Health Inequities in Manitoba: Is the Socioeconomic Gap

Health Inequities in Manitoba: Is the Socioeconomic Gap in Health Widening or Narrowing Over Time?
Regional Health Authority (RHA)
In 1997, the province of Manitoba established the Regional Health Authorities (RHA) as governance and
management structures to be responsible for the delivery and administration of selected health services
for geographically defined areas. As of July 1, 2002, there are 11 RHAs in Manitoba: Winnipeg, Brandon,
South Eastman, Assiniboine, Central, Parkland, North Eastman, Interlake, Burntwood, NOR–MAN, and
Churchill.
Schizophrenia
The percentage of residents aged 10 or older diagnosed with schizophrenia (ICD–9–CM code 295;
ICD–10–CA codes F20, F21, F23.2, F25) in hospital abstracts or physician visits. Values were calculated
for two 5–year periods, 1996/97–2000/01 and 2001/02–2005/06. Within each period, records going back
12 years were examined to ensure inclusion of residents diagnosed earlier, but who have not had the
diagnosis attributed to recent service use records.
Substance Abuse
The proportion of residents aged 10 or older diagnosed with any of the following codes in one or more
physician visits or hospital abstracts over a five–year period: alcoholic or drug psychoses, alcohol or
drug dependence or nondependent abuse of drugs, ICD–9–CM codes 291, 292, 303, 304, 305; ICD–10–
CA codes F10–F19, F55.
Suicide Deaths or Suicide Attempts
Suicide is the act of intentionally killing oneself. Suicide attempt, also known as “self–inflicted injury” or
para–suicide, does not result in death. The three–year prevalence of suicide or suicide attempts is the
rate per 1,000 of the population aged 10 or older who attempted or completed suicide at least once in a
three–year period. The most recent event (suicide or suicide attempt) in each calendar year is counted,
adjusted by age at the time of the event. The total number of events over each three–year period is used
as the numerator. The denominator is the December 31 population age 10 or older summed over each
three–year period.
Suicidal individuals were identified by the presence of any of ICD–9–CM or ICD–10–CA codes in Vital
Statistics records, physician billing claims, or hospital discharge abstracts.
Suicide was defined as the presence of any cause of death in Vital Statistics data with a code of:
• ICD–9–CM codes: E850–E854, E858, E862, E868 (accidental poisoning), E950–E952 (self–inflicted
poisoning), E953 (self–inflicted injury by hanging), E954 (self–inflicted injury by submersion), E955
(self–inflicted injury by firearms), E956 (self–inflicted injury by cutting), E957 (self–inflicted injury by
jumping from high places), E958 (other/unspecified self–inflicted injury), E959 (late effects of self–
inflicted injury); or
• ICD–10–CA codes: X40– X42, X46, X47 (accidental poisoning by analgesics, antipyretics, anti–
rheumatics, sedative–hypnotic, narcotics), X46 (solvents and vapours), X47 (other gasses and vapours),
X60–X69 (intentional self poisoning), X70 (suicide hanging), X72–X74 (suicide by gunshot), X78 (suicide
by cutting), X71, X75–X77, X79–X84 (other suicide).
Suicide attempts were defined as the presence of any of hospital or physician claims coding a suicide
attempt using the following definitions:
1. A hospitalization with a diagnosis code of E950–E959 for suicide and self–inflicted injury.
2. A hospitalization with a diagnosis code for accidental poisoning only if there is a physician
visit with a diagnosis code for accidental poisoning and a psychiatric tariff code either during
the hospital stay or within 30 days post–discharge.
Manitoba Centre for Health Policy 205