Number of people in a given age group by gender in a given year per 100 population.

A population pyramid shows the basic characteristics of the population structure of a given area and a specific point in time (i.e., its age and gender). The population pyramid portrays events that have marked the composition of a population (i.e wars, economic crises, migrations, "baby boom", declines in fertility, aging, etc.). The population structure is a descriptor which can be combined with non-demographic variables to highlight population structures of particular interest: demolinguistic, socio-demographic and socioeconomic.

Considered more as a descriptor of the state of a population than an indicator. Certain sub-groups, such as young mobile adults and the homeless, may be undercounted through the census. · Age and sex are the two factors which most influence population health status. · The total population includes both institutional and non-institutional populations. An institutional resident is defined as a resident of an "institutional" collective dwelling, other than staff members and their families. Institutional collective dwellings are defined in the 1996 Census Dictionary as children's group homes (orphanages), nursing homes, chronic care hospitals, residences for senior citizens, hospitals, psychiatric institutions, treatment centres and institutions for the physically handicapped, correctional and penal institutions, young offenders' facilities and jails.

Can be used to target and identify sub-populations which can ultimately help determine required services. It allows for comparisons between age groups.

The population growth rate is an indicator of the demographic change in a population. When the rate is negative, the population is declining, while a positive rate indicates growth. In some cases, slight growth or a decline in a population may be linked to socioeconomic hardship.

A growth rate of zero does not mean there are no changes in the composition of the population between the two measurement points. For instance, a high birth rate might be offset by high emigration. The rate is affected by differential under-enumeration of the population between two censuses. Under-enumeration of the population may vary from one census to another, affecting interpretation of the growth rate. It is also influenced by age structure.

The growth rate is useful because it allows crude estimates to be made of future changes in a population based on past trends. This facilitates the planning of programs and services related to growth in the total population or certain subgroups.

Number of people per square kilometre.

In rural areas with very low population densities, access to services and programs may be difficult. The direct implications of levels of population density and their relationship to health are unclear.

Forecasts of future trends of growth over the years following the last census year. These forecasts assume varying degrees of change within three major factors affecting population growth: fertility, mortality, and migration.

Population projections forecast the future growth trends, emerging age-gender structure and the population distribution that would occur under the stated assumptions. Usually, alternative projections are offered which encompass a plausible range of variation in the factors affecting future size and structure of the population. The population projections were based on the 1996 updated post-censal estimates of Ontario population released by Statistics Canada in the fall of 1999. These estimates incorporate adjustments to the 1996 census counts, reflecting estimated net census under-coverage rates in each age-sex group. The Ontario population projections to 2021 were prepared by the Ministry of Finance in June 1994.

The accuracy of the population projections are conditional on the degree to which the underlying assumptions are correct during the period projected. Demographic changes are influenced by the interrelations of many social and economic factors and the policies adopted by governments at all levels.

The age specific fertility rate is the average number of live births to mothers in a given age group per 1000 women in that age group during a given year. In this report the age specific rates have been calculated for women 15-49, by five-year intervals.

Age specific fertility rates show the age specific rates of live births. This rate is affected by low birth weight, prematurity and perinatal morbidity which are in turn influenced by socioeconomic status, maternal lifestyle factors and maternal age. Age-specific fertility rates show a shift towards Canadian women postponing childbirth and having fewer children. The overall decline in fertility is mostly attributable to trends among younger women. Fertility rates of women in their thirties have risen almost steadily.

The distribution of live births by age of the mother is influenced by the age structure of the female population. Generally, some sub-groups of the female population are more difficult to observe than others. (young adults, the homeless, and others)

Total number of live births per 1,000 population.

The crude birth rate does not take into account the age and sex distribution of the population. A high rate may be due to a large number of women of reproductive age in the population and/or to a high fertility rate among the women in that population. Includes all live births, including those occurring to women under age 15

Proportion of people who report belonging to a given ethnic or cultural group relative to the population reporting a single ethnic origin in a given year. Note that the Census inquires about the ethnic origin of respondents’ ancestors. Therefore, ethnic or cultural origin refers to the ethnic roots or ancestral background of the population, and should not be confused with citizenship or nationality.

Census respondents were instructed to specify as many origins as applicable. Therefore, two categories of responses were generated: single responses (only one ethnic origin) and multiple responses (more than one ethnic origin). To simplify calculation of this indicator, only single responses are presented.

Social environment and personal factors including awareness of family background, length of time since immigration and confusion with other concepts such as citizenship, nationality, language or identity affect the measurement of ethnicity. Ethnic origin cannot be used to identify mother tongue or home language. For time comparisons, it is important to check the comparability of the instructions to the respondent, the wording of questions, the categories chosen, and the treatment of answers.

Proportion of people who report speaking a given language at home relative to all residents who speak only one language at home.

The proportion of the population speaking a given language most often at home provides a measure of the relative size of different cultured communities. Members of these communities may have little interaction with much of society. They may have demographic, social, economic and health characteristics that differ from those of Anglophones or Francophones. As opposed to mother tongue, home language is considered at a given point in time, based on frequency and a specific place of use. Data on home language demonstrates the current language profile of the population. In most communities the home language profile is usually similar to that for mother tongue. 

People who speak English or French may include natives and people of African origin who have their own cultural characteristics. Data obtained from the question on home language do not provide information on the languages spoken at work or school, with friends, etc., so these data do not reflect the overall language habits of respondents.

Proportion of census families made up of one parent and one or more children relative to all census families with children at home in a given year. Note that the term single or lone-parent refers to a mother or father with no spouse or common-law partner present, living in a dwelling with one or more never-married children regardless of their age. Note that "census families" are made up of two spouses (married or in common-law union) with or without never-married children or of a single parent with one or more never-married children living in the same dwelling.

The proportion of single-parent families is an indicator of poor socioeconomic conditions. These families are likely to need social support, childcare and other services. The living conditions of single-parent families have been associated in a number of studies with the following problems: low socioeconomic status, increase in female heads of families, poor housing conditions, behavioural problems in children, overload of parental responsibilities, loneliness, dissatisfaction with social situation, and health problems.

Published data may occasionally understate the phenomenon of single parenthood by using in the denominator all census families, whether or not they have children. The proportion of single-parent families is calculated without taking parental responsibilities into consideration, e.g., an 80 year old parent living with a 55 year old son or daughter who may be taking care of the 80 year old parent. However, the proportion of people aged 45 or older living with a parent was only 0.56% in 1996.

Proportion of the population age 15 and older by level of schooling attained relative to the total population age 15 and older.

Education, along with income, is one of the most reliable indicators of socioeconomic status. There is a direct relationship between education and health status. This indicator uses data from residents who are 15 and older, to include only those persons who have likely reached grade nine.

The age structure of the population studied may influence the value of this indicator. An older population may show a higher percentage of less educated people than a younger population due to improved access to education over time. The age structure of the population may influence the indicator: an older population generally has lower education levels than a younger population due to improved access to education over time. In general, the indicator refers to the population aged 15 or older so as to include only those persons likely to have reached 9th grade. A higher level of education does not ensure a good job with higher income. Most people aged 15-19 are still in school.

Proportion of the population living in low-income households relative to the total population living in private households.

There are several measures of low income; the two measures most commonly used are the Statistics Canada low-income cut-off and the poverty lines set by the Canadian Council on Social Development (CCSD). Statistics Canada low-income cut-off points are calculated based on a survey of family spending and are readjusted annually in line with consumer price index. These levels are set at a level that, on average, corresponds to 58.5% of total income before any deductions, spent on basic needs (lodging, food, and clothing). These levels may vary by family size and place of residence. CCSD poverty levels correspond, for a family of three people, to half the average Canadian income. Low income, with education, is one of the two most predictive indicators of socioeconomic status. It is associated with low skilled jobs, high unemployment rates, unhealthy lifestyles and living conditions and a greater prevalence of disability and health problems.

There is an arbitrary element in the criteria used to define low-income levels based on dollars spent on lodging, food and clothing. This level may vary from one region to another. The low-income cut-off is the amount necessary for material survival. It is not an indicator of general welfare. It provides no information about the intensity or duration of poverty. The low-income cut-off does not take into account the near-poor or low wage earners who have incomes barely above the low-income cut-off and who have similar living conditions.

Identification of risk groups for specific problems: marginialization and lower health status, malnutrition, poor housing conditions, learning problems in children, single-parent families, single persons and the aged. This indicator is also useful for planning programs and services for the economically disadvantaged.

Sum of employment income received by persons 15 years of age and older divided by the total employed population age 15 and older in a given year. Employment income includes wages and salaries; net income from unincorporated non-farm business and/or professional practice and net farm self-employment income.

Research has repeatedly shown a strong positive relationship between income and health. Employment is important for individuals and communities. Employment provides people, not only with income, but also with identity, self-esteem and social contact.

The reporting of income is subject to under reporting bias. Certain sub-groups, such as young adults, may be undercounted. Averaging does not reveal the range of employment income in the population.

The composition of total income of a population group or a geographic area refers to the relative share of each income source or group of sources, expressed as a percentage of the aggregate income of that group or area. The composition of total income is categorized as follows:

Employment income: refers to total income received by persons 15 years of age and over as wages and salaries, net income from unincorporated non-farm business and/or professional practice and net farm self-employment income

Government transfer payments: refer to all transfers or payments received from any level of government and covered as a separate source of income.

Other income: refers to investment income, retirement pensions and other money income

Research has repeatedly shown a strong positive relationship between income and health. Low incomes are associated with difficult living conditions, low socioeconomic status and health and social problems. Areas with a high relative share of government transfer payments as a percentage of aggregate income may indicate low incomes for a large proportion of the population.

The reporting of income is subject to underreporting bias. Certain sub-groups are less well counted than others, e.g. young adults, homeless.

Proportion of occupied private, including rental dwellings needing major repairs relative to all occupied private dwellings. Major repairs refer to defective plumbing or electrical wiring, structural repairs to walls, floors or ceilings, etc., and not to desire remodeling or additions.

Safe housing is an important determinant of health. Occupants of dwellings needing major repairs may be at higher risk of injury from fire or falls, or of illness from exposure to cold, damp and unsanitary conditions. Poor housing can be socially and psychologically detrimental. Dwellings in need of major repairs may be clustered in neighborhoods that are unhealthy due to pollution, high crime rates, and lack of safe recreation areas.

Since the indicator is expressed in terms of dwellings rather than individuals, it is not known how many people are affected.

The proportion of owner occupied private dwellings that are owned by some member of the household relative to all private dwellings. Band housing on a First Nations reserve or settlement is excluded.

Populations with a higher percentage of owner occupied dwellings may have higher socioeconomic status.

It is difficult to determine what is an appropriate level of home ownership. The number of individuals involved is not known because the indicator is expressed in terms of dwellings rather than individuals.

Proportion of eligible voters who in a given year voted in a federal or provincial election.

Voting gives individuals the opportunity to voice their interests and indicate their preferences for governance. Low voter participation rates may suggest lack of interest in voting which may be because individuals feel a lack of control or that their votes will not make a difference. Studies have found that voters are more likely to be older, married, and have higher income and education levels.

Data are available at the electoral district level which may not correspond to the boundaries of public health units and district health councils. The voting eligibility criteria have changed over time. For example, inmates of penal institutions are now eligible to vote. Since only Canadian citizens are eligible to vote, communities with a high number of immigrants will have fewer people with the opportunity to participate in a election. This would not be reflected in voter participation rates.

Proportion of residents age 12 and older who have scores of 4 on the social support scale.

The 1996 Ontario Health Survey determined level of social support by asking four questions: if respondents had 1)someone they could confide in; 2) someone they could count on in a crisis; 3) someone they could count on for advice; 4) someone that makes them feel loved and cared for. Those responding yes to all questions are considered to have a high level of social support.

Although a strong case exists for a relationship between social support and health, much research remains to be done about how the index relates to health and other measures in the Ontario Health Survey.

The number of times per year that any Maximum Acceptable Concentration (MAC) is exceeded in drinking water monitored by the Drinking Water Surveillance Program (DWSP)

The Drinking Water Surveillance Program for Ontario monitors water quality at municipal water supply systems. The objectives of the program are to provide: immediate, reliable, current information on drinking water quality; a flagging mechanism to identify events that exceed certain guidelines; a definition of contaminant levels and trends; a comprehensive background for remedial action; a framework for assessment of new contaminants; and an indication of treatment efficiency of plant processes. Water quality is measured by testing a sample for the presence and concentration of bacteria, chemicals, and radioactive elements. The length of time a Maximum Acceptable Concentration (MAC) can be exceeded without injury to health depends on the nature and concentration of the contaminant. The microbiological quality of drinking water is the most important aspect of drinking water quality because of its association with outbreaks of acute waterborne diseases such as Typhoid Fever, Giardia and various other gastrointestinal diseases. Most MAC’s for chemicals in water are health related while others are factors that affect taste and smell of the water, such as chlorides, sulfides, etc. Sampling for chemical contaminants is usually done at the request of a homeowner and special surveys may be carried out if individual results warrant further investigation. The local Medical Officer of Health is notified if any MAC is exceeded in drinking water.

About 180 parameters are measured in drinking water, with 73 chemical and physical parameters having MACs. An index has not yet been developed to combine information about those thought to be most important to health. The development of drinking water objectives and MACs is a continuous process. Information is not available about all parameters and the process is further complicated by the continual introduction of new chemicals into the environment. Little is known about interactions between parameters. Some sources of drinking water are excluded from the DWSP, including households on individual wells (this means about half of the residents in LGL).

The Brockville water treatment plant is a direct filtration plant which treats water from the St. Lawrence River. The process consists of coagulation, flocculation, filtration, fluoridation and disinfection. This plant has a design capacity of 40.7 x 1000 m3/day. The Brockville Water Treatment Plant serves a population of approximately 21,200. From 1993 to 1995, a total of 5,388 tests were performed in 13 sample events from the Brockville Water Treatment Plant. Fluoride exceeded the ODWO Maximum Acceptable Concentration of 1.5 mg/L in 2 of 23 treated and distributed water samples. The District Officer was notified. The treatment process for fluoride addition should be reviewed. No other known health related guidelines were exceeded. The Brockville Water Treatment Plant, for the sample years 1993, 1994 and 1995, produced good quality water and this was maintained in the distribution system. For 1996 and 1997 raw and treated water at the plant and at one location in the distribution system were sampled for the presence of approximately 200 bacteriological, inorganic, organic and radiological parameters. For 1996 and 1997, a total of 2,247 tests were performed in 6 sample events from the Brockville Water Treatment Plant. The Ontario Drinking Water Objective (ODWO) for Lead (10 µg/L) was exceeded in 1 treated water sample. The MOE District Officer was notified. Subsequent samples had lead levels well below the ODWO. Inadequate flushing of the standing water from the lines prior to sampling may have contributed to the elevated lead level. No other known health related guidelines were exceeded. The Brockville Water Treatment Plant, for the sample years 1996 and 1997, produced acceptable quality water and this was maintained in the distribution system.

The Perth Water Treatment Plant is a conventional treatment plant which treats water from the Tay River. The process consists of coagulation, flocculation, sedimentation, filtration, pH adjustment, taste and odour control and disinfection. Powder activated carbon is added for taste and odour control when required and chlorine dioxide is generated on site to provide an initial disinfection. This plant has a design capacity of 9.1 x 1000 m 3 /day. The Perth Water Treatment Plant serves a population of approximately 6,100. Raw and treated water at the plant and treated water at one location in the distribution system were sampled for the presence of approximately 200 bacteriological, inorganic, organic and radiological parameters. For 1996 and 1997, a total of 2,096 tests were performed in 6 sample events from the Perth Water Treatment Plant. The Ontario Drinking Water Objective for lead (10 µg/L) was exceeded in 1 distributed water sample. The MOE District Officer was notified. Inadequate flushing of the standing water from the pipes may have contributed to the elevated lead level. Subsequent samples showed the lead level to be well below the guideline. No other known health related guidelines were exceeded. From 1993 to 1995, a total of 6,985 tests were performed in 16 sample events from the Perth water treatment plant. No known health related guidelines were exceeded. The Perth Water Treatment Plant, for the sample years 1993, 1994, 1995 ,1996 and 1997, produced acceptable quality water and this was maintained in the distribution system.

The Prescott Water Treatment Plant is a direct filtration plant which treats water from the St. Lawrence River. The process consists of coagulation, flocculation, filtration, fluoridation and disinfection. Chlorine dioxide is generated on site to provide initial disinfection. This plant has a design capacity of 11.1 x 1000 m 3 /day. The Prescott Water Treatment Plant serves a population of approximately 4,600. Raw and treated water at the plant and water at two locations in the distribution system were sampled for the presence of approximately 200 bacteriological, inorganic, organic and radiological parameters. For 1996 and 1997, a total of 1,800 tests were performed in 5 sample events from the Prescott Water Treatment Plant. No known health related guidelines were exceeded. From 1993 to 1995, a total of 5,358 tests were performed in 13 sample events from the Prescott Water Treatment Plant. Fluoride exceeded the ODWO Maximum Acceptable Concentration of 1.5 mg/L in 1 treated water sample. The District Officer was notified. The treatment process for fluoride addition should be reviewed. No other known health related guidelines were exceeded. The Prescott Water Treatment Plant, for the sample years 1993, 1994, 1995, 1996 and 1997 produced water of good quality and this was maintained in the distribution system.

The Smiths Falls Water Treatment Plant is a conventional treatment plant which treats water from the Rideau River. The process consists of coagulation, flocculation, sedimentation, filtration, fluoridation and disinfection. Chlorine dioxide is generated on site and is used when required for taste and odour control. This plant has a rated capacity of 18.1 x 1000 m 3 /day. The Smiths Falls Water Treatment Plant serves a population of approximately 10,700. Raw and treated water at the plant and water at one location in the distribution system were sampled for the presence of approximately 200 bacteriological, inorganic, organic and radiological parameters. For 1996 and 1997, a total of 2,106 tests were performed in 6 sample events from the Smiths Falls Water Treatment Plant. No known health related guidelines were exceeded. From 1993 to 1995, a total of 6,461 tests were performed in 15 sample events from the Smiths Falls Water Treatment Plant. For 1993, 1994 and 1995 turbidity was detected above the ODWO Maximum Acceptable Concentration of 1.0 FTU in 1 treated water sample. This was an unusual situation caused by many water main breaks and a subsequent loss of pressure in the distribution system. The treatment plant was operated at maximum capacity during this time and the disinfection process was increased to ensure no adverse microbiological activity. The District Officer was notified. No other known health related guidelines were exceeded. The Smiths Falls Water Treatment Plant, for the sample years 1993, 1994 1995, 1996, and 1997 produced acceptable quality water and this was maintained in the distribution system.

Proportion of days per season that beaches are closed. Beaches are closed where the daily geometric mean of the samples exceeds 100 E. coli per 100 ml. of water.

The Medical Officer of Health is responsible for monitoring beach water quality. Routine beach surveillance consists of a minimum of one sample per week from each sampling site, with a minimum of 5 sampling sites per beach. Bacterial counts, as measured by E. coli an indicator of fecal contamination and water pollution. Contact with polluted water may result in skin rashes, ear and throat infections and gastrointestinal illness. Bacterial counts fluctuate and may be high temporarily because of rainfall and surface run-off. Other factors affecting bacteria levels include turbidity, wind velocity, air and water temperature, number of bathers and time of sampling. A pollution survey of a bathing beach area is an on-site investigation into factors and conditions that may influence the quality of bathing beach water. Public bathing beach means a beach area, owned and operated by a municipality, which has a supervised aquatics program or is staffed by a lifeguard, and meets the requirements of the sampling protocol for sampling sites. Sample collection protocols vary among public health units (PHUs) making it difficult to compare results across PHUs. However, this should not affect long term trends within a health unit if the sampling protocol has remained consistent. Need to look at the number of days each beach is posted because of wide differences between beaches in length of monitoring period.

Need to look at the number of days each beach is closed because of wide differences between beaches. The actual number of days that the beaches are closed is important because some people may be willing to ignore postings and go into the water on very hot days.

Number of hours that the Air Quality Index (AQI) is greater than 31.

In 27 Ontario cities with 34 AQI – monitoring sites, The AQI measures 6 parameters: ozone, sulphur dioxide, total reduced sulphur compounds, suspended particles, nitrogen dioxide and carbon monoxide. The air pollution index (API: combined sulphur dioxide and suspended particles) is also a sub-index of the AQI.

High AQI can have adverse effects on the health of large segments of the exposed population, particularly those with respiratory or heart problems. The index takes into consideration not only human health effects but also effects on plants and animals and aesthetics. The calculation methods for the ozone sub-index changed in 1995 to reflect new scientific findings. If an AQI station records an index above 50, the local medical officer of health is informed. Because values depend on the location of the monitor, the AQI cannot be used to assess the air quality of a large area such as a health unit. Values can change dramatically with even a small change in the monitor's location.Trends over time can be assessed only if the location has not changed.

Not all public health departments and district health councils have monitoring sites within their boundaries and not all parameters are measured at all sites. The sites were chosen based on the surrounding population size, previous air quality history, and expected potential for high levels of contaminants. Some monitors are placed in high pollution areas, i.e., high traffic zones, and do not reflect the general quality of ambient air in the community. Air quality can vary greatly within an area such as a city. Factors such as the amount of sunshine and precipitation affect air quality. Lower AQI values may be from changes in weather, not decreases in the amount of pollution generated by industry and other point sources. This indicator assesses only outdoor air quality. Indoor air quality is also of concern.

Proportion of the population 15 years and over unemployed relative to the total non-institutional population 15 years and over in the labour force.

Proportion of the population 15-24 years unemployed relative to the total non-institutional population 15-24 years in the labour force.

Unemployment indicates socially disadvantaged status. It is associated with difficult living conditions, low socio-economic status, and health and social problems. Unemployment figures are obtained mainly through censuses and labour force surveys. The criteria used to define the unemployed population may vary by source with respect to reference period, number of hours worked and wages earned. Eligibility criteria may also vary over time.

The Census provides figures on unemployment every five years. To examine trends over time, it is preferable to use monthly rates from the Canadian Labour Force Survey (by Statistics Canada); however, the criteria used to determine these rates are different. As well, data are not always available at the local level. The number of hours worked during the reference week is not taken into consideration in calculating the rate. The rate may underestimate the true unemployment rate since it does not take into account persons who have stopped actively looking for a job. Interpretation of trends is hindered by the number of persons who are working (employed) and the number of persons who are looking for work (unemployed). Thus, the unemployment rate may increase as much from a decrease or an increase in the number of jobs.

A food costing tool that is a measure of the cost of healthy eating based on current nutrition recommendations. It consists of a weekly cost of a fixed basket of food items for various age/sex groups, often expressed for a reference family of four (a man and woman, each aged 25-49 years; a boy, 13-15 years of age; and a girl 7-9 years old).

The calculation is based on the cost of a nutritious food basket according to the Ministry of Health's Monitoring the Cost of a Nutritious Food Basket Protocol (June 1, 1998). The steps to cost the nutritious food basket are described in the protocol.

Comparisons between communities, urban/rural areas, or health units is not recommended. The average prices used to generate the nutritious food basket costs are not straight average, and they do not reflect the relative market share (either in terms of volume or dollar sale) of the stores priced. The mix of stores in one community, in terms of market share, may be quite different from those in another, making area comparisons inappropriate. It is a fixed basket of 66 foods. Spending patterns from Statistics Canada's 1996 Family Food Expenditure Survey become the starting point for building the baskets with some foods excluded because of their low nutrient density (e.g., soft drinks, potato chips). The food-costing plan is thus consistent with actual buying patterns. Items in the food basket are priced at the lowest price available in the store in a specified purchase size, regardless of brand. Foods are priced in a minimum of six stores. The resulting food basket cost is based on the average cost of each food item from all grocery stores sampled. Pricing is done during a two-week period in May or June. If more than one store is priced from a grocery store chain, all stores within the chain must be priced in the same promotional week. The Basket makes no allowance for seasonal availability. Foods eaten away from home in restaurants are not considered in total weekly food costs. There is no adjustment to account for possible economies or diseconomies resulting from different sizes of families. The Basket is not truly representative of the eating habits of Canadians since it excludes highly processed convenience foods, snack foods of little nutritional value and food eaten away from home. It is based on average household purchasing patterns