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Ministry of Health

Quarterly Digest
Volume 12 - Number 4 May 2003

  • Preface

  • Map: B.C. Local Health Areas

  • Local Health Areas(LHA) within Health Service Delivery Area (HSDA) and Health Authority

  • Vital Event Statistics - October 1, 2002 - December 31, 2002 and Year-End
    (Population, Livebirth, Death, Marriage, Stillbirth, Infant Deaths)

  • Selected Birth Statistics - October 1, 2002 - December 31, 2002 and Year-End
    (Low Birthweight, Preterm, Teenage Mother, Elderly Gravida, Cesarean Section)

  • External Causes of Death - October 1, 2002 - December 31, 2002 and Year-End
    (Accidents - [Motor Vehicle Accidents, Poisoning, Falls, Burns/Fire, Drowning, Other], Suicide, Homicide, Other External Causes)

  • Neoplasm Deaths - October 1, 2002 - December 31, 2002 and Year-End
    (Lung, Female Breast, Colorectal, Other G.I., Female Reproductive, Prostate, Blood/Lymph, Other Malignancy, Nonmalignant and Unspecified)

  • Heart Disease Deaths - October 1, 2002 - December 31, 2002 and Year-End
    (Rheumatic/Valvular, Hypertension, Ischemic, Conductive & Dysrhythmic, Heart Failure, Congenital, Other)

  • Respiratory Disease Death Statistics - October 1, 2002 - December 31, 2002 and Year-End
    (Emphysema, COPD, Pneumonia, Influenza, Asthma, Lung Disease from External Agents, Pulmonary Fibrosis, Other Respiratory)

  • Other Selected Death Statistics - October 1, 2002 - December 31, 2002 and Year-End
    (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)

Preface

This edition of the B.C. Vital Statistics Agency's Quarterly Digest contains the standard vital event tables for the final quarter of 2002 (October 1- December 31) and for year-end 2002.

The year-end data contained in this publication will not necessarily be consistent with those data presented in the forth-coming Vital Statistics 2002 Annual Report. The reason for these potential discrepancies is that the Agency's research files are continually updated and data that are not produced simultaneously reflect "snapshots" of provincial vital event data at different points in time.

For the same reason, totals compiled by adding the figures from successive quarters will not correspond exactly to year-end figures.

Finally, the reader should keep in mind the effect of small fluctuations on certain health status indicators. The impact of these changes on small numbers of events can create artificially exaggerated trend lines.

As usual, the fourth quarter report contains an index of articles that have been published in the Quarterly Digest in the past.

The most recent of these articles appeared in the second quarter report of 2002, but they are no longer a regular feature of this publication. We will attempt to produce high quality original research reports addressing issues of interest to British Columbians on a periodic basis and reader suggestions for future research articles are welcomed. Your support and input into the production of this publication are always appreciated.



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 North Fraser
LHA

32 Hope
33 Chilliwack
34 Abbotsford
75 Mission
76 Agassiz-Harrison

HSDA
22 West Fraser
LHA

40 New Westminster
41 Burnaby
42 Maple Ridge
43 Coquitlam
HSDA
23 Central 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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Index of Quarterly Digest Articles to date:

Volume 1 - Number 1 & 2 - October 1991

  1. Alcohol Related Deaths.
  2. Status Indians in British Columbia, 1989 - A Vital Statistics Overview.

Volume 1 - Number 3 - January 1992

  1. Fatal Poisonings in British Columbia - 1989 - by J.M. Macdonald.
  2. Fatal Head Injuries in British Columbia - 1990 - by J.M. Macdonald.

Volume 1 - Number 4 - April 1992

  1. Mortality Mapping in British Columbia - by M.C.R. Edgell & L.T. Foster.
  2. Suicide Deaths in British Columbia, - by T.A. Tuk & J.M. Macdonald.
  3. Selected Health Status Indicators in British Columbia, 1985-1990 by K.F. Burr, L.T. Foster, & J.H. Mohamed.

Volume 2 - Number 1 - July 1992

  1. Charting Birth Weight of British Columbia Newborns: How do we compare? - by W.J. Kierans.
  2. Cardiovascular Disease Death in British Columbia: Still number one - by J.M. Macdonald, T.A. Tuk & J.H. Mohamed.

Volume 2 - Numbers 2 & 3 - November 1992

  1. A Deadly Affair: Cigarette Smoking - Attributable Deaths, British Columbia, 1985 and 1989 - by R.M. Strohmaier & W. Hu.
  2. Health Status Registry: A Health Planning Tool Revisited and Revitalized by W.J. Kierans & A.K. McBride.

Volume 2 - Number 4 - February 1993

  1. Recent Advances in Community Health Related Information: A Vital Statistics Perspective - by T.A. Tuk, M.A. Collison, L.T. Foster.
  2. Cesarean Section Rates: A British Columbia Overview Prepared by Division of Vital Statistics.

Volume 3 - Number 1 - May 1993

  1. Cancer Mortality in British Columbia Part I: Cancer as an Underlying Cause of Death - by C. Cranfield, T.A. Tuk & J.M. Macdonald.
  2. Estimates for Health Effects Attributable to Second-Hand Smoke in British Columbia - by M.E. Thomson.

Volume 3 - Number 2 - August 1993

  1. Cancer Mortality in British Columbia Part II: Cancer Mortality Multiple Conditions - by J.M. Macdonald, T.A. Tuk & C. Cranfield.
  2. Technical Notes - An Alternative Approach to Mapping Mortality: A Bayesian Procedure - by Ying C. MacNab.

Volume 3 - Number 3 - November 1993

  1. Injury Facts and Prevention Strategies for Children and Youth in British Columbia - by Office for Injury Prevention.
  2. Ethnicity and Health Status, Part One: The IndoCanadian Community - by W.J. Kierans.
  3. Technical Notes - Measurement of Mortality Part I: Crude Rate - by Ying C. MacNab & T.A. Tuk.

Volume 3 - Number 4 - May 1994

  1. Ethnicity and Health Status, Part Two: The Chinese Immigrant Community - by W.J. Kierans.
  2. Potential Years of life Lost: British Columbia, 1985-1992 - by R.M. Strohmaier.
  3. Technical Notes - Measurement of Mortality Part II: Age Standardized Mortality Rate - by Ying Cai MacNab & T.A. Tuk.

Volume 4 - Number 1 - June 1994

  1. Vital Statistics in British Columbia: An Historical Overview of 100 Years, 1891 to 1990 - by J.M. Macdonald.
  2. Technical Notes: Measurement of Mortality Part III: Standardized Mortality Ratio - by Ying Cai MacNab & T.A. Tuk.

Volume 4 - Number 2 - August 1994

  1. Status Indians in British Columbia: A statistical Overview [1987-1992] - prepared by Medical Services Branch of Health Canada and BC Division of Vital Statistics.

Volume 4 - Number 3 - November 1994

  1. Drug-Related Deaths in British Columbia: 1981 to 1993 - by T.A. Tuk and J.M. Macdonald.

Volume 4 - Number 4 - February 1995

  1. Sudden Infant Death Syndrome in British Columbia: 1981 to 1993 - by H. Amershi.

Volume 5 - Number 1 - May 1995

  1. AIDS/HIV Related Mortality in British Columbia: 1985 to 1994 - by N. Fast.

Volume 5 - Number 2 - August 1995

  1. Suicide, Homicide, and Gun Deaths, British Columbia, 1985 to 1993 - by T.A. Tuk & J. Macdonald.

Volume 5 - Number 3 - November 1995

  1. Respiratory Disease Mortality in British Columbia, 1985 to 1994 by Y.C. MacNab, J. Macdonald, T.A. Tuk.

Volume 5 - Number 4 - March 1996

  1. Diabetes in Birth and Death: British Columbia, 1987 to 1994 - by K. Stenning.

Volume 6 - Number 1 - July 1996

  1. Increased Maternal Age and the Outcome of Pregnancy: An eight year population based study, British Columbia, 1987 - 1994 by Y.C. MacNab, J. Macdonald, T.A. Tuk.

Volume 6 - Number 2 - October 1996

  1. Marriage and Family in British Columbia: 1931 - 1994 - by Z. Kashaninia.

Volume 6 - Number 3 - January 1997

  1. Accident Fatality in British Columbia, 1987 - 1995 [Introductory chapter of in progress longer report] - by E. Demaere.

Volume 6 - Number 4 - April 1997

  1. A Review of Delivery Mode in British Columbia, 1987 - 1995 - by Y.C. MacNab.

Volume 7 - Number 1 - July 1997

  1. Pregnancy Outcomes in British Columbia, - by Cathy Hull.

Volume 7 - Number 2 - October 1997

  1. Women and Cancer: Lung and breast cancer among women in BC, 1974-1996 - by Z. Kashaninia.

Volume 7 - Number 3 - January 1998

  1. Women and Cancer (Part II): Ovarian, uterine and cervical cancer among women in B.C., 1980 to 1996 - by Z. Kashaninia.

Volume 7 - Number 4 - May 1998

  1. The Declining Trend of Sudden Infant Death Syndrome: Comparison with other major causes of infant mortality and deaths due to unknown causes, BC, 1985 to 1996 - by R. Fisk, J Macdonald, W. Vander Kuyl with editorial comments by S. Peck.

Volume 8 - Numbers 1 & 2 - December 1998

  1. Animal Caused Fatalities, British Columbia, 1969 to 1997 - by R. Armour and J. Macdonald.

Volume 8 - Number 3 - March 1999

  1. The Impact of Infectious Diseases on Mortality in BC, 1990-1997 - by Z. Kahsaninia.

Volume 8 - Number 4 - August 1999

  1. Hepatitis Deaths in British Columbia, 1990-1998 - by Z. Kashaninia.

Volume 9 - Numbers 1 & 2 - October 1999

  1. Drowning and Other Water-Related Accidental Fatalities, British Columbia, 1990 to 1998 - by Z. Kashaninia, J. Macdonald and R. Armour.

Volume 9 - Number 3 - March 2000

  1. Fire Deaths in British Columbia, 1986 to 1998 - by Z. Kashaninia.

Volume 9 - Number 4 - June 2000

  1. Beautiful and Deadly British Columbia: Natural Environmental Deaths, 1985 to 1998 - by T. Stubbings and J. Macdonald.

Volume 10 - Number 1 - October 2000

  1. Tuberculosis and Mycobacterium: Impact on Mortality in British Columbia, 1990 to 1999 - by Z. Kashaninia.

Volume 10 - Numbers 2& 3 - December 2000

  1. The Health Status Registry - adapted from original report by M. Silver.

Volume 10 - Number 4 - July 2001

  1. The Impact of ICD-10 (in year 2000) on identifying, classifying, coding and UCOD selecting neoplasm(s) on death records - by J. Macdonald and R. Armour.

Volume 11 - Number 1 - September 2001

  1. The Use of Vital Statistics Data by a Social Policy Ministry - Revisited - by L.T. Foster, M. Shinto and W. Wei.

Volume 11 - Number 2 - October 2001

  1. Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig's disease) Deaths in British Columbia to Year 2000 - by Z. Kashaninia, M. Marquette and S. Fricke.

Volume 11 - Number 3 & 4 - May 2002

  1. Accidental Falls Mortality in British Columbia, 1990-2000 - by Z. Kashaninia.

Volume 11 - Number 3 & 4 - May 2002

  1. Accidental Falls Mortality in British Columbia, 1990-2000 - by Z. Kashaninia.

Volume 11 - Number 3 & 4 - May 2002

  1. Accidental Falls Mortality in British Columbia, 1990-2000 - by Z. Kashaninia.

Volume 11 - Number 3 & 4 - May 2002

  1. Accidental Falls Mortality in British Columbia, 1990-2000 - by Z. Kashaninia.

Volume 12 - Number 2 - December 2002

  1. 1. Leukemia Mortality in British Columbia, 1986-2000 - by R Pelletier and Z. Kashaninia.

Topics in progress/planned

  1. Suicide in British Columbia, 1987-2002

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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.

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