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1. Regional health indicators 4. Indicators based on Statistics Canada surveys
|
| Age (in years) | Standard Population | Age (in years) | Standard Population |
| <1 | 403,061 | 45-49 | 1,674,153 |
| 1-4 | 1,550,285 | 50-54 | 1,339,902 |
| 5-9 | 1,953,045 | 55-59 | 1,238,441 |
| 10-14 | 1,913,115 | 60-64 | 1,190,217 |
| 15-19 | 1,926,090 | 65-69 | 1,084,588 |
| 20-24 | 2,109,452 | 70-74 | 834,024 |
| 25-29 | 2,529,239 | 75-79 | 622,221 |
| 30-34 | 2,598,289 | 80-84 | 382,303 |
| 35-39 | 2,344,872 | 85-89 | 192,410 |
| 40-44 | 2,138,891 | 90+ | 95,467 |
Source: Statistics Canada Cat. No. 84F0208XPB, Causes of Death 1997,
Appendix 3
The formula for age-standardized death rate r is:
Where for age group i, 
is the age-sex specific death count, 
is the population size for a given cause of death and geographical area, and 
is the weight for that group. Note that the same weight is used for each sex. To yield a rate per 100,000 population, r is multiplied by 100,000.
2.2.3 Geographic coding (geo-coding) to health regions
Birth and death data have been linked to health regions using postal codes reported with place of residence and converted to census geography using the automated geo-coding system (PCCF Plus)5 developed by the Health Statistics Division of Statistics Canada. These data were then aggregated to health region based on correspondence files6 developed by the Health Statistics Division with the cooperation of provincial Ministries of Health, Alberta Treasury and BC Stats.
Where postal codes were not available or invalid, additional steps were taken to assign records to health regions using the census subdivision codes for place of residence recorded on the national birth and death database. Stillbirth data, used to calculate perinatal mortality, were linked to health regions solely using census subdivision codes.
2.2.4 Birth statistics
Birth data on the Vital Statistics Database for Ontario are underestimated due to incomplete files. Thus, birth-related indicators (low birth weight, infant mortality and perinatal mortality), particularly for Ontario, should be interpreted with caution.
2.2.5 Life expectancy
This variable was calculated using the Chiang methodology for abridged life tables. The estimates are based on three years (e.g., 2000-2002) of mortality data and the mid-year population estimates, as described above. Abridged life tables use five-year age groupings of both population and mortality rate inputs (as opposed to single year age breakdown). Since there is more variability in the number of events by age in smaller geographic areas, abridged life tables are more suitable for the adaptation to a sub-provincial level (health region). Chiang’s method in particular was chosen because it was relatively easy to adapt to the health region level data and included the calculation of standard error (in this case, addressing the variability of deaths from one year to the next).
2.2.6 Disability-free life expectancy
Estimates of disability-free life expectancy are calculated using Sullivan’s method7. Essentially, the latter generalizes Chiang’s method8.
Sullivan’s method is based on activity limitation rates within a population, according to sex and age group, in the calculation of life expectancy with disability. In the case of people living in health institutions, it was assumed that everyone had at least one activity limitation. For people living in other types of institutions, the hypothesis established is that the activity limitation rate by age group and sex was identical to the population in private households.
Disability-free life expectancy represents the difference between life expectancy and life expectancy with disability. The standard deviations of disability-free life expectancy estimates (and consequently the upper and lower limits of the confidence intervals associated with these estimates) are based on Colin Mathers’ method9. This method takes into account both the stochastic fluctuations in the observed death rates and the sampling variability of the activity limitation rates.
NOTE: The disability data for DFLE came from the 1996 Census of Population. Questions on disability in the Census of Population are generally used to capture the sample of post-censal Health and Activity Limitations Survey. Because of the decision not to conduct this survey in 1996, data on disability from the Census of population of 1996 were neither verified nor imputed. More precisely, no validation was undertaken to check the completeness or consistency of the data, and as a result, no corrections to the data were made. In addition, the data were not adjusted to account for population undercounts.
DFLE estimates will vary according to both the concepts from which they are based and the surveys from which the data are extracted.
DFLE (Volume 2001, No’s. 1 and 2): For these issues, disability was defined as “having any activity limitation or handicap”.
DFLE (Volume 2001, No. 3 and beyond): Disability is defined as “having an activity limitation that affects activities at home, work or at school”. This differs from previous Health Indicators issues by excluding limitations that only affect activities other than home, work or school as well as respondents who stated that they had some form of handicap other than an activity limitation.
2.2.7 Disability-adjusted life expectancy (DALE)
Disability-adjusted life expectancy (DALE) is similar to DFLE, in that they are both measures of quality of life lived and both are based on mortality and disability data. However, DALE is an expectation of life weighted to account for four health states defined in terms of disability. These health states are, in order of greatest to least weight: (1) having no activity limitations; (2) having activity limitations in leisure time activities and/or transportation; (3) having activity limitations at work, home and/or school; and (4) institutionalization in a health care facility. Specifically, state #1 has a weight of 1.0; state #2 has a weight of 0.8; state #3 has a weight of 0.65; and state #4 has a weight of 0.5. The sum of life expectancies of persons in a specific age group within a given geography, based on their health states, produces the value of DALE for that specific age group.
The calculation of the confidence intervals for DALE is based on Colin Mathers’ method. Specifically, for any particular age group,
Where 
is the standard error, LE denotes life expectancy and 'state n' refers to the specific health state.
2.2.8 Deaths due to medically treatable diseases
The definitions of medically treatable diseases were taken from a paper written by WW Holland10. This was based on earlier work from JRH Charlton11. The types of medically treatable diseases mentioned in Charlton originally came from a paper by DD Rutstein12.
All results were age-standardized according to the age group considered for reasonable odds of survival. These age-standardized rates per 100,000 reflect these age groups, not the total population.
The method of calculating confidence intervals was the Spiegelman method (refer to section 2.2.1).
2.2.9 Potential Years of Life Lost
In this publication, death was considered premature if the person died before age 75. This is more reflective of life expectancies in recent years and is more reflective of international standards. Many previous Statistics Canada publications provide PYLL data based on death before age 70. Additionally, PYLL can be presented as an age-standardized rate or as a crude rate; in this publication, it is presented as a crude rate. As well, the denominator can be based on population aged 0 to 74 or for the total population. In this publication, the denominator is based on the former.
In this publication, a PYLL rate was produced, where the weights are taken as proportions of the years lost per death within each age group over the total years lost in all age groups. Each death event is multiplied by its age-specific weight. The sum of all these values represents the total PYLL. The PYLL rate is PYLL per 100,000 population aged 0 to 74. The use of weights allows for the calculation of confidence intervals. The confidence intervals for each PYLL rate were produced by the Spiegelman method (refer to section 2.2.1).
| AGE GROUP |
YEARS LOST |
WEIGHT |
| Under 1 |
74.9 |
74.9/636.9 |
| 1-4 |
72.0 |
72.0/636.9 |
| 5-9 |
67.5 |
67.5/636.9 |
| 10-14 |
62.5 |
62.5/636.9 |
| 15-19 |
57.5 |
57.5/636.9 |
| 20-24 |
52.5 |
52.5/636.9 |
| 25-29 |
47.5 |
47.5/636.9 |
| 30-34 |
42.5 |
42.5/636.9 |
| 35-39 |
37.5 |
37.5/636.9 |
| 40-44 |
32.5 |
32.5/636.9 |
| 45-49 |
27.5 |
27.5/636.9 |
| 50-54 |
22.5 |
22.5/636.9 |
| 55-59 |
17.5 |
17.5/636.9 |
| 60-64 |
12.5 |
12.5/636.9 |
| 65-69 |
7.5 |
7.5/636.9 |
| 70-74 |
2.5 |
2.5/636.9 |
| SUM |
636.9 |
1.0 |
This publication only presents PYLL rates based on the sum of all age groups. Thus, the rate is calculated as follows:
Where 
is the sum of PYLL for ages 0 to 74 for the three years of data, w is a weight of 1, and ' POP' is the population aged 0-74 for the middle year of the three years.
To calculate the age-specific PYLL rates:
where i is the specific 5-year age group.
For more information on vital statistics: Birth database (3231), death database (3233).
Latest health region level rates are based on the boundaries in effect as of June 2005.
3.1 Cancer Incidence
The Canadian Cancer Registry (CCR) is a central database located at Statistics Canada that contains patient-oriented information about diagnosis of cancers in Canada. Data on the incidence of cancer are collected by the provincial and territorial cancer registries. The information is used for descriptive and analytic epidemiological studies: to identify risk factors for the cancer; to plan, monitor and evaluate a broad range of cancer control programs (e.g., screening); and for health services and economic research and planning.
Cancer incidence is based on place of residence at time of diagnosis.
Rates contained in this publication have been tabulated using the July 2005 tabulation file, the International Classification of Diseases for Oncology 3rd Edition (ICD-O-3) from the World Health Organization, and the International Agency for Research on Cancer (IARC) rules for determining multiple primaries sites.
Cancer incidence data in this product are based on three years of data (e.g., 1999 to 2001) averaged over the population estimate of the middle year (e.g., 2000). Table titles associated with these data reflect the mid-point of the three-year period being averaged (i.e., 2000).
All data presented have an associated 95% confidence interval (CI). The confidence interval illustrates the degree of variability associated with a rate. Wide confidence intervals indicate high variability, thus, these rates should be interpreted and compared with due caution. Some age-standardized rates were suppressed due to both a very small underlying count plus extremely high variability. Confidence intervals can also be used to determine whether a rate in one health region is statistically below, above or no different than the rate for the same indicator in another health region.
The confidence intervals for the age-standardized cancer incidence rates were produced via the Spiegelman method (refer to section 2.2.1).
Cancer incidence rates are age-standardized using the direct method and the 1991 Canadian Census population structure. See “Age-standardized rates” section for details.
For more information on the Canadian Cancer Registry (CCR) 3207.
4.1 National Population Health Survey
The National Population Health Survey (NPHS), which began in 1994/95, collects information about the health of the Canadian population every two years. It covers household and institutional residents in all provinces and territories, except persons living on Indian reserves, Canadian Forces bases, and in some remote areas. The NPHS has both a longitudinal and a cross-sectional component. Respondents who are part of the longitudinal component will be followed for up to 20 years.
The Health Indicators data are based on both the longitudinal and cross-sectional components for household residents (institutional excluded) living in the provinces (territories excluded). Data are available for the first three cycles (1994/95, 1996/97 and 1998/99).
The 1994/95 and 1996/97 cross-sectional samples are made up of longitudinal respondents and their household members and individuals who were selected as part of supplemental samples, or "buy-ins", in some provinces. The 1998/99 cross-sectional sample is made up mostly of longitudinal respondents and their cohabitants. No buy-ins were added to 1998/99 data. However, to keep the sample representative, infants born in 1995 and thereafter and immigrants who entered Canada since the beginning of 1995 were randomly selected and added to the NPHS sample.
The 1994/95 provincial, non-institutional cross-sectional sample consisted of 27,263 households, of which 88.7% agreed to participate in the survey. After application of a screening rule to maintain the representativeness of the sample, 20,725 households remained in scope. In 18,342 of these households, the selected person was aged 12 or older. Their response rate to the in-depth health questions was 96.1% or 17,626 respondents. In 1996/97, the overall response rate at the household level was 82.6%. The response rate for the randomly selected individuals aged 2 or older in these households was 95.6%. A total of 81,804 respondents answered the in depth health questions in 1996/97. In 1998/99, the overall response rate was 88.2% at the household level. The response rate for the randomly selected respondents 0 or older in these households was 98.5%. A total of 17,244 respondents answered the in depth health questions in 1998/99.
The 1994/95 provincial, non-institutional longitudinal sample consisted of 17,276 respondents. A response rate of 93.6% was achieved in 1996/97, and a response rate of 88.9% was achieved in 1998/99.
4.2 National Population Health Survey -- Northern Component
Statistics Canada conducted the northern component of the NPHS in conjunction with the statistical bureaus in Yukon and NWT. Data were obtained through a separate survey due to the special challenges of survey taking in Canada’s North.
The target population of the Yukon/NWT integrated NPHS/NLSCY survey included household residents living in private occupied dwellings located in the two territories, with the exclusion of populations on Indian Reserves, Canadian Forces Bases and in institutions. Moreover, persons living in unorganized areas in the Yukon (13% of the population) and persons living in unorganized areas, very small or extreme northern communities of the NWT (4.9% of the population) were also excluded from the target population.
Most of the core content from the 1994-95 NPHS main survey is included in the northern survey; however, special "focus content" on stress was excluded. In each selected household in the North, demographic information was collected from all household members, then one person, aged 12 years and over, was randomly selected for a more in-depth interview. The questionnaire included components on health status, use of health services, risk factors and demographic and socio-economic status. Some content changes were made in the 1996/97 NPHS North survey.
Collection operations ran from November 1994 to March 1995 (and again from November 1996 to March 1997). Computer-assisted personal interviewing (CAPI), used for the NPHS in the provinces, was not available in the territories at the time of the survey. A paper and pencil questionnaire designed to replicate the CAPI application was used instead. Telephone interviews were conducted where available, otherwise personal interviews were done.
The selected person response rate for the NPHS 1994/95 was 94.2% at the North level (2,020 respondents). For the Yukon this rate was 94.8%, while the rate for the NWT was 93.1%. The cross-sectional response rate at the North level (both territories) for the NPHS 1996/97 was 86.2% (1,499 respondents). For the Yukon, this rate was 83.9% while the rate for the NWT was 89.8%.
Heavy drinking, 1994/95: Due to a high proportion (42.8%) of refusals/non-stated responses to the question on frequency of heavy drinking in the 1994/95 NPHS-North, these data were deemed unreleasable/unreliable. Heavy drinking has been defined as the number of times current drinkers drank 5 or more alcoholic beverages on one occasion.
For more information about the NPHS (Household or North component), see /concepts/hs-es/index-eng.htm
4.3 Canadian Community Health Survey
Health region level rates from the latest survey cycle (2003) are based on the boundaries in effect as of June 2003.
Starting with data year 2000/01, the Canadian Community Health Survey (CCHS) replaces the cross-sectional aspect of the NPHS.
The primary objective of the CCHS is to provide timely cross-sectional estimates of health determinants, health status and health system utilization at a sub-provincial level (health region or combination of health regions).
The CCHS collects information from individuals aged 12 or older who are living in private dwellings. People living on Indian reserves or Crown lands, residents of institutions, full-time members of the Canadian Armed Forces, and residents of certain remote regions are excluded. The CCHS covers approximately 98% of the Canadian population aged 12 or older.
Each two-year collection cycle is comprised of two distinct surveys: a health region-level survey in the first year with a total sample of 130,000 and a provincial-level survey in the second year with a total sample of 30,000. Sample sizes in any particular month or year may increase due to provincial or health region-level sample buy-ins.
The response rate for the first cycle of the CCHS at the national level was 84.7% (131,535 respondents). The response rate for the second cycle of the CCHS at the national level was 80.6% (135,573 respondents).
For more information about the CCHS, see:
/concepts/hs-es/index-eng.htm
4.4 National Longitudinal Survey of Children and Youth
The National Longitudinal Survey of Children and Youth (NLSCY), developed jointly by Human Resources Development Canada and Statistics Canada, is a comprehensive survey which follows the development of children in Canada and paints a picture of their lives. The survey monitors children’s development and measures the incidence of various factors that influence their development, both positively and negatively.
The first cycle of the NLSCY, which was conducted in late 1994 and early 1995, interviewed parents of approximately 23,000 children up to the age of 11. They shared information not only about their children, but also about themselves and the children's families, schools and neighbourhoods.
The second cycle, carried out in winter and spring of 1996-97, interviewed parents of the same children and provides unique insights into the evolution of children and their family environments over a two-year period. A new sample of newborn and 1-year-old children was added to cycle 2 to allow for cross-sectional estimates.
Collection of cycle 3 began in the fall of 1998 and was carried until June 1999. In addition to the original sample of children, who were aged 2 to 13 years at the time of the second data collection, a new sample of newborn and 1-year-old children was added to cycle 3 to allow for cross-sectional estimates. An extra cross-sectional sample of children 5 years old was also added to allow some provincial estimates for that age group.
4.5 Bootstrapping
To ensure high data quality for estimates from the NPHS, the CCHS and NLSCY, a weighted bootstrap resampling procedure (and for the NPHS-North, a modified bootstrap procedure) was used to calculate coefficients of variation (CVs) for totals and rates. If the CV was greater than 33.3% or the sample size was less than 10, the data were suppressed and an ‘F’ symbol appears in the data cell. If the CV is greater than 16.5% and no greater than 33.3%, the data should be interpreted with caution and an ‘E’ symbol appears in the same cell as the data. Data with CVs of 16.5% or less are presented without restrictions.
Sampling theory dictates that sample survey results of exactly 100% or 0% must have a coefficient of variation of exactly 0. In reality it is possible that in rare circumstances the true estimate may be lower than 100% or conversely greater than 0% and results should be interpreted as such.
Health region level data are not available for the crime-related indicators.
Data on crime incidents that come to the attention of the police are captured and forwarded to the Canadian Centre for Justice Statistics (CCJS) via the Uniform Crime Reporting (UCR) Survey according to a nationally-approved set of common scoring rules, categories and definitions. The survey has been in operation since 1962 and has full national coverage.
The URC is a summary or aggregate-based survey that records the number of criminal incidents reported to the police. The survey does not gather information on the victims, but does collect information on the number of persons charged by sex and by an adult/youth breakdown. For all violent crimes (except robbery), a separate incident is counted for each victim. For non-violent crimes, one incident is counted for each distinct occurrence. Incidents that involve more than one infraction are counted under the most serious violation. As a result, less serious offences are under-represented by the URC survey.
The aggregate URC survey scores violent incidents (except robbery) differently from other types of crime. For violent crime, a separate incident is recorded for each victim (i.e. if one person assaults three people, then three incidents are recorded; but if three people assault one person, only one incident is recorded). Robbery, however, is counted as if it were a non-violent crime in order to avoid inflating the number of victims (e.g. for a bank robbery, counting everyone present in the bank would result in an over-counting of robbery incidents).
The aggregate URC Survey records the total number of youths (aged 12 to 17) and adults (aged 18 and over) charged. When a person is charged with more than one offence, they are counted only once, under the most serious offence. The most serious offence is generally the offence that carries the longest maximum sentence under the Criminal Code of Canada. Violent offences always take precedence over non-violent offences.
The comparison between youth and adult crime rates poses some difficulties. The entire youth population represents a high-risk group for becoming involved in criminal activity. By contrast, the level of risk among adults is not consistent across the entire age group. Almost half of the adult population is 45 years and older; this age group is affected by fewer risk factors and as a result, is rarely involved in crime. A more direct comparison would look at youths and young adults. Unfortunately, data are not currently available to make this comparison.
With URC charge data it is possible for someone to be charged (and counted) more than once in a year. As a result, it is likely that the actual number of persons charged is less than the figure reported for a given time period.
Rates are calculated on the basis of 100,000 population.
For more information on the Uniform Crime Reporting Survey (UCR), please refer to 3302.
Latest health region level rates are based on the boundaries in effect as of June 2005.
Regional unemployment rates and youth unemployment rates where calculated as annual averages from the Canadian Labour Force Survey (LFS). The estimates were derived by linking, at the enumeration area (EA) level, the LFS geography to health regions.
The LFS is a monthly sample of approximately 52,000 households. The survey is designed to represent the Canadian population aged 15 years and older. The survey excludes Indian reserves, full time members of the Canadian Forces, and persons living in institutions. The survey also excludes the Territories.
The areas that are excluded from the LFS affect estimates for Peer Groups F and H. Just over 40% of the population of Peer Group F is excluded, while less than 10% of Peer Group H is excluded. As a result, estimates for Peer Group F are not available.
Some health regions could not be published as the estimated rate did not meet the minimum requirements for quality and confidentiality.
The unemployment rate is the number of unemployed persons divided by the labour force population, expressed as a percentage.
An unemployed person is someone who:
was without work and had looked for work; or
was on temporary layoff and available for work; or
had a new job to start in the future.
The labour force population consists of the unemployed people plus the employed persons. To be employed, a person
worked at any job at all; or
had a job but was not at work during the reference week.
For more information on the Labour Force Survey (LFS), please refer to 3701.
Health region level rates are based on the boundaries in effect as of June 2003 unless otherwise noted.
For more information on census concepts, please refer to the 2001 Census Dictionary, 92-378-XIE.
CIHI’s Privacy and Confidentiality policy does not permit the publication of data that might reasonably identify an individual, whether a patient or care provider, without consent. As a result, measures were taken to protect against residual disclosure from the dissemination of the regional rates including the suppression of small cell sizes. In addition, reporting data based on the region of the patient’s residence (not hospitalization) reduces opportunities for identifying individual care providers.
8.1 Hospitalization data and rates (CIHI)
Data are reported based on the region of the patient’s residence, not region of hospitalization. Consequently, these figures reflect the hospitalization experience of residents of the region wherever they are treated, as opposed to the comprehensive activity of the region’s hospitals (who will also treat people from outside of the region).
Regional rates for British Columbia were derived from the reported postal codes and a translation file developed by BC STATS, BC Ministry of Finance and Corporate Relations. Health region level data for the other provinces and territories were produced through a geo-coding process using correspondence files developed with input from each provincial and territorial health ministry and Alberta Treasury. The link between dissemination areas and health regions was first created to provide the best resolution to census geography, and a census subdivision link to health regions was derived from this file. The boundaries are those that were in effect as of April 2005. Records with invalid, missing, or partial postal codes are not included in the regional rates. The absence of complete postal codes from Quebec may affect rates for the Champlain LHIN (Ottawa area) and other border regions.
Where possible, an all-Canada rate is provided for comparison purposes.
At the Canada level and provincial levels, rates for health data that are based on a fiscal year (April to March) use October 1st population estimates. Unless otherwise specified, Canadian and provincial hospitalization rates are standardized using the same methodology as regional rates. Other rates are based on appropriate population figures. Standardized rates are age-adjusted using a direct method of standardization based on the July 1st, 1991 Canadian population. See section 2.2.2 for details.
Unless otherwise specified, hospitalizations include discharges and deaths for inpatients in acute care hospitals for the reference period. Same day surgery (outpatient) cases and patients admitted to non-acute care hospitals (e.g. chronic care, psychiatric or rehabilitation facilities) are not included in the totals.
Indicators based on the Discharge Abstract Database include only jurisdictions that submit comprehensively to the database. Therefore, data from Quebec and some parts of Manitoba are not available.
CCI-10-CA and the Canadian Classification of Health Interventions (CCI) systems of coding diagnoses and procedures came into effect April 1, 2001, and were adopted by Newfoundland, PEI, Nova Scotia, parts of Saskatchewan, British Columbia and the Yukon Territory. Ontario, the remainder of Saskatchewan, Alberta, the NWT and Nunavut implemented ICD-10-CA/CCI on April 1, 2002 and New Brunswick on April 1, 2003. Indicator cases that were originally coded in ICD-10-CA or ICD have been extracted on the relevant codes and not the ICD-9 or CCP translations.
Bypass Surgery: Variations in the use of this procedure may be related to utilization rates of coronary angioplasty, an alternative intervention for improving blood flow to the heart.
The definition of the ambulatory care sensitive conditions (ACSC) indicator has been revised. Rates are not comparable to those published by CIHI in previous years. See Definitions for further information.
Where information is available, cancelled, previous, and “abandoned after onset” procedures are excluded from the calculations. For Quebec data, cancelled procedures are not reported and therefore have not been excluded.
8.2 Physician data (CIHI)
While physician density ratios are useful indicators of changes in physician numbers relative to the population, inference from total numbers or ratios as to the adequacy of provider resources should not be made. Various factors influence whether the supply of physicians is appropriate, such as: distribution and location of physicians within a region or province; physician type (i.e., family medicine physicians vs. specialists); level of service provided (full-time vs. part-time); physician age and gender; population's access to hospitals, health care facilities, technology and other types of health care providers; population needs (demographic characteristics and health problems); and society's perceptions and expectations.
Physician counts include all active general practitioners, family practitioners and specialist physicians as of December 31 of the reference year. The data include physicians in clinical and non-clinical practice and excludes residents and physicians who are not licensed to provide clinical practice and have requested to the Business Information Group that their data not be published. For purposes of reporting, physician specialty classification is based on postgraduate certification credentials achieved in Canada. Physicians designated as family practitioners include certificants of the College of Family Physicians of Canada (CCFP and CCFP-Emergency Medicine). Specialist physicians include certificants of the Royal College of Physicians and Surgeons of Canada and/or the College des médecins du Québec. All other physicians, including non-College of Family Physicians general practitioners, foreign-certified specialists and other non-certified specialists, are included in the family practice counts. It is recognized that physician classification in this manner does not necessarily reflect the services provided by individual physicians. The range of services provided by a physician is subject to provincial licensure rules, medical service plan payment arrangements and individual practice choices. Therefore, rates may differ from other publications. For example, the Newfoundland Medical Board (NMB) grants full and provisional licenses to non-certified specialists. These physicians are counted as family practitioners in the Health Indicators rates, but are counted as specialist physicians in annual reports of the NMB Registrar.
8.3 National Health Expenditure Database (CIHI)
1 Greville TNE. Short methods of constructing abridged life tables. The Record of American Institute of Actuaries 1943; 32(65):29-42, Part 1.
2 Ng Edward and Gentleman Jane F, "The Impact of Estimation Method and Population Adjustment on Canadian Life Table Estimates", Health Reports 1995, Vol. 7, No.3, pp.15-22.
3 Spiegelman M. Introduction to Demography, Revised Edition. Cambridge Massachusetts: Harvard University Press, 1968. p 113, Formula (4.29).
4Fleiss JL, Statistical Methods for Rates and Proportions, 2nd Ed, Wiley and Sons, NY, 1981. pg. 14, Formula (1.26) and (1.27).
5Postal Code Conversion File –Plus, 82F0086XDB
6Health regions: boundaries and correspondence with census geography, 82-42-XIE
7Sullivan, DF. A single index of mortality and morbidity. HSMHA Health Reports 86 (April 1971) : 347-354
8Chiang, CL. The Life Table and its Applications. Robert E. Krieger Publishing Co., Malabar, Florida, 1984: 316
9 Mather, C. Health Expectancies in Australia 1981 and 1988. Australian Government Publishing Service, Canberra, 1991: 117
10 Holland WW and EC Working Group on Health Services and Avoidable Deaths (1997), “European Community Atlas of Avoidable Death 1985 to 1989”, Oxford, Oxford Medical Publications, Commission of the European Communities Health Services Research Series, no.9, p. 371
11 Charlton JRH, "Avoidable deaths and diseases as monitors of health promotion", pp. 467-479, in Measurement in health promotion and protection, Copenhagen and Albany NY: World Health Organization and the International Epidemiological Association, 1987
12 Rutstein DD, "Monitoring progress and failure: sentinel health events (unnecessary diseases, disabilities and untimely deaths", pp. 195-212, in Measurement in health promotion and protection, Copenhagen and Albany NY: World Health Organization and the International Epidemiological Association, 1987
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is the standard population (refer to section 2.2.2), 
is the age-specific standard population, x is the age group (using 5-year age groups), 
is the population estimate for the corresponding age group, 
is the mean age-specific crude mortality rate and n is the number of years of data used. 
, where 
is the number of deaths in age group x in year i . 
. Remember that n is comprised of three years worth of data, and 
, where pop is three years worth of life-years.
