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    Health regions: boundaries and correspondence with census geography

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    Appendices and tables

    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 legislated administrative areas defined by provincial ministries of health. These administrative areas represent geographic areas of responsibility for hospital boards or regional health authorities. Health regions, being provincial administrative areas, are subject to change.

    Since the last update of this product in 2007 there have been few changes in the provincial health regions. Existing changes include a small boundary change in New Brunswick and the abolishment of the health regions in Prince Edward Island. The 2011 Health Regions: Boundaries and Correspondence with Census Geography reflects the boundaries as of October 2011 and provides the geographic linkage to 2001 and 2006 Censuses.

    Description

    The generic term "health region" applies to a variety of administrative areas across Canada that are defined by provincial ministries of health. To complete the Canadian coverage, each northern territory is represented as 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 and relevant legislation, by province 2007. Table 1
    Health regions and relevant legislation, by province 2011

    Health region code structure

    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 in Canada, 2011 (names and codes).

    Correspondence files

    Production of health region level data requires geographic coding tools. Since census geography does not recognize provincial health region boundaries, a health region-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.

    To accommodate various data sources producing health region level data, linkage has been created for both 2006 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).

    Most health regions comprise entire CSDs (see Table 2). However, there are some cases where health regions do not conform with municipalities. The 2006 and 2001 Census linkages were created at the dissemination area (DA) level and block level for British Columbia, Alberta, Saskatchewan, Manitoba, and Ontario (LHINS). Even these smaller geographic areas (DA/blocks) sometimes straddle health region boundaries. In those cases, the entire 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.

    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.

    Correspondence files were provided by Alberta (Alberta Treasury supplied files with health region to 2006 Census blocks), British Columbia (BC Stats provided health region to 2006 DAs), Quebec (ministère de la Santé et des Services Sociaux provided health region to 2006 DAs) and Manitoba (Manitoba Health provided health region to 2006 DAs).

    Table 2: Census geography definitions. Table 2
    Census geography definitions

    The dissemination area/block-to-health region (DA/block-to-HR) correspondence files provided in this publication are available in DBF format for each province and for the northern territories for 2006, and comma-separated value (CVS) format for 2001.

    Record layout

    The record layout of the files is shown in the following tables.

    Table 3: 2006 Census health region correspondence file layout. Table 3
    2006 Census health region correspondence file layout

     

    Table 4: 2001 Census health region correspondence file layout. Table 4
    2001 Census health region correspondence file layout

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

    Boundary files

    The health region boundaries provided in this product are based on 2006 and 2001 Census geographic units. The smallest geographic unit available has been used as the building block to define health regions. In general, the legislated limits respect these units, but they do not respect DA's or blocks once the legislated boundaries are digitized. In all provinces except British Columbia, Alberta, Saskatchewan, Manitoba and Ontario (LHINs), the dissemination area was used to define health regions. However, in several instances, the actual physical legal limits split DAs. In the Prairie provinces and B.C. the dissemination block (DB) was used to improve the accuracy of these boundaries. Even with this, the physical legal boundaries do not always reflect the legislated limits recognized by the provinces thus creating many instances of split dissemination blocks.

    The limits that did not respect STC geometry (the splits) were digitized by utilizing maps, spatial layers and/or descriptions supplied by and with the cooperation of the authority for each province.

    Method used to create health region 2011 boundary files

    All processes and procedures to update the digital boundary files were carried out using ESRI ® ArcGIS TM 9.2 and 9.3.1, Microsoft ® Access 2002 and 2007, and Microsoft ® Excel 2002 and 2007.

    1. Provinces reporting no geographic changes since 2007

    The majority of the provinces and all of the territories did not report any geographic changes since the 2007 update. Contacts in the health ministries in Newfoundland and Labrador, New Brunswick, Quebec, Ontario, Manitoba, Saskatchewan, British Columbia, Yukon, Northwest Territories and Nunavut reported no health region boundary changes.

    2. Boundary changes – correspondence files created by Statistics Canada

    The province of New Brunswick has made minor name changes to its health regions. The Regions are now referred to as Zones.

    In November 2010, five new zones were approved for use in Alberta by the Joint Alberta Health Services - Alberta Health and Wellness Geographies Committee. These five zones are aggregations of the previous nine Regional Health Authorities.

    In 2011, in order to aggregate Nova Scotia District Health Authority (DHA) boundaries to Zone boundaries, Dissemination Area (DA) 12080119 (2006 Census population is 887) was reassigned to Zone 6 from Zone 3. Also reassigned was DA 12080120 from DHA 4 (Zone 3) to DHA 9 (Zone 6), correcting the boundary for both DHAs and Zones.

    Boundary file formats

    All digital health region boundaries in this publication are available in two formats: An ESRI ® shapefile format and MapInfo® table format.

    The ESRI ® shapefile is supplied in a zip file. This file expands to provide four files of different extensions which are: (DBF, SHP, PRJ and SHX).

    The MapInfo® format, ©Pitney Bowes Software Inc., is supplied in a zip file. This file expands to provide four files of different extensions which are: (TAB, DAT, ID, and MAP).

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

    Projection information

    The disseminated projection coordinate system of the health region boundary files is as follows:

    Lambert Conformal Conic
    Datum = NAD83
    Units = meters
    Spheroid = GRS 1980

    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

    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, Alberta Treasury, le ministère de la Santé et des Services sociaux du Québec and Manitoba Health also contributed directly to this work by providing health region-to-census geography correspondence files.

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