Cause-Related Mortality in Canada by Income Quintile: Examining the Impact of Multiple Causes before and after the COVID-19 Pandemic
Bibliographic record
Abstract
Mortality rates are fundamental to understanding the overall health of a population. However, statistics are usually reported using the primary underlying cause of death, overlooking potentially relevant contributing causes listed on death certificates. This paper presents indicators for multiple cause-related mortality in Canada from 2000 – 2022. Deaths from the Canadian Vital Statistics Database (2000 – 2022) were merged with multiple cause files and classified into 136 cause of death groupings. Summary statistics for multiple causes were calculated, including the Standardized Ratio of Multiple to Underlying (SRMU), which is also calculated by neighbourhood income quintile. Age-Standardized Mortality Rates (ASMR) were calculated for the underlying cause of death (ASMRUC) and compared to rates including any mention of each respective cause (ASMRAM). These were then compared to ASMRs based on a contributing-cause weighting scheme (ASMRW). The average number of causes reported on death certificates has increased from 2.79 in 2002 to 3.19 in 2021. Those in the lowest income quintiles have a higher average number of causes (3.31 in 2021) compared to those in the highest income quintile (3.09 in 2021). When employing multiple cause weighting strategies, the rank order of age-standardized mortality rates is significantly elevated for conditions including renal failure, hypertension, pneumonia, septicemia, arterial fibrillation, and artery diseases. Multiple cause-of-death approaches provide further insight into the patterns of mortality and highlight conditions that become leading causes using weighted approaches. This provides evidence to support efforts to address these conditions. There are also differences in multiple causes of death reporting by income quintile which warrants further investigation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.006 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".