Mortality Health Indicators PDF

By Ashraf Hussain MBChB.PhD/COM.MED Objectives 1. Describe the most Imporatant Moratality Indicators 2. How to assess community health depending on Moratality Indicators INDICATORS OF HEALTH The subject of health measurement is complicated, cannot be in terms of a single indicator; it must b...

By Ashraf Hussain MBChB.PhD/COM.MED Objectives 1. Describe the most Imporatant Moratality Indicators 2. How to assess community health depending on Moratality Indicators INDICATORS OF HEALTH The subject of health measurement is complicated, cannot be in terms of a single indicator; it must be conceived in terms of a profile, employing many indicators, which may be classified as: 1. Mortality indicators 2. Morbidity indicators 3. Disability rates 4. Nutritional status indicators 5. Health care delivery indicators 6. Utilization rates 1. Mortality indicators a. Crude death rate: It is defined as the number of deaths per 1000 population per year in a given community.  The usefulness of the crude death rate is restricted because it is influenced by the age-sex composition of the population.  Although not a perfect measure of health status, a decrease in death rate provides a good tool for assessing the overall health improvement in a population.  b. Expectation of life :  Life expectancy at birth is "the average number of years that will be lived by those born alive into a population if the current age-specific mortality rates persist".  It is estimated for both sexes separately.  Life expectancy is a good indicator of socio-economic development in general and has been adopted as a global health indicator.  An increase in The expectation of life is regarded, inferentially, as an improvement in health status. c. Age-specific death rates : is defined as total number of deaths occurring in a specific age group of the population (e.g. 20-24 years} in a defined area during a specific period per 1000 estimated total population of the same age group of the population in the same area during the same period.  d. Infant mortality rate :  Infant mortality rate is 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  It is one of the most universally accepted indicators of health status not only of infants, but also of whole population and of the socioeconomic conditions under which they live.  In addition, the infant mortality rate is a sensitive indicator of the availability, utilization and effectiveness of health care, particularly perinatal care. e. Child mortality rate  Early childhood (1-4 years) mortality rate  It is defined as the number of deaths at ages 1-4 years in a given year, per 1000 children in that age group at the mid-point of the year concerned.  It excludes infant mortality.  Whereas the IMR may be more than 10 times higher in the least developed countries than in the developed countries, the child mortality rate may be as much as 25 times higher. This indicates the magnitude of the gap and the room for improvement.  Child mortality rate correlates with 1. Inadequate MCH services. 2. Insufficient nutrition 3. Low coverage by Immunization 4. Adverse environmental exposure(accidents). f. cause-specific mortality rate :  Deaths caused by specific diseases or disease groups per 100,000 inhabitants  Deaths such as from cancer, cardiovascular accidents, diabetes, etc have emerged as measures of specific disease problems.  g.Proportional mortality rate :  The simplest measure of estimating the burden of a disease in the community is proportional mortality rate, i.e., the proportion of all deaths currently attributed to it.  For example, coronary heart disease is the cause of 25 to 30 per cent of all deaths in most western countries.  Also the PMR of communicable diseases has been suggested as a useful health status indicator; it indicates the magnitude of preventable mortality.  h. Case fatality rate :  Case fatality rate measures the risk of persons dying from a certain disease within a given time period.  Case fatality rate is calculated as number of deaths from a specific disease during a specific time period divided by number of cases of the disease during the same time period, usually expressed as per 100.  The case fatality rate is used to measure various aspects of a disease such as its pathogenicity, severity or virulence.  It can also be used in poisonings, chemical exposures or other short-term non-disease cause of death. i. Maternal {puerperal) mortality rate (Ratio):  Defined as the number of maternal deaths within 42 days of pregnancy termination due to complications of pregnancy, childbirth, and the puerperium in a specified geographic area divided by total live births for the same geographic area for a specified time period multiplied by 100,000.  Maternal (puerperal} mortality accounts for the greatest proportion of deaths among women of reproductive age in most of the developing world.  There are enormous variations in maternal mortality rate according to country's level of socioeconomic status.