The Centre for Disease Prevention and Control of Latvia

Health Statistics Unit of Department of Research and Health Statistics

Duntes Street 22, K-5, Riga, Latvia, LV-1005

Data on causes of death (COD) provide information on mortality patterns and form a major element of public health information.

COD data refer to the underlying cause which - according to the World Health Organisation (WHO) - is "the disease or injury which initiated the train of morbid events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury".

Causes of death are classified by the 86 causes of the "European shortlist" of causes of death. This shortlist is based on the International Statistical Classification of Diseases and Related Health Problems (ICD).

COD data are derived from death certificates. The medical certification of death is an obligation in all Member States. Countries code the information provided in the medical certificate of cause of death into ICD codes according to the rules specified in the ICD.

Data are broken down by sex, 5-year age groups, cause of death and by residency and country of occurrence. For stillbirths and neonatal deaths additional breakdows might include age of mother.

Annual national data are provided in absolute number, crude death rates and standardised death rates. At regional level (NUTS level 2) the same is provided in form of 3 years averages. Annual crude death rates are also available at NUTS level 2.

Public Health

1. National definition used for usual residency

Resident population refers to persons permanently residing in Latvia and residents of Republic of Latvia residing abroad for a period less than one year.

2. Stillbirths

a) National definition used for stillbirths

Stillbirth – is foetus born lifeless after 22 weeks of pregnancy (after 154 days, when weight of foetus is 500 g, usually). Death is confirmed with fact that foetus is not breathing after separation from mother and showing no evidence of life as heart activity, pulsation of umbilical cord or motion of muscles.

b) What are the characteristics that you collect (gestational age, weight, crown-heel)?

We collect gestational age, weight and crown-heel.

Resident population refers to persons permanently residing in Latvia and residents of Republic of Latvia residing abroad for a period less than one year.

Stillbirths

a) National definition used for stillbirths

Stillbirth – is foetus born lifeless after 22 weeks of pregnancy (after 154 days, when weight of foetus is 500 g, usually). Death is confirmed with fact that foetus is not breathing after separation from mother and showing no evidence of life as heart activity, pulsation of umbilical cord or motion of muscles.

b) What are the characteristics that you collect (gestational age, weight, crown-heel)?

We collect gestational age, weight and crown-heel.

The statistical units are the deceased persons and the stillborns, respectively.

1. Neonates: Are neonatals of non-resident mothers considered residents?

Neonatal of non-resident mother considered resident when father is resident. When both mother and father is non-residents – non-resident.

2. Coverage

a) Do you include non-residents in your national statistics?

No

b) Do you include residents dying abroad in your national statistics? If yes, how do you record the cause of death? 

Yes, we record them as died abroad - if we receive a medical certificate or certificate of death. In case we have no information about cause of death, the recorded cause of death is R99. 

Neonatal of non-resident mother considered resident when father is resident. When both mother and father is non-residents – non-resident.

Mortality registry contain information about non-residents' deaths.

The data about residents dying abroad are included in the Mortality registry in case if such information has received. Most often is missing the information about cause of death, external cause of death. The information abot sex, age and month of death is more or less available.

Latvia

Time series available from 1996 onwards.

Constant series refers to calendar year.

The data are published in absolute numbers, crude death rate and standardised death rate.

Data refer to the calendar year (i.e. all deaths occurring during the year).

The last reference year provided 2021.

Countries submitted data to Eurostat on the basis of a gentleman's agreement established in the framework Eurostat's Working Group on "Public Health Statistics" until data with reference year 2010. The first data submitted according to the Regulation (EU) No 328/2011 is data with reference year 2011.
A Regulation on Community statistics on public health and health and safety at work (EC) No 1338/2008 was signed by the European Parliament and the Council on 16 December 2008. This Regulation is the framework of the data collection on the domain.
Within the context of this framework Regulation, a Regulation on Community statistics on public health and health and safety at work, as regards statistics on causes of death (EU) No 328/2011 was signed by the European Parliament and the Council on 5 April 2011.

Legal acts that assign responsibility as well as the authority to the CDPC for the collection, processing, and dissemination of statistics.

Statistics Law,

Law on Registration of Civil Status Acts,

Republic of Latvia, Cabinet Regulation No.761, Regulations Regarding Registers of Civil Status Acts

Republic of Latvia, Cabinet Regulation No. 241, By-laws of the Centre for Disease Prevention and Control

ESTAT, WHO, EMCDDA

Regulation (EC) No 223/2009 on European statistics (recital 24 and Article 20(4)) of 11 March 2009 (OJ L 87, p. 164), stipulates the need to establish common principles and guidelines ensuring the confidentiality of data used for the production of European statistics and the access to those confidential data with due account for technical developments and the requirements of users in a democratic society.

Law on the Rights of Patients.

All age groups showing a total mortality of less than 4 cases are considered as confidential. Therefore, any 'confidential' agegroup is grouped with another one to have higher numbers. In practice, this problem mainly occurs for young ages so, either the ages from 0 to 14 years old, or the ages from 0 to 14 and 15 to 24 years old are grouped. The age groups considered as confidential show then the value ':' and the age group '0-14y' (and '15-24y' if needed) shows the sum of all ages before 15 years old (or between 15 and 24 years old). In addition, special measures for ensuring confidentiality may be taken for small countries.

For stillbirth and neonatal figures, no breakdown by parity is displayed to ensure confidentiality.

The data is released according to the release calendar. 

The release calendar can be accessed on the CDPC homepage.

The data release policy is based on publication calendar. All data users have equal access to information when data will be available, what are the definitions and metadata.

Annual.

News releases on-line.

Annual data published on homepage.

Data Presentation System (contain data for 1989-2017).

Health Statistics Database (contain data for 2008-2023).

Please consult free data on-line or refer to contact details.

https://statistika.spkc.gov.lv/pxweb/lv/Health/Health__Mirstiba/?tablelist=true 

Not available

Micro-data are not disseminated.

Not available

Not available.

Methodological documents are available together with published data.

https://statistika.spkc.gov.lv/pxweb/lv/Health/Health__Mirstiba/?tablelist=true

100%

The quality of COD data is subject to the way in which the information on causes of death is reported and classified in each country (i.e. national certification and coding procedures). In general, all countries follow the standards and rules specified in the ICD, and the overall procedures for the collection of COD data are relatively homogenous between European countries (medical certification of cause of death, use of ICD).

However, national differences in interpretation and use of ICD rules exist and as a result important quality and comparability issues remain. Based on the report "Comparability and Quality Improvement of the European Causes of Death Statistics" countries work towards further improving certification and coding procedures.

Ongoing work is reported to Eurostat's Working Group "Public Health Statistics" (documents available on circabc).

The causes of death data are based on a regulation, which defines scope, definitions of variables and characteristics of the data.

Not available.

Based on the 34 answers received from the web survey, the main users are Research Institutes,  Universities, Public Government agencies, Private, Commission services and Business companies. On these 34 answers, Eurostat data on Causes of Death are "essential", "important", or "used for background information" for 25 respondents.
Asking about the availability of needed data in the Eurostat production, users are divided in two equivalent part: 12 answered that they do not need statistics on the field not currently available from Eurostat and 13 answered that they need, giving information about defects and lacks of the Eurostat data.

The main mortality data users in Latvia are:

Ministry of Health

Other state institutions

Self-governments

Health Registries

Universities

Insurance companies

Researchers

Users were asked to assess each of the classical elements that characterise the quality of statistics.

Respondents generally give high scores to the different dimensions of data quality and to the supporting service that is perceived as "Good or Very Good" by the users (14 out of 21 respondents expressing opinions about this). The overall quality, comprising both data quality and supporting service, is perceived as "Good" or "Very good" by 16 out of 24 respondents to those questions.

Among different data quality dimensions, coherence and comparability receive the higher satisfaction. The less appreciated dimension is the completeness.

There are no user satisfaction surveys or other user consultations performed in Latvia.

All data received are disseminated on Eurostat's website.

The only problem is data about death cases for persons deceased abroad. This information is not received completely yet. However, we are improving the data flow, so data for 2022 should contain all information about deceased persons abroad too.

Mandatory variables are provided completely.

All known death cases are registered.

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From data collection with reference year 2011 onwards, Eurostat asks for the submission of final data for the year N at N+24 months.

Not applicable.

Not applicable.

From data collection with reference year 2011 onwards, Eurostat asks for the submission of final data at national and regional level and related metadata for the year N at N+24 months, according to the Implementing Regulation (EC) No. 328/2011, Article 4.

The data are comparable between the regions of the country.

The process of collecting, coding, transmission the data is the same for all regions.

Not applicable.

The comparability of the data over time in the National database is from 1996.

The data before and after 2011 are not always comparable due to the fact that 2011 data is the first data collection with a legal basis and there were some changes in the requested variables and breakdowns.

The main problem is the loss of medical information for deaths of residents of Latvia registered abroad. At this moment it is impossible to indicate the % of missing certificates for deaths registered abroad, as all find cases are registered. This information could be available for data starting from 2022.

Not applicable, only annual data are available.

Not applicable.

All known deaths are registered in the death registry. 

The cost and burden of the data collection is reduced by using validation and dissemination IT tools.

Not applicable.

Data is systematically revised with Central Statistical Bureau of Latvia. Data are occasionally revised, e.g. if the "NUTS" changes or if a country notifies Eurostat about any changes in the data.

Not applicable.

Data are collected by two certificates - Medical death certificate and Medical perinatal death certificate.

Civil registry offices submit death certificates once a month.

4. Stillbirths and Neonates: Do you have a different death certificate or do you code these data differently from other deaths? If yes, how?

a) Stillbirths

For perinatal deaths (stillbirths and children aged less than 7 days) we use separate certificate of death.

b) Neonates

For neonates aged less than 7 days we use separate death certificate, and for neonates 7-27 days old we use general Medical certificate of cause of death. 

See in 18.3

See in 18.3

See in 18.3

See in 18.3

See in 18.3

The coding is only on the Central level.  Data comparison is performed with other available data sources.  Certificates are updated after the consultation with certifiers. The information from all autopsies is available for coding. Double coding exercises are performed within activities of Nordic-Baltic Mortality group.

Description of coding procedure (central level, distributed among other bodies, etc.):

 Central level

Description of the procedures to detect errors (i.e.errors such as potential inconsistency in the death certificate or error due to mistake when filling the deaths certificates):

 Data comparison with other available data sources

Description of the measures taken in order to solve detected errors:

 Consultation with certifiers, certificates' updating

Coding performed by a certifier:

 Not applicable. The coding is only on the central level.

Estimation of the percentage of autopsy from which information is available for coding:

  Information from all autopsies are available for coding

Description of double coding exercises and rate of codification errors for underlying cause of death:

 Double coding exercises are performed within activities of Nordic-Baltic Mortality group

Not available

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Register of Natural Persons

CDPC of Latvia is in charge of data compilation.

Not applicable.

WHO and EUROSTAT coding rules are used to reach international standards.

Not applicable.

None.