Unit 3.1 Flashcards
“The death rate is a fact; anything beyond this is an inference”
William Farr
“What gets measured gets done”
Mason Haire
Author of modern organization theory
Mason Haire
“the state of mental, physical and social well being, and does not merely connote
the absence of illness.”
Health; as per WHO
- Derived from the word heal (hael) which means “whole”
- signaling that health concerns the whole person and his or her integrity, or well-being
Health
absence of symptoms in an individual may not necessarily connote a healthy
condition (purpose of further medical examination/lab tests.)
Health
the concept of varying degrees or states of health (multi-factorial
phenomenon)
Health
Difficult to both qualify and quantify.
Health
Uses of health indicators
- Identify public health needs and problems
- Determine factors that contribute to causation and control of diseases
- Indicating priorities for resource allocation
- Monitoring implementation of health programs
- Evaluating outcomes of health programs
Public health needs and problems > determine factors > resource allocation > monitoring > evaluation
- One number divided by another number
- x/y
- Often multiplied by k
Ratio
OR
Odds ratio
SMR
Standardized mortality ratio
- Specific ratio
- numerator is a subset of the denominator
- x/(x+y)
- usually multiplied by k
x - with characteristic C
x+y - with and without characteristic C
Proportion
- Basic measure in disease occurrences and vital statistics
- x*/(x+y)
- usually multiplied by k
x* - frequency of events during a certain time period
x+y - no. of at risk of the event during that time period
Rate
- Prevalence
- incidence
Health status indicators
- crude and specific death rates
- maternal mortality
- infant mortality
- Neonatal mortality
- post-neonatal mortality
- child mortality
- post proportionate mortality
- case fatality
- life expectancy at birth
- DALYs lost
Health status (mortality)
- age-sex structure of the population
- population density
- Migration
- population growth indicators (crude birth rate, fertility rate, total fertility rate, annual growth rate)
Population indicators
- Access for health programs and facilities
- availability of health resources (facilities, health manpower, finances)
Indicators for the provision of health care
- cases consulting a health provider (%)
- infants exclusively breast-fed for the first 6 months (%)
- children fully vaccinated (%)
- people using treated bednets (%)
Risk reduction indicators
- level and distribution of economic wealth
- types and levels of employment,ent
- school enrollment and adult literacy
- availability of housing
- number of persons per room
- availability and distribution of food supplies
Social and economic indicators
- quantity of suspended particulate matter (SO2, CO2, hydrocarbons, oxidants)
- potability of drinking water (turbidity, coliform counts, inorganic and organic chemicals, contamination of surface water with sewage and industrial waste)
Environmental indicators
mathematical & statistical study of the:
1. size
2. Composition and spatial distribution of human populations
3. of changes over time in these aspects through the operation of 5 processes of:
- fertility
- mortality
- migration
- marriage
- social mobility
Demography
Uses of demography
- To determine the number and distribution of a population
- To determine growth or decline and dispersal odds population in the last
- To establish causal relationship between population trends and various aspects of social organization
- To predict future developments and their possible consequences
Population composition
- Sex (sex ratio, sex structure)
- Age (median age, dependency ratio)
- Age and sex (population pyramid)
Compares the number of males to the number of females
Sex ratio
Compares the sex ratio across different categories/levels of another characteristic
Sex structure
The value which cuts-off the upper 50% and lower 50% of the ages of the population.
Median age
Used to gauge whether the population is young or old
Median age
The computed value represents the number of dependents that need to be supported by every 100 persons in the economically-active groups.
Age dependency ratio
A graphical presentation of the age and sex composition of the population
Population pyramid
enables one to explain and describe the demographic trends of the population in the past.
Population pyramid
How to construct a population pyramid
- Compute the percentage of the population falling in each age-sex group using the total population, that is, males and females combined) as the denominator.
- Each group is represented by a horizontal bar. The first bar representing the youngest age group is drawn at the base of the pyramid.
- The bars for males are traditionally presented on the left side of the centralvertical axis while bars for females are presented on the right side.
- The length of each bar corresponds to the percent (%) of the population falling in *the specific age and sex group being plotted.
Population pyramid stages
- Expanding
- Expanding
- Stationary
- Contracting
• Quantitative measures
• Describe & summarize various aspects of health status of the population
- Usually expressed as ratios, proportions or rates
Health indicators
Measures how fast people are added to the population
Crude birth rate
_____ rate because the denominator is not the population at
risk
CBR
• Measures rate at which mortality occurs in a given population
Crude death rate
GFR
General fertility rate
for determining the leading causes of mortality
Cause of death rate
sensitive index of the health conditions of the general population
Infant mortality rate
Poor populations
60-150 deaths per 1000 births per year
Severe conditions
≥ 200 deaths per 1000 births per year
Infant mortality rate
Mortality rate of < 28 days old
Neonatal
Mortality rate of 28 days old to <1 yo
Post neonatal
Mortality rate of 28 weeks gestation to 7 days
Perinatal
- special kind of proportionate mortality ratio
- a sensitive indicator of the standards of healthcare
- Developed countries have higher compared to developing
Swaroop’s index
- how much of the afflicted die from the disease
- a higher CFR means more fatal disease
Case fatality rate
- the “killing power” of a disease
- the probability of dying of a certain disease
Case fatality rate
- Measures the frequency of existing disease (cases)
- Measure the burden of the disease to the community
- Assess the public health impact of a disease
Prevalence proportion (ratio)
- Measures the occurrence of new cases, episodes, events
- For identifying etiologic factors
Incidence
2 types of incidence measures
- Cumulative incidence or incidence proportion
- Incidence density
- Indicator of trend
- Evaluate program effectiveness
- Associated to RISK = the probability that a person will develop within a
specified period of time
Incidence
- Projection of medical care needs
- Proportion with the disease at a point in time
- “point in time”: calendar time, birth, employment, retirement
Prevalence proportion (ratio)
- Proportion of “disease” free individuals who contract the “disease within a specified period of time
- The average risk of developing the “disease”
Cumulative incidence or incidence proportion
- Rate at which new cases occur
- Denominator can either be ave. pop x followup period or the midyear pop
Incidence density (ID)
The proportion of deaths assigned to a specific cause during a given time interval
to the total number of deaths from all causes during the same time interval
Proportionate mortality rate
Shows disease rates in specific population groups
Specific morbidity rates
- age
- sex
- occupation
- education
- exposure to risk factors
- place of residence
- or combination of these
Specific morbidity rates
An alternative form of the incidence rate that is used when the nature of disease or condition is such that a population is observed for a short time period
Attack rate
Calculate as the number of people who became ill divided by the number of people at risk for the illness
Attack rate
Measure of burden of disease (BOD) as present value of future years lost as result of disability (morbidity) and premature death (mortality)
DALY
Indicator of population health status
DALY
YLD
Years lived with disability
YLL
Years of life lost
Computation for DALY
YLD + YLL = DALY
