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Health regions and peer groups

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"Health region" refers to administrative areas defined by the provincial ministries of health. For complete Canadian coverage, each of the northern territories also represents a health region.

See Table 1 Health regions in Canada – reference maps by province and territory.
See Map Health regions 2007 by peer group.

Health region boundary changes

Since June 2005, only minor changes to health regions have occurred. See Table 2 Summary of changes to health region codes, names and boundaries, 2005 and 2007 in the appendices for details.

The publication Health regions: boundaries and correspondence with census geography, describes the health region limits as of December 2007 and their correspondence with the 2006 and 2001 Census geography. However, many data tables within this publication continue to reflect the boundaries in effect as of 2005 and 2003. These will be updated as new data tables are produced with future issues.

Health region peer groups

In order to effectively compare health regions with similar socio–economic characteristics, health regions have been grouped into 'peer groups'. Statistics Canada used a statistical method to achieve maximum statistical differentiation between health regions. Twenty–four variables were chosen to cover as many of the social and economic determinants of health as possible, using data collected at the health region level mostly from the Census of Canada. Concepts covered include:

  • basic demographics (for example, population change and demographic structure),
  • living conditions (for example, socio-economic characteristics, housing, and income inequality), and
  • working conditions (for example, labour market conditions).

Peer groups based on 2007 health region boundaries and 2001 Census data are now available. There are currently nine peer groups identified by letters A through I.

See Table 3 Health regions 2007 by peer group.
See Table 4 Summary table of peer groups and principal characteristics.

A more detailed discussion on the rationale and methods involved in the development of peer groups is available in the Health Region (2000) Peer Groups Working Paper and Health Region (2003) Peer Groups Working Paper.

Since the peer groups were established, there have been relatively few geographic changes to the component health regions. The most significant development was the establishment of Regional Integrated Health Authorities in Newfoundland , reducing the number of health regions from 6 to 4. Another important change to health region boundaries has been the creation of the Local Health Integration Networks (LHIN) in Ontario , replacing the District Health Councils. This development, however, does not impact the peer groups because public health units, which are also recognized as health regions, were used to form the peer group classification.

To maintain comparability and minimize changes to the classification, the latest health regions have, for the most part, been refit to the current peer groups. Since there were so few changes, reconstruction of peer groups using the original cluster analysis method was not practical, especially since the census data required for this work were also not available. Instead, regions with significant boundary changes were analysed individually to determine best fit.

In Alberta, the December 2003 boundary change between Calgary Health Region (Peer group B) and David Thompson RHA (Peer group E) resulted in a population shift which decreased the population of David Thompson by 4.4% and increased that of Calgary by 1.2%. Since the relative population affected is small, the peer group assignments remain appropriate.

In Ontario, Muskoka-Parry Sound Health Unit (3545) was dissolved, and the territory split into current health regions North Bay Parry Sound District Health Unit (3547) and Simcoe Muskoka District Health Unit (3560). The receiving health regions retain their peer group classification, although this represents a shift from peer group “E” to peer group “C” for the municipality of Parry Sound.

For this peer group update, the recent boundary changes in Newfoundland and Labrador were the most problematic. Even though this was a simple aggregation of health regions, they represented a merge of regions with similar population size, from different peer groups. Census data available for these areas were examined to determine whether the population characteristics were affected enough to change the associated peer group. The two changes in Newfounland and Labrador requiring further analysis were:

  1. Health and Community Services St. John’s Region (1001 – in peer group “A”) and Health and Community Services Eastern Region (1002 – peer group “I”) have been combined to form Eastern Regional Integrated Health Authority (1011). In this case, the aggregation especially impacts on the following characteristics:
  • urban-rural mix (now 65.6% urban and 34.4% rural),
  • population density (now 15.03 per square kilometre), and
  • total population change (represents a decline of 4.97%).

As a result, this new health region is assigned to Peer Group “C”.

  1. Grenfell Regional Health Services Board (1005 – peer group “I”) and Health Labrador Corporation (1006 - peer group “H”) have been combined to form Labrador-Grenfell Regional Integrated Health Authority (1014). A high proportion of Aboriginal population is the significant characteristic of peer group “H”, setting it apart from “I”. The proportion of Aboriginal population for the combined region remains relatively high (26%). Consequently, this new region is assigned to peer group “H”.

The other two Regional Integrated Health Authorities assume the same boundaries as and therefore represent a code and name change only. Hence, they keep the same peer group assignment (both remaining in peer group “I”.)

Special notes:

In Prince Edward Island, the four health regions were abolished in November 2005 as a result of health system restructuring. These boundaries have been maintained for the release of indicators from 2005 Canadian Community Health Survey. The breakdown of the Health Regions into peer groups has changed slightly for 2007 due to health region (HR) changes in Prince Edward Island. This may affect comparability of the 2007 data to those of 2005 and 2003 for the following peer groups: A, C, D, I.

In Nova Scotia , the six zones were recognized as health regions although a smaller level of administrative regions exist, nine district health authorities (DHA). The province has requested that Statistics Canada begin to use these administrative units instead of the zones. Due to limits in generating data for the smaller units, both zones and DHA boundaries remain useful and will appear as two levels of the 2007 health regions. Zones, which for the most part represent aggregations of the DHAs, remain the unit for peer group assignment.

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