Causes of death: documentation of statistics

Data description (SIMS 3.1)

Statistics Finland annually produces statistics on causes of death and the development of mortality. Statistics Finland also maintains death certificate archives from where death certificate data or copies of death certificates are released for purposes defined by law. The archives contain Finnish residents' death certificates from 1936 onwards. The death certificates from 1936 to 1965 are located in the National Archive and newer certificates are archived at Statistics Finland. The statistics on causes of death are based on data derived from the death certificates that are complemented with data on deaths from the Population Information System of the Population Register. The statistics on causes of death include all deaths in Finland or abroad of persons permanently resident in Finland at the time of their death. Investigating the cause of death and the related procedures including the production of statistics and archiving of death certificates is based on the Act (1973/459) and Decree (1973/948) on the investigation of the cause of death. Commission Regulation (EC) No 328/2011 confirms the data that EU Member States have to deliver concerning the statistics on causes of death.

Concepts and definitions (SIMS 3.4)

Age-standardised mortality rate

The change in mortality is described with the comparative mortality figure (CMF), which is a ratio of the age-standardised mortality rate. The standardisation is necessary so that changes in mortality not due to the ageing of the population structure can be highlighted. The age-standardised mortality rate indicates the number of deaths per 100,000 persons of the mean population, when the age structure is kept calculatorily unchanged during the whole reference period. In the publication on cause of death statistics, the European standard population as defind by Eurostat in 2012 has been used as the standard population in calculating age-standardised mortality rates.

Alcohol-related causes of death

Alcohol-related diseases include all diseases in the classification of diseases that are caused by alcohol (categories F10, G312, G4051, G621, G721, I426, K292, K70, K852, K860, O354, P043, Q860 in the International Statistical Classification of Diseases and Related Health Problems, ICD-10). Accidental poisonings by alcohol are poisoning deaths caused by alcohol or a similar substitute (category X45).

Basis for an investigation of the cause of death

The basis for an investigation of the cause of death is the information on the death certificate. The basis in law for an investigation of the cause of death is the Act on the Investigation of the Cause of Death (1973/459) Forensic autopsy: Forensic autopsy is most often performed if death has occurred in such circumstances that police investigation is necessary in order to establish the cause of death. A forensic autopsy is performed at the request of police. A police investigation will be conducted in following situations: - If the deceased was not under a doctor's care during his/her latest illness, or - If the death was caused by a crime, accident, suicide, poisoning, occupational disease or medical treatment or there is cause to suspect that the death was caused by such a reason, or - If the death otherwise occurred unexpectedly. Medical autopsy: A medical autopsy can be performed: - If the cause of death cannot be established from information on the deceased person during his/her lifetime and information related to the event of his/her death, and the deceased person was in the care of a doctor during his/her latest illness, and if an autopsy is necessary in the interest of public health and medical science, - The next of kin or otherwise close person of the deceased requests it. Thus, a medical autopsy is performed at the request of a physician or relatives of the deceased. Other basis for investigating the cause of death: The commonest other basis for an investigation of the cause of death is a clinical examination of the deceased and information on his/her latest illness or medical treatment.

Contributing cause of death

The contributing cause of death is recorded in the death certificate. The doctor will report in part II of the death certificate as contributing causes of death the reasons which have adversely affected the development of the condition leading to death and hence contributed to it. The contributing cause of death can be recognised from the data, but it is not used in the compilation of annual statistics.

Deaths

Persons permanently resident in Finland on the day of their death are recorded in the statistics as deaths. Data on deaths are obtained from the Digital and Population Data Services Agency’s Population Information System. The number of deaths may differ somewhat from each other in different statistics. The difference is due to the different compilation times of the statistics. The official number of deaths in Finland is derived from the deaths in the population statistics.

Drug-related deaths

In calculating drug-related deaths, use is made of a classification compiled by the EU's European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) (Selection B). According to it, cases where the underlying cause of death is drug psychosis, accidental poisoning, intentional poisoning, and poisoning by undetermined intent are calculated as drug-related deaths. Drugs included in the EMCDDA classification primarily refer to opioids and cannabis and its derivatives, other hallucinogens and psychostimulants suitable for abuse, such as amphetamine and its derivatives (The International Statistical Classification of Diseases and Related Health Problems, ICD-10: categories F110-F112, F120-F122, F140-F142, F150-F152, F160-F162, F190-F199, X41+T436, X42+T400-T409, X61+T436, X62+T400-T409, Y11+T436, Y12+T400-T409). The cases have been calculated in accordance with WHO's recommendation based on the substance judged as most influential. In many cases, it is a question of multiple substance poisoning where the person has also digested alcohol and/or psy-chopharmacons, for example.

Early neonatal mortality

Early neonatal mortality refers to the number of deaths during the first week of life relative to the live births during the statistical year.

General death rate

General death rate indicates the number of deaths per 1,000 or 100,000 persons of the mean population.

Immediate cause of death

Immediate cause of death refers to the disease, failure of injury whose symptoms cause the person to die. However, the actual mechanism of death, e.g. cardiac arrest, are not regarded as immediate causes of death. The immediate cause of death is recorded in the death certificate and saved in the statistical data files, but it is not used in the compilation of annual statistics.

Infant mortality

Infant mortality is calculated by dividing the number of deaths of infants under one year of age by the number of live births during the statistical year. Multiplying the result by 1,000 gives the figure in per mille.

Intermediate cause of death

Intermediate cause of death refers to the condition which leads from the underlying cause of death to the immediate cause of death. The intermediate cause of death is recorded in the death certificate and saved in the statistical data files, but it is not used in the compilation of annual statistics.

Ischaemic heart disease

Deaths from ischaemic heart diseases include deaths from coronary thrombosis and other ischaemic heart diseases (category 27 in the national classification of diseases with 54 categories; categories I20-I25 in the International Statistical Classification of Diseases and Related Health Problems, ICD-10).

Late neonatal mortality

Late neonatal mortality refers to the number of deaths which occur at the age of 7 to 27 days relative to the live births during the statistical year.

Maternal mortality

Maternal mortality covers all deaths which occur during the pregnancy or during 42 days after the end of the pregnancy, regardless of the duration or location of the pregnancy. Included are all deaths of pregnant women due to any pregnancy related cause or a cause exacerbated by pregnancy, but not accidental or violent deaths. Maternal deaths are included in Chapter XV of the International Classification of Diseases. Maternal mortality is obtained by dividing the number of maternal deaths by 100,000 live-born children.

Neonatal mortality

Neonatal mortality is calculated by dividing the number of deaths during the first week of life by the number of live births during the statistical year and multiplying the result by 1,000.

Perinatal mortality

Perinatal mortality is calculated by dividing the number of stillbirths and deaths during the first week of life by the number of all births during the statistical year. The age during the first week is calculated in hours.

Stillborn

Stillbirths include a fetus or a newborn who shows no signs of life at the time of birth after a pregnancy lasting at least 22 weeks or the newborn weighs at least 500 grams. Miscarriages that occurred at an earlier stage of the pregnancy are not regarded as stillbirths and are not included in cause of death statistics.

Underlying cause of death

The underlying cause of death is the disease which has initiated the series of illnesses leading directly to death, or the circumstances connected with an accident or an act of violence which caused the injury or poisoning leading to death. The cause of death used in statistics (the so-called statistical underlying cause of death) is determined according to the selection and application rules of the International Classification of Diseases (ICD-10) compiled by the World Health Organisation (WHO). Annual cause of death statistics are compiled according to the underlying cause of death.

Institutional mandate (SIMS 6)

Quality assurance (SIMS 11.1)

Release calendar (SIMS 8.1)

User access (SIMS 8.3)

Confidentiality - policy (SIMS 7.1)