22/12/2010 1dr. salwa tayel demography. 22/12/2010 2dr. salwa tayel demography associate professor...

22/12/2010 1Dr. Salwa Tayel Demography


Associate Professor Associate Professor Family and Community Medicine DepartmentFamily and Community Medicine Department

King Saud UniversityKing Saud University

ByBy

Dr. Salwa TayelDr. Salwa Tayel

DEMOGRAPHYDEMOGRAPHY

Mortality RatesMortality Rates


Learning objectives Learning objectives

By the end of this lecture you will be able to:By the end of this lecture you will be able to:

1.1. Define rates of mortality and study how to Define rates of mortality and study how to calculate them.calculate them.

2.2. Identify importance of each rateIdentify importance of each rate


Factors affecting population DynamicsFactors affecting population Dynamics

Fertility Fertility (births)(births)

Mortality Mortality (deaths)(deaths)

Migration.Migration.


A A mortalitymortality rate rate is a measure of the frequency of is a measure of the frequency of

occurrence of death in a defined population during a occurrence of death in a defined population during a

specified period of time.specified period of time.

Mortality RatesMortality Rates


Crude Mortality Rate (Crude Crude Mortality Rate (Crude Death Rate)Death Rate)

The crude mortality rate is the mortality rate from all causes of death for a population.

We usually multiply by 1000.1000X

locality)andyear(SamepopulationyearmidEstimated

localityandyearcertainaindeathsofnumberTotalRateDeathCrude

= … Deaths/1000 individual in the specified year and locality.


It is important to use the population size at the It is important to use the population size at the

midpointmidpoint of the time interval as an estimate of the of the time interval as an estimate of the

average population at risk especially if:average population at risk especially if:

a denominator population is growing or shrinking a denominator population is growing or shrinking

during the period of time for which a rate is to be during the period of time for which a rate is to be

computed.computed.

e.g. If a death rate is to be calculated for the year e.g. If a death rate is to be calculated for the year

2000, then the population of July 1, 2000 is used for 2000, then the population of July 1, 2000 is used for

the denominator.the denominator.


100,000XlocalityandyearsameinpopulationyearmidEstimated

localityandyeargivenaincausespecificaofDeaths

Cause-specific mortality rateCause-specific mortality rate

The cause-specific mortality rate is the mortality rate from a The cause-specific mortality rate is the mortality rate from a

specified cause for a population.specified cause for a population.

• The The numeratornumerator is the number of deaths attributed to a specific is the number of deaths attributed to a specific

cause. cause.

• The The denominatordenominator remains the size of the population at the remains the size of the population at the

midpoint of the time period.midpoint of the time period.

We multiply by 100,000.We multiply by 100,000.


100,000XlocalityandyearsameinpopulationyearmidEstimated

localityandyearcertainainTBofdeathsofNo.

istuberculostodueratedeathSpecific

This rate permits the comparison of causes of death (within the

same country and between different countries).

Example of cause specific death rates: Example of cause specific death rates:

22/12/2010 Dr. Salwa Tayel Demography 10

Proportionate mortality rates

It shows -within any population- the relative importance of It shows -within any population- the relative importance of

specific causes of death in the total mortality picture.specific causes of death in the total mortality picture.


100

locality andyear same the in disease same the having cases ofnumber Total

locality given a in andyear a in disease certain a from deaths ofnumber Total

rate fatality Case

x

Case fatality rate (Death to case ratio)

It reflects severity and virulence of diseasesIt reflects severity and virulence of diseases


Age-specific mortality rateAge-specific mortality rate

An age-specific mortality rate is a mortality rate limited An age-specific mortality rate is a mortality rate limited

to a particular age group. to a particular age group.

• The The numeratornumerator is the number of deaths in that age is the number of deaths in that age

groupgroup

• The The denominatordenominator is the number of persons in that is the number of persons in that

age group in the population. age group in the population.

Examples of age-specific mortality rates are neonatal, Examples of age-specific mortality rates are neonatal,

post-neonatal, infant and under 5-years mortality rates.post-neonatal, infant and under 5-years mortality rates.


1000x

area same andyear same in the

group age same in thenumber Total

area andyear certain a and age

certain ain dying persons ofNumber

ratedeath specific Age


a) Infant mortality ratea) Infant mortality rate•The infant mortality rate is one of the most commonly The infant mortality rate is one of the most commonly

used measures for comparing health services among used measures for comparing health services among

nations. nations. • The The numeratornumerator is the number of deaths among is the number of deaths among

children under 1 year of age reported during a given children under 1 year of age reported during a given

time period. time period. • The The denominatordenominator is the number of live births reported is the number of live births reported

during the same time period. during the same time period. • The infant mortality rate is usually expressed per The infant mortality rate is usually expressed per

1,000 live births.1,000 live births.


1000

locality andyear same the

in births live ofnumber Total

localitygiven ain andyear

a duringyear one than less toup zero

from deaths ofnumber Total

ratemortality Infant x

Infant Mortality Rate in KSA in 2005 is 18.5/1000 Infant Mortality Rate in KSA in 2005 is 18.5/1000

live birthlive birth


b) Neonatal mortality rateb) Neonatal mortality rate The neonatal period is defined as the period from birth The neonatal period is defined as the period from birth

up to (but not including) 28 days. up to (but not including) 28 days. The The numeratornumerator of the neonatal mortality rate is the of the neonatal mortality rate is the

number of deaths among children under 28 days of number of deaths among children under 28 days of age during a given time period. age during a given time period.

The The denominatordenominator of the neonatal mortality rate is the of the neonatal mortality rate is the number of live births reported during the same time number of live births reported during the same time period.period.

The neonatal mortality rate is usually expressed per The neonatal mortality rate is usually expressed per 1,000 live births.1,000 live births.


c) Postneonatal mortality ratec) Postneonatal mortality rate The postneonatal period is defined as the period from The postneonatal period is defined as the period from

28 days of age up to (but not including) 1 year of 28 days of age up to (but not including) 1 year of age.age.

The The numeratornumerator of the postneonatal mortality rate is of the postneonatal mortality rate is the number of deaths among children from 28 days the number of deaths among children from 28 days up to but not including 1 year of age during a given up to but not including 1 year of age during a given time period.time period.

The The denominatordenominator is the number of live births during is the number of live births during the same time period. the same time period.

The postneonatal mortality rate is usually expressed The postneonatal mortality rate is usually expressed per 1,000 live births. per 1,000 live births.


1000

locality andyear same the in births live ofnumber Total

locality given a in andyear a during days 28 than ssle to up zero


rate mortality Neonatal

x

1000



locality given a in andyear

a duringyear one than less to up days 28


rate mortality Neonatal-Post x


NeonatalNeonatal Post-NeonatalPost-Neonatal

2828 dayday(0 day)(0 day) 1year1yearBirthBirth

InfancyInfancy


ExampleExample

• In 1988, infant mortality rate in the United States

was 9.9 per 1,000 live births

In 1988, the neonatal mortality rate in the United

States was 6.3 per 1,000 live births

In 1988, the postneonatal mortality rate in the In 1988, the postneonatal mortality rate in the

United States was United States was 3.63.6 per 1,000 live births per 1,000 live births


?? What are the causes of neonatal and postneonatal What are the causes of neonatal and postneonatal

mortality?mortality?

What is the ratio of neonatal to postneonatal mortality?What is the ratio of neonatal to postneonatal mortality?

Compare it between developed and developing Compare it between developed and developing

countries?countries?


d) Perinatal Mortality Rated) Perinatal Mortality Rate

It is expressed as the sum number of still births It is expressed as the sum number of still births and early neonatal deaths (less than 7 days of and early neonatal deaths (less than 7 days of life) per 1000 total births (still births plus live life) per 1000 total births (still births plus live births).births).

X1000

localityandyearsamethein )livebirthsand(StillbirthsTotal

localityandyearcertainindeathsneonatalearlyNo.ofsstillbirthNo.of

M.R.Perinatal

It the best indicator of Maternal and Child Health services


NeonatalNeonatal

EarlyEarly

Post-NeonatalPost-Neonatal

InfancyInfancy

LateLateNeonatalNeonatal

77 282800dayday

1year1year


Under 5-years mortality rateUnder 5-years mortality rate

• The The numeratornumerator is the number of deaths among children under is the number of deaths among children under

5-years of age reported during a given time period5-years of age reported during a given time period

• The The denominatordenominator is the number of live births reported during is the number of live births reported during

the same time period. the same time period.

• The under 5-years mortality rate is usually expressed per 1,000 The under 5-years mortality rate is usually expressed per 1,000

live births. live births.

• In 2005, under 5-years mortality rate in KSA was 20.3/1,000

live birth


1000



locality given a in andyear a during age of years-5

under children among deaths ofnumber Total

rate mortality years-5under The

x


Maternal mortality Maternal mortality

The World Health Organization define The World Health Organization define maternal maternal

mortality mortality as: Death of the women while pregnant as: Death of the women while pregnant

or within 42 days of termination of her pregnancy or within 42 days of termination of her pregnancy

(i.e. during pregnancy, delivery and puerperium), (i.e. during pregnancy, delivery and puerperium),

for any reasons related to / or aggravated by the for any reasons related to / or aggravated by the

pregnancy or its management, but not as a result of pregnancy or its management, but not as a result of

unrelated accidental or incidental causes unrelated accidental or incidental causes


Maternal mortality rateMaternal mortality rate The maternal mortality rate is really a ratio used to The maternal mortality rate is really a ratio used to

measure mortality associated with pregnancy. measure mortality associated with pregnancy. The The numeratornumerator is the number of deaths assigned to is the number of deaths assigned to

causes related to pregnancy during a given time causes related to pregnancy during a given time period. period.

The The denominatordenominator is the number of is the number of live birthslive births reported reported during the same time period. during the same time period.

Because maternal mortality is much less common Because maternal mortality is much less common than infant mortality, the maternal mortality rate is than infant mortality, the maternal mortality rate is usually expressed per 100,000 live births.usually expressed per 100,000 live births.


Maternal mortality rateMaternal mortality rate

In 1988, the maternal mortality rate in USA In 1988, the maternal mortality rate in USA

was 8.4 per 100,000 live births.was 8.4 per 100,000 live births.

In 2000, the maternal mortality rate in KSA In 2000, the maternal mortality rate in KSA

was 12 per 100,000 live births.was 12 per 100,000 live births.

What are the main causes of maternal What are the main causes of maternal

mortality?mortality?


Sex-specific mortality rateSex-specific mortality rate

A sex-specific mortality rate is a mortality

rate among either males or females.

Both numerator and denominator are

limited to the one sex.

1000x

locality andyear same he t

duringsex same theofnumber Total

localitygiven ain andyear a during

sexcertain a of deaths ofnumber Total

ratedeath specificSex


Combinations of specific mortality ratesCombinations of specific mortality rates

Different combinations of specific mortality Different combinations of specific mortality

rates can be calculated e.g. cause-specific, rates can be calculated e.g. cause-specific,

age-specific,…age-specific,…


MigrationMigration

MigrationMigration is the movement of populations across a specified is the movement of populations across a specified

boundary for the purpose of residing. boundary for the purpose of residing.

MigrationMigration is the change of residence of a person or group of is the change of residence of a person or group of

persons for better life and higher standard of living.persons for better life and higher standard of living.

The terms The terms immigrationimmigration and and emigrationemigration are used to refer are used to refer

to moves between countries (international migration). to moves between countries (international migration).

The parallel terms: The parallel terms: in-migrationin-migration and and out-migrationout-migration are are

used for internal movement between different areas within used for internal movement between different areas within

a country (internal migration).a country (internal migration).


TypesTypes ofof migrationmigration

I- Internal migrationI- Internal migration

It is the movement within the boundaries of a It is the movement within the boundaries of a

given country.given country.

Examples of internal migration:Examples of internal migration:

1 - Rural - Urban migration.1 - Rural - Urban migration.

2 - Movement of nomads.2 - Movement of nomads.

3 - Movement of temporary and seasonal nature.3 - Movement of temporary and seasonal nature.

4 - Movement between and within urban areas.4 - Movement between and within urban areas.


II- External migrationII- External migration

a)a) PermanentPermanent migrationmigration::

An example is the permanent movement of Arabs to the An example is the permanent movement of Arabs to the

U.S.A., Australia and Canada.U.S.A., Australia and Canada.

b)b) TemporaryTemporary migrationmigration::

It is the migration over the borders of one society to another It is the migration over the borders of one society to another

for the aim of working for a number of years, with the intent of for the aim of working for a number of years, with the intent of

an eventual return to the motherland.an eventual return to the motherland.

e.g. migration of Egyptian professionals and laborers to Arab e.g. migration of Egyptian professionals and laborers to Arab

Countries.Countries.

In many countries, the effect of migration is minimal when In many countries, the effect of migration is minimal when

compared to fertility and mortality.compared to fertility and mortality.


Thank Thank youyou

Bibliotheca Alexandrina

Website http://faculty.ksu.edu.sa/73234/default.aspx

[email protected]

22/12/2010 1dr. salwa tayel demography. 22/12/2010 2dr. salwa tayel demography associate professor...

Documents

salwa tayel demographyfactors

salwa tayel demographyit

salwa tayel demographydr

rates of mortality

specific mortality rates

proportionate mortality

years mortality rates

denominator population