Background

In 1998, over 500 people - health administrators, researchers, caregivers, government officials, health advocacy groups, and consumers – were brought together to identify health information needs. One of their priorities was comparable quality data on key health indicators for health and health services.

In response to the consultations, Statistics Canada and the Canadian Institute for Health Information (CIHI) have launched a collaborative process to identify what measures should be used to report on health and the health system – and then to share this information with Canadians from coast to coast.

Health indicators are:

• relevant to established health goals
• based on standard (comparable) definitions and methods
• broadly available – disseminated electronically across Canada at the regional, provincial and national level

The primary goal of the Health Indicators project is to support health regions in monitoring progress in improving and maintaining the health of the population and the functioning of the health system for which they are responsible through the provision of quality, comparative information on:

• The overall health of the population served, how it compares to other regions in the province and country and how it is changing over time;
• The major non-medical determinants of health in the region;
• The health services received by the region’s residents; and
• Characteristics of the community or the health system that provide useful contextual information.

 

Consultations continue with provincial and regional health authorities to refine and expand the initial list of indicators confirmed at the consensus conference of May 1999. As data are compiled, the provincial and regional authorities are also involved in the verification process. This collaborative process is intended to ensure relevant data and consistent methods.

Regional health indicators

The core list of health indicators is presented in the following table, within the Indicators Framework. The indicators included in this publication (underlined) are available at the health region level and represent a subset of this core list of indicators. Subsequent releases will add indicators and time series as these data are developed at the regional level, and new health data are collected.

Health Status
Well-Being	Health Conditions	Human Function	Deaths
Self-rated health Self-rated ‘excellent’ health for two consecutive survey cycles Self-esteem Mastery	Low birth weight Overweight Arthritis Diabetes Asthma High blood pressure Cancer incidence Chronic pain Depression Injury hospitalizations Food and waterborne diseases	Functional health Disability-days Activity limitation	Infant mortality Perinatal deaths Life expectancy Total mortality Circulatory deaths Cancer deaths Respiratory deaths Suicide Unintentional injury deaths AIDS deaths Potential Years of Life Lost
Non-Medical Determinants of Health
Health Behaviours	Living and Working Conditions	Personal Resources	Environmental Factors
Smoking rate Youth smoking rate Smoking initiation (average age) Quitting smoking Regular heavy drinking Physical activity Breastfeeding	High school and post-secondary graduation Unemployment rate Long-term and youth unemployment Low income rate Children in low income families Average personal income Income inequality Housing affordability Crime rate and youth crime rate Decision-latitude at work	School readiness Social support Life stress
Health System Performance
Acceptability	Accessibility	Appropriateness	Competence
	Influenza immunization, 65+ Screening mammography, women age 50-69 Pap smears, age 18-69 Childhood immunizations	Vaginal birth after caesarean Breast-conserving surgery Caesarean sections
Continuity	Effectiveness	Efficiency	Safety
	Pertussis Measles Tuberculosis HIV Chlamydia Pneumonia and influenza hospitalizations Deaths due to medically-treatable diseases Ambulatory care sensitive conditions	Surgical day case rates May not require hospitalization % Alternate level of care days Expected compared to actual stay	Hip fractures
Community and Health System Characteristics
Population count Percent population over 65 years of age Percent ‘urban’ population Percent aboriginal population Percent immigrant population Teen pregnancy/teen births Expenditures per capita Doctors (GP/FP and specialists) Nurses per capita		CABG rates Hip replacement Knee replacement Hysterectomy Myringotomy

Health Regions

Health regions are defined by provincial governments as the areas of responsibility for regional health boards (i.e., legislated) or as regions of interest to health care authorities.

(1) In PEI, Nova Scotia and Saskatchewan, the legislated health regions have relatively small populations. In order to produce reliable and comparable health indicators, these provinces have defined health regions for statistical purposes. In PEI, the two health regions divide the province into an 'urban' and 'rural' component. In Nova Scotia, these are known as 'health zones' and relate to the province's administrative health region boundaries. In Saskatchewan, 'service areas' have been created from groupings of the 33 health districts.

(2) Public health units (PHU) administer health promotion and disease prevention programs. District health councils (DHC) are advisory, health planning organizations that make recommendations on resource distribution and provide advice on integration of health services in their community.