• Youth dependency ratio – number of youth aged 0-19 years relative to the total number of people aged 20-64 years
• Elderly dependency ratio – number of people aged 65 years and older relative to the total number of people aged 20-64 years 
• Total dependency ratio –number of youth 0 -19 years and people aged 65 years and older relative to the total number of people aged 20-64 years.

Specific Indicators

• Youth dependency ratio
• Elderly dependency ratio
• Total dependency ratio

Ontario Public Health Standards

The Ontario Public Health Standards (OPHS) establish requirements for the fundamental public health programs and services carried out by boards of health, which include assessment and surveillance, health promotion and policy development, disease and injury prevention, and health protection. The OPHS consist of one Foundational Standard and 13 Program Standards that articulate broad societal goals that result from the activities undertaken by boards of health and many others, including community partners, non-governmental organizations, and governmental bodies. These results have been expressed in terms of two levels of outcomes: societal outcomes and board of health outcomes. Societal outcomes entail changes in health status, organizations, systems, norms, policies, environments, and practices and result from the work of many sectors of society, including boards of health, for the improvement of the overall health of the population. Board of health outcomes are the results of endeavours by boards of health and often focus on changes in awareness, knowledge, attitudes, skills, practices, environments, and policies. Boards of health are accountable for these outcomes. The standards also outline the requirements that boards of health must implement to achieve the stated results.  

Assessment and/or Surveillance Requirements Related to this Indicator
·         The board of health shall assess current health status, health behaviours, preventive health practices, health care utilization relevant to public health, and demographic indicators in accordance with the Population Health Assessment and Surveillance Protocol, 2008 (or as current) (Foundational Standard) 

Protocol Requirements Related to this Indicator
·         The board of health shall collect or access the following types of population health data and information: Socio-demographics including population counts by age, sex… (Population Health Assessment and Surveillance Protocol, 1b) 

http://www.ontario.ca/publichealthstandards

Corresponding Health Indicator(s) from Statistics Canada and CIHI

The internet publication Health Indicators, produced jointly by Statistics Canada and the Canadian Institute for Health Information, provides over 80 indicators measuring the health of the Canadian population and the effectiveness of the health care system. Designed to provide comparable information at the health region and provincial/territorial levels, these data are produced from a wide range of the most recently available sources. A pdf copy of this report can be found on CIHI’s website (http://www.cihi.ca) under Research and Reports or under the PDF tab on the Statistics Canada web-page at http://www.statcan.ca/bsolc/english/bsolc?catno=82-221-X 

Population Estimates:
Data are derived from the census and administrative sources on births, deaths and migration. Postcensal estimates are based on the latest census results adjusted for net census undercoverage and for the estimated population growth that occurred since that census. More information about the data can be obtained in the Beyond 20/20 (IVT) file by selecting “File>Summary” or by browsing the footnotes below a retrieved CANSIM table. 

Data Sources (see Resources: Population Estimates)

Alternative Data Sources

• Statistics Canada CANSIM tables (Population and Demography)
• Statistics Canada Community Profiles 

• Use “Population Estimates PHU Municipality” pre-defined report from “02 Populations” shared folder in IntelliHEALTH Ontario if you wish to have counts based on PHU or Municipality (Census Subdivision) boundaries. Use “Population Estimates and Projections LHIN v2” pre-defined report from “02 Populations” shared folder in IntelliHEALTH Ontario if you wish to have counts based on LHIN boundaries.  
• To view population estimates by county (which is generally equivalent to PHU for Southern Ontario health units, but varies considerably for Northern Ontario health units), change the geography parameter in the query. You may also change the filter applied to the report to view years previous to 1999 (data currently available from 1986 – onwards).
• For more details about the methodology and assumptions in the calculation in the measures that are used in this indicator, refer to the Population Estimates resources.

 Method of Calculation

Basic Categories

• Youth (ages 0-19), elderly (65+), total (0-19 + 65+)
• Geographic areas of residence: province (sum of municipalities or health units), public health unit, census subdivision (municipality), county, and LHIN.

Indicator Comments

• The current definition of dependency ratio (youth, elderly and total) represents a change from the previous APHEO Core Indicator definitions. This has been done to align the APHEO indicator definitions with the definitions used by Statistics Canada. 
• Starting in 2001, there was a change in the definition of the dependency ratio used by Statistics Canada. Prior to 2001, the definition of dependency ratio was the ratio of the number of people aged 0-14 years and 65 years and older relative to the number of people aged 15-64 years. Starting in 2001, the definition was changed to be the ratio of the number of people aged 0-19 years and 65 years and older relative to the number of people aged 20-64 years.
• It is important to also report on the youth and elderly dependency ratios, as they have a counter-balancing effect on the total dependency ratio.¹
• The use of dependency ratios assumes that all elderly persons (65 years and older) are economically dependent upon the population aged 20-64 years, which is not true for all elderly persons.¹ The dependency ratio also assumes that all persons aged 20-64 years are not economically dependent, which may not be true (e.g. due to disability).
• As the baby boomer generation enters retirement, the elderly and total dependency ratios may increase as the proportion of the population aged 65 years and older increases.²

Definitions

Cross-References to Other Sections

• None

Cited Reference(s)

1. Gee, E.M. Misconceptions and Misapprehensions About Population Aging. International Journal of Epidemiology. 2002; 31:750-753. 
2. PricewaterhouseCoopers LLP. Population Aging and Public Infrastructure: a Literature Review of Impacts in Developed Countries. April 2008. Available at: http://www.infc.gc.ca/research-recherche/results-resultats/rs-rr/rs-rr-2008-02-eng.html  

Acknowledgements

Lead Author(s)
Nancy Ramuscak, Region of Peel Public Health
Cam McDermaid, Ottawa Public Health
Luanne Jamieson, Hamilton Public Health Services
Virginia McFarland, Grey Bruce Health Unit
Alissa Palangio, Sudbury and District Health Unit
William Kou, York Region Community and Health Services 

Contributing Author(s)
Core Indicator Reviewers
External Reviewers
Carol Paul, Ministry of Health and Long-Term Care
Jessica Deming, Region of Waterloo Public Health
Mike Delorme, Region of Waterloo Public Health

Date of Last Revision: April 8, 2011