FCM 1 Dr.

Bugayong

Vital Rates and Dec. 13, 2012

Ratios

Ratio  Indicates the number of live births per 1000 population in a given
 Single numbers which represent two different variables year
 Result of dividing one variable by another variable  Crude rate because it is related to the total population
 Formula  Mainly affected by the ff:
o Ratio= (a/b) * k (k=factor) o Fertility/ marriage patterns and practices of a place
 Examples o Sex & age composition of a population
o No. of midwives/ size of entire population  Birth registration practice
o No. of hospital beds/ No. of ward admissions  If a place is under registered then the CBR is low
o No. of facilities/ No. of students
B. General Fertility Rate (GFR)
Proportion  More specific than the CBR since births are related to the
 Also a kind of ratio but the numerator is part of the denominator segment of the population capable of giving birth
 Formula
o Proportion= [(a/(a+b)] * k
o When the k (factor) becomes 100, proportion becomes
percentage
 Examples
o deaths from measles/deaths from all causes  More indicative of changes in fertility behavior than the CBR

Rate MORTALITY RATES

 The frequency of occurrence of events over a given interval of  Mortality
time o refers to deaths as a component of population change.
 Use rates when we are describing populations which have events  Rate at which deaths that occur is linked to many factors
that are dynamic  Reveals much about a population’s standard of living and health
 Are classified into two main categories care
o Crude Rates
 Denominator used is total population or midyear A. Crude Death Rate (CDR)
population  Rate at which mortality occurs in a given population
o Specific Rates
 More specific depending on the type of characteristic that
you want to measure
 Denominator used is from the corresponding segment of
the population  Factors affecting the CDR
o Age & sex composition
Vital Statistics • Younger population has a lower CDR
 Statistical data which relate the total number of various kinds of o Adverse environmental & occupational conditions
biologic or vital events to the size and characteristics of the o Peace & order conditions
affected population • In places with war CDR is high
 Serve as indices of the health conditions of a community or
population group B. Specific Mortality Rates
 Indispensable tools in the planning and evaluation of health  Shows rates of dying in specific population groups
programs
 Generally expressed as Vital Rates which are grouped under 3
categories:
o Fertility or birth rates
o Morbidity or sickness rates
o Mortality or death rates
 For each category there is a crude rate and a specific rate  can be made specific according to age, sex, occupation,
education, or a combination of these
FERTILITY RATES  They are much more valid to use than the CDR when comparing
 Fertility mortality experiences between groups
o Refers to the actual reproductive performance of a population  A graph of the age-specific mortality shows a J-shaped or U-
o Factors affecting fertility are: shaped curve
 Fecundity (fruitfulness, the state of being fertile)  In graphs of the sex-and-age-specific mortality rates, male rates
 Age at marriage or cohabitation are consistently higher than the female ones
 Availability & use of family planning
 Status of women C. Cause-of-Death Rate
 Age-sex structure
 Mortality rate from specific diseases or conditions
 Fertility & marriage practices
 Gives the rate of dying secondary to specific causes
 Economic development
**men and women in developing countries are most likely to be  Specifies the cause rather than the age & sex
uneducated about family planning practices  The ten leading causes of death are determined using this
measure
A. Crude Birth Rate (CBR)
 Measures how fast people are added to the population through
births

 The factors affecting this rate are:

o Completeness of registration of deaths
o Composition of the population
o Disease ascertainment level in the community

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KEN (Kim, Ecar, Neenya)
 D. INFANT MORTALITY RATE (IMR)
 Defined as the number of deaths among infants under 1 year of
age in a calendar year per one thousand live births in the same
period.
 Formula:
 A sensitive index of the level of health in community.
 High IMR means low levels of health standards which maybe
secondary to poor maternal & child health care, malnutrition, poor
environmental sanitation, or deficient health service delivery.
 IMR can be artificially lowered by improving the registration of
births.
 Can be divided into:
o neonatal mortality rate (NMR)
 Causes of neonatal deaths are mainly due to prenatal or genetic
factor.
o post-neonatal mortality rate (PNMR)
 Deaths occurring during the post-neonatal period are influenced
by environmental, genetic, nutritional factors and infections.
 The 2 rates add up to the infant mortality rate.
E. MATERNAL MORTALITY RATE (MMR)
 Measures the number of deaths due to diseases directly related
to pregnancy, delivery, & puerperium per 1000 live births.
 This rate is affected by maternal health practices, diagnostic
ascertainment & the completeness of registration of births.
 The ideal denominator for the MMR ought to be the number of
pregnancies.
F. Proportionate Mortality Ratio (PMR)
 Proportion of total deaths occurring in a particular population
group or from a particular cause
 Formula:
 Always expressed as a percentage
 Similar to cause of death rate, nag-iba lang sa denominator
 Increased during epidemics
Example: If the reported deaths from Pneumonia in the Phil. in 1990 were
43,349 & the total deaths were 271,136. Compute for PMR.
Answer: In 1990, 16% of all deaths in the Philippines were from
Pneumonia.
G. Swaroop’s Index
 a special kind of proportionate mortality ratio
 gives the percentage of all deaths which occur in persons 50 yrs.
and above
 Formula:
 Sensitive indicator of the standards of health care & is directly
proportional to the health status of a population.
 Swaroop’s index of 80% means that only 20% of the population
are dying before the age of 50
KEN (Kim, Ecar, Neenya)
 Developed countries have a higher Swaroop’s index than less
developed ones.
H. CASE FATALITY RATE (CFR)
 CFR is the proportion of cases which end up fatally.
 Formula:
 This measure tells us how much of the afflicted die from the
disease.
 High CFR means a more fatal disease.
 The time element implied is not annual but the usual duration of
the particular disease.
 The rate depends on the nature of the disease itself, the
diagnostic ascertainment & the level of reporting in the
population.
 CFR from hospital statistics will be higher than from the
community.
MORBIDITY OR SICKNESS RATES
 Measures the occurrence of illness or conditions in a community.
 There are 2 types of morbidity measures:
o Incidence rate (new cases)
o Prevalence rate (old & new cases)
INCIDENCE RATES
 measure the development of a disease in a group exposed to the
risk of the disease in a period of time.
Example: There were 246,057 cases of Influenza reported for the year
1975. With a population of 45,527,300. The incidence rate for Influenza
during that year would be:
Answer: The Incidence rate of Influenza in the Phil. in 1975 was 540
persons / 100,000 population.
 Incidence rate tells us the speed of development of a disease
condition & is more appropriately used to describe acute
conditions.
 It is also the measure of choice (over prevalence proportion) in
determining etiologic factors of diseases.
 There are also 2 types of measures of incidence or disease
occurrence:
1. Cumulative incidence
measures the proportion of persons in a population who are
initially free of the disease of interest & who develop the
disease within the specified time interval. (Ito na yung
incidence rate sa taas)
2. Incidence density - Used when the time of exposure varies
PREVALENCE PROPORTION
 Measures the proportion of existing cases of a disease in the
population.
 Prevalence proportion is more useful than incidence measure in
describing the occurrence of chronic conditions & as an indicator
or basis for making decisions in the administration of health
services.
 Both incidence rate & prevalence proportion are influenced by
diagnostic capabilities in the community, levels of notification, &
the age & sex composition of the population, among others.
Example: The total no. of TB cases reported in the Phil. for 1975 was
133,537 with a population of 42,527,300.
Answer: The prevalence rate of TB in the Phil in 1975 was 314 persons
per 100,000 population.
OTHER MEASURES OF HEALTH & HEALTH SERVICES
 Expectation of life at birth (life expectancy)
 Average length of stay of patients in hospitals measures the
length of time a specific group of patients spend in the hospital
continuously.
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