Download Measures of Mortality

Measures of Mortality
Dr. Asif Rehman

Learning outcome/Objectives
 Define Mortality, Crude death rate, Case fertility rate, Cause specific
death rate, Infant mortality rates, Maternal mortality rate
 Compare maternal mortality rate of different countries and give
reason for the differences.
 Differentiate between cause specific death rate and crude death rate.
 Calculate case fertility rate. Maternal mortality rate, infant mortality
rate and cause specific mortality rate
 Discuss the teachings of Quran about the best ending and the endless
gift of paradise that are given to those believers who strive to please
Allah by doing good.
Measurements of Mortality
 Epidemiology:
The study of the distributions and determinants of health related states
or events in specified population and the application of this study to
control health problems.
(K Park, 20th edition)
Measurements of Mortality
Specific objectives of epidemiology ?
 Cause of the disease
 Distribution/frequency of the problem
 Natural history and prognosis
 Evaluate both existing and new preventive and therapeutic
measure and modes
 To provide foundation for developing public policy
Measurements of Mortality
Mortality data:
 Traditionally and universally, most epidemiological studies begin
with mortality data. Mortality data are relatively easy to obtain,
and, in many countries, reasonably accurate. Many countries have
routine systems for collecting mortality data.
 Each year information on deaths is analyzed and the resulting
tabulations are made available by each government. Mortality data
provide the starting point for many epidemiological studies. In fact,
they are the major resource for the epidemiologist.
(K Park, 20th edition)
Measurements of Mortality
Uses of Mortality data:
Statistics on causes of deaths are important and widely used for a
number of purposes.
 They may be employed in explaining the trends and differentials in
overall mortality.
 Indicating the priorities for health action and allocation of resources.
 Mortality data is helpful in designing intervention program, and in the
assessment and monitoring of public health problems and programs.
 Moreover, they give important clues for epidemiological research.
Measurements of Mortality
Mortality Rates and Ratios;
 Crude death rate
 Age specific mortality rate
 Cause specific mortality rate
 Case fatality rate
 Infant mortality rate
 Maternal mortality rate
 Proportionate mortality rate………………………etc
Measurements of Mortality
Crude Death Rate:
 It is the number of deaths (from all causes) per 1000 estimated
mid year population in one year, in a given place.
 It measures the rate at which deaths are occurring from
various causes in a given population, during specified period.
CDR =
number of deaths (from all causes) during the year x 1000
mid year population
(K Park, 20th edition)
Measurements of Mortality
Population
CDR
Age specific death rates per 1000 populations
0-1 yrs
1-4 yrs
5-7 yrs
8-44 yrs
45-64 yrs
65+ yrs
A
15.2
13.5
0.6
0.4
1.5
10.7
59.7
B
9.9
22.6
1.0
0.5
3.6
18.8
61.1
Measurements of Mortality
Problem with CDR
The limitations of the CDR is exposed when we compare the agespecific rates b/w the two populations. Population B has higher
age-specific rates in all age group. This seeming contradiction is
due to difference in the age composition of the population. The
higher crude rate in population A is due to its older population
compared with population B which has relatively younger
population.
Currently this is the prevailing situation in most developing
countries with low crude death rates, but high age-specific death
rates.
Measurements of Mortality
Cause/Age specific death rate:
When analysis is planed to throw a light on etiology, it is essential
to use specific death rate. The specific death rates may be
a. Cause or disease specific (TB, cancer, accident etc)
b. Specific group (age, sex etc)
CSDR = No of deaths from sp disease during calendar year X 1000
Mid year population
(K Park, 20th edition)
Measurements of Mortality
Case fatality rate:
a. CFR represents the killing power of a disease. It is simply the
ratio of deaths to cases.
b. The time interval is not specified
c. CFR is typically used in acute infectious diseases (Food
poisoning, cholera, measles)
d. CFR for the same disease may vary in different epidemics
because of change in the agent, host and environment.
CFR= Total no of deaths due to particular disease X 100
Total no of cases due to the same disease
Measurements of Mortality
Infant Mortality rate
The infant mortality rate is the ratio of deaths under 1 year of age
in a given year to the total no of live births in the same year.
IMR = No of deaths of children under 1 year of age X 1000
Total no of live births in the same year
(K Park, 20th edition)
Measurements of Mortality
Maternal Mortality rate
Maternal deaths is defined as “the death of a women while pregnant or within
42 days of termination of pregnancy, irrespective of the duration and site of
pregnancy, from any causes related to or aggravated by the pregnancy or its
management but not from accidental causes”
MMR = Total no of female deaths due to complication of pregnancy, child birth
or within 42 days of delivery from puerperal causes in an area during
given year X 1000
Total no of live births in the same area and year
Measurements of Mortality
MMR of different countries
Country
MMR
Pakistan
270 per 100000 live births
India
200 per 100000 live births
USA
21 per 100000 live births
UK
12 per 100000 live births
Afghanistan
460 per 100000 live births
Measure of Mortality
 Proportionate mortality rate
 Survival rate
 Adjusted or standardized rate (Direct & indirect age
standardization)
And the best ending
An-Nahl: (32)
َ‫الَّذِينَ تتوفَّا ُه َُم ْالمَل ِئك َةُ ط ِي ِبينَ َۙ يقُولُونَ سَلَمَ عل ْي ُك َُم ا ْد ُخلُوا ْالجنَّةَ ِبما ُكنت َُْم ت َْعملُون‬
“The ones whom the angels take in death, [being] good and pure;
[the angels] will say, "Peace be upon you. Enter Paradise for what
you used to do.”
Endless gift of paradise
Al Fajr:(27,28,29)
ْ ‫س ْال ُم‬
‫فا ْد ُخ ِلي ِفي ِعبادِي‬.َ‫ضيَّة‬
َِ ‫ار ِج ِعي ِإلىَ ر ِب‬
َُ ‫يا أيَّتُها النَّ ْف‬.
ْ . َُ‫طمَ ِئنَّة‬
ِ ‫اضيةَ َّم ْر‬
ِ ‫كر‬
(To the righteous soul will be said:) "O soul, in (complete) rest and
satisfaction!. Return to your Lord, well-pleased and pleasing [to
Him], And enter among My [righteous] servants.
Exercise
In an Asian country with a mid year population of 6 million people,
60,000 deaths occurred during the year ending December 31st ,
1995. These include 30,000 deaths from cholera in 100,000 people
who were sick with cholera.
 Calculate the case fatality rate from cholera in 1995 ?

What was the cause specific mortality rate from cholera in
1995?
 Calculate the crude death rate?
THANK YOU