Module 2 Flashcards by Deborah Karp

What are three general categories of rates?

Crude
Specific
Adjusted

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Definition of crude rates

Summary rates based on the actual number of events in a population over a given time period.

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Crude birth rate formula

Crude birth rate = (number of live births within a given period/Population size at the middle of that period) x 1,000 population

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Purpose of crude birth rate

Useful measure of population growth
An index for comparison of developed and developing countries.

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General fertility rate definition

Consists of the number of live births reported in an area during a given time interval, divided by the number of women aged 15-44 years in that area.

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Total fertility rate definition

The average number of children that would be born per woman if all women lived to the end of their childbearing years and bore children according to a given set of age-specific fertility rates.

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Fetal mortality definition

Spontaneous intrauterine death at any time during pregnancy

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Fetal death rate formula

(Number of fetal deaths after 20 weeks’ gestation or more/number of live births + number of fetal deaths after 20 weeks or more ) x 1,000

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Fetal death ratio formula

(Number of fetal deaths after 20 week’s gestation or more/number of live births) x 1,000 (during a year)

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Infant mortality rate formula

(Number of infant deaths among infants aged 0-365 days during the year/number of live births during the year) x 1,000 live births

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Neonatal mortality rate formula

(Number of infant deaths under 28 days of age/number of live births) x 1,000 lived births (during a year)

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Postneonatal mortality rate formula

(Number of infant deaths from 28-365 days after birth/number of live births - neonatal deaths) x 1,000 live births

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What is considered the perinatal period?

Late fetal deaths (stillbirths) plus infant deaths within 7 days of birth

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Late fetal death rate formula

(Number of fetal deaths after 28 weeks’ gestation or more/number of live births + number of fetal deaths after 28 weeks’ or more gestation) x 1,000

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Perinatal mortality rate formula

(Number of late fetal deaths + infant deaths within 7 days of birth/number of live births + number of late fetal deaths) x 1,000 live births and fetal deaths

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Perinatal mortality ratio formula

(Number of late fetal deaths + infant deaths within 7 days of birth/number of live births) x 1,000 live births

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What are factors that affect maternal mortality?

Maternal age
SES
Nutritional status
Healthcare access

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Maternal mortality rate formula

(Number of deaths assigned to causes related to childbirth/number of live births) x 1,000 live births (during a year)

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Specific rates definition

A type of rate based on a particular subgroup of population defined, for example, in terms of race, age, or sex, or they may refer to the entire population but be specific for some single cause of death or illness.

Cause-specific rate definition

A rate that specifies events, such as deaths according to their cause.

Cause specific rate formula

Cause specific rate = (mortality for frequency of a given dz/population size at midpoint of time period) x 100,000

What is a disadvantage of specific rates?

The difficulty of visualizing the big picture of these situations.

Proportional mortality rate (PMR) formula

PMR= (Mortality due to a specific cause during a time period/mortality due to all causes during the same period) x 100

What does PMR not measure?

The risk of dying of a particular cause

Definition of adjusted rates

Summary measures of the rate of morbidity or mortality in a population in which statistical procedures have been applied to remove the effect of differences in composition of the various populations.

What are two methods for adjusting rates?

Direct and indirect

Direct method definition

A rate adjustment that applies specific rates for a group to a standard population.

When would a direct method be used?

If age-specific death rates in a population to be standardized are known and a suitable standard population is available.

What are the requirements for direct adjustment?

The application of the observed rates of dz in a pop to some standard pop to derive an expected # (rate) of mortality.

When is the indirect method used?

If age-specific death rates of the population for standardization are unknown or unstable

Standard mortality ratio formula

SMR= observed deaths/expected deaths

Case fatality rate formula

CFR (%) = (# of deaths due to disease X/# of cases of disease X) x 100 during a time period.

What are ways of measuring morbidity?

Prevalence Incidence Quality of life measures (disability adjusted life years)

What questions do cause-specific mortality answer?

How likely is death from this cause among the whole population? What is the risk of death from this cause for the whole population?

What questions do case-fatality rate answer?

Given that one acquires the disease, how likely is it to kill you? How lethal is this disease, once you get it?

What influences the cause-specific mortality rate?

Case-fatality Incidence of the dz

Where do the numerators from mortality statistics come from?

Death certificates

What information do death certificates contain?

DOB of date of death Stated age Place of birth Place of residence Education Occupation Sex Race/ethnicity Marital status Up to four causes of death ICD-10 code for cause of death

Order of causes of death on a death certificate

Immediate cause of death Up to three contributing causes The underlying cause (any disease or injury which initiated the set of events resulting in the death)

What influences the birth rate?

The proportion of the population that is of childbearing age The average number of children that each woman has

Causes of neonatal mortality in developed countries

Congenital malformations Prematurity Low birth weight Maternal complications of pregnancy

Causes of neonatal mortality in developing countries

Low birth weight Trauma/asphyxia Tetanus

Causes of post-neonatal mortality in developed countries

SIDS Accidents Congenital malformations

Causes of post-neonatal mortality in developing countries

Pneumonia and other infectious diseases Malnutrition Accidents

Trends in developing vs developed countries in neonatal vs post-neonatal

Developed countries: mostly neonatal Developing countries: mostly post-neonatal

Leading causes of maternal mortality

Hemorrhages Lack of access to healthcare Infections Eclampsia Poor sanitation Unsafe abortions Lack of contraceptives Child marriage Women treated as inferiors

Limitation of category-specific rates

May be confusing when stratifying on multiple variables such as age, race, gender Tables become incomprehensible Use of adjusted rates preferred in these situations