Tuesday, September 8, 1997
10:00 am - 3:30 p.m.
North York Civic Centre
Committee Room #1

Present: Mary-Anne Pietrusiak, Durham Regional Health Unit (Chair)
                Patrick Seliske, Waterloo Regional Community Health Department
                Ruth Sanderson, Bruce-Grey-Owen Sound Health Unit
                Hyewon Lee-Han, Population Health Service, Public Health Branch
                Ian Johnson, Toronto Public Health, North York Office
                Julie Stratton, Perth District Health Unit
                Terry Delmore, Halton Regional Health Department
                Nam Bains, Health Information Partnership, Eastern Ontario Region
                Doug Manuel, Federal Field Epidemiologist, Ministry of Health

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

Corresponding Member: Dr. Vivek Goel, ICES

Regrets: Carol Paul, IPE Branch, Ministry of Health
                Jessie Wong, IPE Branch, Ministry of Health
                Vic Sahai, Northern Health Information Partnership
                Jo-Anne Peterson, Kingston, Frontenac- Lennox and Addington Health Unit

1.0 Provincial Heath Status Report Update (Ian Johnson)

• Standardization of geographic codes:

Problems have arisen with geographic coding and the need for consistency across all the databases being used. Due to the amalgamation of municipalities in 1998, the MOH residence codes (MOHRCs) have changed substantially this year. Therefore, we had to develop a conversion file to convert pre-1998 MOHRCs to 1998 MOHRCs. For example, there is only one code for Toronto in the 1998 code book and it is different from any of the codes used for the former 6 municipalities. Hence the working group had to convert all of the data using the old codes for these 6 municipalities to the new 1998 code.

There are some older codes that require even more detailed work. For example, even after making the 1998 changes, many of the codes for areas such as Simcoe, had to be converted. Hyewon has been working with the Ministry and has provided the conversion for these codes. There is some concern that the PHS project is behind due to the geographic coding. However, the group agreed that it was important to get these codes correctly done and that it was a major infrastructure accomplishment.

• Mortality and cancer data files have been corrected and sent out for analyses.
• Birth data files are still being updated with the standardized codes.
• Still awaiting the arrival of the OHS 96.

2.0 Final Documentation of Health Indicators List

• Introduction

The title for the health indicators list must be decided upon; a working title is Core Population Health Indicators for Ontario.

Each indicator will stand alone in the report, even if it means repeating some information and increasing the volume of the final document. Preferably, one indicator per page.

Explicit criteria used to select the indicators should be included. Some of the criteria include: availability of data at the local level, accessibility, offering health relevant interpretation and usefulness as a tool for assessing needs for planning purposes.

Stress that the Mandatory Health Programs were an anchor in preparing the report and selecting the indicators.

• The citing of HELPS data should be consistent with HELPS documentation, which will likely be revised in the second release.
• Comments on data source will stand with each indicator.
• Hyewon will explore secretarial support from the Ministry of Health for preparing the report.
• Ian to explore printing costs as part of the PHRED program.
• Distribution - Copies of the report will be distributed to Public Health Units and District Health Councils; the report should also be available as a resource to universities and graduate programs. The report will also be available on the APHEO website and potentially CD ROM.

3.0 Population (Julie Stratton)

It was that decided for each indicator, within the section labeled Data Sources, that the specific census year would not be specified unless changes in definition required that certain years not be compared.

• Dependency Ratios

Method of calculation for Aged dependency ratio is (total elderly over 65/total population aged 15 to 64)*100.

• Proportion of Immigrants

When using the 1991 Census, a note will explain differences in the way the immigrant population was determined from previous censuses. Julie will verify the changes.

• Proportion of Recent Immigrants

In Comments, add the sentence "This census only identifies landed immigrants, not children of landed immigrants born in Canada."

In Comments, state "The proportion of immigrants provides an indication of the degree to which the population is foreign born independent of the fact how long they have been in Canada."

Within Data Sources, the numerator should read, "Census 1996 onward."

For Ethnicity, Home Language and Mother Tongue indicators, the top 15 languages in Ontario will be chosen, as used in the Provincial Report.

• Ethnicity

The exact question from the census will be included with two calculations

(Number of people in a single ethnic group (single response)/total respondents (single response))*100

(Total number of people in a given ethnic group (single response)+(multiple response)/total respondents for ethnicity)*100

• Mother Tongue

The exact question from the census will be included with two calculations

(Number of people in a single mother tongue (single response)/total single respondents)*100.

English Mother Tongue: (Total number of people speaking English (single response)+(multiple response)/total respondents for mother tongue)*100, similarly for French Mother Tongue.

• Home Language

(Number of people in a single home language (single response) / total single respondents) * 100

English-speaking (Total number of people with English as their home language (single response) + (multiple response) / total respondents for home language)*100, similarly for French-speaking/Francophones.

• Proportion of Allophones

In Method of Calculation, denominator should be Total non-institutional population.

4.0 Social Environment and Health (Hyewon Lee-Han)

• Incidence of Low Income

Hyewon has purchased a special tabulation from Stats Canada for the Public Health Branch that will provide income by age group from the 1996 census, by census sub-division level.

Child Poverty and Senior Poverty indicators will stay within this section.

• Proportion of Households paying 30% or more Household income on Housing

It has been verified with Stats Canada that the numerators, Number of households with gross rent spending 30% of more of household income on shelter cost and number of owned households with total average payments spending 30% of more of household income on shelter cost are considered to be classified under family household income. The denominators Total households in rental units and Total owned households are classified as a physical private dwelling. Hyewon will verify the definition of household income.

• Cost of a Nutritious Food Basket

Indicator to be submitted by Hyewon

5.0 Environment and Health: Physical Environment (Vic Sahai)

This section to be discussed at the next PHIWG meeting

6.0 Mortality (Patrick Seliske)

• Crude Death Rate, All cause Mortality and Mortality by ICD Chapter

Method of calculation: denominator should be Total Population instead of Total non-institutional population.

Appendix should include examples of direct and indirect methods of standardization. Although it is difficult to recommend grouping of years, a suggested guideline is that small numbers should be grouped around census years with confidence intervals included (i.e for the 1991 census, group years 1989-1993).

Potential Years of Life Lost (PYLL) calculations should also be included in an appendix.