Low birth weight is a key determinant of infant survival, health, and development. Low birth weight infants are at a greater risk of having a disability and for diseases such as cerebral palsy, visual problems, learning disabilities and respiratory problems.

This indicator contributes to an understanding of the adequacy and effectiveness of injury prevention efforts, including public education, product development and use, community and road design, and prevention and treatment resources.

A long-established measure, not only of child health, but also of the well-being of a society. Reflects the level of mortality, health status, and health care of a population, and the effectiveness of preventive care and the attention paid to maternal and child health.

1.4 Perinatal Mortality Rate

The probability that a fetus considered to be viable will be stillborn or will die before the end of the first week of life. Reflects standards of obstetric and pediatric care, as well as the effectiveness of public health initiatives.

A widely used indicator of the health of a population. Life expectancy measures quantity rather than quality of life.

Indicates the overall health of the population and is similar to what is measured by life expectancy. Age-standardization (as opposed to crude rates) allows for comparisons between health regions, provinces, and countries.

Measures long-term success in reducing deaths due to circulatory disease, compared with other regions, provinces, and countries. Lower death rates indicate success in circulatory disease prevention, detection, and treatment.

Measures long-term success in reducing deaths due to cancer, compared with other regions, provinces, and countries. Lower death rates indicate success in cancer prevention, detection, and treatment.

Measures long-term success in reducing suicide, a social as well as a major public health concern.

Measures long-term success in reducing deaths due to unintentional injuries, compared with other regions, provinces, and countries. Measures the adequacy and effectiveness of injury prevention efforts, including public education, community and road design, prevention, emergency care, and treatment resources.

Measures success in preventing and treating AIDS and HIV (Human Immunodeficiency Virus, the agent that causes AIDS). Information on deaths can be used to estimate the number of persons living with HIV/AIDS, as well as the impact of treatment.

A measure of educational attainment and socio-economic status.

A measure of educational attainment and socio-economic status.

A traditional measure of the economy. Unemployed people tend to experience more health problems.

Unemployed people tend to experience more health problems. Long-term unemployment could extend ones' susceptibility to poor health.

A widely used measure of socio-economic status. Higher income is associated with better health.

2.7 Children in Low-income Families (1995 income)

A widely used measure of children at risk.

Definition: Average personal income for persons aged 15 or older, from all sources.

Higher income is associated with better health.

As a general rule, households are considered to have affordability problems if more than 30% of household income is spent on housing costs. At that level of spending, it is likely that inadequate funds will be available for other necessities such as food, clothing, and transportation. Housing affordability problems affect renters more than owners.
Band housing on Indian reserves was not included in the calculation of housing affordability.

There is considerable evidence that vaginal birth is safe for many women who have previously delivered by caesarean section. Women presenting with a history of a previous transverse low segment caesarean section, a single fetus in vertex presentation and no contraindications to a trial of labour should be offered the opportunity of vaginal delivery. (Clinical Practice Guidelines. Vaginal birth after previous caesarean birth. Society of Obstetrics and Gynecologists of Canada, 1997).

(CCP procedure code of 86.0-86.2, 86.8, or 86.9; ICD-9-CM procedure code of 74.0-74.2, 74.4 or 74.99).

This indicator reflects the burden of illness due to pneumonia and influenza, a portion of which may be preventable through influenza and pneumococcal immunization programs. High rates of preventable pneumonia and influenza may suggest a problem with access to immunization.

While not all admissions for ambulatory care sensitive conditions are avoidable, it is assumed that appropriate prior ambulatory care could prevent the onset of this type of illness or condition, control an acute episodic illness or condition, or manage a chronic disease or condition. The "right" level of utilization is not known although a disproportionately high rate is presumed to reflect problems in obtaining access to primary care.

3.5 May not Require Hospitalization

MNRH analyses may prompt review of inpatient cases to identify opportunities for providing such care in ambulatory settings. Case mix groups associated with MNRH do not suggest that a patient must be treated as ambulatory, as these patients may have a justifiable basis for inpatient admission.

This indicator is designed to assess the processes that ensure the placement of patients in the most appropriate care setting. It identifies the proportion of patients who are occupying acute care beds due to the unavailability of services in another more appropriate setting.

Expected length of stay (ELOS) is calculated on typical patients taking into account the reason for hospitalization, age, comorbidity, and complications. Typical cases exclude deaths, transfers, voluntary sign-outs, and cases where the actual length of stay is greater than the "trim point" established by CIHI. The calculation uses the Case Mix Group (CMG) methodology and calibration for the given year (i.e., 1998/99 data uses CMG 1999 methodology). A positive ratio indicates actual days stay was longer than expected while a negative value suggests the average actual stay was shorter than expected.

Hip fractures occur for various reasons including environmental hazards, the prescription of potentially inappropriate psychotropic medications to the ambulatory elderly, and safety issues in long-term care facilities. As well as causing disability or death, hip fractures can have a major impact on independence and quality of life. This measure is based on the number of cases admitted to hospital, not the number of unique individuals. Some cases may represent readmissions for additional treatments or transfers from one medical setting to another. Thus, the hospitalization rate may over-estimate the incidence of hip fractures.

A population’s size and age/sex composition impact the health status of a region and its need for health services. Population data also provide the "denominators" used to calculate rates for most health and social indicators.

Canadians aged 65 or older are specifically noted, because of their growing proportion of the population and their greater health care needs.

This community characteristic allows users to compare regions with similar proportions of urban/rural population.

Health status characteristics and non-medical determinants of Aboriginal people differ from the non-Aboriginal population, for example, infant mortality, unintentional injury deaths, suicides and smoking rates. Knowing the proportion of Aboriginal people in a geographic area provides context to better interpret health indicators.

Canadian, American and Australian studies have shown that immigrants, particularly non-European immigrants, generally have a longer life expectancy and lower risk of certain chronic conditions than the native-born population. However, the Canadian studies have also shown that as the immigrants' period of residence in Canada increases, so does the prevalence of chronic conditions, smoking and disability. Understanding the proportion of immigrants in a geographic area, along with the period of immigration, provides a context for interpreting health indicators.

Physician to population ratios are used to support health human resource planning. Physician density ratios do not take into account workload or type of services provided. In some regions, health facilities and personnel provide services to a larger community than the residents of the immediate region. In others, residents may seek care from physicians and Specialists outside the region where they live. The ratio of physicians to population reflects the number of doctors in a region and has not been adjusted to take these movements into account. The extent to which this affects individual regions is likely to vary.

As with other types of procedures, variations in CABG surgery rates can be attributed to numerous factors, including differences in population demographics, physician practice patterns, availability of services, and prevalence of cardiovascular disease. In Ontario, the provincial benchmark for CABG surgery is 100 per 100,000 population (Cardiovascular Health and Services in Ontario. ICES, 1999).

4.8 Hip Replacement Surgery Rate

Hip replacement surgery has the potential to result in considerable improvement in functional status, pain relief, as well as other gains in health-related quality of life. Over the past two decades, rates of surgery have increased substantially. Wide inter-regional variation in the hip replacement rate may be attributable to numerous factors including the availability of services, provider practice patterns, and patient preferences.

Knee replacement surgery has the potential to result in considerable improvement in functional status, pain relief, as well as other gains in health-related quality of life. Over the past two decades, rates of surgery have increased substantially. Wide inter-regional variation in the knee replacement rate may be attributable to numerous factors including the availability of services, provider practice patterns, and patient preferences.

Utilization rates may reflect the level of uncertainty about the appropriate use of this surgical procedure. The "right" level of utilization is not known. In Canada, inter-regional hysterectomy rates vary two to three-fold.