Trends of Mortality Indicators and

Life Expectancy during the last one

Decades
 Mortality
Mortality is the conditions of being mortal, or susceptible to deaths; the
opposite of immortality.
 Limitations in Mortality data
• Incomplete reporting of death
• Lack of accuracy
• Lack of uniformity
• Choosing a single cause of death
• Changing coding system and changing fashion in diagnosis
• Disease with low vitality
 Uses of Mortality Data
• In explaining trends and differentials in overall mortality
• Indicating priorities for health action and allocation of resources
• In designing intervention programme
• Assessment and monitoring of public health problems and programmes
• Gives clues for epidemiological research
 Measures of Mortality
•  Crude Death Rate (CDR): It is defined as the number of deaths per 1000
estimated mid- year population per year in a given community.
• It indicates the rate at which people are dying.
• CDR = 1000
• The usefulness is restricted because it is influenced by the age-sex composition of
population, socioeconomics, and socio-cultural environment of the communities.
Current Status of CDR in World
Measures of Mortality…..
•  Infant Mortality Rate (IMR): The ratio of deaths under 1 year of age in
a given year to the total number of live births in the same year. Usually
expressed as a rate per 1000 live births.
• IMR = 1000
• Neonatal Mortality: Number of deaths occurred within 28 days of life of the
newborn.
• Post Neonatal Mortality: Number of deaths occurred after 28 days but before
attaining first birthday of the life of the newborn.
• IMR of India in 2016 was 34 per 1000 live births.
Measures of Mortality…..
• Under 5 Mortality Rate (U5MR): It is defined as the number of death at age of 0 to 59
months in a given year, per 1000 live births during that year.
• U5MR of India in 2016 was 29 per 1000 live births.

• Under 5 mortality rate in two major state of India.

Maharashtra Madhya Pradesh
100
92 89
80 82 77 75
73 69
60 62
40 40
20 41 36 33 28 28 26 32
24 18
0
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
 Measures of Mortality…..
•  Maternal Death: It is defined as the death of a women of age between 15-49
years while pregnant or within 42 days of termination of pregnancy irrespective
of the duration, and the site of pregnancy from any cause related to or aggravated
to by the pregnancy or its management but not from accidental or incidental
causes.
• MMR= 100000
Measures of Mortality…..
• Life Expectancy (LE): The average lifespan of a newborn can expected if
current mortality rates continue to apply.
• It is short when child deaths is common.
• In general LE at birth of women is higher than men.
• It is a mortality indicator which describes overall health status and development of
particular place.
 Determinant of Life Expectancy
• Mainly determined by other mortality indicators.
• But in real, determinants of health also determines LE.
• Education and social security
• Health services (Health care system, Equity and effectiveness).
• Women empowerment (decision making over health care)
• Diseases, epidemics and disasters (Communicable, NCD and injuries)
 The current life expectancy at birth in south Asian countries

Life Expectancy (2015)

80 78.49
78
76 74.93
74
72 71
69.82 69.24
70 68.31
68 66.42
66
64
62
60
Maldives Sri Lanka Bangladesh Bhutan Nepal India Pakistan
Trends of Mortality Indicators
 Trend of Crude Death Rate (CDR) in India,
Maharashtra, Madhya Pradesh and World
World India Maharashtra Madhya Pradesh
10.0 9 8.9 8.7 8.6
9.0 8.5 8.3 8.2 8.1 8 7.8
8.0 8.2 8.1 8.1 8.0 7.9 7.5
7.6 7.9 7.8 7.8 7.7 7.7 7.6 7.1
7.5 7.4 7.4 7.3 7.2
7.0 7.1 7 7 6.7 6.5 6.4
6.0 6.7 6.7 6.6 6.6 6.7 6.5 6.3 6.3 6.2 6 5.8 5.9
5.0
4.0
3.0
2.0
1.0
0.0
2004 2006 2008 2010 2012 2014 2016 2018
 Region wise trend of Crude Death Rate (CDR) in
India
EAG and Assam States Southern States Other States
9.0 8.4 8.2 8.1 8.0 7.8 7.7
8.0 7.6 7.5 7.5
7.1 6.9
7.0 6.7
6.8 6.8 6.9 6.8 6.7 6.7
6.6 6.6 6.6 6.5 6.5
6.2
6.0 6.4 6.4 6.4 6.4 6.3 6.1 6.1 6.0 6.0 5.7 5.6 5.7
5.0
4.0
3.0
2.0
1.0
0.0
2004 2006 2008 2010 2012 2014 2016 2018
 Trend of Infant Mortality Rate (IMR) in India,
Maharashtra, Madhya Pradesh and World
India Maharashtra Madhya Pradesh World

80 76 74 72 70
70 67
62 59
58 57 55 56
60 53 54 52
50 47 50 47
50 44 42
45.1 43.4 40 39 37
40 41.8 40.3 38.8 34
37.4 36 34.7 33.6 32.4 31.4
30 36 35 34 33 31 28
20 25 25 24 22 21 19
10
0
2004 2006 2008 2010 2012 2014 2016 2018
 Region wise trend of Infant Mortality Rate (IMR) in
India

India EAG and Assam States

Southern States Other States
67 65 64 62
58 57 58
55 53 55
50 51 49
47 48
44.9 44.9 44.5 44 45 43
42.6 40.5 42 41
40 39
37.3 37
33.6 34.3 33.1 34.9 33.1 34
32.4 31.8
29.1 27.6 28.9
25.4 24.4 26.4 24.4
24.0 23.9 22.6
20.1

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
 Trend of Neonatal Mortality Rate (NNMR) in two
Major States of India (MH, MP), India and World

India Maharashtra Madhya Pradesh World

50 44
41 39
40 36 35 34
33 31 29 28
30 26 25
20 22 22 21 20
22 20 19
18 18 17 16
10 15

0
2009 2010 2011 2012 2013 2014 2015 2016
 Region wise trend of Neonatal Mortality Rate
(NNMR) in India
India EAG and Assam States
Southern States Other States
40 37
35 33
35 32 30
33 29
30 31
27 29 28
25 25 26 25
23 22
20 20 18
15 20 19 18 18
17 17
10
5
0
2009 2010 2011 2012 2013 2014 2015 2016
 Trend of Under five Mortality Rate (U5MR) in two
Major States of India (MH, MP), India and World

Trend of Under five Mortality Rate (U5MR) in two Major States of India (MH, MP), India and
World India Maharashtra Madhya Pradesh World
100 92 89
82 77 73 75
80 69
69 62
60 64 59 49 47
56 54 52 55 52 46 55 43
42 41
40
49 44
40
41 36 29
20 33 28 28 32
26 24
18
0
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
 Region wise trend of Under five Mortality Rate
(U5MR) in India
India EAG and Assam States
Southern States Other States
72
67
63 61
59 53 50
55 52 55
49
44 41 43
39 36
32 31
34 31 29 28 28 27

2010 2011 2012 2013 2014 2015

Trend of Maternal Mortality Ratio (MMR) in India,
Maharashtra and Madhya Pradesh/Chhattisgarh
India Maharashtra
Madhya Pradesh/Chhattisgarh
400
335
350
300
254 269
250 212 230 221
200 178 167
130
150 104 87
100 68
50
0
2004 - 06 2007 - 09 2010 - 12 2011 - 13
 Region wise trend of Maternal Mortality Ratio
(MMR) in India
India EAG and Assam States
Southern States Other States
400
375
350
300 308
254
250 257 246
200 212
174 178 167
150
149 149
127 127 115
100 105 93
50
0
2004 - 06 2007 - 09 2010 - 12 2011 - 13
Trend of Maternal Mortality Ratio (MMR) in World

350

300 288 277 268 258 254 246

250 237 232 226 221 216
200

150

100

50

0
2005

2008

2011
2006

2007

2009

2010

2012

2013

2014

2015
 Increasing trends of Life Expectancy during
the last decades in India
Life Expectancy at Birth

68.35
68.01
67.66
67.29
66.9
66.51
66.1
65.7
65.3
64.91
64.52

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
 Differential in Mortality due to Age

U Shaped Curve J Shaped Curve

ASDR, India 1971 ASDR, India 2015
250.0
120.0

100.0 200.0

80.0 150.0

60.0
100.0
40.0
50.0
20.0
0.0
0.0 1 -9 9 9 9 9 9 9 9 +
w -1 -2 -3 -4 -5 -6 -7 85
10 - 14

70+
0-4
5-9

20-24

30-34

40-44
45-49
50-54
55-59
60-64
65-69
15-19

25-29

35-39

lo 5 15 25 35 45 55 65 75
B e