User guide

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• Background
• Description
• Health region code structure
• Geographic coding tools
• Health regions and standard geography
• Boundary files
• Acknowledgements

Appendices

• Appendix 1: Health regions in Canada, 2005
• Appendix 2: Summary of changes to health regions, 2003 and 2005
• Appendix 3: Detailed list of census subdivisions split by two or more health regions, 2001

Background

In recent years there has been an increasing demand for relevant health information at a ‘community’ level. As a result, health regions have become an important geographic unit by which health and health-related data are produced.

Health regions are legislated administrative areas defined by provincial ministries of health. These administrative areas represent geographic areas of responsibility for hospital boards or regional health authorities. Health regions, being provincial administrative areas, are subject to change.

The first national health region geographic product was created by Statistics Canada in collaboration with provincial health ministries. Health regions 2000 - Boundaries, geographic information and population estimates (catalogue. no. 82F0082XCB) was released on a CD-ROM by the Health Statistics Division of Statistics Canada in October 2000. The reference date for these health region boundaries was January 2000. In May 2003, Health Statistics Division produced the second version of this product.

Health Regions 2003 – Boundaries, geographic information and population estimates (catalogue. no. 82F0082XCB) was released in the bi-annual electronic publication of Health Indicators. Health Regions 2003 reflects the boundaries and names in effect as of June 2003 and provides the geographic linkage to 1996 and 2001 Censuses.

Since the ‘Health Regions 2003’ product was created, a number of provinces have undergone regional restructuring of health administration with substantial boundary changes, especially in Newfoundland and Labrador and Ontario. Other provinces have also adjusted their boundaries and health region names. In 2005, work began to bring the health regions recognised by Statistics Canada up to date. Health Regions 2005 reflects the boundaries and names in effect as of June 2005 and, like the 2003 product, provides the geographic linkage to 1996 and 2001 Censuses.

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Description

The generic term "health region" applies to a variety of administrative areas across Canada that are defined by provincial ministries of health. For complete Canadian coverage, each northern territory represents a health region.

The following table describes the health regions, by province, with reference to the provincial legislation under which these areas have been defined:

Standard symbols

1. In Newfoundland and Labrador, six community health regions were reduced to four regional integrated health authorities (RIHAs). Boundaries are unchanged for two RIHAs and the other four have been collapsed into two. Name and code changes in effect as of March 1st, 2005
2. Nova Scotia health zones aggregate to the nine district health authorities.
3. Régions sociosanitaires in Quebec coincide with the 17 administrative regions in the province.
4. Ontario Public Health Units (PHU) are official health agencies that administer health promotion and disease prevention programs. As of April 1st, 2005 Muskoka-Parry Sound Health Unit dissolved. The Muskoka part of this region was combined with Simcoe Country District and Parry Sound joined North Bay.
5. Ontario Local Integrated Networks (LHINs) are boundaries that were developed based on travel patterns of residents to acute hospital care and replace the previous district health councils.
6. Slight boundary change in which the Calgary Health Region gained a .population of 1.2% from David Thompson Regional Health Authority.
7. Health Service Delivery Areas (HSDAs) in British Columbia aggregate into five Health Authorities (HAs).
8. Entire territory represents a health region

Health region code structure

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A four digit numeric code is used to uniquely identify health regions. The first two digits represent the province, and the second two digits represent the health region. These codes reflect the same codes used by the provincial ministries of health. For those provinces where a numeric code is not applicable, a two-digit code was assigned. Ontario uses a 4-digit code for public health units. This code was truncated to the last two digits for consistency in the national health region code structure. Since Ontario has two sets of health regions, which do not entirely relate hierarchically, their codes are unique within the province.

The names of the health regions also represent the official names used by the provinces.
See Appendix 1: Health regions in Canada, 2005.

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Geographic coding tools

Production of health region level data requires geographic coding tools. Since census geography does not recognize provincial health region boundaries, a health region-to-census geography correspondence file provides the linkage between health regions and their component census geographic units. These correspondence files use the smallest relevant census geographic unit.

To accommodate various data sources producing health region level data, linkage has been created for both 1996 and 2001 Census geographies. The layout of these correspondence files includes the seven-digit Standard Geographic Classification (SGC) code. The SGC code uniquely represents census subdivisions (CSDs).

Most health regions comprise entire CSDs (see Table 2). However, there are some cases where health regions do not conform with municipalities. The 1996 Census linkage was done at the enumeration area (EA) level, while the 2001 Census linkage was created at the dissemination area (DA) level (and block level for Alberta, Saskatchewan and Manitoba). Even these smaller geographic areas (EA/DA/blocks) sometime straddle health region boundaries. In those cases, the entire EA or DA (or block) was assigned, in conjunction with the affected province, to just one health region and therefore represents a “best fit” with census geography.

Other data sources use postal codes to geographically reference data records. These data are first converted to census geographic units using the Statistics Canada postal code conversion file, then linked to health regions based on the correspondence file.

Correspondence files were provided by Alberta (Alberta Treasury supplied files with 1996 EA and 2001 link to Census blocks) and British Columbia (BC Stats provided EA and 2001 link to DAs).

The dissemination/enumeration area-to-health region (DA/EA-to-HR) correspondence files provided in the Health Regions - 2005 product are available in comma-separated value (.CSV) format for each province and for the northern territories. The record layout of the files is shown in the following tables.

1.10-digit census block ID (BLKUID) applies to the provinces of Manitoba, Saskatchewan, and Alberta only. The first 8 digits comprise the DA code (DAUID) for these provinces.

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Health regions and standard geography

For the most part, health regions can be described as groupings of counties (census divisions) or municipalities (census subdivisions). This description holds especially true in the Atlantic provinces, Quebec, and Ontario (with minor exceptions in northern Ontario). In the western provinces, health regions are less likely to follow census division or census subdivision boundaries.

The following table provides a count, by province, of census subdivisions that fall in more than one health region.

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Boundary files

The health region boundaries provided in this product are based on 2001 Census geographic units. The smallest geographic unit available has been used as the building block to define health regions. In all provinces except Alberta, Saskatchewan and Manitoba, the dissemination area was used to define health regions. In the western provinces, the DA is not ideal and would create additional distortion as a building block. Therefore, the census block (a smaller geographic unit introduced for 2001 Census) has been used to improve the accuracy of these boundaries. Even with this improved resolution, the boundary files do not always reflect the true, legal limits recognized by the provinces. For the most part, they are based on a best-fit linkage to census geography. To maximize comparability, the provincial ministries of health shared their census linkage files where applicable.

Method used to create health region 2005 boundary files

The latest boundaries for health regions were produced under several different circumstances:

1. Provinces reporting no geographic changes since 2003
The majority of the provinces and all of the territories did not report any geographic changes since the 2003 update. Contacts in the health ministries in Prince Edward Island, Nova Scotia (Zones) New Brunswick, Quebec, Manitoba, Saskatchewan, British Columbia, Yukon, Northwest Territories and Nunavut reported no health region boundary changes.

2. Boundary changes – correspondence files created by Statistics Canada
In Newfoundland and Labrador, the 2005 health regions were reduced from six community health regions to four regional integrated health authorities. Boundaries were unchanged for two of the regions and the remaining four were collapsed into two. The new boundaries were created based on aggregations of the 2001 census subdivision (municipality) components. In Nova Scotia, current geographical boundaries using zones remained unchanged. However, a correspondence file to reflect the nine administrative regions of the province was created. Contacts in the province provided documentation that directed the assignment of 2001 census subdivisions to the appropriate district health authority. Public health units (PHU) in Ontario, based on 2001 census subdivision components, underwent minor changes. The number of PHUs decreased from thirty-seven to thirty-six when one PHU was dissolved and the CSDs within its boundaries were reassigned to two other PHUs.

3. Boundary changes – correspondence files provided by the province
In 2003, Alberta (Alberta Treasury) provided correspondence files with linkage to 2001 census units from which the boundaries were created. Alberta provided the linkage between the latest regional health authority boundaries using the best-fit to 2001 census blocks. These DA and census block based files were used to update the new health region boundary file. In 2005, there was a minor boundary change between two regional health authorities, affecting a population of approximately 13,000 residents. For more information about the quality of the geographic linkages contact Alberta Treasury.

The files for the new local health integrated networks (LHIN) in Ontario were provided by the Ontario Ministry of Health. These new boundaries are based on 2001 census subdivision components.

Boundary file formats

All digital health region boundaries in the Health Regions - 2005 product are available in two formats: ARC/INFO® EXPORT and MapInfo®, Version 5.0 for Windows. The coordinates are in latitude/longitude.

The extension of the ARC/INFO® EXPORT files is E00. In MapInfo® for Windows, a self-extracting executable (EXE) is provided. This file expands to provide the four files, with different extensions, for each province. The four extensions are: TAB, DAT, ID, and MAP.

Boundary files are provided as one national boundary file and as individual provincial boundary files.

Projection information

The map projection parameters used to create the health region boundaries are as follows;

Lambert Conformal Conic
Datum = NAD83
Units = meters
Spheroid = GRS North American 83

Parameters:

1st standard parallel: 49° 00' 00"
2nd standard parallel: 77° 00' 00''
Central Meridian: -91° 52' 00''
Latitude of Projection Origin: 63° 23' 26.43''
False Easting: 6200000
False Northing: 3000000

Minimum system requirements

• Pentium PC
• Windows 98 / NT 4.0
• Minimum 32 MB RAM
• Minimum 30 MB free space on Hard disk
• Microsoft Mouse or compatible

To use MapInfo boundary files:

• MapInfo Version 5.0 for Windows or newer

To use ARC/INFO EXPORT boundary files:

• ARC/INFO Version 7.0 or newer
• ArcView Version 3.0 or newer

Acknowledgements

Health Statistics Division worked closely with the provincial Ministries of Health and the Geography Division of Statistics Canada to produce this product. BC Stats and Alberta Treasury also contributed directly to this work by providing health region-to-census geography linkage files. Saskatchewan Health and Manitoba Health provided digital boundaries (shape files).