The study and practice of epidemiology and public health benefits from the use of core demographic statistics, such as mortality rates, which are frequently used as key health indicators. Statistics on mortality related to each condition are usually based on underlying cause of death, which is selected from the diseases declared on the standardized death certificate using international rules. However, the assumption that each death is caused by exactly one disease is debatable, particularly with an aging population in an era where infectious diseases are replaced by chronic and degenerative diseases where comorbidity is frequent. The Covid-19 pandemic has also illustrated this, where there has been a lack of evidence for contributing causes and risk factors for deaths related to coronavirus infections. The need to consider multiple causes of death has long been acknowledged in demographic research, with a small body of literature producing statistics based on contributing causes.

This project will perform the first large-scale analysis of multiple causes of death in Canada and to uniquely consider socioeconomic and spatial variation of multiple causes. This project will also evaluate the risks and prevalence for deaths related to Covid-19 as either the underlying or contributing cause of death. Using comprehensive multiple cause data from vital statistics death records in addition to Census-linked administrative data, this project will describe, assess, and visualize the nature of mortality via multiple underlying causes.

Our project has the following objectives:

  • Examine and estimate multiple cause of death relative risks, prevalence differences, standardised ratios of multiple to underlying causes, and cause of death association indicators;
  • Evaluate the above in relation to Covid-19 related deaths;
  • Assess the socioeconomic, ethnocultural, and spatial variations of multiple causes of death using Census-linked administrative data; and,
  • Visualize the 5 leading underlying causes of death and multiple contributing causes of death indicators with interactive tables and charts.