"just get on with it." Linking data systems to report on infant mortality and the First Nations population in Manitoba (Canada)

Abstract

The routine reporting of actionable statistics to improve system performance and prevent premature mortality has been promoted for decades. A key statistic produced nationally and globally is infant mortality. State governments define, collect and report vital events. In Canada, vital statistics is a provincial responsibility. The provinces, however, do not uniformly collect vital events for First Nations who are under Federal fiduciary responsibility or uniformly maintain a registration group field for disaggregation purposes. In 2008, Canada's Public Health Agency conceded that a lack of a First Nations identifier has obscured any understanding of First Nations perinatal health. Given these drivers of variability and the complex multi-jurisdictional vital statistics environments in which they occur, this paper demonstrates, using data linkage methods, a way to improve the estimation of infant mortality for the First Nations population in Manitoba, Canada. The method improved estimation, and demonstrated a persistent gap in infant mortality.