Concepts and definitions
- 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 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.
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.
Statistics on deaths are based on data derived from the Population Register Centre's Population Information System maintained by local register offices. People who lived permanently in Finland at the time of their death are entered in the statistics on deaths in Finland. Death certificates are used at Statistics Finland for compiling cause-of-death statistics. The number of deaths in the population statistics differs somewhat from the figure given in the statistics on causes of death. The difference is caused by that the vital statistics do not contain deaths registered as deaths after the compilation time of the statistics (the end of the following year's January).
- 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.
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.
Official Statistics of Finland (OSF):
Causes of death [e-publication].
ISSN=1799-5078. Helsinki: Statistics Finland [referred: 23.4.2017].
Access method: http://www.stat.fi/til/ksyyt/kas_en.html