INTRODUCTION In 1986, the Federal/Provincial/Territorial Advisory Committee on Institutional and Medical Services Sub-committee on Health Information created a working group to identify a set of health indicators intended for senior officials at the provincial and federal levels. The group gave the responsibility for creating and distributing the database to the Health Statistics Division (HSD). A list of approximately 125 indicators were identified and analyzed leading to the creation of the 56 indicators contained in the Health Indicators database. The Health Indicators diskette product contains the entire database of 56 indicators and the software to access the information on a personal computer. The database can be accessed on the mainframe computer by using Statistics Canada's CANSIM cross-classified database. The Health Statistics Division is pleased to present the 1997 edition of a comprehensive set of health indicators containing the latest information available from a wide variety of national surveys and administrative databases, making this package a versatile and powerful tool for the analysis of Canadian health issues. The indicators are grouped into four categories that reflect one objective of modern governments and health professionals; that is, to provide for a long and active life for the largest possible number of persons: Determinants: The indicators under this category cover the wide range of topics which influence health status, namely: demography, environment, socio-economic conditions, lifestyle of individuals and the many behavioral elements of risks to the health of the individual. Health Status: These indicators measure the levels of health and well-being, perceived or diagnosed, in the population. Resources: The indicators under this category reflect the multiple array of means developed and allocated to restore and maintain the health of individuals. The resources are of four types: Human, Physical, Financial, and Organizational. Utilization: These indicators cover the extent of health resources and services used by the population to influence positively their health. As this indicator program evolves over time, it should prove useful in establishing health goals for the population and offer objective measures of their success. Health Statistics Division would like to take this opportunity to thank the provincial/territorial health administrations, Health Canada and other government agencies for their cooperation and support in this endeavour. HIGHLIGHTS 82-221-XDE HEALTH INDICATORS What's new with the product * Thirty of fifty six indicators updated for this edition. * More text and notes have been added for the user's convenience. Highlights, the list of indicators and the outline of the data base have all been included. * Data for some tables contain suppressions for values less than three in line with the policy on confidentiality and sensitive information. * Education indicators now contain 1994/95 data for university and college enrollments. Community College Graduates are for 1993/94. * The 1994/95 National Population Health Survey has again been used for the indicators on job satisfaction and perceived health status. * Health Expenditures indicators have been completely revised to include the time series from 1975 to 1994. * Total fertility rate, age specific fertility, age standardized mortality and other indicators from the vital statistics database have all been updated to 1994. * Notifiable diseases and sexually transmitted diseases are for the year 1995. What's new with the Data * Approved beds in institutions shows the impact of health care reform in the reduction of hospital beds and the increase in residential care facilities beds. * Age standardized mortality shows cancer leading heart disease, 188 versus 184 per 100,000 population. * Hospitalizations are continuing to decrease reflecting the ongoing changes in the way care is delivered. * Enrollments in the caring professions in community colleges are 35, 137 for 1994/95, while graduates are 10, 488 (93/94). The bulk of enrollments (62%) and graduates (58.7 %)are in nursing. * Full time enrollments in universities in 1994/95 are 100, 947 and graduates are 23, 157. Medicine and nursing are by far the most popular programs. * Health Expenditures decreased to 9.7 % of the Gross Domestic Product in 1994, from 10.1 per cent in 1993. Canada is allocating a similar amount to health as France (9.8%) and Switzerland (9.9%) * Public health expenditures account for 66.3% of national health expenditures while private sector expenditures account for 28.2 %. * Public health expenditures are dominated by hospital and physician expenditures - 46.5% and 19.6 % of the public sector total. ACKNOWLEDGEMENTS The original set of indicators was outlined by the members of two working groups reporting to the Federal/Provincial/Territorial Advisory Committee on Institutional and Medical Services through the former Sub-Committee on Health Information: Working Group on Key Indicators Working Group on Health Status Information L. de G. Fournier, Chairman, HSD Nick Haazen, Chairman, B.C. Jerry Vila, MOH, Ontario Lily Eastridge, MOH, Ontario Michel Blondeau, MSSS, Québec Vivien Lai, HMC, Alberta Michel Trahan, HWC Owen Adams, HSD Claude Strohmenger, HWC Claude Strohmenger, HWC Owen Adams, HSD Michel Trahan, HWC The overall responsibility for planning and coordinating the content of Health Indicators rested with the Product Development Section of Health Statistics Division. The concept and design of the original data dissemination formats and database was accomplished by John Menic. The revisions and updates were coordinated by Deirdre Gillieson. Numerous staff members throughout Statistics Canada contributed towards the preparation of the tables and graphs: Health Canada Communicable Diseases: Mary Jane Garnett Statistics Canada Labour: Horst Stiebert Labour Force Survey: Marc Levesque Education: Jim Donnelly Household Surveys: Edith Lamoureux HSD: Deirdre Gillieson Dissemination Division: Patrick Conway GarryMacDonald Francine Ladouceur Michel Gunville Michael Gagnon To all these persons, and many others, we at Health Statistics Division say thank you. Your cooperation and assistance are greatly appreciated. LIST OF TABLES Table Health Determinants Number 105 Population Distribution 106 Job Satisfaction 104 Total Fertility Rate 107 Age-specific Fertility Rate 109 Livebirths 108 Teenage Abortions and Births 118 Smokers 119 Cigarettes Smoked per Day 120 Drinkers 124 Drinks per Week 121 Persons with High Blood Pressure 133 Elderly Individuals and Income 135 Elderly Below Low Income Cutoffs 134 Time-loss Injuries 207 Exercise Frequency 208 PAP Smears 209 Seatbelt Use 210 Measures to Improve Health 211 Body Mass Index 212 Satisfaction with Weight 213 Breast Examination 214 Breakfast Food Consumption 138 Labour Force 139 Stress 140 Bradburn Affect Balance Scale 215 Drinking and Driving 216 Lone Parent Families 217 Age at First Sexual Intercourse Table Health Status Number 115 Life Expectancy 113 Potential Years of Life Lost 114 Age standardized mortality 110 Infant and Perinatal Mortality 112 Perceived Health Status 111 Suicides 128 Hospital Separations by Cause 103 Ambulatory Care 122 Disability 123 Disability Due to Motor Vehicle Accidents 127 Motor Vehicle Accident Morbidity 132 Sexually Transmitted Diseases 136 Notifiable Diseases 137 Disability by living arrangement 141 Stillbirths by Parity Table Health Resources Number 201 Expenditures by Sector 202 Expenditures by Category 205 Health Personnel 131 University Health Discipline Enrolment 129 University Health Discipline Graduates 126 Community College Enrolment and Graduates 101 Institutional Beds Table Health Resource Utilization Number 116 Institutional Bed Occupancy Rate 117 Institutional Patient-days 102 Institutional Separations 125 Hospital Patient-days (Age and Sex) 130 Average Stay in Hospital 206 Payments for Medical Services HEALTH INDICATORS PROGRAM - OUTLINE OF DATABASE Health Determinants ============================================================================= Table |Type of Indicator |Per. |Specific Data |Disaggregations for Number | | |Series (Dimensions)|Each Data Series | | |(Quantifiers) |(Dimensions) ============================================================================= 00060105 Population 1961 1. Population 1. Canada, provinces distribution to 2. Percentage and territories (13) 1996 distribution 2. Age groups (21) 3. Sex (3) ----------------------------------------------------------------------------- 00060106 Job satisfaction 1985 1. People 1. Canada and 1991 satisfied with provinces (11) their job 2. Age groups (5) 2. Population 3. Sex (3) 3. Percentage of people satisfied with their job ----------------------------------------------------------------------------- 00060104 Total fertility 1961 1. Total fertility 1. Canada, provinces rate to rate and territories (13) 1994 ----------------------------------------------------------------------------- 00060107 Age-specific 1961 1. Number of 1. Canada, provinces fertility rate to livebirths and territories (13) 1994 2. Age-specific 2. Age group of fertility rate mother (9) 3. Order of birth (7) ----------------------------------------------------------------------------- 00060109 Livebirths 1961 1. Number of 1. Canada, provinces to livebirths and territories (13) 1994 2. Age group of mother (10) 3. Weight of child (4) 4. Period of gestation (11) ----------------------------------------------------------------------------- 00060108 Teenage abortions 1974 1. Therapeutic 1. Canada, provinces and births to abortions and territories (13) 1994 2. Number of 2. Ages 13 through 19 births (7) ----------------------------------------------------------------------------- 00060118 Number of smokers 1985 1. Number of 1. Canada and the 1989 smokers provinces (11) 1991 2. Age groups (5) 1994 3. Level of education (4) 4. Sex (3) ============================================================================= Table |Type of Indicator |Per. |Specific Data |Disaggregations for Number | | |Series (Dimensions)|Each Data Series | | |(Quantifiers) |(Dimensions) ============================================================================= 00060119 Consumption of 1985 1. Number of 1. Canada and the cigarettes 1989 smokers provinces (11) 1991 2. Age groups (5) 1994 3. Average number of cigarettes per day (5) 4. Sex (3) ----------------------------------------------------------------------------- 00060120 Number of 1985 1. Number of 1. Canada and the drinkers 1989 drinkers provinces (11) 1991 2. Age groups (5) 1994 3. Level of education (4) 4. Sex (3) ----------------------------------------------------------------------------- 00060121 Population with 1985 1. Number of 1. Canada and the high blood 1991 people with high provinces (11) pressure 1994 blood pressure 2. Age groups (5) 2. Population aged 3. Sex (3) 15 and over 3. Percent of population with high blood pressure ----------------------------------------------------------------------------- 00060124 Consumption of 1985 1. Number of 1. Canada and the alcohol 1989 drinkers provinces (11) 1991 2. Age groups (5) 1994 3. Number of drinks per week (5) 4. Sex (3) ----------------------------------------------------------------------------- 00060133 Elderly 1973 1. Number of 1. Canada and the population by to unattached elderly provinces (11) income group 1991 individuals 2. Age groups (4) 1993 3. Income group (8) (biennial) 4. Sex (3) ----------------------------------------------------------------------------- 00060134 Time-loss work 1982 1. Number of 1. Canada, provinces injuries to time-loss work and territories (13) 1993 injuries 2. Age groups (5) 3. Industry (20) 4. Sex (4) ============================================================================= Table |Type of Indicator |Per. |Specific Data |Disaggregations for Number | | |Series (Dimensions)|Each Data Series | | |(Quantifiers) |(Dimensions) ============================================================================= 00060135 Elderly 1973 1. Estimated 1. Canada and the population below to number of elderly provinces (11) income cutoffs 1993 individuals 2. Age groups (4) (biennial) 2. Percent 3. Low income cutoffs distribution of (3) elderly 4. Sex (3) ----------------------------------------------------------------------------- 00060138 Labour force 1966 1. Size of labour 1. Canada and to force provinces (11) 1994 2. Number of 2. Age groups (5) people employed 3. Sex (3) 3. Number of people unemployed 4. Number of people not in labour force ----------------------------------------------------------------------------- 00060139 Stress 1985 1. Number of 1. Canada, provinces, 1991 people Yukon (12) 2. Age groups (5) 3. Stress level (4) 4. Sex (3) ----------------------------------------------------------------------------- 00060140 Bradburn affect 1978 1. Percent 1. Canada and balance scale 1991 distribution of provinces (11) people 2. Bradburn affect balance scale (5) 3. Sex (3) ----------------------------------------------------------------------------- 00060207 Exercise 1985 1. Number of 1. Canada, provinces frequency 1990 persons who and territories (13) 1994 exercise regularly 2. Age groups (8) 3. Exercise frequency (5) 4. Sex (3) ----------------------------------------------------------------------------- 00060208 Pap smear 1985 1. Number of women 1. Canada, provinces 1990 who had a pap and territories (13) 1994 smear 2. Age groups (8) ============================================================================= Table |Type of Indicator |Per. |Specific Data |Disaggregations for Number | | |Series (Dimensions)|Each Data Series | | |(Quantifiers) |(Dimensions) ============================================================================= 00060209 Seatbelt users 1985 1. Number of 1. Canada, provinces 1990 people who always and territories (13) wear seatbelts 2. Age groups (8) 3. Sex (3) ----------------------------------------------------------------------------- 00060210 Measures taken to 1985 1. Measures 1. Canada, provinces improve health 1990 and territories (13) 2. Measures (13) 3. Age groups (5) ----------------------------------------------------------------------------- 00060211 Body mass index 1985 1. Body mass index 1. Canada, provinces 1990 groupings and territories (13) 1994 2. Body mass index (5) 3. Age groups (8) 4. Sex (3) ----------------------------------------------------------------------------- 00060212 Weight change 1985 1. Number of 1. Canada, provinces 1990 persons desiring a and territories (13) weight change 2. Age groups (8) 3. Sex (3) ----------------------------------------------------------------------------- 00060213 Regular breast 1985 1. Annual 1. Canada, provinces examination 1990 professional and territories (13) examination 2. Age groups (8) 2. Monthly self examination ----------------------------------------------------------------------------- 00060214 Food consumption 1985 1. Number of 1. Canada, provinces at breakfast 1990 persons consuming and territories (13) selected breakfast 2. Selected foods (5) foods 3. Consumption (4) 4. Age groups (5) 5. Sex (3) ============================================================================= Table |Type of Indicator |Per. |Specific Data |Disaggregations for Number | | |Series (Dimensions)|Each Data Series | | |(Quantifiers) |(Dimensions) ============================================================================= 00060215 Drinking and 1985 1. Number of 1. Canada, provinces driving 1990 people and Yukon (12) 2. Age groups (5) 3. Drinking and driving frequency (5) 4. Sex (3) ----------------------------------------------------------------------------- 00060216 Lone parent 1986 1. Number of 1. Canada, provinces families 1991 lone-parent and territories (13) families 2. Sex (3) ----------------------------------------------------------------------------- 00060217 Age at first 1990 1. Number of 1. Canada and sexual people provinces (11) intercourse 2. Age groups (7) 3. Sex (3) ----------------------------------------------------------------------------- HEALTH INDICATORS PROGRAM - OUTLINE OF DATABASE Health Status ============================================================================= Table |Type of Indicator |Per. |Specific Data |Disaggregations for Number | | |Series (Dimensions)|Each Data Series | | |(Quantifiers) |(Dimensions) ============================================================================= 00060112 Perceived health 1991 1. Perceived 1. Canada and 1994 health compared to provinces (11) others 2. Age groups (5) 2. Self reported 3. Sex (3) health problems ----------------------------------------------------------------------------- 00060115 Life expectancy 1920 1. Life expectancy 1. Canada and the 1922 provinces (11) to 2. Age groups (20) 1990 3. Sex (3) 1992 ----------------------------------------------------------------------------- 00060113 Potential years 1961 1. Potential years 1. Canada, provinces of life lost to of life lost and territories (13) 1994 2. Cause of death (10) 3. Age groups (15) 4. Sex (3) ----------------------------------------------------------------------------- 00060114 Age-standardized 1950 1. Age- 1. Canada, provinces mortality rate to standardized and territories (13) 1994 mortality rate 2. Cause of death (25) 3. Sex (3) ----------------------------------------------------------------------------- 00060110 Infant, 1974 1. Number of 1. Canada, provinces perinatal, early to infant deaths and territories (13) neonatal 1994 under 1 year 2. Cause of death mortality 2. Number of (11) livebirths 3. Sex (4) 3. Infant mortality rate 4. Stillbirths 5. Deaths under one week 6. Perinatal mortality 7. Early neonatal mortality ----------------------------------------------------------------------------- 00060111 Suicides 1961 1. Number of 1. Canada, provinces to suicides and territories (13) 1994 2. Suicides per 2. Age groups (8) 100,000 population 3. Sex (3) ============================================================================= Table |Type of Indicator |Per. |Specific Data |Disaggregations for Number | | |Series (Dimensions)|Each Data Series | | |(Quantifiers) |(Dimensions) ============================================================================= 00060128 Hospital 1979 1. Number of 1. Canada and the separations by 1980 hospital provinces (11) diagnostic group to separations 2. Age groups (6) 1993 2. Separations per 3. ICD chapter (19) 1994 100,000 population 4. Sex (3) ----------------------------------------------------------------------------- 00060103 Ambulatory care 1976 1. Ambulatory and 1. Canada, provinces and surgical day to surgical day care and territories (13) care visits 1993 visits 2. Type of visit (4) 1994 2. Visits per 1,000 population ----------------------------------------------------------------------------- 00060122 Disability 1986 1. Number of 1. Canada, provinces to people with a and territories (13) 1987 disability 2. Age groups (6) 1991 2. Percentage of 3. Nature of the the population disability (8) with a disability 4. Sex (3) ----------------------------------------------------------------------------- 00060123 Disability due to 1986 1. Number of 1. Canada, provinces motor vehicle 1991 persons with a and territories (13) accidents disability due to 2. Age groups (4) a motor vehicle 3. Nature of the accident disability (4) 4. Sex (3) ----------------------------------------------------------------------------- 00060127 Motor vehicle 1979 1. Separations due 1. Canada and the accident 1980 to motor vehicle provinces (11) morbidity to accidents 2. Age groups (6) 1993 2. Separations per 3. Sex (3) 1994 1,000 population 3. Days' stay in hospital 4. Days' stay per 1,000 population ----------------------------------------------------------------------------- 00060132 Sexually 1979 1. Number of 1. Canada, provinces transmitted to reported cases and territories (13) disease 1995 2. Type of disease (4) 3. Age groups (12) 4. Sex (4) ============================================================================= Table |Type of Indicator |Per. |Specific Data |Disaggregations for Number | | |Series (Dimensions)|Each Data Series | | |(Quantifiers) |(Dimensions) ============================================================================= 00060136 Notifiable 1979 1. Reported cases 1. Canada, provinces diseases to and territories (13) 1995 2. Diseases (10) 3. Age groups (12) 4. Sex (4) ----------------------------------------------------------------------------- 00060137 Disability by 1986 1. Number of 1. Canada, provinces living 1991 people and territories (13) arrangement 2. Age groups (5) 3. Severity of disability (4) 4. Living arrangement (3) 5. Sex (3) ----------------------------------------------------------------------------- 00060141 Stillbirths by 1974 1. Livebirths 1. Canada, provinces parity to 2. Stillbirths and territories (13) 1994 2. Age groups (11) 3. Order of birth (7) ----------------------------------------------------------------------------- HEALTH INDICATORS PROGRAM - OUTLINE OF DATABASE Health Resources ============================================================================= Table |Type of Indicator |Per. |Specific Data |Disaggregations for Number | | |Series (Dimensions)|Each Data Series | | |(Quantifiers) |(Dimensions) ============================================================================= 00060201 Health 1987 1. Health 1. Canada, provinces expenditures by to expenditures and territories (12) sector 1994 2. Per capita 2. Sector (4) health expenditures ----------------------------------------------------------------------------- 00060202 Health 1975 1. Health 1. Canada, provinces expenditures by to expenditures and territories (12) category of 1994 2. Per capita 2. Category of service health service (7) expenditures 3. Health expenditures as a percentage of GDP ----------------------------------------------------------------------------- 00060205 Population per 1977 1. Number of 1. Canada, provinces health to health and territories (14) professional 1992 professionals 2. Type of health 2. Population per professionals (48) health professional ----------------------------------------------------------------------------- 00060131 University 1972 1. University 1. Canada and the students in health 1973 students in health provinces (11) care disciplines to care disciplines 2. Type of health 1994 discipline (15) 1995 3. Level of program (3) 4. Status of student (3) 5. Sex (3) ----------------------------------------------------------------------------- 00060129 University 1972 1. Number of 1. Canada and the graduates in 1973 university health provinces (11) health care to graduates 2. Type of health disciplines 1994 discipline (15) 1995 3. Level of program (3) 4. Sex (3) ----------------------------------------------------------------------------- 00060126 College graduates 1975 1. Number of 1. Canada, provinces and students in 1976 students and territories (13) health care to 2. Number of 2. Type of health disciplines 1994 graduates discipline (9) 1995 3. Sex (3) ----------------------------------------------------------------------------- 00060101 Approved beds in 1979 1. Number of 1. Canada, provinces institutions 1980 approved beds and territories (13) to 2. Approved beds 2. Type of 1993 per 1,000 institution (3) 1994 population 3. Type of care (7) ----------------------------------------------------------------------------- HEALTH INDICATORS PROGRAM - OUTLINE OF DATABASE Health Resources Utilization ============================================================================= Table |Type of Indicator |Per. |Specific Data |Disaggregations for Number | | |Series (Dimensions)|Each Data Series | | |(Quantifiers) |(Dimensions) ============================================================================= 00060116 Institutional bed 1979 1. Percentage 1. Canada, provinces occupancy rate 1980 occupancy rate and territories (13) to 2. Type of 1993 institution (2) 1994 3. Type of care (7) ----------------------------------------------------------------------------- 00060117 Institutional 1979 1. Number of 1. Canada, provinces patient-days 1980 patient-days and territories (13) to 2. Patient-days 2. Type of 1993 per 1,000 institution (3) 1994 population 3. Type of care (3) ----------------------------------------------------------------------------- 00060102 Hospital 1979 1. Number of 1. Canada, provinces separations 1980 hospital and territories (13) to separations 2. Type of separation 1993 2. Separations per (3) 1994 1,000 population ----------------------------------------------------------------------------- 00060125 Hospital 1979 1. Number of 1. Canada and the patient-days 1980 patient-days provinces (11) to 2. Age groups (6) 1993 3. Sex (3) 1994 ----------------------------------------------------------------------------- 00060130 Average length of 1969 1. Days' stay in 1. Canada and the stay in hospitals 1970 hospital provinces (11) to 2. Number of 2. Age groups (6) 1993 hospital 3. Diagnostic group 1994 separations (19) 3. Average length 4. Sex (3) of stay in hospital ----------------------------------------------------------------------------- 00060206 Physician 1982 1. Dollar amount 1. Canada, provinces services 1983 of services and territories (13) to 2. Number of 2. Category of 1992 services service (18) 1993 3. Average payment 3. Category of per service physician specialty (21) -----------------------------------------------------------------------------