Provincial Health Indicators Work Group

Provincial Health Indicators Work Group

Minutes

Monday, June 19, 1998
10:00 AM - 3:00 PM
North York Civic Centre
Committee Room #2

Present: Mary-Anne Pietrusiak, Durham Regional Health Unit (Chair)
                Terry Delmore, Halton Regional Health Department
                Julie Stratton, Perth District Health Unit
                Hyewon Lee-Han, Population Health Service, Public Health Branch
                Ian Johnson, Toronto Public Health, North York Office
                Jessie Wong, IPE Branch, Ministry of Health
                Carol Paul, IPE Branch, Ministry of Health
                Jo-Anne Peterson, Kingston, Frontenac and Lennox and Addington Health Unit
                Ruth Sanderson, Bruce-Grey-Owen Sound Health Unit

Others: Anna Goral, Toronto Public Health, North York Office (recorder)
Jill Mallon, Toronto Public Health, North York Office (recorder)

Corresponding Member: Dr. Vivek Goel, ICES

Regrets: Patrick Seliske, Waterloo Regional Community Health Department
                Vic Sahai, Northern Health Information Partnership
                Doug Manuel, Federal Field Epidemiologist
                Nam Bains, Health Information Partnership Eastern Ontario Region

1.0 Introduction

2.0 Provincial Health Status Report Update

2.1 Provincial Health Status Report Working Group

The working group met on June 16, 1998. Ian gave an update on the progress of the PHS report . The working group will be carrying out their analyses by data source. Ian discussed the issues that surround the use of each database:

Vital statistics: The group will be using the data from HELPS since it is equivalent to that in the data warehouse and is already in SPSS/PC format (1981-1994/95). There are some problems with the abortion files only paper copies are available for some years.

CIHI: Ian and Hyewon met with Vivek Goel, and he has offered to help with the CIHI analysis. Don DeBoer, also from ICES, has pledged his support to the working group.

OHS: The Ontario sharing file has arrived at IPE Branch with over 37,000 records. However, there is no documentation nor variable labels.

IRIS/RDIS: Ian and Anna are investigating RDIS database. Ian has set up a meeting with Monika Naus from Public Health Branch for early July. Record layouts for download are being developed at the North York office and it is hoped that these data will arrive in July.

Census: The data are available and analysis can start shortly. The working group will be using the Census 96 files provided by Carol Paul.

2.2 Issues

Provincial comparisons: The working group will be comparing with all of Canada rather than the Rest of Canada since the latter would require additional analysis.

PHSR May Overtake PHIWG: The PHSR Working Group is moving along much faster than the PHIWG. To deal with practical issues that may come up as a result of data analysis, Ian may ask for input from the PHIWG. If an issue comes up, Ian will send out an e-mail to PHIWG members stating the issue and recommendations. The group is asked to respond with a

3.0 Provincial Health Status Framework (Hyewon Lee-Han)

(See handout distributed by Hyewon during the meeting)

The framework was reviewed from section 7 to section 15 in order to clarify which indicators had been agreed upon in the previous PHIWG meeting. Throughout the rest of the meeting, the group revised the framework as new indicators were selected.

4.0 Moving through the Indicators

The group continued their discussion on which indicators should be included as the core set. The limitations and definitions of indicators for Reproductive Health, Injury Prevention and Chronic Disease were discussed.

4.1 Reproductive Health (Mary-Anne Pietrusiak)

(See handout distributed by Mary-Anne during the meeting)

The final list of indicators for Reproductive Health section includes:

Crude birth rate - single years from 1986 to most recent data

Age-specific fertility rates - single years from 1986 to most recent data, for women aged 15-49 by 5-year age groups

Total fertility rate - single years from 1986 to most recent data, for women aged 15-49

General fertility rate - single years from 1986 to most recent data, for women aged 15-49

Age-specific therapeutic abortion rate - single years from 1992 to most recent data, for women aged 15-49 by 5-year age groups, combining hospital and clinic data

Therapeutic abortion ratio - single years from 1992 to most recent data, for women aged 15-49 by 5-year age groups, combining hospital and clinic data

Total pregnancy rate - single years from 1992 to most recent data, for women aged 15-49 by 5-year age groups, combining hospital and clinic abortion data

Teenage pregnancy rate - single years from 1992 to most recent data, for women aged 15-19, combining hospital and clinic abortion data

Rate of multiple births - single years from 1986 to most recent data

Low birth weight rate - single years from 1986 to most recent data, includes all births. The recommendation will be that low birth weight should also be examined by: a) type of birth (i.e., single, multiple births), b) age of mother, c) gestational age, and d) very low birth weight even though these will not be core indicators.

Low birth weight for singleton births - single years from 1986 to most recent data.

Rate of neural tube defects - includes anencephalus and similar anomalies (ICD-9: 740.0-740.2), spina bifida (ICD-9: 741.0-741.0), or encephalocele (ICD-9: 742.0). Hyewon to confirm that all are available from the Canadian Congenital Anomalies Surveillance System (encephalocele was not included in last provision of data)

Stillbirth rate - single years from 1986 to most recent data

Perinatal mortality rate - single years from 1986 to most recent data

Infant mortality rate - single years from 1986 to most recent data
Neonatal mortality rate not be included as a core indicator, but will be in the PHS report.

4.2 Injury Prevention (Terry Delmore)

(See handout distributed by Terry)

Hospital morbidity due to injury - from CIHI discharge data

a) motor vehicle accidents (E810-E825)
b) cycling crashes (E826)
c) accidental falls (E880-E888)

Mortality due to Injury - single years from 1986 to most recent data

a) accidental drownings and submersions (E910)
b) motor vehicle crashes (E810-E825)
c) cycling crashes (E826)
d) accidental falls (E880-E888)

Terry will further investigate the following:

Ministry of Transportation data (collision, driver, and injured person files available, with all three being linkable) for alcohol-related motor vehicle injuries and deaths
Indicators from the OHS 96

Proportion of the population wearing seat belts will not be included as an indicator because the only data available is ad hoc observational studies from the Ministry of Transportation. Not all areas would have data.

7.0 Chronic Diseases (Jo-Anne)

(See handout distributed by Jo-Anne)

Perceived health - proportion of people 12 and over who perceive themselves to be in excellent or very good health. Because of a wording difference between OHS 90 and OHS 96, the recommendation will be not to directly compare them.

Prevalence of selected chronic health problems - prevalence of chronic bronchitis or emphysema or asthma, diabetes, and high blood pressure from OHS 96

Proportion of women aged 18 and over ever screened for cervical cancer - from OHS 96

Proportion of women aged 50-69 who had a mammogram in the past 2 years - from OHS 96

Incidence of breast cancer - age-standardized incidence rate for women, from HELPS, ICD-9: 174

Incidence of lung cancer - age-standardized incidence rates for men and women, from HELPS, ICD-9: 162

Incidence of prostate cancer - age-standardized incidence rate for men, from HELPS

Incidence of colorectal cancer - age-standardized incidence rates for men and women, from HELPS

Incidence of melanoma - age-standardized incidence rates for men and women from HELPS, ICD-9: 172?; Mandatory Health Program specifies skin cancer but does not define. Jo-Anne to check further.

The PHS report will also include oral cancer, but this indicator will not be included in the set of core indicators.
Cancer incidence rates to use population estimates from 1996 Census for denominators, standardizing to the 1991 Canadian population (to be provided in Appendix of report).
Osteoporosis, a Mandatory Health Program indicator, to be flagged as problematic since there is no source of data.

Next meetings:
July 7, 1998
10:00 AM - 3:00 PM
North York Civic Centre
Committee Room #4

July 16, 1998
10:00 AM - 3:00 PM
North York Civic Centre
Committee Room #1