Crude Birth Rate Core Indicator

Total number of live births per 1,000 population

Report an Issue Appendices

Method of Calculation

Crude Birth Rate:

total number of live births

1,000

total population

1,000

Recommended Subset Analysis Categories

Geographic areas of patient residence

Vital Statistics, Hospitalization, Population Estimates data: Ontario, public health unit, municipality, and smaller areas of geography based on aggregated postal code.
BORN data: Ontario, public health unit

Data Sources

Births Numerator: Option 1	Births Numerator: Option 2	Births Numerator: Option 3
Vital Statistics Live Birth Data Vital Statistics Stillbirth 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 Vital Statistics Live Birth Data [years], Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO, Date Extracted: [date].	Hospitalization Data Deliveries Original Source: Discharge Abstract Database (DAD), Canadian Institute for Health Information (CIHI) Distributed by: Ontario Ministry of Health and Long-Term Care (MOHLTC): IntelliHEALTH Ontario (IntelliHEALTH) Suggested Citation: Inpatient Discharges [years], Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO, Date Extracted: [date].	BORN Information System Live Births and Stillbirths Original Source: Better Outcomes Registry Network (BORN) Ontario Distributed by: Better Outcomes Registry Network (BORN) Ontario Suggested Citation: BORN Information System [years], Date Extracted: [date].

Denominator
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].

Denominator

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].

Analysis Checklist

Checklist

Exclude stillbirths.
The IntelliHEALTH licensing agreement does not require suppression of small cells, but caution should be used when reporting at a level that could identify individuals, (e.g. reporting at the postal code level by age and sex). Please note that privacy policies may vary by organization. Prior to releasing data, ensure adherence to the privacy policy of your organization.
Aggregation (e.g. combining years, age groups, categories) should also be considered when small numbers result in unstable rates.
Exclude births to mothers that reside out-of-province. Births to Ontario mothers that occur out-of-province are not included in the data.
Include all births, not just those for mothers aged 15-49 years.
Include live births with birth weight <500 g. For more information, refer to the Reproductive Health Core Indicators Documentation Report.
HELPS Data: Historically, PHUs obtained data for live births, stillbirths, therapeutic abortions, congenital anomalies, and deaths from the Ministry of Health through HELPS (the HEalthPlanning System). Although these data are no longer commonly used, some PHUs may still be accessing these data files. Information about the data can be found in the HELPS Data Source resource.

Vital Statistics

In IntelliHEALTH under Standard Reports, folder "01 Vital Stats", open "Birth Summary V2". This report summarizes information on births by age group and mother's residence (Ontario, PHU and LHIN). IntelliHEALTH also provides population data (total population, female population aged 15-49 years) for the calculation of rates. Refer to the Notes tab for information. Open tab "1.2 Births x PHU x Type x Age" to obtain public health unit data and tab "1.1 ON Births x Type x Age" to obtain Ontario data. The report can be modified, renamed and saved under your own folder or can be exported into Excel.
The predefined report provides live birth and population data for the calendar years from 2000 to the most recent available. Table options can be edited to change the number of years of data presented. For years that are not displayed modify the calendar year filter to include the required years.
The data contained in the Birth Summary V2 report includes births to Ontario mothers in Ontario only.
The notes section of the report provides important data caveats and background information on data sources and should be consulted.

Hospitalization

In IntelliHEALTH under Standard Reports, folder ‘05 Inpatient Discharges' folder, use the "Hospital Births - newborns, stillbirths" predefined report. This report can be modified, renamed and saved under your own folder. The report provides hospital birth counts (Admit Entry Type = N for Newborn or S for Stillbirth) for Ontario and by PHU, including only Ontario residents (Patient Province equal to ON).
The calendar year for date of admission is used (Admit CYear) rather than date of discharge since the date of admission will be the same as the birthdate for newborns.
Select the appropriate calendar years, PHU, and "Newborn - Born Alive in Reporting Institution" (i.e., exclude stillborn infants) as prompted from the pre-defined filters.
Even though counts are grouped by calendar year of admission, it is the actual number of discharges that are counted.
The notes section of the report provides important data caveats and background information on data sources and should be consulted.

BORN

Public Health Units access the BORN data through public health reports or data cubes.
Refer to the BORN Information System resource for more information about the data.

Indicator Comments

General Comments

Crude birth rate is influenced by the age structure of the population - it will be higher in populations with more women of childbearing age (1).
Crude birth rate may be affected by foreign immigrant settling patterns within Ontario, the pattern of migration into and out of Ontario from other provinces as well as migration between jurisdictions within Ontario (2).
Total number of births, migration information as well as age structure of the population may be helpful when interpreting crude birth rates.

Definitions

Live birth – the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of the pregnancy, which, after such separation, breathes or shows any other evidence of life such as heartbeat, umbilical cord pulsation, or definite movement of voluntary muscles, whether the umbilical cord has been cut or the placenta is attached. A live birth is not necessarily a viable birth.

References

Cited References

Adams MM, Alexander GR, Kirby RS. Perinatal Epidemiology for Public Health Practice. New York: Springer, 2009.

Statistics Canada 2006. The Daily: Births 2004. Statistics Canada Catalogue no. 11-001-XIE. Version updated July 2006. Ottawa. Available from: http://www.statcan.gc.ca/daily-quotidien/060731/dq060731b-eng.htm. (accessed October 6, 2011).

Other References

Central East Health Information Partnership. Under reporting of live births in Ontario: 1991-1997. Toronto: CEHIP, 2001.

Joseph KS, Kramer MS. Recent trends in Canadian infant mortality rates: the effect of changes in registration of live newborns weighing less than 500g. Can Med Assoc J 1996; 155:1047-52.

Acknowledgements

Lead Authors

Amira Ali, Ottawa Public Health

Deshayne Fell, BORN Ontario

Carol Paul, Ministry of Health and Long Term Care

Mary-Anne Pietrusiak, Durham Region Health Department

Core Indicator Reviewers

Deborah Carr, Oxford County Health Unit

Sherri Deamond, Durham Region Health Department (Core Indicators Work Group member)

Suzanne Fegan, Kingston Frontenac Lennox and Addington Public Health (Core Indicators Work Group member)

Carmen Yue, Toronto Public Health

Contributing Authors

Reproductive Health Sub-group

External Reviewers

Name, Organization (at time of contribution)

Revision History

Date	Review Type	Author	Changes	PDF
March 2010	Formal Review	Reproductive Health Sub-Group	Replaced Mandatory Health Programs section with updated Ontario Public Health Standards outcomes.
March 29, 2012 - January 16, 2013	Formal Review	Built Environment Subgroup	Three data sources cited with analysis check-list for each Include all live births, including those with birth weight less than 500g.
October 11, 2019	Website Update: No Content Review	Sherri Deamond, on behalf of CIWG	No changes made to indicator definitions. Migrated to new website structure and format, including: 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" section 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.

Crude Birth Rate (DRAFT)