EXPLANATORY NOTES


INTRODUCTION

1 This publication contains summary information on causes of death for all doctor certified deaths for Australia.

2 In order to complete a death registration, the death must be certified by either a doctor using the Medical Certificate of Cause of Death, or by a coroner. Approximately 80-90% of deaths each year are certified by a doctor. The remainder are reported to a coroner.

3 Reportable deaths which were certified by a coroner will be included in the full Causes of Death, Australia (cat. no. 3303.0) to be released in 2011. This publication will present causes of death for all deaths in 2009, whether certified by a doctor or coroner.

4 The data presented in this publication are also included in a series of spreadsheets that are available on the ABS website.

5 A glossary is provided in the Explanatory Notes tab detailing definitions of terminology used.


SCOPE AND COVERAGE

6 The statistics in this publication relate to the number of doctor certified deaths that were registered, not those which actually occurred, in the years shown.


Scope of Causes of Death Statistics

7 The ABS full causes of death statistics collection includes all deaths that occurred and were registered in Australia, including deaths of persons whose usual residence is overseas. Deaths of Australian residents that occurred outside Australia may be registered by individual Registrars, but are not included in ABS deaths or causes of death statistics.

8 The scope of the statistics includes:

• all deaths being registered for the first time;
• deaths in Australia of temporary visitors to Australia;
• deaths occurring within Australian Territorial waters;
• deaths occurring in Australian Antarctic Territories or other external territories (excluding Norfolk Island);
• deaths occurring in transit (i.e. on ships or planes) if registered in the State of "next port of call";
• deaths of Australian Nationals overseas who were employed at Australian legations and consular offices (i.e. deaths of Australian diplomats while overseas) where able to be identified; and
• deaths that occurred in earlier reference periods that have not been previously registered (late registrations).

9 The scope of the statistics excludes:

• still births/fetal deaths - these are accounted for in Perinatal Deaths, Australia (cat. no. 3304.0);
• repatriation of human remains where the death occurred overseas;
• deaths overseas of foreign diplomatic staff (where these are able to be identified); and
• deaths occurring on Norfolk Island.

10 For the 2009 reference year, the scope of the collection is:

• all deaths registered in Australia for the reference year and which are received by the ABS by the end of the March quarter of the subsequent year; and
• deaths registered prior to the reference year but not previously received from the Registrar nor included in any statistics reported for an earlier period.

11 As an example: records received by the ABS during the March quarter of 2010 which were initially registered in 2009 or prior (but not forwarded to the ABS until 2010) are assigned to the 2009 reference year. Any registrations relating to 2009 which are received by the ABS after the end of the March quarter are assigned to the 2010 reference year.

12 For the 2009 doctor certified cause of death publication, only deaths certified by a medical practitioner are presented.


Coverage of Causes of Death Statistics

13 Ideally, for compiling annual time series, the number of events (deaths) should be recorded and reported as those occurring within a given reference period such as a calendar year. However, due to lags in registration of events and the subsequent delays in the provision of that information to the ABS, not all deaths are registered in the year that they occur. This ideal is unlikely to be met under the current legislation and registration business processes. Therefore, the occurrence event is approximated by addition of the event on a state/territory register of deaths. Also, some additions to the register can be delayed in being received by the ABS from the Registrar (processing or data transfer lags). In effect there are three (3) dates attributable to each death registration:

• the date of occurrence (of the death),
• the date of registration or inclusion on the state/territory register,
• the month in which the registered event is lodged with the ABS.

14 About 4% to 6% of deaths occurring in one year are not registered until the following year or later. These are included with the count of registered deaths published for that year.


CLASSIFICATIONS

Socio-Demographic Classifications

15 A range of socio-demographic variables are available for data in the causes of death collection. Standard classifications used in the presentation of causes of death statistics include age, sex, birthplace, and Indigenous status. Statistical standards for social and demographic variables have been developed by the ABS, and are used to code these variables.


Geographic Classifications

Australian Standard Geographical Classification (ASGC)

16 The ASGC is a hierarchical classification system consisting of six interrelated classification structures. The ASGC provides a common framework of statistical geography and thereby enables the production of statistics which are comparable and can be spatially integrated. Cause of death statistics are coded to Statistical Local Area (SLA) and can be produced for aggregates of these, for example, Statistical Division, Statistical Sub-Division and State.

17 For further information about the ASGC refer to Australian Standard Geographical Classification (ASGC), Jul 2006 (cat.no. 1216.0).


Health Classifications

International Classification of Diseases (ICD)

18 The International Classification of Diseases (ICD) is the international standard classification for epidemiological purposes and is designed to promote international comparability in the collection, processing, classification, and presentation of causes of death statistics. The classification is used to classify diseases and causes of disease or injury as recorded on many types of medical records as well as death records. The ICD has been revised periodically to incorporate changes in the medical field. Currently ICD 10th revision (ICD-10) is used for Australian causes of death statistics.

19 ICD-10 is a variable-axis classification meaning that the classification groups diseases not only based on anatomical sites, but also on the type of disease. Epidemiological data and statistical data is grouped according to:

• epidemic diseases
• constitutional or general diseases
• local diseases arranged by site
• developmental diseases
• injuries.

20 For example, a systemic disease such as septicaemia is grouped with infectious diseases; a disease primarily affecting one body system, such as a myocardial infarction, is grouped with circulatory diseases and a congenital condition such as spina bifida is grouped with congenital conditions.

21 For further information about the ICD refer to: WHO International Classification of Diseases (ICD).

22 An online version of the ICD-10 can be found following this link.


DATA SOURCES

23 The registration of deaths in Australia is the responsibility of the individual state and territory Registrars of Births, Deaths and Marriages. As part of the registration process, information about the causes of death is supplied by either the medical practitioner certifying the death or by a coroner. This publication only includes data for deaths certified by medical practitioners. Coroner certified deaths for 2009 will be published in Causes of Death, Australia (cat. no. 3303.0) in 2011.

24 Other information about the deceased is compiled by the funeral director, based on information supplied by a relative or other person acquainted with the deceased, or by an official of the institution where the death occurred. This information is provided to the Australian Bureau of Statistics (ABS) by individual Registrars for coding and compilation into aggregate statistics shown in this publication. Further information regarding causes of death data sources can be obtained from:

25 Information Paper: External Causes of Death, Data Quality, 2005 (cat.no. 3317.0.55.001)

26 Information Paper: ABS Causes of Death Statistics: Concepts, Sources, and Methods, 2006 (cat.no. 3317.0.55.002)


MORTALITY CODING

27 The extensive nature of the ICD enables classification of causes of death at various levels of detail. For the purpose of this publication, data is presented according to the ICD at the chapter level, with further disaggregation for major causes of death.

28 To enable the reader to see the relationship between the various summary classifications used in this publication, all tables show in brackets the ICD codes which constitute the causes of death covered.


Updates to ICD-10

29 The Updating and Revision Committee (URC), a WHO advisory group on updates to ICD-10, maintains the cumulative and annual lists of approved updates to the ICD-10 classification. The ICD-10 is subject to several types of updates, including addition and deletion of codes, changes to coding instructions and modification and clarification of terms.

30 The cumulative list of ICD-10 updates can be found following this link.


Swine Flu

31 In response to the H1N1 virus (Swine flu) outbreak in 2009, an official update of ICD-10 called for these deaths to be coded to the cause category Influenza due to identified avian influenza virus (J09). This publication marks the first time any deaths in Australia have been coded to this category.

32 This update followed an earlier change of the ICD-10 classification in which the J09 category was added to the block Influenza and pneumonia (J10-J18) to form the J09-J18 block.

33 The ABS has not updated its publication software applications to incorporate the creation of the J09-J18 block in time for this publication. Instead, Influenza due to identified avian influenza virus (J09) can be found directly below the Acute upper respiratory infections of multiple and unspecified sites (J06) category; the death data for J09 is included in both the Acute upper respiratory infections (J00-J06) block subtotal and the total for Chapter X Diseases of the respiratory system (J00-J99).

34 The inclusion of Influenza due to identified avian influenza virus (J09) in the J09-J18 block will be implemented for the Causes of Death, Australia (cat. no. 3303.0) publication due for release in 2011. Note that in January 2011, the J09 category will have an official name change to "Influenza due to certain identified influenza virus (J09)".


State and Territory Data

35 Causes of death statistics for states and territories in this publication have been compiled in respect of the state or territory of usual residence of the deceased, regardless of where in Australia the death occurred and was registered. The state or territory of usual residence for a neonatal death is determined by the state or territory of usual residence of the mother.

36 Statistics compiled on a state or territory of registration basis are available on request.


DATA QUALITY

37 In compiling causes of death statistics, the ABS employs a variety of measures to improve quality, which include:

• providing certifiers with certification booklets for guidance in reporting causes of death on medical certificates; and
• editing checks at the individual and aggregate levels.

38 The quality of causes of death coding can be affected by changes in the way information is reported by certifiers.


STANDARDISED DEATH RATES (SDR)

39 Standardised death rates (SDRs) enable the comparison of death rates between populations with different age structures by relating them to a standard population. The ABS standard populations relate to the years ending in 1 (e.g. 2001). The current standard population is all persons in the Australian population at 30 June 2001. SDRs are expressed per 1,000 or 100,000 persons.


CONFIDENTIALISATION OF DATA

40 Data cells with small values have been randomly assigned to protect confidentiality. As a result some totals will not equal the sum of their components. It is important to note that cells with 0 values have not been effected by confidentialisation.


EFFECTS OF ROUNDING

41 Where figures have been rounded, discrepancies may occur between totals and sums of the component items.


ACKNOWLEDGEMENT

42 This publication draws extensively on information provided freely by the state and territory Registrars of Births, Deaths and Marriages. Their continued cooperation is greatly appreciated: without it, the wide range of vitals statistics published by the ABS would not be available.


ADDITIONAL STATISTICS AVAILABLE

43 ABS products and publications are available free of charge from the ABS website. Click on Statistics to gain access to the full range of ABS statistical and reference information. For details on products scheduled for release in the coming week, click on the Future Releases link on the ABS homepage.

44 As well as the statistics included in this and related products, additional information is available from the ABS website by accessing the topics listed at Themes>People. The ABS may also have other relevant data available on request. Inquiries should be made to the National Information and Referral Service on 1300 135 070 or by sending an email to client.services@abs.gov.au.