The global Moran's I for MIR was 0.35 (p = .001), indicating statistically significant spatial autocorrelation  with a tendency towards clustering of health regions. Mapping of the clusters and further analysis using the LISA test revealed two clear clusters. One cluster of significantly higher MIRs was observed in the predominantly northern part of Canada, including two of the three territories (Northwest Territories = .55, Nunavut = .88), the most northern health region in Manitoba (Northern Regional Health Authority = .56), and several of the most northern regions in Quebec (Région des Terres-Cries-de-la-Baie-James = .61, Région du Nunavik = .49) and Ontario  (Porcupine Health Unit = .47, Thunder Bay District Health Unit = .45) (Figure 2). The second cluster was of significantly lower MIRs and was observed in the southern BC area (Fraser East Health Service Delivery Area = .41, and Fraser North Health Service Delivery Area = .40).