Health Indicators, vol. 2001, no. 3 Definitions and data Sources

Community and health system characteristics

Community
Health system
Resources

Community

Definition:
The number of people living in a geographic area by age and sex.

A population’s size and age/sex composition impact the health status of a region and its need for health services. Population data also provide the "denominators" used to calculate rates for most health and social indicators.

Sources:
Statistics Canada, Demography Division. Data are derived from the Census and administrative sources on births, deaths, and migration. Population growth for Quebec, Alberta and British Columbia were supplied by the Institut de la statistique du Québec, Alberta Health and Wellness and BC Stats respectively.

Definition:
Number of people per square kilometre. Calculated by dividing the total population by land area.

Sources:
Statistics Canada, 1996 Census, and Geography Division (special tabulations)

Dependency ratio

Definition:
The ratio of the combined child population (aged 0 to 14) and elderly population (aged 65 and over) to the working age population (aged 15 to 64). This ratio is usually presented as the number of dependents for every 100 people in the working age population.

Canadians aged 65 and over and those under age 15 are more likely to be socially and/or economically dependent on working age Canadians, and they may also put certain additional demands on health services.

Sources:
Statistics Canada, Demography Division. Data are derived from the Census and administrative sources on births, deaths, and migration. Population growth for Quebec, Alberta and British Columbia were supplied by the Institut de la statistique du Québec, Alberta Health and Wellness and BC Stats respectively.

Definition:
People living in urban areas. An urban area is defined as having a minimum population of 1,000 and a population density of 400 people per square kilometre.

This community characteristic allows users to compare regions with similar proportions of urban/rural population.

Source:
Statistics Canada, 1996 Census

Definition:
Aboriginal people living in a geographic area. Aboriginal people are those persons who reported identifying with at least one Aboriginal group (e.g. North American Indian, Métis or Inuit) and/or those who reported being a Treaty Indian or a Registered Indian as defined by the Indian Act and/or those who were members of an Indian Band or First Nation.

Health status characteristics and non-medical determinants of Aboriginal people differ from the non-Aboriginal population, for example, infant mortality, unintentional injury deaths, suicides and smoking rates. Knowing the proportion of Aboriginal people in a geographic area provides context to better interpret health indicators.

Sources:
Statistics Canada, 1996 Census (20% sample), 1996 Census Coverage Studies, and Demography Division (population estimates)

Definition:
All immigrants living in a geographic area, and those immigrants who came to Canada from 1981 to 1996.

Canadian, American and Australian studies have shown that immigrants, particularly non-European immigrants, generally have a longer life expectancy and lower risk of certain chronic conditions than the native-born population. However, the Canadian studies have also shown that as the immigrants' period of residence in Canada increases, so does the prevalence of chronic conditions, smoking and disability. Understanding the proportion of immigrants in a geographic area, along with the period of immigration, provides a context for interpreting health indicators.

Source:
Statistics Canada, 1996 Census (20% sample)

Definition:
Percentage of people that lived in a different Canadian municipality at the time of the previous Census (5-year internal migrants) or one year before the current Census (1-year internal migrants). External migrants who were living outside Canada are excluded.

Source:
Statistics Canada, 1996 Census (20% sample)

Definition:
Strong MIZ (Census Metropolitan Area and Census Agglomeration Influenced Zones) represents the proportion of the population living in Census Metropolitan Areas (CMA), Census Agglomerations (CA) and communities that fall outside CMAs/CAs that have at least 30% of the employed labour force commuting to CMAs/CAs. The larger the proportion, the stronger the relationship between the specific community and a nearby CMA/CA.

The CMAs and CAs are large urban areas with adjacent urban and rural areas that have a high degree of economic and social integration. These CMAs and CAs are defined around urban areas that have attained certain population thresholds: 100,000 for CMAs and 10,000 for CAs.

Sources:
Statistics Canada, 1996 Census (20% sample), Geography Division

Definition:
Percentage of lone-parent families among all census families living in private households. A census family refers to married or common-law couple or lone parent with at least one never-married son or daughter living in the same household.

Source:
Statistics Canada, 1996 Census (20% sample)

Definition:
Population belonging to a visible minority group. As defined by the Employment Equity Act (1986), visible minorities are persons (other than Aboriginal people) who are non-caucasian in race or non-white in colour.

Source:
Statistics Canada, 1996 Census (20% sample)

Definition:
Number and rate of pregnancies per 1,000 women aged 15 to 19.

Pregnancies are composed of live births, induced (therapeutic) abortions and fetal loss, including stillbirths (at least 20 weeks gestation or fetal weight of at least 500 grams) and cases of spontaneous abortion, illegally induced abortion, other and unspecified abortion treated in general and allied hospitals in Canada.

Sources:
Statistics Canada, Vital Statistics, Birth and Stillbirth Databases; Canadian Institute for Health Information, Hospital Morbidity Database, and Therapeutic Abortion Survey

Health system

Definition:
A ratio of the number of separations from acute care hospitals within a given region divided by the number of acute care hospital discharges generated by residents of that region. An overall ratio is calculated for discharges associated with any diagnosis or procedure and separately for coronary artery bypass graft surgery (CABG), total hip replacement, total knee replacement and hysterectomy procedures.

(CABG: CCP code 48.1 or ICD-9-CM procedure code 36.1, Hip replacement: CCP code of 93.51 or 93.59 or ICD-9-CM procedure code of 81.51or 81.53, Knee replacement: CCP code of 93.41 or ICD-9-CM procedure code of 81.54or 81.55, Hysterectomy: CCP code of 80.2-80.7 or ICD-9-CM procedure code of 68.3-68).

This indicator reflects the balance between the quantity of hospitals stays provided to both residents and non-residents by all acute care hospitals in a given region and the extent of acute care utilization by residents of that region, whether they receive care within or out of the region. A ratio less than one indicates that hospital stays utilized by residents of a region exceeded hospital care provided within that region, suggesting an outflow effect. A ratio greater than one indicates hospital stays provided by a region exceeded the quantity of stays utilized by its residents, suggesting an inflow effect. A ratio of one indicates that the volume of hospital discharges in the region is equivalent to that generated by its residents, suggesting that inflow and outflow activity, if it exists at all, is balanced.

Source:
Canadian Institute for Health Information, Hospital Morbidity Database

Definition:
Age-standardized rate of coronary artery bypass graft (CABG) surgery performed on inpatients in acute care hospitals per 100,000 population age 20 and over.

(CCP code 48.1 or ICD-9-CM procedure code 36.1).

Variations in CABG surgery rates can be attributed to numerous factors, including differences in population demographics, physician practice patterns, and availability of services. In some cases, coronary angioplasty (an alternative intervention to improve blood flow to the heart muscle) may be used. Variations in the extent of the procedure may result in variations in bypass surgery.

Source:
Canadian Institute for Health Information, Hospital Morbidity Database

Definition:
Age-standardized rate of total unilateral or bilateral hip replacement surgery performed on inpatients in acute care hospitals per 100,000 population.

(CCP code of 93.51 or 93.59 or ICD-9-CM procedure code of 81.51or 81.53).

Hip replacement surgery has the potential to result in considerable improvement in functional status, pain relief, as well as other gains in health-related quality of life. Over the past two decades, rates of surgery have increased substantially. Wide inter-regional variation in the hip replacement rate may be attributable to numerous factors including the availability of services, provider practice patterns, and patient preferences.

Source:
Canadian Institute for Health Information, Hospital Morbidity Database

Definition:
Age-standardized rate of total unilateral or bilateral knee replacement surgery performed on inpatients in acute care hospitals per 100,000 population.

(CCP code of 93.41 or ICD-9-CM procedure code of 81.54or 81.55).

Knee replacement surgery has the potential to result in considerable improvement in functional status, pain relief, as well as other gains in health-related quality of life. Over the past two decades, rates of surgery have increased substantially. Wide inter-regional variation in the knee replacement rate may be attributable to numerous factors including the availability of services, provider practice patterns, and patient preferences.

Source:
Canadian Institute for Health Information, Hospital Morbidity Database

Definition:
Age-standardized rate for hysterectomies provided to inpatients in acute care hospitals, per 100,000 women age 20 and older.

(CCP code of 80.2-80.7 or ICD-9-CM procedure code of 68.3-68.9).

Utilization rates may reflect the level of uncertainty about the appropriate use of this surgical procedure. The "right" level of utilization is not known. In Canada, inter-regional hysterectomy rates vary two to three-fold.

Source:
Canadian Institute for Health Information, Hospital Morbidity Database

Resources

Definition:
Health expenditures in current dollars; expenditures per capita; percent of Gross Domestic Product; public sector expenditures as a percent of total spending; expenditures by use of funds.

Source:
Canadian Institute for Health Information, National Health Expenditure Database

Definition:
Active civilian general practitioners or family practitioners per 100,000 population on December 31^st of the reference year; active civilian medical specialists per 100,000 population on December 31^st of the reference year.

Physician to population ratios are used to support health human resource planning. Physician density ratios do not take into account workload or type of services provided. In some regions, health facilities and personnel provide services to a larger community than the residents of the immediate region. In others, residents may seek care from physicians and specialists outside the region where they live. The ratio of physicians to population reflects the number of doctors in a region and has not been adjusted to take these movements into account. The extent to which this affects individual regions is likely to vary.

Source:
Canadian Institute for Health Information, Southam Medical Database

Definition:
Number of health professionals (selected professions) per 100,000 population, including Registered Nurses and Licensed Practical Nurses. Registered nurses (RN) rates are based on RN’s working in nursing.

Source:
Canadian Institute for Health Information, Registered Nurses Database

Definition:
Number of health professionals (selected professions) per 100,000 population, including Pharmacists, Dentists, Physiotherapists, Psychologists, Dental Hygienists, Chiropractors and Optometrists. Physician rates are based on medical specialists on December 31^st of the reference year.

Source:
Canadian Institute for Health Information, Health Personnel Database