HEALTH STATISTICS AND

EPIDEMIOLOGY
DEMOGRAPHY
 Sources of Data for Calculation

• Census
• Vital registration system
• Disease notification
• Disease registries
• Surveillance system
• Hospital data
• Health insurance
• School health program
• Downloadable data sets
• Surveys (morbidity, demographic and health)
 STATISTICS

• Quantitative measures, usually expressed as rates,

ratios, or proportions, that describe & summarize
various aspects of the health status of the population.
• VITAL STATISTICS is a Systematic study of vital events.
• Statistics of Disease( morbidity) and Death( Mortality)
that indicate the health status of the community.
• Population statistics is the distribution.
 Terminologies

TERM DESCRIPTION

RATE Relationship between the VITAL event and the PERSON exposed to occurrence of the event, within
a GIVEN AREA and during a specified unit of time,

RATIO Relationship between two(2) numerical measures of events without taking particular
considerations to the time and place

CRUDE/GENERAL Total living population. It must be presumed that the population was exposed to the risk of the
RATE occurrence on the event

SPECIFIC RATE Specific population group. It limits the occurrence of the event to just PORTION of the TOTAL
POPULATION exposed to it.
 Formulas

•  
• Crude birth rate- measures how fast people are added to
the population through births.
 Formulas

•  
• Crude death rate (CDR) sometimes called force of mortality
is defined as the rate with which DEATH occurs in all cause
in a given population, that results in the decreased of the
Population
 Formulas

•  
• Infant Mortality Rate- risk on dying during the 1st year of life.
• a good index of the level of health in a community because infants are very
sensitive to adverse environmental conditions
 Formulas

•• Maternal
  Mortality rate- measure the risk of dying from maternal cause.
• Index of the obstetrical care needed and received by the women in a community
 Formulas

• Fetal death rate- Pregnancy wastage

FDR=total # of fetal deaths registered in a given calendar year x1000

Total # of live births registered on the same year

• Neonatal Death rate = risk of dying the 1st month of life

index of effects of prenatal care and obstet manage of newborn
NDR= No. of death under 28 days of age registered in a given calendar year
x1000
No. of live birth registered of the same year
 Formulas

• Specific Death rate= more accurately the risk of exposure of

certain group to a particular dse.

• SDR= no. of death in (specific group) registered in a calendar year

X100,000
Estimated midyear population of ( Specific group) of the said year
 Formulas

• Incidence rate= frequency of occurrence

IR= No. of new case of a particular Dse registered at period of time X100,000
No. of population at RISK
• Prevalence Rate = Proportion of the population which exhibit the dses
in a particular time.
PR= No. of existing case(dse) (old and new) registered at a period of time X100
total no. of person examine at the same time
 Formulas

• Attack rate- more accurate measure of the risk of exposure

• AR= # of person acquiring the dse registered in a given year

X100
No. of exposed to same dse in the same year
Proportionate Mortality ( death ratio)- numerical relationship between
death from specific cause /age AND the total no. of deaths from all cause
in all ages taken together
PM= # of registered death from specific cause or age for a given calendar year
X100
# of registered death from all cause all ages in the same year
 Formulas

• Case Fatality Ratio - index of a killing power of a disease

• CFR = # of registered deaths from specific dse for a given year X100
# pf registered case from specific dse in the same year
 Philippines:Life eXPECTANCY

•Male: 66.2 YEARS

•Female: 72.6 YEARS

•Average: 69.3 YEARS

• 2018 WORLD HEALTH RANKING

 Ten Leading Causes of Morbidity
Philippines, 2018

DISEASES NUMBER OF CASE RATE PER 100,000

POPULATION
Acute Respiratory Tract Infection 1 ,209,821 1,139.53
Hypertension 602,811 567.79
ALRTI and Pneumonia 5 03,884 474.61
Urinary Tract Infection 2 80,687 264.38
Bronchitis 1 30,057 122.50
Acute Watery Diarrhea 1 12,543 106.00
Influenza 9 1,681 86.35
Diseases of the Heart 6 6,688 62.81
Dengue Fever 5 1,361 48.38
TB Respiratory 3 9,923 37.60
 Ten Leading Causes of Mortality
Philippines, 2017

DISEASE
Diseases of the heart
Diseases of the vascular system
Pneumonia
Cancers/neoplasm
Tuberculosis(all forms)
Accidents
COPD and allied conditions
DM
Kidney disease
Other respiratory diseases
 19

• In the past 20 years some

Health situation
infectious degenerative
NATIONAL
diseases are on the rise.
 Many Filipinos are still living in
remote and hard to reach areas
where it is difficult to deliver
the health services they need
 The scarcity of doctors, nurses
and midwives add to the poor
health delivery system to the
POOR
 20

Vital Health situation2005 2018

Health Statistics
NATIONAL
Projected Population:

• Male – 42,874,766

 Female – 42,362,147
 Both Sexes – 85,236,913 106,168,803
Life Expectancy:

 Female – 70 yrs. Old 72.6 YEARS

 Male – 64 yrs. Old 66.2 YEARS
 21
Health situation NATIONAL
Leading Causes of Morbidity

 Most of the top ten leading causes of morbidity are communicable disease
 These include the diarrhea, pneumonia, bronchitis, influenza, TB, malaria
 Leading non CD are heart problem, HPN, accidents and malignant neoplasms
Leading Causes of Mortality

 The top 10 leading causes of mortality are due to non CD

 Diseases of the heart and vascular system are the 2 most common causes of deaths.
 Pneumonia, PTB and diarrheal diseases consistently remain the 10 leading causes of
deaths.

Reference: 
Ms Ma. Adelaida Morong, Far Eastern University- Institute of Nursing 
In-House Nursing Review 
 Health profile/statistics

• Total population
• Natality
• Mortality
• Morbidity
• Notifiable diseases
Epidemiology AND THE NURSE
 Epidemiology

• Is the study of Occurences and distribution of

disease,
as well as the distribution and determinants of
health status
In a specified population. And the application of the
study to
the control of health problems.
 Epidemiological nurse

• Are concerned not only with

DEATHS, ILLNESS and DISABILITY
but with more on the POSITIVE
HEALTH STATES with the means to
IMPROVE HEALTH
 Epidemiological nurse

• Implement public health surveillance

• Monitor local health personnel conducting diseases
surveillance
• Conduct and/or assist other health personnel in out break
investigation assist in rapid surveys and surveillance during
disasters
• Assist in the conduct of surveys, program evaluations and
epidemiological studies.
 Epidemiological nurse

• Assist in the conduct of training course in epidemiology

• Assist epidemiologist in preparing the annual report and
financial plan
• Responsible for inventory and maintenance of (ESU)
equipment.
 Areas of investigation

• Patterns of disease distribution in

• Distribution of health
term of causal factor.
statistic( age, sex, race,
geography etc)

Thus making EPIDEMIOLOGY the

BACKBONE of PREVENTION OF
DISEASE
 Epidemiology in the COMMUNITY

• Study the history of the health population and rise and fall of diseases
and changes in their character.
• Diagnose the Health of the community and the condition of people to
measure the distribution and dimension of illness in terms of
(Incidence, prevalence disability and mortality) to set health problems
in perspective and to define their relative importance and to identify
groups needing special attention.
• Study the work of health service with view of improving them.
• Estimate the risk of disease, accidents, disability and chance of
avoiding them
 Epidemiology in the COMMUNITY

• Identify syndromes by describing the

distribution and association of clinical
phenomena in the population
• Complete the picture of chronic disease and
describe their natural history
• Search for causes of health and disease by
comparison of experiences of different groups.
 TERMINOLOGIES

TERMS MEANING
STUDY OBSERVATION, HYPOTHESIS TESTING, analytic research,
experiments, surveillance

DISTRIBUTION Analysis by time, places and classes of the people

concern/affected

DETERMINANTS All that influence HEALTH ( chemical, biological, physical, social,

cultural, economic, genetics, behavior)

HEALTH-RELATED EVENTS CAUSE OF THE DISEASE/DEATH (use of tobacco, reaction from

regimens, use of health services

SPECIFIED POPULATION Groups with identifiable characteristics.

APPLICATION to PREVENTION To promote, protect and restore good health
and CONTROL
 Natural History of Disease

• Natural history of a disease: course of the diseases over

time from pre-pathogenesis stage to termination.
• A prospective cohort study could plot the natural history of
disease better because of the benefit of observing the
cohort from the time that the members are disease-free to
the time they develop the disease through its termination.
• The applicable level of prevention that is administered to
the patient is dependent on the stage of the disease when
the patient was diagnosed.
 NATURAL history of disease

Stage of susceptibility Stage of subclinical Stage of clinical

Resolution stage
(pre-pathogenesis) disease disease

Not sick but may be Still healthy since No With sign ang
expose to factors that clinical manifestation. symptoms
may influence the Pathologic changes
health have already occurred
• RECOVERS
completely
• CHRONIC case
Primary level of Secondary level of Tertiary level of • DISability
prevention prevention prevention • DIES
• Health education • Early detection • Limit disability
• Health promotion • Screening • Restoration of fxn
capability
 The EPIDEMILOGICAL triANGle

HOST

TIME

AGENT ENVIRONMENT

• A CHANGE in any of the component will alter the EXISTING

EQUILIBRIUM to increase or decrease the frequency of DSE.
 AGENT HOST ENVIRONMENT
EXTRINSIC FACTORS
NUTRITIVE ELEMENTS
PHYSICAL ENVIRONMENT
CHEMICAL AGENTS
BIOLOGICAL ENVIRONMENT
PHYSICAL AGENTS SOCIO-ECONOMIC ENVIRONMENT

INFECTIOUS AGENTS
INTRINSIC FACTOR

GENETIC

AGE

SEX

ETHNIC GROUP

PHYSIOLOGIC

IMMUNOLOGIC EXPERIENCES

PRE-EXISTING DSE

HUMAN BEHAVIOR
 S
HOS HO
T T

TIME M
E
MEN
TI N
R O
NVI
E
T

AGEN ENVIRONMEN
T T
E NT
AG
 Disease distribution 37

 Detect the cause of the disease( Causative agent)

IN RELATION

CHARACTERISTIC of the Person

FACTORS Present in his ENVIRONMENT
Epidemiological variables 38

TIME variable Person/host variable

Place/environment variable
Period during characteristic of the The condition
individual exposed
the disease is on the
Age
being studied or environment in
Sex
the period which which the dse
Lifestyle activities
the illness occurred
occured
Patterns of OCCURRENCE and 39

DISTRIBUTION
SPORADIC Intermittent occurrence, of few isolated and unrelated cases in a given
locality

ENDEMIC Continuous occurrence, throughout a period of time of the usual # of cases in

a given locality

EPIDEMIC Occurrence is unusually large # of cases but short period of time

PANDEMIC Simultaneous occurrence of epidemic of the same dse in several countries.

Epidemiological Investigation 40
1. establish fact of PRESENCE of EPIDEMICS
 Verification diagnosis- clinical and lab studies to confirm the data
 Report
 An unusual prevalence of the disease
2. Established time and space relationship of the disease
 where is the affected community
 Onset of the first known cases
3. Relationship to characteristic of the group of community
4. Correlation of all data obtained
Outbreak Investigation

 Importance of:
 Control and prevention
 Severity and risk to others
 Research opportunities
 Public, political or legal concerns
 Program consideration
 training
Epidemiology and
surveillance Units

Is mainly responsible for

providing timely and
accurate information on
disease in the locality

42
PUBLIC HEALTH SURVEILLANCE
 THE NURSE IN SURVEILLANCE

• FUNCTION AS RESEARCHER
• CONTINUOUS ANALYSIS AND GATHERS DATA ( CASES AND
DEATH)
• MONITORING THE PROGRESS OF DISEASE REDUCTION