HEALTH INDICATORS

/ VITAL STATISTICS
OUR LADY OF FATIMA UNIVERSITY
College of Nursing
Community Health Nursing 2
 LEARNING OUTCOMES:
1.
Describe the
concept of vital
statistics and health
indicators, including
3.
their relatedness Calculate rates,
2. ratio and proportion
Discuss vital health of dealth, illness and
related statistics populationss

4.
Comprehend
significance of
health indicators
 HEALTH
INDICATORS
 DEFINITION OF HEALTH
INDICATORS
Variable,
susceptible to direct
measurement, it
mirrors the state of
health of persons in
community.
DEFINITION OF HEALTH INDICATORS

Summary measures that

capture relevant information on
different attributes &
dimensions of health status &
performance of health system.
DEFINITION OF HEALTH INDICATORS

Quantitative measures,
expressed as RATES,
RATIOS OR
PROPORTIONS. I t
describes & summarize
various aspects of the
health status of the
populations
USES OF HEALTH
INDICATORS
(Tumock, 2007)
Identify public health
problems & needs

USES OF HEALTH INDICATORS

 determine factors that
contribute to causation &
control of diseases

USES OF HEALTH INDICATORS

Indicating priorities
for resource
allocation

USES OF HEALTH INDICATORS

 Monitoring Evaluating
implementation of outcomes of
health programs health programs

USES OF HEALTH INDICATORS

 Types of
Health
Indicators
 VITAL
STATISTICS
 VITAL STATISTICS

Conventionally
numerical records of
marriage, birth,
sickness & death by
which health & growth
of community may be
studied.
 VITAL STATISTICS

A tool in estimating
extent or magnitude
of health needs &
problems in
community.
Sources of Data for Vital Statistics
1. 2.
Population Registration
Census of Vital Signs

3. 4.
Studies Researches
 Statistic on population &
characteristics such as
age & sex, distribution are
obtained from Philippine
Statistic Authority (PSA)
Birth &Deaths are
registered in Office
of Local Civil
Registrar of
municipality or city
 VITAL STATISTICS

Statistics of disease
(morbidity), & death
(mortality) INDICATE VITAL HEALTH
STATISTICS INDICATORS
state of health of
community, success /
failure of health work.
Common Vital
Statistical
Indicators
FERTILITY RATES

POPULATION
INDICATORS
measures how fast people are added to the
population through births

The crude birth rate is the

annual number of live births
per 1,000 population.
 Number of births
CBR = ---------------------------------------------------- x 1000
Mid-year population.
 Number of births
CBR = ---------------------------------------------------- x 1 0 0 0
Mid-year population.

Ex.
In barangay X, there were 7,600 births in year
2010. Total population that same year was
20,600. Compute the crude birth rate?
CRUDE BIRTH RATE ( CBR)

In barangay X, there were 7,600 births in

year 2010. Total population that same year
was 20,600. Compute the crude birth rate?

7,600 Live births year 2010

CBR X 1000
20,600 total population year 2010
Measures • Population Growth
• Fertility
• Marriage Pattern & practices of
Affected
the place
by
• Sex and Age Composition
• Birth Registration Practice
 General
Fertility Rate
(GFR)
 General Fertility Rate (GFR)

Number of live births

GFR = x1000
Midyear population of 15 – 44 years of age
General Fertility Rate (GFR)

Calculates the number

of live births per 1000
women between the
ages of 15 and 44
years
 General Fertility Rate (GFR)
Number of live births
GFR = x1000
midyr population of 15 – 44 years of age

Ex. Suppose the total mid-year female population

of the reproductive age group in Barangay Y in
2008 were 65,100 and the total number of live
births in the same year registered at 860. Find out
the general fertility rate (GFR) of Barangay Y in
2008?
 General Fertility Rate (GFR)
860 registered live births
GFR = x1000
65,100 mid-yr. female pop in Reproductive Age

GFR = 13/1000 female in reproductive age group

Ex. Suppose the total mid-year female population of the

reproductive age group in Barangay Y in 2008 were
65,100 and the total number of live births in the same
year registered at 860. Find out the general fertility rate
(GFR) of Barangay Y in 2008?
General Fertility Rate (GFR)

Indications:

• High GFR
• 200/100 women
• Low GFR
• 60/100 women
 Mortality rate
Measure of frequency
of occurrence of death
in defined population
during a specified
interval.
 CRUDE MORTALITY
RATE
(CRUDE DEATH RATE)
 CRUDE MORTALITY
RATE
(CRUDE DEATH RATE)

● The mortality rate from all causes of death

for a population
CRUDE DEATH RATE

● Example: In 2018 there were 5,100

deaths in a municipality with a population
of 2,100,000. Compute the Crude Death
Rate?
 CRUDE DEATH RATE

● Example: In 2018 there were 5,100 deaths in a municipality

with a population of 2,100,000. Compute the Crude Death
Rate?
5,100 deaths in 2018
CDR = x 1000
2,100,000 total population in 2018

CDR = 2.4 per 1,000 population

 SPECIFIC
MORTALITY
RATE
 SPECIFIC MORTALITY
RATE
Number of Death in a
Specified Group
Specific Mortality Rate = --------------------------------- x1000
Midyear Population of the Same Specified Group
SPECIFIC MORTALITY RATE

Show rates of
dying in specific
population groups
SPECIFIC MORTALITY RATE age
SPECIFIC MORTALITY RATE Sex – Age
Specific Mortality
Rates
SPECIFIC MORTALITY RATE gender
CAUSE – OF –
DEATH RATE
 CAUSE – OF –
DEATH RATE
Number of Deaths from a
Specified Cause
Cause – of – Death Rate = ---------------------------- x F
Midyear Population
1,000
100,000
CAUSE – OF – DEATH RATE
Also called : Cause-Specific Mortality Rate.
Mortality rate from a specified cause for a
population.
Numerator is the number of deaths attributed to a
specific cause.
Denominator remains the size of the population at
the midpoint of the time period.
CAUSE – OF – DEATH RATE

Ex. Dublin in Republic of Ireland has a total

population 516,000 in 2016. 4,000 people
died from respiratory diseases and 9,000
died from cancer-related diseases.

Compute the Cause – of- Death Rate in

Dublin for a) Cancer & b) respiratory-related
diseases.
CAUSE – OF – DEATH RATE

Ex. Dublin has a total population 516,000 in 2016. 4,000

people died from respiratory diseases and 9,000 died
from cancer-related diseases. Compute the Cause – of-
Death Rate in Dublin per 1,000 population ?

DEATH D/T CANCER-RELATED DISEASES.

9,000 died from cancer-related diseases
Cause – of – Death Rate = x 1,000
516,000 total population in Dublin

Cause-of Death Rate = 17.4 cancer –related deaths per 1,000 population
CAUSE – OF – DEATH RATE

Ex. Dublin has a total population 516,000 in 2016. 4,000

people died from respiratory diseases and 9,000 died
from cancer-related diseases. Compute the Cause – of-
Death Rate in Dublin per 1,000 population ?

DEATH D/T CANCER

9,000 died from respiratory diseases
Cause – of – Death Rate = x 1,000
516,000 total population in Dublin

Cause-of Death Rate = 17. 4 or 17 cancer-related deaths per 1,000 population

CAUSE – OF – DEATH RATE

Ex. Dublin has a total population 516,000 in 2016. 4,000

people died from respiratory diseases and 9,000 died
from cancer-related diseases. Compute the Cause – of-
Death Rate in Dublin per 1,000 population ?

DEATH D/T RESPIRATORY DISEASES

4,000 died from respiratory diseases
Cause – of – Death Rate = x 1,000
516,000 total population in Dublin

Cause-of Death Rate = 7.7 or 7.8 respiratory – related deaths per 1,000 population
CAUSE – OF – DEATH RATE
 INFANT
MORTALITY
RATE
INFANT MORTALITY
RATE

Deaths Under One Year of Age

Infant Mortality Rate = - x 1,000
Number of Live Births
 INFANT MORTALITY RATE

Infant mortality is death of infant

before his/her first birthday.

IMR is the number of infant deaths

for every 1,000 live births.
 INFANT MORTALITY RATE

Deaths Under One Year of Age

Infant Mortality Rate = x 1,000
Number of Live Births

Example:
In the local registry somewhere in New
Zealand, record shows 58,200 live births and
200 infant deaths in year 2018.Compute IMR?
 INFANT MORTALITY RATE
Deaths Under One Year of Age
Infant Mortality Rate = x 1,000
Number of Live Births

Example:
In the local registry somewhere in New Zealand, record shows 58,200 live births and
200 infant deaths in year 2018.Compute IMR?
200 infant deaths Year2018
IMR = x 1,000
58, 200 registered live births Year 2018

IMR = 3.4 infant deaths per 1,000 live births.

 INFANT MORTALITY RATE
IMR is a good index of the general
health condition of a community.

It reflects changes in environment and

medical condition
 INFANT MORTALITY RATE

IMR is an important marker of the overall

health of a society
 Number of Deaths among those under 28
days of age in a calendar year
NMR = x 1000
Number of live births in the same year
Due to
prenatal genetic
factors
POSTNEONATAL
MORTALITY RATE
 POSTNEONATAL
MORTALITY RATE

Number of Deaths Among those 28

days to less than 1 year of age in a
calendar year
PMR = x 1000
Number of live births in the same year
POSTNEONATAL
MORTALITY RATE
Due to

• environmental
• Nutritional factor
• infectons
MATERNAL
MORTALITY RATE
MATERNAL
MORTALITY RATE
Number of Deaths due to pregnant,
delivery, puerperium in a calendar year
MMR = xF
Number of live births in the same year
1,000
100
MATERNAL
MORTALITY RATE
DEFINITION:
Death of female from any cause related to/or
aggravated by pregnancy or its management
(excluding accidental or incidental causes)
during pregnancy & childbirth or within 42
days of termination of pregnancy irrespective
of duration & site of pregnancy
MATERNAL
MORTALITY RATE
Measure obstetrical risk

Affected by maternal practices

• Diagnostic ascertainment
• Completeness of registration of births
MATERNAL
MORTALITY RATE
Ex. Data of Country B
reveals a total of 560,000
livebirths in year 2000
and a total of 360 deaths
of mothers are related to
pregnancy in the same
year. Compute MMR per
1,000 livebirths
MATERNAL
MORTALITY RATE
Ex. Data of Country B reveals a total of
560,000 livebirths in year 2000 and a
total of 3600 deaths of mothers are
related to pregnancy in the same year.

3600 deaths related to pregnancy Year 2000

MMR = x 1,000
560,000 livebirths Year 2000

MMR = 6.4 maternal deaths per 1,000 livebirths

PROPROTIONATE
MORTALITY RATE
 PROPROTIONATE
MORTALITY RATE

Number of deaths
from a particular cause
Proportionate Mortality =------------------------------- x 100
Rate Total deaths
 PROPROTIONATE
MORTALITY RATE

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
PROPROTIONATE
MORTALITY RATE

Ex. In year 2017, a certain

country in African has 1,200
deaths due to HIV among 25 – 34
years old age group. Report also
reveals 518,200 total deaths from
all causes in the same year.
 PROPROTIONATE MORTALITY RATE

Ex. In year 2017, a certain country in African

has 1,200 deaths due to HIV among 25 – 34
years old age group. Report also reveals
518,200 total deaths from all causes in the
same year.

1,200 total deaths d/t HIV 25-34 y/o, 2017

Proportionate Mortality = x 100
Rate 518,200 total deaths 2017

PMR = 0.23 or 0.23%

SWAROOP’S
INDEX
 SWAROOP’S INDEX

Number of deaths among those

50 years and over
Swaroop’s Index = x 100
Total deaths
 SWAROOP’S INDEX

an index of deaths above 50-year-old.

It is said that the higher this rate the better

is the health status of the population.
 SWAROOP’S INDEX
The higher the index means that the higher
number of population reaches 50 years of age.
Measure of longevity of Life.

very good indicator in comparing health status

of different countries
SWAROOP’S INDEX

Ex. In Italy with 257,000 confirmed cases

of COVID-19 of the current year, 4,200
patients have died. 184 among those who
died are from age 65 to 90 years old.
 SWAROOP’S INDEX

Ex. In Italy with 257,000 confirmed cases of

COVID-19 of the current year, 4,200 patients have
died. 184 among those who died are from age 65
to 90 years old.

184 deaths among elders age 50 yrs old & above

Swaroop’s Index = x 100
4,200 total patients died
SI = 4.38 or 4.4 %
CASE FATALITY
RATE
CASE FATALITY RATE

Number of deaths from a

specified cause
Case Fatality Rate = x 100
Number of cases of the Same Disease
CASE FATALITY RATE

Risk of dying
among person
Proportion of persons afflicted
cases that ends with a particular
up in mortality disease.
CASE FATALITY RATE

Ex. As of Sept 2020,CDC reports that

globally there are 28,600,000 Covid-19
confirmed cases. Deaths at 917,000 are
mostly co-morbid cases of cardiovascular
disease, diabetes, chronic respiratory
diseases, hypertension & cancer.
CASE FATALITY RATE

Ex. As of Sept 2020,CDC reports that

globally there are 28,600,000 Covid-19
confirmed cases. Deaths at 917,000 are
mostly co-morbid cases of cardiovascular
disease, diabetes, chronic respiratory
diseases, hypertension & cancer.

917,000 COVID-19 deaths

Case Fatality Rate = x 100
28, 600,000 Confirmed cases of covid-19
CFR = 3.2%
CASE FATALITY RATE

Ex. As reported from year 1918 to 1920,

around 500,000,000* (500 Million) were
infected of Spanish Flu. Around
50,000,00* million people died from the
same disease in those same year.

*estimation
50,000,000 deaths due to Spanish Flu
Case Fatality Rate = x 100
500,000,000 cases of Spanish – Flu
CFR = 10 %
CASE FATALITY RATE
 MORBIDITY
INDICATORS
Morbidity Indicators

based on disease-
specific incidence &
prevalence
PREVALENCE PROPORTION
PREVALENCE PROPORTION

Measures total number of existing cases of

disease at particular point in time divided by
the number of people at that point in time
PREVALENCE PROPORTION
Number of existing cases of disease
at a particular point in time
P= xF
Number of people examined
at that point in time
PREVALENCE PROPORTION
Increased by
Longer duration of disease
Prolongation of life of pt without cure
Increase in NEW cases (increase in Incidence)
In-migration of cases
Out-migration of Healthy people
In-migration of susceptible people
Improved diagnostic facilities (better reporting)
PREVALENCE PROPORTION
Decreased by
Shorter duration of disease
High case-fatality rate from disease
Decrease in new cases (decrease in
incidence)
In-migration of healthy people
Out-migration of cases
Improved Cure Rate of Cases
INCIDENCE
INCIDENCE
MEASURES
INCIDENCE MEASURES

Measures the number

of new cases episodes
or event occurring over
a specified period of
time (usually year)
within a specified
population at risk.
INCIDENCE MEASURES

Indicators • increasing,
of decreasing,
Condition : static

• evaluate
effect of
Measures: health
intervention
INCIDENCE MEASURES

Cumulative Incidence

Number of new cases that

developed during the period
CI = ____ X F
Number of Persons Followed - Up
INCIDENCE MEASURES

CUMULATIVE INCIDENCE
(CI)
Number of new cases that
developed during the period
CI = XF
Number of Persons Followed - Up
INCIDENCE MEASURES

INCIDENCE DENSITY RATE (ID)

Number Of New Cases That Develop During The Period

ID = XF
Sum of Person Time at Risk
 SPECIFIC
MORBIDITY
RATES
SPECIFIC MORBIDITY RATES

• Age
Shows • Sex
disease •
•
Occupation
Education
rates in • Exposure to risk
specific factors
• Place of
population residence
groups • Or combinations
of these
SPECIFIC MORBIDITY RATES

ex.
Number of TB cases among
those aged 20 -24 years
x 1,000
Midyear Population
ATTACK
RATE
 ATTACK RATE

Attack rate-- An alternative

form of the incidence rate
that is used when the nature
of a disease or condition is
such that a population is
observed for a short time
period
 ATTACK RATE

The Attack Rate is

calculated as the
number of people
who became ill
divided by the
number of people at
risk for the illness.
Useful links:
VIDEO_What Are Community Health Indicators?
https://www.youtube.com/watch?v=Yn5Lc-j4eU4

VIDEO_Incidence and Prevalence - Everything you need to

knowhttps://www.youtube.com/watch?v=cTp_ONVVrh8

VIDEO_The DALY Show, Disability-Adjusted Life Year

(DALY)https://www.youtube.com/watch?v=Exce4gy7aOk

Practice Test for Local Board Examination - TESt 1 _CHN

http://pinoybsn.blogspot.com/2006/11/community-health-nursing-
examination.html
Thanks !

01 02 03

Prepared by: Aida V. Garcia, MAN, RN

 References
Famorca, Z. 2013. Nursing Care of the Community, a
comprehensive text on community and public health nursing in
the Philippines, 2013, 62- 75.

Choi et al, Jan 2019 on Health Indicators Related to Disease,

Death, and Reproduction. Journal of Preventive Medicine and
Public Health at ww.ncbi.nlm.nih.gov/pmc/articles/PMC6378386/

Epidemiology on CDC at www.cdc.org

Health Indicators, 2018 at www. who.org

Maglaya, A, (2009) Nursing Practice In The Community 5th

Edition, Community Health Nursing: Context and Practice (pp
229 -235). Marikina: Argonauta Corporation
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