User guide

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• Background
• Description
• Health region code structure
• Geographic coding tools
• Health regions and standard geography
• Boundary files
• Acknowledgements

Appendices

• Appendix 1: Health regions in Canada, 2003
• Appendix 2: Summary of changes to health regions, 2000 and 2003
• Appendix 3: Detailed list of Census subdivisions split by two or more health regions, 2001

Background

In recent years there has been an increasing demand for relevant health information at a ‘community’ level. As a result, health regions have become an important geographic unit by which health and health-related data are produced.

Health regions are defined by provincial ministries of health, and generally comprise legislated administrative areas representing geographic areas of responsibility for hospital boards or regional health authorities.

The first national health region geographic product was created by Statistics Canada in collaboration with provincial health ministries. Health regions 2000 - Boundaries, geographic information and population estimates (Cat. no. 82F0082XCB) was released on a CD-ROM by the Health Statistics Division of Statistics Canada in October 2000. The reference date for these health region boundaries was January 2000.

Health regions, being provincial administrative areas, are subject to change. Since the ‘Health Regions 2000’ product was created, a number of provinces have undergone regional restructuring of health administration with substantial boundary changes, especially in British Columbia and Alberta. Other provinces have also adjusted their boundaries and health region names. In 2002, work began to bring the health regions recognised by Statistics Canada up to date. In addition to revising these boundaries, links to 2001 Census geographic units became possible. Health Regions 2003 reflects the boundaries and names in effect as of June 2003, and provides the geographic linkage to 1996 and 2001 Censuses.

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Description

The generic term "health region" applies to a variety of administrative areas across Canada that are defined by provincial ministries of health. For complete Canadian coverage, each of the northern territories also represent a health region.

The following table describes the health regions, by province, with reference to the provincial legislation under which these areas have been defined:

Table 1: Health regions in Canada, 2003

Health region code structure

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A four digit numeric code is used to uniquely identify health regions. The first two digits represent the province, and the second two digits represent the health region. These codes reflect the same codes used by the provincial ministries of health. For those provinces where a numeric code is not applicable, a two-digit code was assigned. Ontario uses a 4-digit code for public health units. This code was truncated to the last two digits for consistency in the national health region code structure. Since Ontario has two sets of health regions, which do not entirely relate hierarchically, their codes are unique within the province.

The names of the health regions also represent the official names used by the provinces.

See Appendix 1 – Health regions 2003: Names and codes by province and territory.

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Geographic coding tools

Production of health region level data requires geographic coding tools. Since census geography does not recognize provincial health region boundaries, a HR-to-census geography correspondence file provides the linkage between health regions and their component census geographic units. These correspondence files use the smallest relevant census geographic unit.

Other data sources use postal codes to geographically reference data records. These data are first converted to census geographic units using the Statistics Canada postal code conversion file, then linked to health regions based on the correspondence file.

To accommodate various data sources producing health region level data, linkage has been created for both 1996 and 2001 Census geographies.

The layout of these correspondence files includes the seven-digit Standard Geographic Classification (SGC) code. The SGC code uniquely represents census subdivisions (CSD) with a numeric system. Most health regions comprise entire CSDs (see Table 2). However, given that there are many cases where health regions do not conform with municipalities, the 1996 Census linkage was done at the enumeration area (EA) level and, more recently, the 2001 Census linkage was created at the dissemination area (DA) level (and block level for Alberta, Saskatchewan and Manitoba). Even these smaller areas sometimes straddle health region boundaries. In those cases, the entire EA or DA (or block) was assigned, in conjunction with the affected province, to just one health region and therefore represents a “best fit” with census geography.

Correspondence files were provided by Alberta (Alberta Treasury supplied files with 1996 EA and 2001 link to Census blocks) and British Columbia (BC Stats provided EA and 2001 link to DAs).

Table 2: Census geography definitions

The dissemination/enumeration area-to-health region (DA/EA-to-HR) correspondence files provided in the Health Regions - 2003 product are available in comma-separated value (.CSV) format for each province and for the northern territories. The record layout of the files is shown in the following tables.

Table 3: 2001 Census health region correspondence file layout

**10-digit census block ID (BLKUID) applies to the provinces of Manitoba, Saskatchewan, and Alberta only. The first 8 digits comprise the DA code (DAUID) for these provinces.

Table 4: 1996 Census health region correspondence file layout, (national & Ont. DHC)

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Health regions and standard geography

For the most part, health regions can be described as groupings of counties (census divisions) or municipalities (census subdivisions). This description holds especially true in the Atlantic provinces, Quebec, and Ontario (with minor exceptions in northern Ontario). In the western provinces, health regions are less likely to follow census division or census subdivision boundaries.

The following table provides a count, by province, of census subdivisions that fall in more than one health region.

Table 5: Census subdivisions linked to more than one health region

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Boundary files

The health region boundaries provided in this product are based on 2001 Census geographic units. The smallest geographic unit available has been used as the building block to define health regions. In all provinces except Alberta, Saskatchewan and Manitoba, the dissemination area was used to define health regions. In the western provinces, the DA is not ideal and would create additional distortion as a building block. Therefore, the census block (a smaller geographic unit introduced for 2001 Census) has been used to improve the accuracy of these boundaries. Even with this improved resolution, the boundary files do not always reflect the true, legal limits recognized by the provinces. For the most part, they are based on a best-fit linkage to census geography. To maximize comparability, the provincial ministries of health shared their census linkage files where applicable.

Method used to create health region 2003 boundary files

The latest boundaries for health regions were produced under several different circumstances:

1. Provinces reporting no geographic changes since 2000
Ontario, Newfoundland and Labrador, Nova Scotia and New Brunswick boundaries were created based on the limits of 2000 transposed onto the latest census geographic infrastructure, to relate these areas to their component municipalities as of Jan. 1, 2001. Contacts in these provinces’ health ministries were involved in verifying that the limits reflected correct boundaries as of April 2003. In Ontario and Newfoundland, a few exceptional cases exist where health regions split census subdivisions. These boundary exceptions (or splits) were maintained based on best-fit to dissemination areas (DA). For selected regions in northern Ontario, the boundary files were adjusted to better reflect the shape of the actual public health unit limits.

2. Boundaries based on 2001 census subdivisions components
In Prince Edward Island, the 2003 health regions represent the four administrative areas defined by P.E.I. Ministry of Health and Social Services. These health regions replace the two statistical units (urban and rural regions) previously used by Statistics Canada. The new boundaries were created based on aggregation of the 2001 census subdivision (municipality) components. Quebec health region component CSDs were accessed from the ministère de la Santé et les Services sociaux - MSSS (le découpage territorial et la géomatique). The resulting health region boundaries and correspondence to 2001 Census units were verified by the province.

3. Correspondence files provided
British Columbia (BC Stats) and Alberta (Alberta Treasury) provided correspondence files with linkage to 2001 census units from which the boundaries were created. BC Stats used DAs to create the best-fit linkage between the health service delivery areas and 2001 Census. Alberta provided the linkage between the latest regional health authorities boundaries using the best-fit to 2001 census blocks. These DA and census block based files were used to create the new health region boundary file. Boundaries files created based on DA and especially census blocks produce a more accurate linkage to 2001 Census geography than those created based on linkage to 1996 census enumeration areas. However, there are still cases where health regions are split by blocks and dissemination area boundaries, and therefore the boundaries created from these best-fit linkages do not always represent the actual limits of health regions. For more information about the quality of the geographic linkages contact BC Stats or Alberta Treasury.

4. Boundary overlay process used to create link with census
Contacts in Manitoba and Saskatchewan ministries of health provided “shape files” or digital boundary files reflecting current health region boundaries. Statistics Canada’s Geography Division used a GIS program to ‘reconcile’ these files with the 2001 Census geographic infrastructure to create a one-to-one relationship with census blocks. To involve the provinces in verifying this work, maps were created to indicate the discrepancies between reconciled boundaries (best-fit to blocks) and actual boundary provided. In each province, for only a few northern areas where the census blocks were still insufficiently close to existing health region boundary, arcs were added to better represent the health region boundaries as viewed in the province’s “shape file”. These boundaries were modified with agreement from the provincial authorities, to reduce the distortion of boundaries created by the reconciliation process.

Boundary file formats

All digital health region boundaries in the Health Regions - 2003 product are available in two formats: ARC/INFO® EXPORT and MapInfo®, Version 5.0 for Windows. The coordinates are in latitude/longitude.

The extension of the ARC/INFO® EXPORT files is E00. In MapInfo® for Windows, a self-extracting executable (EXE) is provided. This file expands to provide the four files, with different extensions, for each province. The four extensions are: TAB, DAT, ID, and MAP.

Boundary files are provided as one national boundary file and as individual provincial boundary files.

Projection information

The map projection parameters used to create the health region boundaries are as follows;

Lambert Conformal Conic
    Datum = NAD83
    Units = meters
    Spheroid = GRS North American 83

Parameters:

    1st standard parallel: 49° 00' 00"
    2nd standard parallel: 77° 00' 00''
    Central Meridian: -91° 52' 00''
    Latitude of Projection Origin: 63° 23' 26.43''
    False Easting: 6200000
    False Northing: 3000000

Minimum system requirements

• Pentium PC
• Windows 98 / NT 4.0
• Minimum 32 MB RAM
• Minimum 30 MB free space on Hard disk
• Microsoft Mouse or compatible

To use MapInfo boundary files:

• MapInfo Version 5.0 for Windows or newer

To use ARC/INFO EXPORT boundary files:

• ARC/INFO Version 7.0 or newer
• ArcView Version 3.0 or newer

Acknowledgements

Health Statistics Division worked closely with the provincial Ministries of Health and the Geography Division of Statistics Canada to produce this product. BC Stats and Alberta Treasury also contributed directly to this work by providing health region-to-census geography linkage files. Saskatchewan Health and Manitoba Health provided digital boundaries (shape files). All provincial contacts participated in the final verification.