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about mortality data

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  • For each data source, information about data collection and analytical methods, limitations, the citation and additional resources can be found on the Data Sources and Methods page.

SOURCE

Original Source: Ontario Office of the Registrar General (ORG)
Cite as: Ontario Mortality Database 1986-2011, IntelliHEALTH Ontario, Ministry of Health and Long-Term Care

METHODS

Data Collection Methods

  • The Office of the Registrar General obtains information about mortality from death certificates which are completed by physicians. All deaths within Ontario are registered in the Divisional Registrar office within which the death occurs. A Statement of Death (Form 15) and a Medical Certificate of Death (Form 16) must be filed with a division registrar before a Burial Permit can be issued.
  • The Death Certificate records: the immediate cause of death; antecedent causes, if any, giving rise to the immediate cause, stating the underlying cause last; and other significant conditions contributing to the death but not causally related to the immediate cause (1). However, the mortality files include only the underlying cause of death. The underlying cause of death is:
    • the disease or injury which initiated the train of events leading directly to death, or
    • the circumstances of the accident or violence which produced the fatal injury.
  • Co-morbidity contributes uncertainty to classifying the underlying cause of death.
  • Prior to December 31, 1999, all deaths and external causes of death were coded using the Ninth Revision of the International Classification of Diseases (ICD-9). Since January 1, 2000, deaths were coded using the Tenth Revision of the International Classification of Diseases Canada (ICD-10). Comparison of trends for specific causes of mortality from 2000 onward with earlier rates must therefore be interpreted with caution.
  • A second set of codes, external cause or 'e-codes' are used to classify the environmental events, circumstances and conditions that cause an injury (e.g., motor vehicle traffic injury).
  • The cause of death variable is coded using ICD-10 using ICD-10 codes starting with A through R, but not S and T codes, then continuing with external cause codes starting with V, W, X or Y. The ICD-10-CA codes used in these analyses are available electronically.

Analysis Methods

  • Out-of-province residents who died in Ontario are excluded from analyses.
  • Data in tables are presented as follows:
    • Death by year
    • Death by sex and year
    • Death by age group for most current year and over time if data is available
  • Rates and proportions based on counts less than 5 are suppressed and presented in tables or graphs with the acronym 'NR' not releasable due to small numbers.
  • When calculating directly standardized rates, cell counts of less than 20 are suppressed and presented in tables or graphs with the acronym 'NR' not releasable due to small numbers.
  • Death rates are calculated using two methods:
    • Peel and Peel municipalities compared to Ontario
      • Crude rates are calculated using population estimates as follows:
        • #Deaths/Total population X 100,000
      • Age-standardized rates are calculated using the 1991 Canadian population with population estimates as the denominator, and using the direct method of standardization.
    • Peel data zones compared to Peel and Peel municipalities
      • Crude rates are calculated using the population from individual tax filer data for 2006 to 2011 as the denominator as follows:
        • # Deaths/Total population X 100,000
      • Age-standardized rates are calculated using the 1991 Canadian population and using the population from individual tax filer data for 2006 to 2011 as the denominator, and using the direct method of standardization.

LIMITATIONS

  • Determining true cause of death may be influenced by the social or legal conditions surrounding the death and by the level of medical investigation, e.g., AIDS, suicide.
  • Ontario residents who died outside of the province are excluded. This may affect areas bordering Quebec and Manitoba.
  • Variation in data collection procedures over time and/or geography may reduce the validity of time- and/or place-specific comparisons.
  • There are possible errors in the mortality data file related to assignment of municipality of residence/census subdivision of deceased.

REFERENCES AND RESOURCES

  1. Office of the Registrar General. Medical Certificate of Death, Form 16.
  2. Woodward GL, Delmore T, Fehringer G, Goettler F, Guarda B, McGurran JJ, Pietrusiak M. Questioning one of life's certainties: A comparison of three mortality data sets. Central East Health Information Partnership, July 1999.
  3. Statistics Canada. Comparability of ICD-10 and ICD-9 for Mortality Statistics in Canada. Ottawa: Ministry of Industry, 2005. Catalogue no. 84-548-XIE.
  4. APHEO website


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