Premature Mortality Rates Macro Version 2.1 Leonard R. MacWilliam Manitoba Centre for Health Policy and Evaluation April 7, 1997 (version 1.0) Dec. 13, 1999 (version 2.1) This program is used to create a SAS dataset (temporary or permanent) of deaths (all causes) among persons between the ages of 0 and 74, inclusive. As well, age & sex standardized and crude rates of premature mortality per 1,000 population age 0-74 are computed using MCHPE's POP_RATE program. Deaths among persons aged 0-74 have been called PREMATURE DEATHS and have been suggested by some health researchers has the best single indicator of health status capturing the need for health care. Please refer to: Carstairs V., & R. Morris. 1991. DEPRIVATION AND HEALTH IN SCOTLAND. Aberdeen, Scotland: Aberdeen University Press. AND to: Eyles J., S. Birch, J. Chambers, J. Hurley, and B. Hutchinson. 1993. A NEEDS BASED METHODOLOGY FOR ALLOCATING HEALTH CARE RESOURCES IN ONTARIO, CANADA: DEVELOPMENT AND AN APPLICATION. Social Science and Medicine , 33:489-500. NOTE: Carstairs & Morris considered deaths among persons aged 0-64 while more recent studies (eg. Eyles et al.) have looked at aged 0-74. Given the current life expectancies of women & men in Manitoba (Canada) we define premature mortality as death before are 75. Macro Call: option implmac; option nosource ; %include '/home/lmacwil/healthstatus/concepts/_premort.mac' ; option source ; _premort options; Options: data= name of dataset from which to extract mortality data (REQUIRED , however the user can omit this parameter and the program will use the DEFAULT=cpe.vslk9612) rates= yes(pre-programmed DEFAULT) / no - indicates whether or not you want the macro to compute age-sex standardized rates. If you specify no then the macro will simply create a SAS dataset containing premature death claims. (See out= parameter below). out= name of dataset to which the mortality data is written. A two level SAS name can be used to create a permanent SAS dataset. Be sure to have a corresponding Libname statement in your program preceeding the call to this macro. (REQUIRED, however the pre-programmed DEFAULT=deaths) region= name of an area variable for which the macro will compute premature mortality values. (REQUIRED, however the pre-programmed DEFAULT = RHA). Choices are: RHA - Regional Health Authorities (see: _rha macro) WPGAREA - 9 Winnipeg Areas (see: _wpg_reg macro) PARHA - Physician Service Areas (see: _parha macro) _RANK_ - Winnipeg Urban Quintiles (see: _quint macro) startyr= four digit value representing the beginning YEAR for which to extract mortality records. (REQUIRED, with a pre-programmed DEFAULT=1993) Valid years: 1970-1996 (1997 & 98 available soon) startmth= two digit value representing the beginning MONTH for which to extract mortality records. NOTE: please include leading 0's eg. 06 - for June. (OPTIONAL, Use in conjuction with ENDYR & ENDMTH) . nyrs= an INTEGER representing the number of CALENDAR years of deaths to extract. (REQUIRED, "IF" using STARTYR only, i.e. if not using ENDYR & ENDMTH . There is a pre-programmed DEFAULT = 3). Does NOT have any effect if ENDYR & ENDMTH are specified. IF used, and ENDYR / ENDMTH are blank, this parameter will cause the macro to extract nyrs "CALENDAR" years of death records starting at Jan. 1 of STARTYR . endyr= four digit value representing the last YEAR for which to extract mortality records. (OPTIONAL) Valid years: 1970-1996. endmth= two digit value representing the last MONTH for which to extract mortality records. (OPTIONAL) NOTE: please include leading 0's eg. 06 - for June endyrs= number of CALENDAR years of mortality data to extract. (REQUIRED, only if ENDYR & ENDMTH are used). NOTE: ENDYR and ENDMTH, can be used in conjunction with STARTYR & STARTMTH to extract 12 month periods of deaths starting at dates other than Jan. 1. For example, abstracting deaths from April 1 to March 31 of the following (or later) calendar year. CAUTION : It is perhaps best to ensure that you extract complete year(s) of mortality data (i.e. 12 or 24 or 36 or etc., etc. months of data. Can not guarantee "accuracy" of rates if, say 30 months i.e. endyrs=2.5, of data are extracted. stdpopyr = a TWO digit value representing the cpe.popYR (MCHPE population) dataset to use as the standard year of population to use in the calculation of standardized rates. (REQUIRED, however the macro has a pre-programmed DEFAULT value of 92.) NOTE: the current version of this macro (v 2.1) does NOT require the following parameter (POPYR). The macro now inputs cpe.pop datasets which correspond to the years of death data. For Example, if you ask for rates on the 3 years of deaths 1994, 1995 & 1996 the macro will use cpe.pop94 cpe.pop95 & cpe.pop96 as the denominator data. IF YOU NEED TO RE-CREATE AN EARLIER ANALYSIS WITH ONLY A SINGLE (MID-YEAR) POPULATION AS THE DENOMINATOR PLEASE SEE: /home/lmacwil/healthstatus/concepts/_premort.macro.old popyr = a TWO digit value representing the cpe.popYR dataset to use as the DENOMINATOR data in the computation of rates. (REQUIRED, there is a pre-programmed DEFAULT = 94, which corresponds to the other pre-programmed defaults, that is to extract and compute rates on 3 calendar years of mortality 1993, 1994 & 1995. ) asrates = name of a dataset (temp. or permanent) to which the age-sex specific rates (produced by the pop_rates) are written. NOTE a 2 level SAS name can be used if the users call to the macro is preceeded by an appropriate LIBNAME statement. summdata = name of a dataset (temp. or permanent) to which the age-sex summarized rates (produced by the pop_rates) are written. NOTE a 2 level SAS name can be used if the users call to the macro is preceeded by an appropriate LIBNAME statement. debug= Toggle debugging feature (=debug/=nodebug(default)) Example Calls: LIBNAME dsd '/dsd1/lmacwil/examples' ; _premort startyr=1993 out=dsd.dth9395 nyrs=3 asrates=dsd.asr9395 summdata=dsd.summ9395 debug=no ; * extract 3 calendar years of deaths * 1 Jan. 1993 to 31 Dec. 1995. Save death records * in a premanent SAS dataset dth9395 in dsd1/lmacwil * Compute RATES using cpe.pop93, cpe.pop94 & cpe.pop95 as the * denominator. Save the age-sex specific AND the regional * summarized rates in permanent datasets. **********; _premort ; ** extract the 3 most recent years of deaths *; * 1 Jan. 1994 to 31 Dec. 1996 . Compute rates ; * cpe.pop94, cpe.pop95 & cpe.pop96 as the denominator.*; _premort out=dth9094 rates=no startyr=1990 startmth=04 /* extract mortality data from 1 April 1990 */ endyr=1994 /* to 31 March 1994. to a temp. dataset named */ endmth=03 ; /* dth9094 . **/; Notes: BY default, this macro creates a temporary SAS dataset, named DEATHS, containing the 3 most recent CALENDAR years of Premature Mortality i.e. deaths from Jan. 1, 1994 to Dec. 31, 1996. By default the macro extracts data from cpe.vslk9612 . Also, the macro extracts ALL CAUSE Mortality for both GENDERs. If you need to do an analysis for some sub-set (eg. injury deaths) of these deaths, please use another data step outside this macro in your SAS program. The MCHPE standard 11 age group variable (var = agegrp) is computed. The macro uses the _RHA macro to compute values for a region var. (RHA). NOTE that it has collapsed the three Winnipeg areas (H, I, J) into a single value K. Also, it uses the _WPG_REG macro to create a 2nd area variable, named WPGAREA, containing the 9 Winnipeg sub-regions. AND, The _parha and _quint macros are used to define region = PARHA and region = _rank_ (if this latter region is specified the macro restricts the analysis to Winnipeg Urban Quntile residents only) . If you find you have obtained rates which are different than ones which were previously produced and which you were attempting to replicate, please check to see if the same standard year of population and/or the same year of population for denominator computations were used. Leonard R. MacWilliam December 1999