Demography and Health 5. Week PDF

NUT 107 Demographic Structure and Health İstanbul Kent University Nutrition and Dietetic Lecturer Beyzanur ÇAMLIBEL Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Topics Week 1 Basic Demographic...

NUT 107 Demographic Structure and Health İstanbul Kent University Nutrition and Dietetic Lecturer Beyzanur ÇAMLIBEL Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Topics Week 1 Basic Demographic Concepts and Data Sources Week 2 Demographic Indicators Week 3 World population Week 4 Population Structure and Change Week 5 Fertility/ Mortality Week 6 Migration and Urbanization Week 7 Midterm Week 8 Population Policies/ Population and Nutrition Week 9 Maternal and Child Health Week 10 Anthropometric Indicators of Nutrition Week 11 Sustainable Development Goals Week 12 Homework Presentation Week 13 Homework Presentation Week 14 Homework Presentation Week 15 Final Exam Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic  Fertility/Mortality Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Fertility Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Fertility The performance of women in a population in giving birth live. According to the World Health Organization, a live birth is when a fetus shows at least a thousand signs of life, such as breathing and heartbeat, when it leaves its mother. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic  It is the physiological capacity of women to conceive and Fecundity: give birth. In other words, fertility is actual reproductive performance, and fecundity is potential reproductive performance. Infertility: Doctors define infertility as the inability to achieve pregnancy for at least 12 months. A woman has never been pregnant before. Primary Infertility: A woman has been pregnant at least once before, Secondary Infertility: but cannot get pregnant again. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Reproductive Age In men, it is usually lifelong, as long as there is sperm production. In women, there is a start time and an end time: Menarche Menopause Menarche Onset of menstrual bleeding (around 12-15 years of age) Menopause The end of menstrual bleeding (45 years and older) The reproductive age of women: The 35-year period between the ages of 15 and 45 Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Natural Fertility The level of fertility in the absence of any conscious control to prevent pregnancy or childbirth. Theoretically, assuming that a woman starts childbearing immediately after menarche (around 12-15 years of age) and continues to have childbearing capacity until menopause, the average number of live births she can have without using any contraceptive method is thought to be a maximum of 15. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Factors Affecting Fertility Physiological Factors Demographic Factors Cultural and Religious Factors Economic and Social Factors Health Care and Family Planning Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Physiological Factors Limits of reproductive age (15-49 years old) ✔ Menarche ✔ Menopause ✔ Temporary infertility after childbirth ✔ Breastfeeding Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Demographic Factors Age at first marriage Birth control Education level is important in all these Abortion processes. As the level of education increases, fertility rates generally decrease. Education increases women's participation in the workforce and raises their awareness on family planning. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Cultural and Religious Factors Social norms Some cultures and religious beliefs may Religion encourage high fertility rates. Family size Ethnic Characteristics and the social and religious importance of having children influence these rates. Norms Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Economic and Social Factors Economic and social factors do not directly affect fertility, but they influence other variables. Fecundity Income levels, unemployment rates Marriage/ and economic stability can affect Partnership fertility rates. They generally fall during periods of economic Birth Control uncertainty. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Economic and Social Factors Industrialization Urbanization Women's participation in business life Family structures Social mobility Education level State policies Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Health Care and Family Planning Access to health services and use of family planning methods affect fertility rates. Access to modern contraception can reduce unwanted pregnancies. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Key Fertility Indicators ✔ Child-Female Ratio ✔ Crude Birth Rate ✔ General Fertility Rate ✔ Age Specific Fertility Rate ✔ Population Renewal Level ✔ Age Specific Marital Fertility Rate ✔ Parity Specific Fertility Rate Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Key Fertility Indicators Child-Female Ratio Number of children under 5 years of age per 1000 women of childbearing age. It is a simple indicator that can be calculated from censuses, registers and surveys. In countries where health records are not kept, it is a measure that can be obtained from census results. It is not a sensitive measure. It gives a general idea of fertility in the last five years. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Key Fertility Indicators Child-Female Ratio P 0-4 The number of children under the X 1000 age of 5 in a society, P W15-49 Number of women in the 15-49 age group Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Key Fertility Indicators Crude Birth Rate The number of births per 1,000 inhabitants. The denominator includes people of all sexes and ages. Year/Mid-period population is used (MYP). It is a not very sensitive measure of the fertility level of a population. The reason it is not sensitive is that it does not take age and gender into account. It is widely used because it is easy to obtain. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Key Fertility Indicators Crude Birth Rate b b; number of birth X 1000 MYP; mid-year population of the same P MYP community (including men and women) Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Key Fertility Indicators General Fertility Rate The number of live births per 1000 women of reproductive age. It is more sensitive than crude birth rate. This is because the denominator includes only women who are likely to give birth (Sometimes only 'married women' are written in the denominator, sometimes 'all women' are written in the denominator.) The age distribution in the denominator of this measure is also unclear. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Key Fertility Indicators General Fertility Rate b b; number of birth X 1000 Number of women in the 15-49 P W15-49 age group Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Key Fertility Indicators Age Specific Fertility Rate It is calculated by dividing the number of births given by women of age (x) by the number of women of the same age (x) in a given period. It is usually calculated for age groups of 5. It is the most sensitive measure of the fertility level of women at certain ages during the fertile period (15-49 years). Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Key Fertility Indicators Age Specific Fertility Rate It is a highly sensitive and very useful measure (especially for measuring the effectiveness of family planning services). However, it is difficult to calculate as it requires knowledge of the number of women in each age group and the number of births given by women in each age group. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Key Fertility Indicators Age Specific Fertility Rate bx bx ; number of births by women X 1000 in any age cohort P Wx Number of women in x age group Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Key Fertility Indicators Population Renewal Level The level of fertility that would occur if a couple had enough children to replace themselves. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Approaches to the Measurement of Fertility Cross Section Fertility: Fertility occurring at a given time Generational Fertility: Live births over time for a specific group of women. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic  Data on Fertility in Turkey Lecturer Beyzanur ÇAMLIBEL https://data.tuik.gov.tr/Bulten/Index?p=Dogum-Istatistikleri-2023- Nutrition and Dietetic 53708#:~:text=Toplam%20do%C4%9Furganl%C4%B1k%20h%C4%B1z%C4%B1%201%2C51,1%2C51%20%C3%A7ocuk%20olarak%20ger%C3%A7ekle%C5%9Fti. While the total fertility rate was 2.38 children in 2001, this rate was 1.51 children in 2023. It means that a woman gave approximately 1.51 live births during her reproductive life in 2023. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic The provinces having the lowest total fertility rate was Bartın with 1.13 children. Bartın was followed by Zonguldak and Karabük with 1.14 children, Karabük with 1.16 children. Şanlıurfa was the city with the highest total fertility rate. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic The average total fertility rate for European Union member states was 1.46 children in 2022. Turkey is above this average and its total fertility rate is 1.63 children. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic While the crude birth rate was 20.3 per thousand in 2001, this rate was 11.2 per thousand in 2023. It means that while the number of live births was 20.3 per thousand population in 2001, the number of live births was 11.2 per thousand population in 2023. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic It was seen that crude birth rate of Türkiye was higher than the crude birth rates of 27 European Union member countries. The country having the highest crude birth rate was Greek Cypriot Administration of Southern Cyprus with 11.2 per thousand and the country having the lowest crude birth rate was Italy with 6.7 per thousand in 2022. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Adolescent fertility rate means that the average number of live births per thousand women in 15-19 age group. While the adolescent fertility rate was 49 per thousand in 2001, this rate decreased to 11 per thousand in 2023. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic While the mean age of the mothers giving birth was 26.7 in 2001, it was 29.2 in 2023. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic  When the fertility rate was examined by age group, it was seen that while the highest age specific fertility rate was in 20-24 age group with 144 per thousand in 2001, this rate was in 25-29 age group with 101 per thousand in 2023. This showed that fertility occurred at a later age of the woman. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic It was seen that 40.6% of births were first, 30.4% were second, 16.5% were third, 11.9% were fourth and above in 2023. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Mortality Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Death The irreversible disappearance of all signs of life at any time after birth. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Factors Affecting Mortality Rates Access to adequate and quality health services reduces mortality rates. Health Vaccinations, disease treatment and health awareness are important Care: factors in reducing mortality rates. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Factors Affecting Mortality Rates Good nutrition is critical, especially for infants and children. Malnutrition can Nutrition: increase mortality rates. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Factors Affecting Mortality Rates Access to clean water, hygiene and environmental conditions affect mortality Environmental rates. Dirty water and poor Factors: hygiene can lead to the spread of infectious diseases. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Factors Affecting Mortality Rates Social and economic factors Social such as poverty, low levels of education and and unemployment can Economic contribute to high mortality rates. Factors: Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Life Expectancy Life expectancy at age X shows how many years, on average, you will live after age X and is shown as ex. e60= 12: 60 means that if the current level of mortality continues, a 60-year-old person will live another 12 years and die at the age of 72. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Life Expectancy at Birth It is shown as e0 Life expectancy at birth is defined as the average number of years a newborn individual is expected to live if exposed to current mortality risks. Life expectancy at birth 77.5 years in the 2020-2022 period in Turkey Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic  Life Expectancy at Birth Women Men 2019-2021 in Turkey 75 years 80,5 years 2020-2022 in Turkey 80,3 years 74,8 years In general, women live longer than men and the difference in life expectancy at birth between men and women is 5.5 years. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic  Crude Mortality Rate (CMR) Number of deaths per thousand inhabitants. CMR: The number of deaths that occur in a community over a given period of time (one calendar year) x k (1000) Population of the same community at the same time (mid-year) A real rate; there is a specific time during this time there is one event in the denominator (death) everyone is at risk of death Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Crude Mortality Rate It is the simplest and most commonly used mortality indicator. It is easy to calculate. It is a crude indicator as it does not take into account age and gender structure. It is highly affected by age structure. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic  Age Specific Mortality Rates It shows the level of mortality in certain age groups. Age Specific Mortality Rates : X age group = specific mortality rate The number of people in age group "x" who die in a given period of time (one calendar year) in a community x k (1000) Population of the same society at age group "x" at the same time Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Age Specific Mortality Rates In most countries, age-specific mortality rates for men are higher than for women. The graph of age-specific mortality rate exhibits a 'U' or 'J' shaped structure. It is U-shaped in developing countries with high infant mortality. In developed countries with low infant mortality, it is J-shaped. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic  Gender Specific Mortality Rates It is used to determine the extent of mortality by gender. Mortality Number of women who die in a community in a calendar year x k (1000) in women: Female population in the same calendar year Mortality Number of male who die in a community in a calendar year X k (1000) in male: Male population in the same calendar year Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Settlement Specific Mortality Rate Mortality Number of deaths in settlement 'X' during the year X k (1000) in female: Female population in the same calendar year Mortality Number of deaths in settlement 'X' during the year X k (1000) in male: Male population in the same calendar year Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Cause Specific Mortality Rate It is calculated by dividing the number of people dying from a specific cause (c) in a given period by the number of person-years lived in the same period. Since the number of cause-specific deaths is quite low, it is expressed by multiplying by 100,000. Deaths due to cause X x 100000 Total population Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic  Fatality Rate Indicates how fatal a particular disease is. It is measured by the number of people who die from the disease. Fatality rate of disease ‘A’= The number of deaths from disease 'A' in a population in a given period of time X k (1000) The number of people with disease 'A' in the same population over the same period of time Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Neonatal Mortality Rates Early neonatal mortality rate The number of babies who die in the first 7 days after birth in a given year divided by the number of all babies born in the same year. d. Deaths d first week x k (1000) b b. Births Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Neonatal Mortality Rates Late neonatal mortality rate The number of babies who die in a year after the first 7 days following birth but before the end of the first month, divided by the number of all babies born in the same year. d. Deaths d 7-28 days x k (1000) b b. Births Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Neonatal Mortality Rates Neonatal Mortality Rate The number of babies who die in the first month after birth in a given year divided by the number of all babies born in the same year. d. Deaths d first month x k (1000) b b. Births Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Neonatal Mortality Rates Post-neonatal mortality rate The number of babies who die in a given year after one month but before reaching the age of one year divided by the number of all babies born in the same year. d. Deaths d 1 -12 months x k (1000) b b. Births Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Neonatal Mortality Rates With technological advances, it is possible to prevent postnatal deaths. These deaths are mostly environmental and easier to eliminate. As general health conditions improve, post-neonatal mortality decreases. Since the cause of neonatal deaths is mostly medical, they are also very difficult to reduce. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Infant, Child, Under 5 Age Mortality Rate Infant mortality rate: Deaths occurring in the 0-1 age group divided by all births d 0-1 x k (1000) d. Deaths b b. Births Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Infant, Child, Under 5 Age Mortality Rate Child mortality rate: Deaths occurring in the 1-4 age group divided by all births d 1-4 x k (1000) d. Deaths b b. Births Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Infant, Child, Under 5 Age Mortality Rate Under-5 mortality rate: Deaths occurring in the 0-4 age group divided by all births d 0-4 x k (1000) d. Deaths b b. Births Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic  Perinatal Mortality Rate It is an important indicator of the level of maternal health and in particular the adequacy of antenatal care. Perinatal mortality rate: The number of stillborn and live babies born alive and dying at 0-7 days of age in a community in a year X k (1000) Total number of births (live and stillbirths) in the same population during the same period Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Risk Factors Affecting Infant Mortality Mother's age < 18 years The mother's age is less than 18 Mother's age > 34 The mother's age is more than 34 Birth interval < 24 months The birth December is less than 24 months Birth order > 3 The birth order should be more than 3 Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Life Table The life table shows the transition of members of a generation from one state (life) to another (death). It is a tool to show the progression of mortality as a generation finally passes away. This transition does not only have to be between birth and death (the transition from celibacy to marriage can also form a life table). Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic  Data on Mortality in Turkey https://data.tuik.gov.tr/Bulten/Index?p=Hayat-Tablolari-2020-2022- 49726#:~:text=T%C3%BCrkiye'de%202019%2D2021%20d%C3%B6neminde%20erkeklerde%2075%20y%C4%B1l%20olan%20do%C4%9Fu%C5%9Fta,s%C3%BCresi%20fark%C4%B1%205%2C5%20y%C4%B1ld%C4 %B1r. Lecturer Beyzanur ÇAMLIBEL https://data.tuik.gov.tr/Bulten/Index?p=Olum-ve-Olum-Nedeni-Istatistikleri-2023- 53709#:~:text=T%C3%9C%C4%B0K%20Kurumsal&text=%C3%96l%C3%BCm%20say%C4%B1s%C4%B1%202022%20y%C4%B1l%C4%B1nda%20505,%2C1'ini%20kad%C4%B1nlar%20olu%C5%9Fturdu.&text=Bin% Nutrition and Dietetic 20ki%C5%9Fi%20ba%C5%9F%C4%B1na%20d%C3%BC%C5%9Fen%20%C3%B6l%C3%BCm,y%C4%B1l%C4%B1nda%20binde%206%2C2%20oldu.  Life expectancy at age 65 was 3.5 years higher for women than men. life expectancy according to gender and age Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic While crude death rate which is the number of deaths per thousand persons were 5.9 per thousand in 2022, it was 6.2 per thousand in 2023. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic The provinces having the highest crude death rate was Adıyaman with 18.0 per thousand in 2023. The province having the lowest crude death rate was Şırnak with 2.3 per thousand. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic While infant mortality rate was 9.2 per thousand in 2022, it was 10.0 per thousand in 2023. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic While the under five mortality rate which is the probability of dying during five years after birth was 11.2 per thousand in 2022, it was 14.5 per thousand in 2023. Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic  THANKS [email protected] Lecturer Beyzanur ÇAMLIBEL Nutrition and Dietetic