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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.

DATA SOURCE

Original Source: Ontario Office of the Registrar General (ORG)
Cite as: Ontario Mortality Database, 1986-2015, Ontario Registrar General. IntelliHEALTH Ontario, Ministry of Health and Long-Term Care.

METHODS

Data Collection Methods

  • The Office of the Registrar General obtains information about deaths 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 underlying cause of death, as well as any immediate or antecedent causes of death or other significant conditions contributing to the death (1). However, the death files available to Public Health 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-CA). Comparison of trends for specific causes of death from 2000 onward with earlier data 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-CA 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 for analyses on the Health Status Data website can be accessed here.

Analysis Methods

  • Out-of-province residents who died in Ontario are excluded from analyses.
  • The underlying causes of death are grouped into categories based on ICD-9 or ICD-10-CA coding. A mutually exclusive sub-set of these groupings are defined as “leading causes of death”, which represent specific diseases or conditions of public health interest. ICD groupings which include all residual codes within a chapter not elsewhere classified are not presented on the Health Status Data website as leading causes of death. Therefore, the leading causes of death include only a selected list of specific diseases or conditions.
  • Death rates are calculated using crude and age-standardization methods. Age-standardized rates are calculated using the direct method of standardization with the 2011 Canadian population as the standard population.

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 death 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. Association of Public Health Epidemiologists in Ontario – Vital Statistics Mortality Data

Last updated: June 20, 2019



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