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Quality description of cause of death statistics

1. Relevance of cause of death statistics

In the cause of death statistics statistical information is produced annually on the causes of death of persons permanently resident in Finland. The statistics are compiled on the basis of death certificates on deaths, and the data are supplemented with and verified against data from the Population Information System of the Population Register Centre. Death certificates are archived at Statistics Finland. The cause of death statistics and the archive of death certificates have been operating since 1936.

Cause of death data are used i.a. in health surveys, in allocating health promotion measures and monitoring health as well as in various medical examinations. By combining the data with other data files it is possible to study, for instance, differences in mortality between different population groups.

Establishing the cause of death and the related procedures are based on the Act (459/1973) and Decree (948/1973) on the Inquest into the Cause of Death.

2. Methodological description of survey

The cause of death statistics data are total data including all deaths in Finland or abroad of persons permanently resident in Finland at the time of their death.

Death certificates are issued by physicians. If determining the cause of death requires an autopsy, the death certificate is issued by a forensic pathologist after the information acquired from the autopsy is complete. The physician issuing the death certificate delivers the certificate to the Provincial State Office (from the beginning of 2010 to THL) to the regional unit where the deceased was a resident. There a forensic pathologist checks the correctness of the certificate and the certificates are sent on to Statistics Finland. At Statistics Finland the death certificate data are compared with data on the deceased obtained from the Population Information System and lists of missing death certificates are sent to Provincial State Offices (from the beginning of 2010 to THL) for monitoring purposes. The data files on causes of death are supplemented with other demographic data from the Population Information System.

From the beginning of 2010 the Provincial State Offices were discontinued and the forensic tasks of the Provincial State Offices were transferred to the National Institute for Health and Welfare (THL). These include the responsibility for checking and monitoring death certificates. The Act (459/1973) and Decree (948/1973) on the Inquest into the Cause of Death were amended in this respect.

Statistics on stillbirths are made separately; cases of stillbirths are not included in deaths during the year. The coverage of statistics on stillbirths is supplemented with data from the birth register of the National Institute for Health and Welfare (THL).

3. Correctness and accuracy of data

The data of the cause of death statistics comprise information on causes of death and other background information on the deceased and on the mother of those dead at the age of under 28 days. The information is given on the homepage of the cause of death statistics under Tietoluettelot (In Finnish only).

The physician records the cause of death on the death certificate as a code and as text specifying the diagnosis. At Statistics Finland the causes of death are coded on the basis of the diagnosis text. In case the information in the death certificate is deficient, inconsistent or difficult to classify, the information about the event recorded on the death certificate (as free text) or a medical expert will be consulted or more information is requested from the issuer of the death certificate. In cases of alcohol and medicinal poisonings, the additional information used consists of the research results from the register of forensic chemistry. The underlying cause of death is determined from the event information (free text) in the death certificate in about two to three per cent of the cases yearly. Additional information is requested from the issuer of the death certificate in about 200 to 400 cases per year. Around two to three per cent of the cases are handled by a medical expert every year. Additional information is obtained for around 200 to 300 cases per year from the register of forensic chemistry.

In practice, the coverage of the cause of death statistics is around 100 per cent, because the data on death are verified from the Population Information System as well.

The number of deaths on which no information on the cause of death is obtained is a good 100 per year. Some of them are deaths abroad, on which only a notification on death is obtained, and some are deaths in Finland, on which a death certificate was not acquired by the compilation time of the statistics.

Causes of death are currently coded according to the ICD10 classification (International Statistical Classification of Diseases and Related Health Problems, Volume 1-3, WHO Geneva 1992, new edition 2004). In some exceptional cases domestic specifications are used and in some cases the most accurate classification level cannot be attained in a reliable way. The statistics are compiled according to the rules of the classification in question and the relevant EU recommendations. The death certificate form is confirmed by the Ministry of Social Affairs and Health.

The classification of causes of death has changed several times; the classifications used in different years and the available comparable shortened cause of death classifications are described on the homepage of the cause of death statistics under Classifications.

4. Timeliness and promptness of published data

Cause of death data are produced annually and they are completed in November of the following year. The data are final and describe the deaths during the previous calendar of persons permanently resident in Finland.

5. Accessibility and transparency/clarity of data

A publication is produced yearly on the cause of death statistics and data are released on Statistics Finland's StatFin database under the topic Health. Data are provided on the whole country, by region and by hospital district. The cause of death statistics are produced according to the basic cause of death.

Cause of death data are available since 1969 as time series in the database. The variables in the time series file are described on the homepages of the cause of death statistics under Tietoluettelot (In Finnish only). Tailored statistics and research data can be made from the file for customer needs. A licence to use Statistics Finland's data files is required for research data and statistics produced by municipality. An application for a licence to use the data can be found on Statistics Finland's homepage. The cause of death data can also be combined with other data files, such as longitudinal data of population censuses and employment statistics.

Statistics Finland maintains the Finnish Archive of death certificates. The archive contains the death certificates of Finnish residents since 1936. Copies of death certificates and unit level data on causes of death are released from the archives for the purposes specified in the Act on the Inquest into the Cause of Death (459/1973). These purposes cover the releasing of data

1. to the deceased person's next of kin, a pension institution or to the authorities
2. for scientific research or statistical surveys.

Instructions for requesting death certificates and on the procedures of requesting a license to use statistical data are available on the homepage of Statistics Finland's Archive of death certificates.

6. Comparability of statistics

Statistics on cause of death have been compiled since 1936; the years 1936 to 1968 exist only in printed publications. The classification of causes of death has changed several times. The classifications of causes of death used in the classification of the basic data and the existing comparable shortened classifications are described on the homepage of the cause of death statistics under Classifications.

The longest comparable time series classification (54 categories) is from 1969 onwards. Statistics following this classification are available in Statistics Finland's StatFin database under the topic Health.

Other Statistics Finland's statistics describing the mortality rate and causes of death are vital statistics, statistics on road traffic accidents and occupational accident statistics.

In vital statistics the numbers of deaths are presented by i.a. gender, age and area. The number of deaths differs by some ten cases yearly from their number in the cause of death statistics. The difference is due i.a. to the fact that the vital statistics data do not include deaths registered after the compilation time of the statistics concerned (after January of the following year). On the other hand, the vital statistics can also contain deaths from the five previous years on which information about the death is obtained during the compilation time of the vital statistics (in January of the following year).

Statistics on road traffic accidents concern the number of deaths in road traffic. The data are obtained from the information system of the police. The coverage of these statistics is checked against the data of the cause of death statistics. The numbers of the statistics on road traffic accidents deviate from those in the cause of death statistics by some tens of cases each year. The deviation is caused by the following differences in statistical criteria:

• The statistics on road traffic accidents contain all deaths in traffic in the area of Finland, whereas the cause of death statistics include all deaths of the permanent population of Finland occurring either in Finland or abroad.
• The cause of death statistics are compiled on the basis of the day of the death, but the time period of the statistics on road traffic accidents is the day of the accident and at most the 30 following days.
• In the cause of death statistics suicides committed in traffic are included in suicides, in the statistics on road traffic accidents they are regarded as road traffic accidents.

Occupational accident statisticsare compiled on the basis of information on insurance activities and the statistics include all those accidents at work on which insurance institution have paid compensation. By contrast, in the cause of death statistics the information on occupational accidents is derived from death certificates as defined by the physician. The number of deaths from occupational accidents differs very little from the figures in the cause of death statistics.

7. Coherence and consistency/uniformity

The cause of death statistics are the only comprehensive statistics on causes of death in Finland. Statistics Finland's vital statistics are exhaustive statistics on the numbers of deaths.

When using the cause of death statistics it should be noted that mortality and the frequency of causes of death are strongly dependent on age. For that reason age standardisation is used in the statistics when comparing mortality differences between different time periods and areas. In the cause of death statistics the age standardised mortality figure is calculated most often per 100,000 persons. Age standardisation is described in more detail in Statistics Finland's eCourse in Statistics in the course Demography and population statistics.

8. Documentation

Information on the latest cause of death statistics, the concepts used, definitions and classifications can be found on the homepage of the statistics on causes of death as well as from the annual Causes of Death publication.

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Last updated 18.2.2010