo272262.861.030.921.17
69Qualicum104110.370.940.771.14
70Alberni135106.791.261.061.50
71Courtenay177159.061.110.951.29
72Campbell River127111.691.140.951.35
75Mission122103.871.170.981.40
76Agassiz-Harrison3222.691.410.961.99
77Summerland5141.601.230.911.61
78Enderby4522.202.031.482.71
80Kitimat4438.911.130.821.52
81Fort Nelson3815.732.421.713.32
84Vancouver Island West2312.171.891.202.83
85Vancouver Island North6043.511.381.051.77
87Stikine185.383.341.985.28
88Terrace16383.441.951.672.28
92Nishga85.031.590.693.13
94Telegraph Creek82.333.441.486.75
Unknown21
Provincial Total12,114

Note:
SMR - Standardized Mortality Ratio (Observed/Expected).
Cells that are bolded indicate a statistically significantly high difference between the observed and expected deaths and
cells that are italicized indicate a statistically significantly low difference between the observed and expected deaths (p<0.05, two tailed).
*Lower and Upper 95% confidence intervals.
The standardized mortality ratio (SMR) provides a measure of the degree of mortality in a population from a given cause relative to a "standard" (in this case provincial) population.

  • Thirty four LHAs showed statistically significantly more accidental deaths than were expected if people in the LHAs' population age groups had died accidentaly at the same rate as for the province as a whole. The five LHAs with the largest statistically significant unfavourable discrepancies were: 94-Telegraph Creek (SMR=3.44), 87-Stikine (SMR=3.34), 30-South Cariboo (SMR=2.99), 29-Lillooet (SMR=2.69), and 56-Nechako (SMR=2.44).
  • Twelve LHAs showed statistically significantly fewer accidental deaths than were expected for their areas. The five LHAs with the largest statistically significant favourable differences were: 37-Delta (SMR=0.56), 44-North Vancouver (SMR=0.61), 38-Richmond (SMR=0.63), 63-Saanich (SMR=0.63), and 45-West Vancouver-Bowen Island (SMR=0.70).

Map 1
Accidental Deaths-Standardized Mortality Ratios, by Local Health Areas
British Columbia, 1987 - 1995

Map 1

Table 4
Accidental Deaths by Age Group and Local Health Area
British Columbia, 1987 - 1995

Table 4
Note: Age specific rates per 10,000 population in the specific age group and Local Health Area

Notes to Table 4

Table 4 provides age-specific counts and rates for accidental deaths by Local Health Area. While Table 3 allows regions to determine if they have had significantly more total accidental deaths than were expected in their area over the time period, Table 4 allows identification of specific age groups that had rates that were higher than was found provincially. When comparing an age specific rate in an LHA to the provincial rate, it is important to note how many events the rate is based on as rates based on small numbers of events are highly unstable. The following examples illustrate how these statistics can be examined.

  • LHA 24 - Kamloops and LHA 27 - Cariboo- Chilcotin both had significantly more accidental deaths than were expected for their areas. For residents of Kamloops, higher risks of accidental death than were found provincially were clustered in age groups 20 - 39, 60 - 79, and 85+. Residents of Cariboo-Chilcotin were found to be at higher risk of accidental death across all age groups, except for the very elderly (age 85+).
  • Local Health Areas that were not found to have more total accidental deaths than were expected for their areas may have had rates that were higher than provincial rates in specific age groups. For example, residents of LHA 33 - Chilliwack between the ages of 20 - 39 were at greater risk of an accidental death than was found provincially. Similarly, residents of LHA 43 - Coquitlam between the ages of 70 - 84 were at greater risk than was found provincially.
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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 geographic locations. ASMRs obtained from Statistics Canada for provincial comparisons were standardized using the 1991 gender specific Canada Census population. ASMRs specific to BC produced by the British Columbia Vital Statistics Agency were standardized using the 1971 Canada Census population.

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.

UCOD: Underlying Cause of Death - based upon application of standard international coding rules for determining consequential relationships of conditions and diseases (from immediate cause backwards to underlying cause).

Editor's Note:

Look for the Quarterly on the Web.

By mid-February, 1997, the contents of this publication and that of issues covering the first two quarters of 1996 will be available on our web site. Subsequent editions will be added simultaneous with hardcopy distribution. The web site address is: http://www.hlth.gov.bc.ca:80/vs/.

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Contributors' Note:

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.

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