BIOSTATISTICS

GENERAL

As sanitary engineers, we should be sufficiently acquainted with vital statistics and their uses to
be able apply them to his work. Morbidity statistics and mortality statistics which are concerned
with death and the causes of death, indicate more or less clearly the healthfulness of a community
and the success and failure of health work. What is even more important, they may give valuable
clues as to the character of work that is required. Birthrates are somewhat less important but are
useful in the other lines of health activities. The prediction of future population is essential in
connection with the planning of such sanitary improvements as water treatment plants, sewage
disposal works and sewer extensions. Complete studies of vital statistics include many other
items such as marriage and divorce rates and characteristics of population of the country as to
age, race, etc.

VITAL STATISTICS/BIOSTATISTICS

Pertains to BIRTH and DEATH records in general, VITAL pertains to life or concerning
BIRTHS, MARRIAGES, DEATHS, and ILLNESSES.

The Science and Analysis of Vital on Population with particular reference to Birth,
Marriage, Morbidity and Mortality

Vital statistics are the information maintained by a government, recording the birth and
death of individuals within that government's jurisdiction. These data are used by public health
programs to evaluate how effective their programs are. They are the cornerstone of public health
systems today.

Useful by-products of birth and death registration are official certificates of those events.
These certificates serve as primary evidence of that event.
STATISTICS
It is the study of the collection, organization, analysis, and interpretation of data. It deals
with all aspects of this, including the planning of data collection in terms of the design of surveys
and experiments.

STATISTICIAN
Someone who is particularly well versed in the ways of thinking necessary for the
successful application of statistical analysis and working in any of a wide number of fields.

IMPORTANT TERMS AND ITS DEFINITION

BIRTH CERTIFICATES
 The certificate contains the date and place of birth, the name and sex of the child; the
name, age, race, birthplace and residence of the parents; and the occupation of the father.

CASE FATALITY RATE (CFR)

 The proportion of cases which end up fatality.

1 of 15
CAUSE-OF-DEATH RATE OR MORTALITY RATE FROM SPECIFIC DISEASES OR
CONDITIONS
 Gives the rate of dying secondary to specific causes.
CENSUS
 An official count of a population; the information is obtained through questions may be
classified under the following headings: place of abode, tenure of home, personal
description, citizenship, nativity, and occupation.

CRUDE BIRTH RATE (CBR)

 A measure of one characteristic of the natural growth or increase of a population.
 Measures how fast people are added to the population through births.

CRUDE DEATH RATE (CDR)

 A measure of one mortality from all causes which may result in a decrease of population.
 Gives the speed with which mortality occurs in a given population.

CRUDE or GENERAL RATES

 These rates are referred to the total living population. It must be presumed that the total
population was exposed to the risk of the occurrence of the event.

DEATH
 Is the permanent disappearance of all evidence of life at any time after live birth has
taken place (postnatal cessation of vital functions without capability of resuscitation).

DEATH CERTIFICATES
 Death certificates are required by the Law. They include as to name, usual residence, age,
race, nativity, conjugal condition, occupation and ate of death of the deceased.

FETAL DEATH
 The death prior to the complete expulsion or extraction of a product of conception from
its mother, irrespective of the duration of pregnancy; the death is indicated by the fact
that after such separation the fetus does not breathe or show any other evidence of life,
such as beating of the heart, pulsation of the umbilical cord, or definite movement of
voluntary muscles.

FETAL DEATH RATE (FDR)

 Measures pregnancy wastage. Death of the product of conception prior to its complete
expulsion, irrespective of duration of pregnancy.

INCIDENCE RATE (IR)

 Measures the frequency of occurrence of the phenomenon during a given period of time.
Deals only with new cases.
 Measures the development of disease in a group exposed to the risk of the disease in a
period of time.

2 of 15
INFANT MORTALITY/DEATH
 The death of an infant under one year of age.

INFANT MORTALITY RATE (IMR)

 Measures the risk of dying during the 1st year of life. It is a good index of the general
health condition of a community since it reflects the changes in the environmental and
medical conditions of a community.
 Defined as the number of deaths among infants under one year of age in a calendar year
per one thousand live births in the same period.

GENERAL FERTILITY RATE (GFR)

 More specific rate than the crude birth rate since births are related to the segment of the
population deemed to be capable of giving birth.

LATE FETAL DEATH

 The death of fetus with 28 or more completed weeks of gestation.

LIVE BIRTH
 The complete expulsion or extraction from its mother of a product of conception,
irrespective of the duration of the pregnancy, which after such separation, breathes or
shows any other evidence of life, such as beating of the heart, pulsation of the umbilical
cord, or definite movement of voluntary muscles, whether or not the umbilical cord has
been cut or the placenta is attached; each product of such birth is considered liveborn.

MATERNAL MORTALITY/DEATH
 The death of a woman while pregnant or within 42 days of termination of pregnancy,
irrespective of the duration and the site of the pregnancy, from any cause related to or
aggravated by the pregnancy or its management, but not from accidental or incidental
causes.

MATERNAL MORTALITY RATE (MMR)

 It measures the risk of dying from causes related to pregnancy, childbirth and
puerperium. It is an index of the obstetrical care needed and received by the women in a
community.

MORBIDITY STATISTICS
 The statistics of disease

MORTALITY STATISTICS
 Concerned with death and the causes of death, indicate more or less clearly the
healthfulness of a community and the success and failure of health work.

NEONATAL DEATH

3 of 15
  The death among live births during the first 28 completed days of life. NEONATAL
DEATH RATE (NDR) - Measures the risk of dying during the 1st month of life. May
serve as index of the effects of prenatal care and obstetrical management on the newborn.

PLACE OF OCCURRENCE
 Refers to the place where the vital event took place.

PREVALENCE RATE (PR)

 Measures the proportion of the population which exhibits a particular disease at a
particular time. This can only be determined following a survey of the population
concerned. Deals with total (old and new) number of cases.
Measures the proportion of existing cases of a disease in the population.
The term “existing” refers to old and new cases of the diseases.
PROPORTIONATE MORTALITY (PM)
 Shows the numerical relationship between deaths from a cause (or groups of causes), age
(or groups of age) etc. and the total number of deaths from all causes in all ages taken
together. Not a measure of risk of dying.

RATE
 In Vital Statistics, a rate shows the relationship between a vital event and those persons
exposed to the occurrence of said event, within a given area and during a specified unit of
time. It is evident that the persons experiencing the event (the numerator) must come
from the total population exposed to the risk of same event (the denominator).

RATIO
 It is used to describe the relationship between two (2) numerical quantities or measures of
events without taking particular considerations
to the time or place. These quantities need not necessarily represent the same entities,
although the unit of measure must be the same for both numerator and denominator of the
ratio.

SPECIFIC DEATH RATE/ SPECIFIC MORTALITY RATES

 Describes more accurately the risk of exposure of certain classes or groups to particular
diseases. To understand the forces of mortality, the rates should be made specific
provided the data are available for both the population and the event in their
specifications. Specific rates render more comparable results and thus, reveal the
problems of public health.
 Show rates of dying in specific population groups.

SPECIFIC RATE
 The relationship is for a specific population class or group. It limits the occurrence of the
event to that portion of the population definitely exposed to it.

TOTAL FERTILITY RATE (TFR)

4 of 15
  Refers to the number of children a woman would have by the time she reaches age 50
under a given fixed fertility schedule. It is sometimes referred to as completed family
size. It is the average number of births per 100 females aged 15-49 years.

USUAL RESIDENCE
 Refers to the place where the person/deceased habitually or permanently resides.

SOURCES OF VITAL STATISTICAL DATA

Vital events refer to marriages, births, deaths, fetal deaths, and all such events that have
something to do with an individual's entrance and departure from life, together with the changes
in civil status that may have occurred during the lifetime of a person. Recording of these events
in the civil register is known as vital or civil registration. The following are the sources of Vital
Statistical Dat.

WORLD HEALTH ORGANIZATION (WHO)

The health statistics and information systems of the World Health Organization
provides the comprehensive, timely, and reliable health and health – related statistics which
are fundamental for assessing the state of a population’s health and how it is changing.
The WHO established a Reference Group on Health Statistics in 2013 to provide
advice on population health statistics to WHO with a focus on methodological and data
issues related to the measurement of mortality and cause – of – death patterns. Recent
developments in global health and an increased focus on monitoring and accountability
suggest that the role, responsibilities, scope and membership of the Reference Group must be
renewed to ensure that WHO and its Member States continue to benefit from the best
possible scientific and strategic advice and support in the generation, use, interpretation, and
dissemination of global health statistics.
PHILIPPINE STATISTICS AUTHORITY (PSA)
The Philippine Statistics Authority (PSA) shall primarily be responsible for the
implementation of the objectives of R.A. 10625.
It shall plan, develop, prescribe, disseminate and enforce policies, rules and
regulations and coordinate government – wide programs governing the production of official
statistics, general – purpose statistics, and civil registration services.
It shall primarily be responsible for all the national census and surveys, sectoral
statistics, consolidation of selected administrative recording systems and compilation of
national accounts.
The PSA shall:
 Serve as the central statistical authority of the Philippine government on primary
data collection;
 Prepare and conduct periodic censuses on population, housing, agriculture,
fisheries, business, industry, and other sectors of the economy;
 Collect, compile, analyze, abstract and publish statistical information relating to
the country’s economic, social, demographic and general activities and condition
of the people;
 Prepare and conduct statistical sample surveys on all aspects of socioeconomic
life including agriculture, industry, trade, finance, prices and marketing

5 of 15
 information, income, and expenditure, education, health, culture, and social
situations of the government and the public;
 Carry out, enforce and administer civil registration functions in the country as
provided for in Act 3753, the Law on Registry of Civil Status;
 Collaborate with the department of national government including GOCCs and
their subsidiaries in the collection, compilation, maintenance and publication of
statistical information, including special statistical data derived from the activities
of those departments, corporations and their subsidiaries.
 Promote and develop integrated social and economic statistics and coordinate
plans for the integration of those statistics, including the national accounts;
 Develop and maintain appropriate frameworks and standards for the collection,
processing, analysis and dissemination of data;
 Coordinate with government departments and local government units (LGUs) on
the promotion of statistical standards involving techniques, methodologies,
concepts, definitions and classifications and on the avoidance of duplication in the
collection of statistical information;
 Conduct continuing methodological, analytical and development activities, in
coordination with the PSRTI, to improve the conduct of censuses, surveys and
other data collection activities;
 Recommend executive and legislative measures to enhance the development of
the statistical activities and programs of the government;
 Prepare, in consultation with the PSA Board, a Philippine Statistical Development
Program (PSDP);
 Implement policies on statistical matters and coordination, s directed by the PSA
Board, and;
 Perform other functions as may be assigned by the PSA Board and as may be
necessary to carry out the purposes of R.A. 10625.

In local level, it is the City or Municipal Civil Registry Office has the duty and
responsibility on the collection, analysis and dissemination of different vital health data.

DEPARTMENT OF HEALTH (DOH)

The EPIDEMIOLOGY BUREAU of the Department of Health provides stakeholders
with surveillance and epidemiologic information to prevent and control outbreaks and to
improve health policies, programs and systems and also develop competent health personnel
to detect and respond to public health threats.
The Epidemiology Bureau of DOH has the following functions:
 Develop and evaluate surveillance systems and other health information systems
 Collect, analyze and disseminate reliable and timely information on the health
status
 Investigate disease outbreaks and other threats to public health
 Network public health laboratories in support of epidemiological and surveillance
activities
The Epidemiology Bureau has three divisions which include:
 Applied Epidemiology Health Management Division
 Public Health Surveillance Division

6 of 15
  Survey, Monitoring and Evaluation Division

Registration of vital events is the responsibility of the Local Government

Units (LGU) through the LCRs who are under the technical supervision of the Civil Registrar
General of the NSO by virtue of the provisions of Act 3753. However, pursuant to the Philippine
Statistical Act of 2013, the PSA took over the civil registration function of NSO with the
National Statistician as the Civil Registrar General who provides overall directions in the
implementation of the Civil Registry Law and related issuances and exercises technical
supervision over the LCR.
POPULATION PROJECTION/ESTIMATION

To be able to estimate the population for any date in the future, one should have the population
count for an earlier date. It is upon the population of any particular geographical subdivision that
its vital statistics are based and this information is obtained from census reports.

For vital statistics purposes, population during non - censal years are generally estimated
by the arithmetic increase, the geometric increase, or other suitable methods.

ARITHMETIC METHOD – it is assumed that the actual increase in population per year
is constant.

Pf = Pp + nk

where: Pf – future population

Pp – present population
n – number of years
k – constant annual increase

GEOMETRIC METHOD – it is assumed that the rate of increase in population per year
as a percent of the previous population is constant.

Pf = Pp (1+k) n

where: Pf – future population

Pp – present population
n – number of years
k – constant rate of increase

FORMULA OF VITAL HEALTH INDICATORS

7 of 15
8 of 15
9 of 15
10 of 15
11 of 15
SAMPLE CALCULATIONS
Given the following data with reference to 2016 Philippine Health
Statistics Report, determine the following:
 Crude Birth Rate  Case Fatality Rate for the following diseases:
► Philippines ► Pneumonia
► CALABARZON ► Hypertension
► Batangas Province Crude ► Dengue Fever
 Death Rate ► Cholera
► Philippines ► Measles
► CALABARZON ► Diarrheas
► Batangas Province ► Schistosomiasis

Fetal Death Ratio Proportionate Mortality from:

► Philippines ► Pneumonia
► CALABARZON ► Hypertension
► Batangas Province Fetal ► Dengue Fever

Death Rate ► Cholera
► Philippines
► Measles
► CALABARZON ► Diarrheas
 ► Batangas Province Infant ► Schistosomiasis
Mortality Rate  Cause – Specific Death Rate from:
► Philippines ► Pneumonia
► CALABARZON
► Hypertension
 ► Batangas Province
► Diarrheas
Maternal Mortality Rate
► Dengue Fever
► Philippines
 ► CALABARZON
Maternal Mortality Ratio
► Philippines
► CALABARZON
► Batangas Province

HEALTH INDICES PHILIPPINES CALABARZON BATANGAS PROVINCE

Total Population 103 711 049 15 172 632 1 857 796
Total Live Births 1 731 289 251 344 30 071
Total Deaths 582 183 82 764 10 951

12 of 15
 Infant Deaths 21 874 3 727 408
Maternal Deaths 1 483 213 25
Fetal Deaths 8 020 1 226 143
Female Population
27 138 604 251 344
(15 -49 yrs old)

PHILIPPINES
DISEASES
Cases Deaths

Pneumonia 786 085 57 720

Hypertension 886 203 33 452

Dengue Fever 40 158 1 936

Cholera 136 9

Measles 1 952 5

Diarrheas 174 418 5 393

Schistosomiasis 1 528 318

Solution:
In all the calculations requiring the total population, instead of using the midyear population, the
total population for the whole year was considered.

CRUDE A B C
Total Population Total Live CBR = ( B/A ) *
BIRTH RATE Births 1000
Philippines 103 711 049 1 731 289 16.6934 per 1000
CALABARZON 15 172 632 251 344 16.5656 per 1000
Batangas Province 1 857 796 30 071 16.1864 per 1000

CRUDE A B C
Total Population Total Deaths CDR = ( B/A ) *
DEATH RATE 1000
Philippines 103 711 049 582 183 5.6135 per 1000
CALABARZON 15 172 632 82 764 5.4548 per 1000
Batangas Province 1 857 796 10 951 5.8946 per 1000

13 of 15
 A B C
FETAL DEATH
Total Live Total Fetal FD Ratio =
RATIO Births Deaths ( B/A ) * 1000
Philippines 1 731 289 8 020 4.6324 per 1000
CALABARZON 251 344 1 226 4.8778 per 1000
Batangas Province 30 071 143 4.7554 per 1000

A B C
FETAL DEATH
Total Live Total Fetal FD Rate = [
RATE Births Deaths B/(A+B) ] * 1000
Philippines 1 731 289 8 020 4.6110 per 1000
CALABARZON 251 344 1 226 4.8541 per 1000
Batangas Province 30 071 143 4.7329 per 1000

INFANT A B C
MORTALITY Total Live
Total
IMR = [
Deaths under 1 year
RATE Births of age
B/(A+B) ] * 1000
Philippines 1 731 289 21 874 12.6345 per 1000
CALABARZON 251 344 3 727 14.8283 per 1000
Batangas Province 30 071 408 13.5679 per 1000

MATERNAL A B C
MORTALITY Total Deaths
Total Live from
MM Ratio =
RATIO Births Maternal Causes
[ B/A ] * 1000
Philippines 1 731 289 1 483 0.8666 per 1000
CALABARZON 251 344 213 0.8474 per 1000
Batangas Province 30 071 25 0.8314 per 1000
A B C
MATERNAL
Total Total Deaths
MORTALITY Number of Woman from MM Rate = [ B/A
RATE Under Reproductive Age
Maternal Causes ] * 1000

Philippines 27 138 604 1 483 0.0546 per 1000

CALABARZON 251 344 213 0.8474 per 1000

CASE A B C
Total Total
FATALITY CFR =
Registered Registered
RATE [ B/A ] * 100
Cases Deaths
Pneumonia 786 085 57 720 7.3427 per 100
Hypertension 886 203 33 452 3.7748 per 100
Dengue Fever 40 158 1 936 4.8210 per 100
Cholera 136 9 6.6176 per 100
Measles 1 952 5 0.2561 per 100

14 of 15
Diarrheas 174 418 5 393 3.0920 per 100
Schistosomiasis 1 528 318 20.8115 per 100

A B C
Total
Total Registered PM = [ B/A ] *
PROPORTIONATE

Registered Deaths
Deaths 100
from ALL CAUSES
MORTALITY

Pneumonia 57 720 9.9144 per 100

Hypertension 33 452 5.7460 per 100
Dengue Fever 1 936 0.3325 per 100
582 183 Cholera 9 0.0015 per 100
Measles 5 0.0009 per 100
Diarrheas 5 393 0.9263 per 100
Schistosomiasis 318 0.0546 per 100

A B C
Total Total Registered PM = [ B/A ] * 100
CAUSE – SPECIFIC

Population Deaths 000

DEATH RATE

Pneumonia 57 720 55.6546 per 100 000

Hypertension 33 452 32.2550 per 100 000
Dengue Fever 1 936 1.8667 per 100 000
103 711 049 Cholera 9 0.0087 per 100 000
Measles 5 0.0048 per 100 000
Diarrheas 5 393 5.2000 per 100 000
Schistosomiasis 318 0.3066 per 100 000

15 of 15