Mortality At A Glance

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1 Mortality At A Glance Last Updated: February 2015 Highlights The crude mortality rate in Durham Region has been gradually increasing since 1989, likely as a result of an aging population; however, age-standardized mortality rates, which control for the varying age structures in the population, show a decreasing trend since 1989 for Durham Region and Ontario for both males and females. Life expectancy has been increasing since 2000 for both Durham Region and Ontario and is consistently higher among females than males. The potentially avoidable mortality rate has been declining slowly since 2000 among both males and females, is consistently higher among males than females, and is consistently lower in Durham Region compared to Ontario. The age-standardized rate of all infectious and parasitic diseases has increased in both Durham Region and Ontario since In Durham Region and Ontario the cancer mortality rate for all cancers combined has been declining slowly since 2000 among both males and females. Similarly, mortality rates for colorectal cancer among both males and females, lung cancer among males, prostate cancer among males, and breast cancer among females have also been declining. The diabetes mortality rate is consistently higher among males than females in both Durham Region and Ontario. Rates have been declining since The cardiovascular disease mortality rate is consistently higher among males than females in both Durham Region and Ontario and has been declining since Similarly, mortality rates for ischemic heart disease (or heart attacks) and cerebrovascular disease (including stroke) have been declining. Cardiovascular disease mortality rates are consistently higher in Oshawa males compared to males in other Durham Region municipalities and Durham Region as a whole but have been declining in all municipalities since The respiratory heart disease mortality rate is consistently higher among males than females in both Durham Region and Ontario and has declined slowly since Similarly, mortality rates for Chronic Obstructive Pulmonary Disease (COPD) and pneumonia/influenza have also declined since The mortality rates for COPD were significantly higher in Durham Region females than Ontario females. The unintentional injuries mortality rate is consistently higher among males than females in both Durham Region and Ontario and has increased since The unintentional falls mortality rates in Durham Region are consistently higher than Ontario rates for all ages and for adults 65 years and older and have increased since 2000 in both Durham Region and Ontario. The mortality rate for suicide was significantly lower in Durham Region females than Ontario females. Page 1 of 46

2 Introduction Mortality data are derived from death certificates completed by physicians that are collected by the Office of the Registrar General (ORG), Service Ontario. The cause of death reported is that which initiates the sequence of events leading to death. Consequently, there may be some uncertainty in classifying when there are multiple causes of death. 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, suicide. From causes of death were coded using the Ninth Revision of the International Classification of Diseases (ICD-9). From 2000 onward causes of death were coded using the Tenth Revision of the International Classification of Diseases (ICD-10). Counts and rates for specific causes of death are presented from 2000 onward only since comparison of trends with earlier rates must be interpreted with caution. For all indicators, 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. This report includes mortality indicators relevant to public health programming, as outlined in the Ontario Public Health Standards (OPHS). The new OPHS were published in 2008 by the Ministry of Health and Long-Term Care, pursuant to Section 7 of the Health Protection and Promotion Act. Charts and tables are provided for the following indicators for Durham Region: Crude Mortality Rates for All Causes Age-Standardized Mortality Rates for All Causes Life Expectancy at Birth Age-Specific Mortality Rates for All Causes Potentially Avoidable Mortality Age-Standardized Mortality Rates for the following selected causes: o All Infectious and Parasitic Diseases o Cancers (All Cancers, Colorectal, Lung, Prostate and Breast) o Diabetes o Cardiovascular Disease (All Cardiovascular Disease, Ischemic Heart Disease, and Cerebrovascular Disease) o Respiratory Disease (All Respiratory Disease, Chronic Obstructive Pulmonary Disease, and Pneumonia and Influenza) o Digestive System Diseases o Injury (Unintentional Injuries, Unintentional Falls, Unintentional Falls Among Ages 65+, Motor Vehicle Traffic Collisions and Suicide) Age-Standardized Mortality Ratios for Selected Causes Number of Deaths for Selected Causes Page 2 of 46

3 Charts and tables are provided for the following indicators for Durham Region's eight municipalities (Ajax, Brock, Clarington, Oshawa, Pickering, Scugog, Uxbridge and Whitby): Crude Mortality Rates for All Causes Age-Standardized Mortality Rates for All Causes Age-Standardized Mortality Rates for Selected Causes o Cardiovascular Disease Age-standardized mortality rates are suppressed when the total number of cases included in the rate is less than 20. Counts of deaths, age-specific mortality rates, and crude rates are suppressed when counts are between 1 and 4. Suppressed rates and counts are represented by blank cells in tables. For some indicators, the count of total deaths displayed is more than the sum of male and female deaths because sex is unspecified or classified as other. For more detailed topic-specific reports that include mortality data please go to the Health Statistics in Durham Region webpage found at durham.ca/healthstats. For more information or if you require this information in an accessible format, please contact Durham Health Connection Line at or Page 3 of 46

4 Definitions Definition: Age-Standardized Mortality Ratio (SMR) The ratio of the number of deaths observed in the population of interest to the number of deaths that would be expected if the population had the same age-specific mortality rates as a standard population. Ontario is used here as the standard population. Since statistical estimates may be unstable when the number of events is small, confidence intervals (CIs) are used to determine whether an SMR is statistically different from CIs are represented here by upright bars. If the bar crosses 1.00 this means that Durham Region mortality is no different from Ontario. An SMR and CI greater than 1.00 indicates that mortality is higher in Durham Region than Ontario, whereas an SMR and CI less than 1.00 indicates that mortality is lower in Durham Region. Definition: Crude Mortality Rate The total number of deaths per 100,000 population. This rate depicts the "true" picture of disease in a community although it can be greatly influenced by the age structure of the population. Definition: Age-Standardized Mortality Rate The total number of deaths per 100,000 population that would occur if the population had the same age distribution as the 1991 Canadian population. This age-adjusted rate allows populations with different age compositions to be compared. Definition: Age-Specific Mortality Rate The total number of deaths in a specified age group per 100,000 population in that age group. The numerator and denominator refer to the same age group. Page 4 of 46

5 All-Cause Mortality To best understand mortality trends in a population, it is important to determine crude rates, age-specific rates and age-standardized rates (SRATES) and/or ratios (SMRs). Mortality reflects the upper limit of the disease severity continuum. All-cause mortality provides a picture of the overall death rates in the community regardless of the cause of death. Page 5 of 46

6 Figure 1: Crude Mortality Rate for All Causes, Durham Region and Ontario, Crude rate per 100,000 Population Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate No Data Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate Durham Male Deaths 1,119 1,141 1,141 1,196 1,200 1,291 1,325 1,378 1,378 1,352 1,440 1,402 1,414 1,482 1,553 1,585 1,629 1,678 1,690 1,730 1,790 1,747 Durham Female Deaths 1,016 1,063 1,010 1,084 1,076 1,264 1,253 1,283 1,323 1,391 1,391 1,445 1,460 1,424 1,530 1,524 1,589 1,654 1,690 1,717 1,752 1,707 Durham Total Deaths 2,135 2,204 2,151 2,280 2,276 2,555 2,578 2,661 2,701 2,743 2,831 2,847 2,874 2,906 3,083 3,109 3,218 3,332 3,380 3,447 3,542 3,454 Source: Deaths and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. The crude mortality rate depicts the "true" picture of death in a community; however it is greatly influenced by the age structure of the population with an older population likely to have a higher crude mortality rate than a younger population. The crude mortality rate is higher among Ontario males and females than Durham Region males and females with the male rate consistently higher than the female rate in both Ontario and Durham Region. The crude mortality rate in Durham Region has been gradually increasing since 1989, likely as a result of an aging population. Page 6 of 46

7 Figure 2: Age-Standardized Mortality Rates for All Causes, Durham Region and Ontario, Age-Standardized Rate per 100,000 Population Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate No Data Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate Durham Male Deaths 1,119 1,141 1,141 1,196 1,200 1,291 1,325 1,378 1,378 1,352 1,440 1,402 1,414 1,482 1,553 1,585 1,629 1,678 1,690 1,730 1,790 1,747 Durham Female Deaths 1,016 1,063 1,010 1,084 1,076 1,264 1,253 1,283 1,323 1,391 1,391 1,445 1,460 1,424 1,530 1,524 1,589 1,654 1,690 1,717 1,752 1,707 Durham Total Deaths 2,135 2,204 2,151 2,280 2,276 2,555 2,578 2,661 2,701 2,743 2,831 2,847 2,874 2,906 3,083 3,109 3,218 3,332 3,380 3,447 3,542 3,454 Source: Deaths and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. Age-standardized mortality rates have the advantage of providing a single summary number that allows populations with different age structures to be compared; however, they present an "artificial" picture of the death /disease pattern in a community. Age-standardized mortality rates are similar in Durham Region and Ontario for both males and females with the male rates remaining higher than the female rates. All rates show a decreasing trend since Page 7 of 46

8 Figure 3: Life Expectancy at Birth, Durham Region and Ontario, Life Expectancy in Years Durham Males Durham Females Ontario Males Ontario Females No Data Durham Males Durham Females Ontario Males Ontario Females Source: Deaths and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. Life expectancy is the average number of years that an individual would live if subjected to the mortality experience for the specified population and time period. Life expectancy has been increasing since 2000 for both Durham Region and Ontario and is consistently higher among females than males. Page 8 of 46

9 Figure 4: Age-Specific Mortality Rate for All Causes, Durham Region and Ontario, Age-Specific Rate per 100,000 Population Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate No Data Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate Durham Male Deaths ,253 1,421 1, Durham Female Deaths ,070 1,408 1,588 1,601 Durham Total Deaths ,123 1,231 1,584 2,323 2,829 2,718 2,317 Source: Source: Deaths and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. Age-specific mortality rates can best describe the "true" death pattern within particular age groups of a community, and allow for comparison of age groups across populations that have different age structures. Age-specific mortality rates are similar between Durham Region and Ontario and consistently higher among males. Mortality rates are higher among children less than five than among older children but after age five rates increase steadily with age. Page 9 of 46

10 Potentially Avoidable Mortality The concept of potentially avoidable mortality is based on the knowledge that some deaths can be avoided by either preventing the onset of disease or by preventing or delaying death once a disease or condition has developed.(1) Potentially avoidable mortality is the sum of potentially preventable causes and potentially treatable causes in persons under the age of 75. Mortality from potentially preventable causes refers to deaths that can be avoided by preventing a disease from developing. This includes deaths from conditions linked to modifiable risk factors, such smoking or excessive alcohol consumption (e.g., lung cancer, liver cirrhosis), and deaths linked to effective public health interventions (e.g., vaccinations, traffic safety legislation). Mortality from potentially treatable causes refers to deaths from conditions where it is expected that death can be avoided or delayed by measures, such as screening, early detection, and appropriate treatment (e.g., breast cancer, appendicitis). Potentially avoidable deaths are selected using the ICD-10 codes outlined in the Potentially Avoidable Mortality ICD Code List associated with the Core Indicator Project of the Association of Public Health Epidemiologists in Ontario available from Page 10 of 46

11 Figure 5: Age-Standardized Mortality Rates for Potentially Avoidable Mortality, Durham Region and Ontario, Ages 0-75 Years, Age-Standardized Rate per 100,000 Population Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate No Data Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate Durham Male Deaths Durham Female Deaths Durham Total Deaths , ,008 1, Source: Deaths and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. In Durham Region and Ontario, the potentially avoidable mortality rate has been declining slowly since 2000 among both males and females. The rate is consistently higher among males than females in both Durham Region and Ontario and is consistently lower in Durham Region compared to Ontario. Page 11 of 46

12 Infectious and Parasitic Diseases Infectious diseases are caused by pathogenic microorganisms, such as bacteria, viruses, parasites or fungi; the diseases can be spread, directly or indirectly, from one person to another. All infectious and parasitic disease deaths are selected using ICD-10 codes A00-B99. See the Infectious Diseases At A Glance report for more details on infectious disease incidence in Durham Region at Page 12 of 46

13 Figure 6: Age-Standardized Mortality Rates for All Infectious and Parasitic Diseases, Durham Region and Ontario, Age-Standardized Rate per 100,000 Population Durham Rate Ontario Rate No Data Durham Rate Ontario Rate Durham Male Deaths Durham Female Deaths Durham Total Deaths Source: Deaths and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. Due to small numbers, male and female deaths are combined to create more stable rates. The age-standardized rate of all infectious and parasitic diseases has increased in both Durham Region and Ontario since Although Durham Region rates have fluctuated due to small numbers they have remained similar to Ontario rates. Page 13 of 46

14 Cancer Although cancer is commonly treated as one disease, it is really many different diseases. All cancers are characterized by the uncontrolled growth and spread of abnormal cells. They are typically named after the part of the body where the cancer starts. Even within one organ (e.g. the lung), there are several different types of cancer. Each type of cancer has different causes, risk factors, preventive factors and characteristics. All cancer deaths are selected using ICD-10 codes C00-C97 which includes all deaths from malignant cancers. See the Cancer At A Glance report for more details on cancer incidence in Durham Region at Page 14 of 46

15 Figure 7: Age-Standardized Mortality Rates for All Cancers, Durham Region and Ontario, Age-Standardized Rate per 100,000 Population Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate No Data Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate Durham Male Deaths Durham Female Deaths Durham Total Deaths ,021 1, ,112 1,077 1,100 Source: Deaths and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. In Durham Region and Ontario the cancer mortality rate for all cancers combined has been declining slowly since 2000 among both males and females. The rate is consistently higher among males than females in both Durham Region and Ontario. Page 15 of 46

16 Figure 8: Age-Standardized Mortality Rates for Colorectal Cancer, Durham Region and Ontario, Age-Standardized Rate per 100,000 Population Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate No Data Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate Durham Male Deaths Durham Female Deaths Durham Total Deaths Source: Deaths and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. Colorectal cancer deaths are selected using ICD-10 codes C18-C20 and C26.0. As with all cancers combined the colorectal cancer mortality rate has been declining slowly since 2000 among both males and females in Durham Region and Ontario. The rate is consistently higher among males than females in both Durham Region and Ontario. Page 16 of 46

17 Figure 9: Age-Standardized Mortality Rates for Lung Cancer, Durham Region and Ontario, Age-Standardized Rate per 100,000 Population Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate No Data Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate Durham Male Deaths Durham Female Deaths Durham Total Deaths Source: Deaths and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. Lung cancer deaths are selected using ICD-10 code C34. While lung cancer mortality rates have been declining since 2000 in Durham Region and Ontario males, the rates have remained relatively stable among females. The rate is consistently higher among males than females in both Durham Region and Ontario although the gap is narrowing over time. While rates are similar among males in Durham Region and Ontario, lung cancer mortality tends to be higher among Durham Region females than Ontario females. Page 17 of 46

18 Figure 10: Age-Standardized Mortality Rates for Prostate Cancer, Durham Region and Ontario, Age-Standardized Rate per 100,000 Population Durham Male Rate Ontario Male Rate No Data Durham Male Rate Ontario Male Rate Durham Male Deaths Source: Deaths and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. Prostate cancer deaths are selected using ICD-10 code C61. The prostate cancer mortality rate has been declining since 2000 in both Durham Region and Ontario. Rates in Durham Region are similar to Ontario. Page 18 of 46

19 Figure 11: Age-Standardized Mortality Rates for Breast Cancer, Durham Region and Ontario, Age-Standardized Rate per 100,000 Population Durham Female Rate Ontario Female Rate No Data Durham Female Rate Ontario Female Rate Durham Female Deaths Source: Deaths and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. Breast cancer deaths are selected using ICD-10 code C50. The female breast cancer mortality rate has been declining since 2000 in both Durham Region and Ontario. The rate in Durham Region is similar to Ontario. Page 19 of 46

20 Diabetes There are two main types of diabetes: type 1 and type 2. Type 1 diabetes is an autoimmune disorder that results in the body s failure to produce insulin and is generally diagnosed in young people. Type 2 diabetes results from the loss of the body s ability to produce sufficient insulin. Mortality rates due to diabetes may be underestimated due to other diseases being specified as the underlying cause of death.(2) See Facts on Diabetes report for more details on diabetes in Durham Region at Page 20 of 46

21 Figure 12: Age-Standardized Mortality Rates for Diabetes, Durham Region and Ontario, Age-Standardized Rate per 100,000 Population Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate No Data Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate Durham Male Deaths Durham Female Deaths Durham Total Deaths Source: Deaths and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. Diabetes deaths are selected using ICD-10 codes E10-E14. The diabetes mortality rate has been declining since 2000 among both males and females in Durham Region and Ontario. The rate is consistently higher among males than females and the rates in Durham Region are similar to Ontario. Page 21 of 46

22 Cardiovascular Disease Cardiovascular disease, also known as heart disease, is a disease of the heart and blood vessels. Cardiovascular disease includes heart attacks, stroke, heart failure, abnormal heart rhythms and heart valve problems. Cardiovascular disease deaths are selected using ICD-10-CA codes I00-I99. Page 22 of 46

23 Figure 13: Age-Standardized Mortality Rates for Cardiovascular Disease, Durham Region and Ontario, Age-Standardized Rate per 100,000 Population Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate No Data Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate Durham Male Deaths Durham Female Deaths Durham Total Deaths ,015 1, , Source: Deaths and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. Cardiovascular disease deaths are selected using ICD-10-CA codes I00-I99. The cardiovascular disease mortality rate has been declining since 2000 among both males and females in Durham Region and Ontario. The rate is consistently higher among males than females and rates in Durham Region are similar to Ontario. Page 23 of 46

24 Figure 14: Age-Standardized Mortality Rates for Cardiovascular Disease, Durham Region Males by Municipality, Rate per 100,000 population Pickering Ajax Whitby Oshawa Clarington North Durham Durham Region No Data Pickering Males Ajax Males Whitby Males Oshawa Males Clarington Males North Durham Males Durham Region Males Source: Deaths and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. Cardiovascular disease deaths are selected using ICD-10-CA codes I00-I99. Cardiovascular disease death rates are consistently higher in Oshawa males compared to males in other Durham Region municipalities and in Durham Region as a whole but have been declining in all municipalities since Page 24 of 46

25 Figure 15: Age-Standardized Mortality Rates for Cardiovascular Disease, Durham Region Females by Municipality, Rate per 100,000 population Pickering Ajax Whitby Oshawa Clarington North Durham Durham Region No Data Pickering Females Ajax Females Whitby Females s Oshawa Females Clarington Females North Durham Females Durham Region Females Source: Deaths and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. Cardiovascular disease deaths are selected using ICD-10-CA codes I00-I99. Cardiovascular disease death rates were higher in Oshawa females compared to females in other Durham Region municipalities and in Durham Region as a whole from 2000 to 2005 but rates have been similar in all municipalities since Rates among females have been declining in all municipalities since Page 25 of 46

26 Figure 16: Age-Standardized Mortality Rates for Ischemic Heart Disease (IHD), Durham Region and Ontario, Age-Standardized Rate per 100,000 Population Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate No Data Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate Durham Male Deaths Durham Female Deaths Durham Total Deaths Source: Deaths and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. Ischemic heart disease (IHD) or heart attack deaths are selected using ICD-10 codes I20-I25. The ischemic heart disease mortality rate has been declining since 2000 among both males and females in Durham Region and Ontario. The rate is consistently higher among males than females and the rates in Durham Region are similar to Ontario. Page 26 of 46

27 Figure 17: Age-Standardized Mortality Rates for Cerebrovascular Disease, Durham Region and Ontario, Age-Standardized Rate per 100,000 Population Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate No Data Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate Durham Male Deaths Durham Female Deaths Durham Total Deaths Source: Deaths and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. Cerebrovascular disease (including stroke) deaths are selected using ICD-10 codes I60-I69. The cerebrovascular disease mortality rate has been declining since 2000 among both males and females in Durham Region and Ontario. The rate is consistently higher among males than females and rates in Durham Region are similar to Ontario. Page 27 of 46

28 Respiratory Disease Respiratory disease includes conditions of the upper respiratory tract, trachea, bronchi, bronchioles, alveoli, pleura and pleural cavity such as asthma, chronic obstructive pulmonary disease (COPD), pneumonia and influenza. Respiratory disease deaths are selected using ICD-10 codes J00-J99. Page 28 of 46

29 Figure 18: Age-Standardized Mortality Rates for Respiratory Disease, Durham Region and Ontario, Age-Standardized Rate per 100,000 Population Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate No Data Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate Durham Male Deaths Durham Female Deaths Durham Total Deaths Source: Deaths and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. Respiratory disease deaths are selected using ICD-10 codes J00-J99. The respiratory heart disease mortality rate has declined slowly since 2000 among males in Durham Region and Ontario but has remained fairly stable among females. The rate is consistently higher among males than females and rates in Durham Region are similar to Ontario. Page 29 of 46

30 Figure 19: Age-Standardized Mortality Rates for Chronic Obstructive Pulmonary Disease, Durham Region and Ontario, Age-Standardized Rate per 100,000 Population Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate No Data Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate Durham Male Deaths Durham Female Deaths Durham Total Deaths Source: Deaths and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. Chronic Obstructive Pulmonary Disease (COPD) deaths are selected using ICD-10 codes J40-J44. This grouping includes diseases such as chronic bronchitis and emphysema but excludes asthma. The COPD mortality rate has declined since 2000 among both males and females in Durham Region and Ontario with a larger decline among males. Rates are higher among males than females although the gap is closing. Rates in Durham Region are similar to Ontario. Page 30 of 46

31 Figure 20: Age-Standardized Mortality Rates for Pneumonia and Influenza, Durham Region and Ontario, Age-Standardized Rate per 100,000 Population Durham Rate Ontario Rate No Data Durham Rate Ontario Rate Durham Male Deaths Durham Female Deaths Durham Total Deaths Source: Deaths and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. Pneumonia and influenza deaths are selected using ICD-10 codes J10-J18. Influenza is often complicated by pneumonia, especially in the elderly. Because the two are linked so strongly, they are often grouped together for data reporting. (3) Due to small numbers, male and female deaths are combined to create more stable rates. The pneumonia and influenza mortality rate has declined since 2000 in Durham Region and Ontario. Rates in Durham Region are similar to Ontario. Page 31 of 46

32 Digestive System Diseases The digestive system is a series of organs that convert food into nutrients and moves unused waste material out of the body. Diseases of the digestive system can affect any part of the digestive or gastrointestinal tract including the mouth, esophagus, stomach, small intestine, large intestine, rectum and anus. Such diseases can include cirrhosis of the liver, pancreatitis, diverticulitis, and Crohn s disease but do not include cancers of the digestive system. Digestive system disease deaths are selected using ICD-10 codes K00-K93. Page 32 of 46

33 Figure 21: Age-Standardized Mortality Rates for Digestive System Diseases, Durham Region and Ontario, Age-Standardized Rate per 100,000 Population Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate No Data Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate Durham Male Deaths Durham Female Deaths Durham Total Deaths Source: Deaths and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. Digestive system disease deaths are selected using ICD-10 codes K00-K93. The digestive system mortality rate has remained relatively stable since 2000 among both males and females in Durham Region and Ontario. The rate is consistently higher among males than females and rates in Durham Region are similar to Ontario. Page 33 of 46

34 Injury Causes of injury deaths used in this report are grouped based on the external cause of the injury rather than the resulting injury or diagnosis (e.g. head injury or fracture). Injury related causes of death include but are not limited to motor vehicle accidents, suicides, falls, poisonings and burns. Injuries can be categorized as unintentional (i.e. accidental) and intentional (i.e. deliberate). (4) See the Injuries At A Glance reports for more details on injuries in Durham Region at Page 34 of 46

35 Figure 22: Age-Standardized Mortality Rates for Unintentional Injuries, Durham Region and Ontario, Age-Standardized Rate per 100,000 Population Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate No Data Durham Male Rate Durham Female Rate Ontario Male Rate Ontario Female Rate Durham Male Deaths Durham Female Deaths Durham Total Deaths Source: Deaths and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. Unintentional injury deaths are selected using ICD-10 codes V01-X59 and Y85-Y86. The unintentional mortality rate has increased since 2000 among both males and females in Durham Region and Ontario. Rates are consistently higher among males than females and rates in Durham Region are similar to Ontario. Page 35 of 46

36 Figure 23: Age-Standardized Mortality Rates for Unintentional Falls, Durham Region and Ontario, Age-Standardized Rate per 100,000 Population Durham Rate Ontario Rate No Data Durham Rate Ontario Rate Durham Male Deaths Durham Female Deaths Durham Total Deaths Source: Deaths and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. Unintentional fall deaths are selected using ICD-10 codes W00-W19. Due to small numbers, male and female deaths are combined to create more stable rates. The unintentional falls mortality rate has increased since 2000 in Durham Region and Ontario. Rates in Durham Region are higher than Ontario rates. Page 36 of 46

37 Figure 24: Age-Standardized Mortality Rates for Unintentional Falls, Durham Region and Ontario Ages 65+, Age-Standardized Rate per 100,000 Population Durham Rate Ontario Rate No Data Durham Rate Ontario Rate Durham Male Deaths Durham Female Deaths Durham Total Deaths Source: Deaths and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. Unintentional fall deaths are selected using ICD-10 codes W00-W19. Due to small numbers, male and female deaths are combined to create more stable rates. The mortality rate among adults 65 years and older has increased since 2000 in Durham Region and Ontario. Rates among Durham Region older adults are higher than Ontario rates. Page 37 of 46

38 Figure 25: Age-Standardized Mortality Rates for Motor Vehicle Traffic Collisions, Durham Region and Ontario, Age-Standardized Rate per 100,000 Population Durham Rate Ontario Rate No Data Durham Rate #N/A 6.3 #N/A Ontario Rate Durham Male Deaths #N/A Durham Female Deaths #N/A 14 6 Durham Total Deaths Source: Deaths and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. Motor vehicle traffic collision (MVTC) deaths are selected using ICD-10 codes V02-V04 (.1,.9), V09.2, V12-V14(.3-.9), V19(.4-.6), V20-V28(.3-.9), V30-V79(.3-.9), V80(.3-.5), V81.1, V82.1, V83-V86(.0-.3), V87(.0-.8), and V89.2. Due to small numbers, male and female deaths are combined to create more stable rates. Rates are suppressed, represented by #N/A in the table and a gap in the graph, when numerator is less than 20, total counts are suppressed when less than 5, and gender specific counts are supressed when either is less than 5. The MVTC mortality rate has decreased since 2000 in Ontario. The rates for Durham Region followed a similar trend but show some fluctuation due to small numbers. Rates in Durham Region are similar to Ontario. Page 38 of 46

39 Figure 26: Age-Standardized Mortality Rates for Suicide, Durham Region and Ontario, Age-Standardized Rate per 100,000 Population Durham Rate Ontario Rate No Data Durham Rate Ontario Rate Durham Male Deaths Durham Female Deaths Durham Total Deaths Source: Deaths and Ontario Population Estimates , Ontario Ministry of Health and Long-Term Care, IntelliHEALTH ONTARIO. Suicide deaths are selected using ICD-10 codes X60-X84 and Y87.0. Due to small numbers, male and female deaths are combined to create more stable rates. The suicide rate has increased since 2000 in Durham Region and Ontario. Rates in Durham Region are lower than Ontario in most years. Page 39 of 46

40 Age-Standardized Mortality Ratios for Selected Causes An Age-Standarized Mortality Ratio (SMR) is the ratio of the number of deaths observed in the population of interest to the number of deaths that would be expected if the population had the same age-specific death rates as a standard population. Ontario is used here as the standard population. Since statistical estimates may be unstable when the number of events is small, confidence intervals (CIs) are used to determine whether an SMR is statistically different from CIs are represented here by upright bars. If these bars cross 1 this means that the Durham mortality rate is no different from Ontario. An SMR and CIs greater than 1.00 indicates that the mortality rate is higher in Durham than Ontario, whereas an SMR and CIs less than 1.00 indicates that mortality is lower in Durham. Significant differences are indicated on graphs with an asterisk (*). Page 40 of 46

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