Calculated Indicators

For the following indicators, pre-calculated measures for Chatham-Kent Public Health and Ontario were extracted from Public Health Ontario’s Snapshots online tool (Ontario Agency for Health Protection and Promotion (Public Health Ontario). Snapshots. Toronto, ON: Queen’s Printer for Ontario; c2019 [updated 2019 Apr 15; cited 2019 June 30].

Chronic Disease

Cancer
    Cardiovascular Disease, Diabetes, Respiratory Disease
    Self-reported Health Conditions

    Mental Health

    Intentional Self-Harm
    Self-Reported Mental Health Conditions

    Behavioural Risk Factors

    Healthy Weights
    Nutrition
    Physical Activity

    Substance Use

    Alcohol Use
    Smoking

    Injury Prevention

    All Unintentional Injuries, Falls, Motor Vehicle Collisions
    Traumatic Brain Injuries

    General Health

    Potentially Avoidable Mortality

    Reproductive Health

    Healthy Pregnancy
    Birth Outcomes

    Description of Data Sources

    This section describes the sources of data used in public health analytics to calculate population health indicators and report on health status at the local and provincial level.

    Better Outcomes Registry & Network (BORN) Information System

    The Better Outcomes Registry & Network (BORN) is Ontario’s prescribed maternal, newborn and child registry that collects, interprets, shares and rigorously protects high-quality data essential to making Ontario the safest place in the world to have a baby. It is a timely maternal-child registry, providing a longitudinal perspective of each birth, from pregnancy, labour and birth, to postnatal visits and care. The BORN Information System (BIS) is a database established to collect, manage, protect and share critical data about every pregnancy, birth and child in Ontario to support the measurement of maternal-child health status and outcomes. For more information about the BIS, visit the BORN website at: https://www.bornontario.ca/en/data/born-information-system-bis.aspx

    Canadian Community Health Survey (CCHS)

    The Canadian Community Health Survey (CCHS) is a cross-sectional (point-in-time) survey conducted by Statistics Canada providing estimates of factors related to health status, health care utilization and health determinants for the Canadian population. The survey contains questions on a wide range of health topics, including: physical activity, height and weight, smoking, exposure to second-hand smoke, alcohol consumption, general health, chronic health conditions, injuries, use of health care services and related socio-demographic information. The target population of the CCHS includes household residents in all provinces and territories, with the exclusion of populations on Indian Reserves, Canadian Forces Bases, and some remote areas. For more information about the CCHS, visit Statistics Canada’s website at: https://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&SDDS=3226

    The 2015 release introduced major changes in the design and collection of the CCHS. With changes made to the questionnaire, sampling frame, the weighting, and guidelines for data release, no comparisons will be made to previous CCHS releases for any variables. For some pages trends may still be presenting historical data from 2003 to 2014; however, these will not be directly comparable to data from 2015 onward, and new trends will replace any historical information when available.

    Census and National Household Survey (NHS)

    Most information presented in Social Determinants of Health is based on the 2016 Census of Canada. This data is collected by Statistics Canada every five years. The census of the population provides a reliable source for describing the population and dwelling counts not only for Canada but also for each province and territory, and for cities or districts within cities. The census also provides information about Canada’s demographic, social and economic characteristics. The census enumerates (counts) everyone living in Canada including: Canadian citizens, landed immigrants and non-permanent residents and members of their families living with them in Canada (non-permanent residents are persons who hold a Ministerial permit, student authorization or employment authorization, or who claim refugee status). By law each household must provide the information requested in the census, and by the same law Statistics Canada must protect the confidentiality of the personal information provided by respondents.

    With the exception of 2011, Statistics Canada collects detailed social and economic data from a sample of Canadian households using a mandatory long-form questionnaire. In 2011, most information collected by the mandatory long-form census questionnaire (immigration and ethnocultural diversity; aboriginal peoples; education and labour; mobility and migration; language of work; income and housing) was collected as part of a new voluntary National Household Survey (NHS). Due to the lack of comparability to other census years and high global non-response, 2011 has been excluded from any trending data on these topic areas.

    In 2016, the government re-instated the mandatory long-form questionnaire (given to 25% of households while the remaining 75% received the short-form census questionnaire). To improve accuracy of income data, Statistics Canada gathered income information directly from the Canadian Revenue Agency’s tax and benefits records, replacing income-related questions from previous census years. For more information about 2016 Census data products or reference materials, visit Statistics Canada’s website at http://www12.statcan.gc.ca/census-recensement/2016/dp-pd/index-eng.cfm.

    As part of the Erie St. Clair Data Consortium, CK Public Health has access to custom tabulations and datasets purchased from Statistics Canada through the national Community Data Program (CDP). Many of these data products include breakdown to smaller geographic levels and different variable combinations not publicly available. For more information about the Community Data Program, visit the CDP website at https://communitydata.ca/.

    Discharge Abstract Database (DAD)

    The Discharge Abstract Database (DAD) captures administrative, clinical and demographic information on hospital discharges. Hospitalization data are collected from each patient’s chart at the time of discharge from hospital and are recorded on an abstract provided by Canadian Institute for Health Information (CIHI). One abstract is completed for each separation from the hospital (including deaths, sign-outs and transfers). Data are collected based on location of hospital but are generally analyzed by the residence of the patient for health status purposes. The data source contains discharge records, not admissions and the data are reported for completed cases only (not on cases still being treated). The data represent the number of discharges, not the number of people. Public health has access to and extracts DAD data via IntelliHealth, a knowledge repository that contains clinical and administrative data collected from various sectors of the Ontario healthcare system.

    Since a person may not be hospitalized, or may be hospitalized several times for the same disease or injury event, or discharged from more than one hospital (when transferred) for the same injury event, hospitalization data provide only a crude measure of the prevalence of a cause. Data are influenced by factors such as availability and accessibility of care, and administrative policies and procedures which may influence comparisons between areas and over time.

    Integrated Public Health Information System (iPHIS)

    Infectious disease data are extracted from the Integrated Public Health Information System (iPHIS). The Health Protection and Promotion Act requires that each public health unit in Ontario collect information about people with reportable diseases in their jurisdiction and report it to the Ministry of Health. iPHIS is the database used by public health units for reporting purposes, and supports local, provincial and national infectious disease surveillance. For Ontario and Chatham-Kent, overall cases counts reported through iPHIS were extracted from Infectious Disease (ID) Query, a dynamic data tool, provided by Public Health Ontario (see: https://www.publichealthontario.ca/en/data-and-analysis/infectious-disease/id-query).

    iPHIS is a dynamic disease reporting system which allows ongoing updates to data previously entered. As a result, data extracted from iPHIS represent a snapshot at the time of extraction and may differ from previous or subsequent results. Since the data represent only those cases reported to public health and recorded in iPHIS, all counts will be subject to varying degrees of underreporting due to a variety of factors, such as disease awareness, medical care seeking behaviours, changes in laboratory testing, reporting behaviours, clinical practice, and severity of illness. As such, the information presented likely underestimates the true number of case counts and rates of infectious disease in Chatham-Kent and Ontario.

    National Ambulatory Care Reporting System (NACRS)

    The National Ambulatory Care Reporting System (NACRS) developed by the Canadian Institute for Health Information (CIHI) and the Ministry of Health holds the Ambulatory Visit Database, capturing administrative, clinical and demographic information on visits to hospital ambulatory services (emergency room/departments as well as other hospital-based outpatient clinics). Data are collected based on location of ambulatory service but can also be analyzed by patient residence. The data represent the number of visits, not the number of people. Public health has access to and extracts NACRS data via IntelliHealth, a knowledge repository that contains clinical and administrative data collected from various sectors of the Ontario healthcare system.

    Since a person may seek emergency treatment several times for the same disease or injury event, data provide only a crude measure of the prevalence of a cause. Data are influenced by factors such as availability and accessibility of care, and administrative policies and procedures which may influence comparisons between areas and over time.

    Ontario Cancer Registry (OCR)

    The Ontario Cancer Registry, managed by Cancer Care Ontario (CCO), is the provincial database of information for all Ontario residents who have been newly diagnosed with malignant cancer (incidence) or who have died of cancer (mortality). Data are collected from hospitals, regional cancer centres, pathology reports and death certificates, and cover the entire province of Ontario. Cancer diagnoses are classified according to the International Classification of Diseases for Oncology, 3rd edition (ICDO-3). OCR incidence and mortality data is made available to public health via CCO’s SEER*Stat package.

    Beginning in 2014, the OCR adopted the National Cancer Institute (NCI) SEER standards for counting multiple primaries for cancer cases diagnosed in 2010 and beyond. This standard is more liberal than the previously used case counting rules from the modified version of the International Association of Cancer Registries (IACR). Cancer incidence data presented now only includes years of data using the new NCI SEER definition (2010 onwards). This change in rule does not apply to the cancer mortality data and further trend data prior to 2010 is presented where possible.

    Oral Health Information Support System (OHISS)

    The Oral Health Information Support System (OHISS) is the database used by public health units to support mandated oral health screening and surveillance of children in schools, as well as claims administration for dental programs. At a minimum, oral health surveillance is conducted every year on JK, SK, and grade 2 children in publicly funded schools, with additional surveillance implemented according to a defined protocol. Children who are absent from school on the day of screening, schooled at home or who refuse are excluded. The objectives of screening are to determine the prevalence of dental disease and the need for preventive and treatment services and the information collected supports program planning and evaluation, and identification of at-risk areas or populations.

    Ontario Mental Health Reporting System (OMHRS)

    The Ontario Mental Health Reporting System (OMHRS) contains demographic, administrative and clinical data for all adults in designated inpatient mental beds in Ontario, including general hospitals with designated adult mental health beds, specialty psychiatric hospitals and provincial psychiatric hospitals. Records in OMHRS are updated at admission, discharge, for significant changes in health status and quarterly. OMHRS contains a broad array of information from scores and scales for assessment of patients’ mental health and status. Reported mental health data from OMHRS should be complemented by child and youth mental health bed access from DAD and mental-health related emergency department visits from NACRS. Public health has access to and extracts OMHRS data via IntelliHealth, a knowledge repository that contains clinical and administrative data collected from various sectors of the Ontario healthcare system.

    Panorama

    Panorama is a database designed to provide high quality, timely health surveillance data across Ontario. It is currently used by public health units to capture data related to immunizations and vaccine inventory movement. Panorama functionality includes tracking student immunizations, exemptions and compliance with the Immunization of School Pupils Act as well as immunizations provided by public health unit staff at schools and clinics. Panorama is also used for accountability and quality assurance for vaccine inventory and storage. Panorama data is used to determine coverage rates and to identify students eligible for suspension.

    Population Estimates & Projections

    Population estimates and projections are required to establish the denominator for all rate calculations.

    Population estimates are produced by the Demography Division of Statistics Canada for Census Divisions (CDs) and Census Subdivisions (CSDs). CDs and CSDs are defined by Statistics Canada and are subject to change with each Census. Estimates are based on the 1986, 1991, 1996, 2001, 2006, 2011 and 2016 Censuses and are adjusted for net under coverage. The ministry converts the population estimates to be released at the County (similar to CD) and Municipal (similar to CSD) level.

    Population projections are produced by the Ontario Ministry of Finance (MOF) at the CD (County) and Public Health Unit (PHU) level and estimate the projected population of Ontario as of July 1st of each year by sex, and single year of age up to 90+. MOF uses the most recent population estimates released by Statistics Canada as the basis for its projections. Standard demographic methodology is used to calculate these projections where assumptions about the components of growth based on recent trends are modeled.

    Public health has access to and extracts population estimates and projections via IntelliHealth, a knowledge repository that contains clinical and administrative data collected from various sectors of the Ontario healthcare system.

    Vital Statistics

    The Office of the Registrar General (ORG) obtains information about mortality from death certificates which are completed by physicians. All deaths within Ontario are registered in the office of the division registrar within which the death occurs. The ORG provides death data to Statistics Canada for national reporting. Data are analyzed by the residence of the deceased, not where the death occurred. Records for Ontario residents who die outside of the province are not available and are therefore excluded. Otherwise, due to legal reporting requirements, registration of deaths is considered to be virtually complete. Public health has access to and extracts vital statistics mortality data via IntelliHealth, a knowledge repository that contains clinical and administrative data collected from various sectors of the Ontario healthcare system.

    The cause of death reported is the occurrence that starts the sequence of events leading to death. Consequently, there may be some uncertainty in classifying deaths when there are multiple causes. Determining true cause of death may be influenced by the social or legal conditions surrounding the death and by the level of medical investigation, e.g. AIDS and suicide.