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of public health epidemiology in Ontario

All-Cause Mortality Core Indicator

Number of deaths from all causes.

  • The crude mortality rate is the total number of deaths in a given year relative to the total population for that year (per 100,000).
  • Age-specific mortality rate is the number of deaths in a given age group per 100,000 population in that age group over a specified period of time. 
  • Age-standardized mortality rate (SRATE): the number of deaths that would occur for a given population if that population had the same age distribution as the 1991 Canadian population (per 100,000).
  • Standardized mortality ratio (SMR): the ratio of observed deaths to the number expected if the population had the same age-specific death rates as Ontario.
Report an IssueAppendices

Related OPHS Topics

None Identified

 

Method of Calculation

Crude Mortality Rate
Total number of deaths
100,000
Total population
100,000

 

Age-specific Mortality Rates
Total number of deaths in an age group
100,000
Total population in that age group

Age groups outlined in Recommended Subset Analysis Categories section below
100,000

 

Age-standardized Rate (SRATE)
Sum of (age-specific rate x 
standard population in that age group),
 for all age groups
100,000
Total standard population

See Standardization of Rates Resource for more information on direct standardization
100,000

 
 
Standardized Mortality Ratio (SMR)
Total number of deaths in the population
100
Sum of (Ontario age-specific rate x population in that age group), for all age groups

See Standardization of Rates Resource for more information on indirect standardization
100

Recommended Subset Analysis Categories

Age Groups
      IntelliHEALTH (CD):
  • <1 - 19 years
  • 20 - 44 years
  • 45-64 years
  • 65-74 years
  • 75+

    •   IntelliHEALTH (inf,5yr):
  • <1 years
  • 1-4 years
  • then 5 year age groups...
  • 90+ years
Sex
  • Male
  • Female
ICD Chapter
 
Leading Cause Groups for Mortality
  • (Becker, APHEO)1
Geographic areas of residence of deceased
  • Local Health Integration Network (LHIN)
  • public health unit
  • county
  • municipality
  • forward sortation area (1996 onward) and postal code (1996 onward)

Data Sources

Numerator Denominator
Vital Statistics Mortality Data

Original Source:

Vital Statistics, Office of Registrar General (ORG), Service Ontario

Distributed by:

Ontario Ministry of Health and Long-Term Care (MOHLTC): IntelliHEALTH Ontario (IntelliHEALTH)

Suggested Citation:

Ontario Mortality Data [years], Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO, Date Extracted: [date].
Population Estimates

Original Source:

Statistics Canada

Distributed by:

Ontario Ministry of Health and Long-Term Care (MOHLTC): IntelliHEALTH ONTARIO (IntelliHEALTH)

Suggested Citation:

Population Estimates [years], Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO, Date Extracted: [date].
ICD Code(s)


Please refer to "Leading Cause Groups for Mortality Tabulation."




 
 

Analysis Checklist  

General Checklist
  • Consider aggregation of data values and/or cell suppression when dealing with small numbers to avoid risk of confidentiality breach. A new resource is currently under development to provide more detailed information on this issue.
  • If small numbers are an issue multiple years of data may be summed in the numerator to create a more stable rate. In this case, be sure to sum an equal number of years of population data for the denominator.

For IntelliHEALTH
  • Use Deaths data source from the Vital Statistics folder in Intellihealth, select # ON Deaths measure (number of deaths for Ontario residents who died in Ontario). Note: deaths for Ontario residents who died outside the province are not captured in Vital Statistics.
  • Select appropriate geography from Deceased Information folder (public health unit or LHIN). Include other items, depending on your requirements (ICD10 Chapter, Lead Cause Group, age group, sex, etc.).
  • For population estimates, use the Population Estimates County PHU Municipality or the Population Estimates and Projections LHIN data source in the Populations folder in Intellihealth; select the # people measure and the appropriate geography (PHU or LHIN), age group(s), and sex. 
  • In the mortality data set, External Cause of Injury Codes (ICD10 V-Y; ICD9 E-Codes), and not Injury & Poisoning Codes (ICD10 S-T codes; ICD9 800-999 codes) are used in assigning primary cause of death.  However for the years 1986-1999, the Injury and Poisoning ICD9 codes are also available and can be accessed from the "Nature of Injury" folder.  The Injury and Poisoning ICD10 codes (S-T) are not available for the years that ICD10 codes are used (beginning in 2000).

Indicator Comments

General Comments
  • To best understand mortality or disease trends in a population, it is important to determine crude rates, age-specific rates and age-standardized rates (SRATES) and/or ratios (SMRs, SIRs). Although the crude death (or disease) rate depicts the "true" picture of death/disease in a community, it is greatly influenced by the age structure of the population: an older population would likely have a higher crude death rate. Age-specific rates can best describe the "true" death/disease pattern within particular age groups of a community, and allow for comparison of age groups across populations that have different age structures.
  • Since many age-specific rates are cumbersome to present, age standardized rates have the advantage of providing a single summary number that allows different populations to be compared; however, they present an "artificial" picture of the death /disease pattern in a community. For more information about standardization, refer to the Resources section: Standardization of Rates.
  • Mortality reflects the upper limit of the disease severity continuum. 
  • Analysis by Leading Cause Group provides a more specific breakdown (e.g. ischaemic heart disease and stroke vs. all cardiovascular disease) within (and sometimes between) chapters.  

References

Cited References
  1. Becker R, Silvi J, Ma Fat D, L'Hours J, Laurenti R. A method for deriving leading causes of death. WHO Bulletin April 2006; 84(4): 297-303, Appendices A-D. Available online at: http://www.who.int/bulletin/volumes/84/4/297.pdf (Accessed March, 2009)

General References
  • Frank J. Causes of death: how the sexes differ. Canadian Social Trends 1996; 41:4-10.
  • Gilmour H, Gentleman JF. Mortality in metropolitan areas. Health Reports 1999; 11(1):9-19.  
  • Nault F. Narrowing mortality gaps, 1978 to 1995. Health Reports 1997;9(1):35-42. 
  • Wilkins K, Wysocki M, Morin C, Wood P. Multiple causes of death. Health Reports 1997; 9(2):19-29.
  • Statistics Canada. Deaths - Shifting Trends. Health Reports 2001; 12(3):41-46. Available at: http://www.statcan.gc.ca/studies-etudes/82-003/archive/2001/5628-eng.pdf.

Revision History

 This Core Indicator Product webpage is maintained by the Health Outcomes Subgroup.
Date Review Type Author Changes PDF
June 19, 2009  Formal Review Leading Causes subgroup 
  • For ICD 10 codes, a set of groups (66) below the level of ICD10 Chapter was added as recommended by CIWG (Lead Cause Sub-group).
  • Indicator was updated in alignment with the new Guide for Creating and Editing Core Indicator pages.
  
November 30, 2010 Update: No Review of Content Sherri Deamond 
  • Added reference and link to Leading Causes of Death in Canada, 2007.
  
July 2, 2013 Ad Hoc Review Natalie Greenidge, on behalf of the CIWG     
  • Updated indicator comments related to standardization of rates 
December 5, 2019 Website Update: No Review of Content James Lane and Caitlyn Paget, on behalf of the CIWG
    No changes made to indicator definitions or documentation.
    Migrated to new website structure and format, including:
  • Added descriptive sub-headings to the Analysis Checklist and Indicator Comments sections.  
  • Added Revision History table.
  • Added PDF copy of previous version for reference.  
  • Reorganized content to provide high-level information at a glance, and move in-depth analytic information into dedicated sections for users to access when needed.
  • Renamed "Basic Categories" to "Recommended Subset Analysis Categories"; "Definitions" renamed to "Glossary".
  • Replaced both "Cross-References to Other Indicators" and "OPHS" sections with "Related OPHS Topics" to crosslink with relevant Core Indicators webpages including OPHS program standard(s) and associated indicator(s).
  • Added descriptive sub-headings to the Analysis Checklist and Indicator Comments sections.
  • Removed "Corresponding Health Indicator(s) from Statistics Canada and CIHI" and "from Other Sources" sections.
  • Updated Revision History table, and added PDF copy of previous version for reference.
APHEO's Core Indicators Project has been developed through collaboration across the field of public health in Ontario, 
to provide standardized methodology for population health assessment, to measure complex concepts of individual and community health.
Please contact core.indicators@apheo.ca for further information.  
   
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