Module 4: Demography
rate – it MEASURES the KILLING power of
Additional Notes on Tools of Demography
specifically Rate and its 4 types and Demographic
Indicators specifically Mortality and Morbidity
Indicators + Sample Computations
Tools of Demography – Rate
4 Types of Rates:
1. Incidence rate – Ratio of the number of cases to
the total time the population at risk of the disease;
Number of NEW cases in a population per unit
time; NEW cases only; Acute conditions; the
relevant information is the Midyear population at
risk
2. Attack rate/ Incidence Proportion/ Risk – used
to measure the frequency or prevalence of a
specific health-related or condition within a
population during a defined period.
3. Prevalence rate – TOTAL number of cases in a
population at a given time: ALL cases (OLD +
NEW); Chronic conditions: the relevant information
is the NUMBER of cases at a given time
4. Case-fatality rate – The proportion of persons
with a particular conditions who die from that
condition (Killing power of the disease)
Demographic Indicators
1. Mortality Indicators
o Crude death rate – Total number of deaths
during a given time interval
o Cause-specific death rate – helps identify
the leading cause of death in a population
o Proportionate mortality rate – Number of
deaths from a particular cause/population
group in a year, Denominator is Total deaths
in a year
o Death-to-case ratio is AKA Case fatality
the disease , High CFR means a more fatal
disease; A higher CFR is expected from a
hospital statistics that that from a
community – MUST KNOW
o Neonatal mortality rate – Number of deaths
among those under 28 days of age in a
calendar year, Denominator is Number of
live births in the same year multiplied by
1000 ; Important: Causes of death are
mainly due to pre-natal or genetic factors
(MUST KNOW)
o Post-neonatal mortality rate – Number of
deaths among those 28 days to less than 1
year of age in a calendar year, Denominator
is Number of live births in the same year
multiplied by 1000 ; Influenced mainly by
environmental or genetic and nutritional fac
tiors as well as infections
o Maternal mortality rate – Number of deaths
assigned to pregnancy-related causes
during a given time interval: denominator is
the estimated midpoint population: Affected
by maternal health practices, diagnostic
ascertainment, and completeness of
registrations of births
o Infant mortality rate – The MOST Sensitive
index of assessing health status in the
community: High IMR means low of health
standards which maybe secondary to poor
maternal and child health care, malnutrition,
poor environmental sanitation, or deficient
health care services.
o Infant mortality rate (IMR) – Reflects level
of health standards related to maternal and
child health care, malnutrition,
environmental sanitation, health care
service
o IMR = Deaths under 1 year of age in a
calendar year divided by Number of live
births in the same year multiplied by 1000

2. Morbidity Indicators
o Incidence proportion aka Attack rate aka
Risk aka Cumulative incidence aka
Probability of getting disease – Proportion of
an initially disease-free population that
develops disease, becomes injured, or dies
during a specified period of time,
Denominator is number of population at the
start of period; Incidence proportion is a
measure of risk.
o Secondary attack rate – it specifically
quantifies the the risk of individuals who
have been exposed to an index case (the
initial infected person) contracting the
disease as a result of that exposure;
Numerator is the Number of secondary
cases (individuals who contracted the
disease due to exposure to the index case).
Denominator is the Number of individuals
exposed to the index case (those at risk of
contracting the disease in the same setting)
o Secondary attack rate is calculated by
dividing the number of secondary cases by
the number of individuals exposed to the
index case and then multiplying by 100 to
express the result as a percentage. This
calculation helps assess the risk of disease
transmission within a specific group or
setting
o Secondary attack rate is often used as a
measure of contagiousness
o Incidence rate aka Person-time rate – is a
measure of incidence that incorporated time
directly into the denominator. It describes
how quickly a disease occurs in a
population; Incidence rates reflect the
occurrence of new disease in a population
o Point prevalence – Refers to prevalence
measured at a particular point in time. It is
the proportion of persons with a particular
disease or attribute on a particular date
o Period prevalence –refers to prevalence
measured over an interval of time. It is the
proportion of persons with a particular
disease or attribute at ANY TIME during the
interval
o Definition of Prevalence – refers to the
proportion of persons who have a condition
at or during a particular period of time;
Numerator of prevalence: all cases
PRESENT during a given time period;
Prevalence reflects the presence of a
disease in a population
o Definition of Incidence – refers to the
proportion or rate of persons who develop a
condition during a particular time period;
Numerator of incidence: new cases that
occurred DURING a given time period;
Incidence reflects the occurrence of new
disease in a population
o Factors that INCREASE Prevalence rate –
longer disease duration, prolongation of life
without cure, increase in incidence, in-
migration of cases and susceptible people,
out-migration of healthy people, and
improved diagnostic facilities
o Factors that DECREASE Prevalence rate –
shorter duration of disease, high case of
fatality, decrease in incidence, out-migration
of cases, in-migration of healthy people and
improved cure rates.
I. Mortality Indicators-
a) Crude death rate –
Example: Liwayway City with a population of
600,000, there were reported 2,000
deaths in a year. Calculate for the crude
death rate
Crude death rate = (Total deaths/ Total population)
x 1000
Crude death rate = (2,000/ 600,000) x 1000 = 3.33
Crude death rate = 3 per 1000 population
b) Cause-specific death rate –
Example: The town of Luningning with a population
of 150,000, and there were 220 deaths
 due to stroke. Calculate the cause-specific
death rate.
Cause-specific death rate for Stroke = (Deaths due
to Stroke/ Total population) x 100,000
Cause-specific death rate = (220/ 150,000) x
100,000 = 146.67
Cause-specific death rate = 147 per 100,000
population
Demographic Indicators
c) Proportionate mortality rate –
Example: Paraluman City with a population of
800,000, and there were 550 deaths due
to various causes and 200 of these are
due to diabetes. Calculate the
proportionate mortality rate.
Proportionate mortality rate for Diabetes= (Deaths
due to Diabetes/ Total deaths) x 100
Proportionate mortality rate for Diabetes =
(200/550) x 100 = 36%
Proportionate mortality rate = 36%
Demographic Indicators
d) Death-to-case ratio aka Case
fatality rate–
Example: In a hospital, there were 50 patients who
contracted a health-care associated
infection, and 10 of them dies. Calculate
the death-to-case ratio
Death-to-case ratio = (Number of Deaths/ Number
of cases) x 100
Death-to-case ratio = (10/50) x 100 = 20%
Demographic Indicators
e) Neonatal mortality rate –
Example: In a a community health center, there
were 650 live births, and 10 neonatal
deaths occurred. Calculate the neonatal
mortality rate
Neonatal mortality rate = (Number of Neonatal
Deaths/ Number of Live Births) x 1000
Neonatal mortality rate = (10/650) x 1000 = 15.38
or 15 per 1,000 live births
f) Maternal mortality rate –
Example: In a rural clinic, there were 3 maternal
deaths during childbirth, and there were
30,000 live births included in the study.
Calculate the Maternal mortality rate
Maternal mortality rate = (Number of Maternal
Deaths/ Number of Live Births) x 100,000
Maternal mortality rate = (3/30,000) x 100,000 = 10
per 100,000 live births
g) Infant mortality rate –
Example: In a research study on infant health, there
were 20 infant deaths, and there were
1,800 live births included in the study.
Calculate the infant mortality rate.
Infant mortality rate = (Number of Infant Deaths/
Number of Live Births) x 1,000
Infant mortality rate = (20/1,800) x 1,000 = 11.11 or
11 per 1,000 live births
II. Morbidity Indicators
a) Incidence proportion aka Attack rate
aka Risk -
Example: In a workplace with 250 employees, 12
employees tested positive for COVID-19
in a given period. Calculate the attack rate
Incidence proportion = (Number of Employees with
COVID-19/ Total number of Employees) x 100
Incidence proportion = (12/250) x 100 = 4.8%
b) Secondary attack rate -
Example: On a rainy season in a household of 7
people, 2 persons initially contract the flu.
Within a week, 3 more family members
become ill. Calculate the secondary attack
rate within the household.
Secondary attack rate = (Number of Secondary
cases/ Number of Susceptible Individuals) x 100
Secondary attack rate = (3/5) x 100 = 60%
c) Incidence rate aka Person-time rate -
Example: In a town with 65,000 residents, there
were 25 new car accidents reported in a
single month. Calculate the monthly
incidence rate for car accidents.
Incidence rate = (Number of New car
accidents/Total population) x 1000
Incidence rate = (25/65,000) x 1000 = 0.38 per
1000 population per month
d) Point prevalence -
Example: In a clinic with 1,600 registered patients,
180 of them have been diagnosed with
hypertension at a specific point in time.
 Calculate the point prevalence of
hypertension in the clinic.
Point prevalence = (Number of Existing cases/Total
number of patients) x 100
Point prevalence = (180/1,600) x 100 = 11.25 or
11%

e) Period prevalence -
Example: In a city with a population of 900,000,
35,000 people have struggled with
substance use disorders at any point in
their lives. Calculate the period
prevalence of substance use disorders in
the city.
Period prevalence = (Number of People with
Substance Use Disorder at any point/ Total
population) x 100
Period prevalence = (35,000/900,000) x 100 =
3.89% or 4%

Prevalence
Example: In a school with 2,500 students. 150
students report experiencing a mental
health disorder at any point in the past
year. Calculate the prevalence of mental
health disorders in the school.
Prevalence = (Number of students with Mental
Health Disorders in the past year / Total number of
students) x 100
Prevalence = (150/2500) x 100 =6%