Introduction to Health Statistics

Hsiao-Ling Chang Ph.D. Section Chief Centers for Disease Control Department of Health,

人口 (population) 定義
人口是人的集合體或集團,是組成社會結構的基本要素。 生活在一定社會生產方式、一定時間、一定地域, 實現生命活動並構成社會生活主體,具有一定數量 和質量的人,所組成的社會群體 聯合國 1958 年定義:人口是指某一地區的全體居民。 不同領域之界定
   生物學上:指某地區內,個體的的集合體,也就是族群的意 思。 統計學上:指某一個體數量總數,亦 母體或母全體之意思。

人口學上:人的集合體或群體, 調人的集體數目,泛指某 一時間,存在於某一地區的一群人。

人口的特性
人口表現出來的自然及社會現象為「人口現象」 ;這些現象隨時都在變化謂之「人口過程 (process) 」。 特性
 空間性:指一定區域而言。區域之範圍可大亦可小 ,大至整 個世界,小至一個家庭。  時間性:一定區域內的人口,常隨時間的改 變而異。  集體性:人口是一集合名詞,是人的集合體或群體 中的一部分。因此,一個人不能稱為 人口。

人口學 (Demography) 定義
定義:研究人口發展,人口與社會、經濟、生態環 境等相互關係的規律性和數量關係及其應用的科學 總稱。包括:人口理論、人口統計學。 聯合國 1958 年定義:人口學主要是對人口的數量、結 構及發展,進行科學研 究的一門學科。
 狹義人口學:即人口分析,又稱為形式 ( 正規或規 範 ) 人口學,是指對人口變量及人口變量間相互關 係的研究。  廣義人口學:即人口研究,探討與人口現象有關之 一切因素的研究。從其他學科的立場來研究人口現 象,及其與各學科間之關係,應用該學科之標準判 斷人口現象。

人口學 究分析方法
人口資料:
 數量及大小:人的多寡。  密度:地區上分布的疏密。  結構或組成:不同的個人、種族等。  生命事件

影響人口資料之因子:出生、死亡、遷移、社會變遷 ( 如都市化、災害等 ) 。 集體特徵,是需要使用統計方法分析人口現象。其資 料的統計為 「人口統計」,其中與衛生 (health) 有 關 的為 衛生統計」,如出生率、生育率、死亡率、罹病率 「 、 ……等。

人口統計
統計學是 研 究定義問題、運用資料蒐集、整理、陳 示、分析與推論 等科學方法,在不 確定 (Uncertainty) 情況下,做出合理決策的科學。 人口統計或人口統計學 (Demography) 為研究一個地 區或國家人口的學門,主要涵蓋人口總數、人口結構 、與人口變遷及發展等方面。  其 精 細之意義 為 「 對人類人口數量及其因 出生、死亡及移民所引起之變動之研 究。」  近年來其範圍擴大為︰「對於生育、婚姻、 移民及死亡等資料之蒐集及統計的分析。」 。

人口統計 究範疇
靜態  人口數量:絕 對數、相對數  人口分布:地理分布 ( 如國內、國外等 )  人口組成:如性別、年齡、種族、婚姻、教 育 、社經等 動 態  人口成長:自然增加 ( 出生、死亡 ) ,社會增加 ( 遷入、遷出 )  組成變化:人口金字塔  推 估 未來人口發展

人口統計的重要觀念 ( 平衡公 式)
P(t+1) = P(t)+B(t)-D(t)+I(t)-E(t)
 P(t) :第 t 個時間的總人數  B(t) :第 t 個時間的出生人數  D(t) :第 t 個時間的死亡人數  I(t) :第 t 個時間的移入人數  E(t) :第 t 個時間的移出人數 也就是說,一個國家或地區的人口變化由出生、死亡 、移民 3 個因素決定。

衛生統計 (Health Statistics)

What Are Health Statistics ?
 Health statistics are numerical data that characterize the health of a population and the factors that influence its health.  In contrast with the related terms, “health data” and “health information,” health statistics are distinguished by their focus on:
 quantification  aggregation of data from observations on individuals, their communities, and the context of their communities  population health and the influences on it.

Definition of Health Statistics (I)
 Defining health statistics is difficult because there are other terms that are often used interchangeably but have other meanings or connotations.  For example, the term “health data” is often used to refer both to a single factual observation (such as the age of an individual) and to the aggregation of such observations (such as the age distribution of a population).  For example, “health information” refers not only to the age of an individual or to the age distribution of a population, but also to knowledge derived from research on the health effects of aging, and to patientoriented information on how to treat illnesses associated with aging.

Definition of Health Statistics (II)
 Health statistics provide information about aggregations of people, institutions, organizations, or health events, rather than information about an individual person or event.  However, health statistics are (1) typically created from raw data collected on individuals (or from the context in which they live and work), and (2) data linkage may occur at either geographic area or individual levels.  Regardless of whether linkage occurs at the individual or aggregate level, health statistics provide information about populations and sub-populations, and never about individuals.

Purposes of Health Statistics (I)
 Health statistics fulfill essential functions for public health, the health services system, and our society.  Through health statistics, we gain a collective understanding of our health, our collective experience with the health services system, and our public health problems and challenges.  Health statistics establish a basis for comparisons between subpopulation groups or geographic areas.  Health statistics enable us to look at the distribution of health in the nation, for example, the existence of health disparities between racial, ethnic, and socioeconomic groups, between people with and without substantial functional disabilities, and across rural, suburban, and central city areas

Purposes of Health Statistics (II)
 Health statistics document our current and past reality, and provide us with the ability to identify health trends and to anticipate future trends in health and health services.  Health statistics provide us with the information upon which we can base important public decisions at the local, state, and national levels.  Once we have made those public decisions, health statistics make us accountable for the decisions that we have made.  Health statistics thus enable us to evaluate the impact of health policies and health programs on the public’s health.  In short, health statistics give us the information we need to improve the population’s health and to reduce health disparities.

Health Statistics Have Three Major Uses
 Creating fundamental knowledge.  Guiding the assessment, development, and evaluation of health policy.  Informing and evaluating the impact of population health programs and interventions as well as personal health decisions.  They provide a basis for public and private decisions at local, state, and national levels.

Use of health statistics to create fundamental knowledge

--- Heart disease -- Health statistics provide insight into factors associated with heart disease and its impact on the population.  Large-sale population surveys yielded some of the first evidence of the association between heart disease and cholesterol, hypertension, and behaviors such as diet, exercise, and smoking.  Statistics document the distribution of risk factors among the population, allowing us to understand differentials in health.  And health statistics provide insight into the impact of heart disease on the population and economy through mortality data that track trends, surveys that document lost productive time to heart disease, and studies that document burden of illness on the health care system and the economy.

Use of health statistics to inform policy

--- Health Insurance -- Health statistics provide into the health insurance coverage of the population, the differences in coverage between subpopulation groups (such as between the poor and the non-poor, the employed and the unemployed), and the relationship between insurance, access to care, and population health.  Health statistics help set the health policy agenda and are closely watched for their implications for publicly funded health insurance programs.  Improving health statistics can have real returns in the efficiency and effectiveness of these and other programs.

Use of health statistics in health programs and interventions

--- Asthma -- Health statistics have played a critical role in improving our understanding of, and our attempts to prevent and treat, asthma.  Health statistics have shown that the prevalence of asthma has increased in the United States, as well as in many other developed countries over the past 20 years.  They have also provided insight into what groups are most affected by asthma and, thereby, facilitated the targeting of programs to reduce the prevalence and adverse effects of asthma.  Fore example, health statistics have shown that mortality is higher African Americans and those of Puerto Rican heritage than among white non-Hipanics, and specific programs have been developed to help these groups.

Factors Influencing Health of Population
 Many factors influence the health of a population, and to be useful, health statistics must provide a comprehensive and coherent picture of them all.  Gathering and presenting data on diseases alone limits understanding of the complex interactions that affect health and encourages concentration on the prevention and management of disease instead of a more broadly integrated approach to maximizing health and reducing illness.

Influences on the population’s health

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