Population Health Indicators PDF

Population Health Indicators Prepared by: DR.KHALED A. SUHAIL  Health Indicators An Indicator Health WHO Definition Health Index; termed as;...

Population Health Indicators Prepared by: DR.KHALED A. SUHAIL  Health Indicators An Indicator Health WHO Definition Health Index; termed as; Indicator is; for Indicator; An Index/Variable is A variable, “Variables A numerical only an indication of a given situation, which Measure indication of Susceptible to direct Change”. the health of a OR measurement, given population A reflection of that Reflects the state of derived from a situation. health of persons in specified a community. composite Help to measure the formula. extent to which the objectives and targets of a program are being attained.  Measurement of the health of the community. Description of the health of the community. Comparison of the health of different Uses of communities. Health Identification the health needs and prioritizing them. Indicators Evaluation of health services. Planning and allocation of health resources. Measurement of health successes.  Characteristics of Health Indicators should measure what they are supposed to Valid – measure. The answers should be the same if measured by Reliable – different people in similar circumstances. Should be sensitive to changes in the situation Sensitive – concerned. Should reflect changes only in the situation Specific – concerned. Feasible – Should have the ability to obtain the data needed. Should contribute to the understanding of the Relevant – phenomenon of interest. Population Health Indicators Measurements of Mortality  Mortality Rates Crude Death Rate:  It is the most used vital rate to measure the decline in total population without specifying the sections of the population or the underlying cause.  Calculated as the number of deaths in a given period divided by the population exposed to the risk of death in that period. For Human Populations;  The period is usually one year.  If the population changes in size over the year; the divisor is taken as the Population at the Mid-Year.  Mortality Rates: Crude Death Rate:  Calculated as the number of deaths in a given period divided by the population exposed to the risk of death in that period; Crude Death Rate = Total Deaths in a specific Place and Time *1000 Total Population Crude Death Rate:  Crude Death Rate: A very general indicator/index of the health status of a population. NOT Appropriate for comparison of different populations or areas; Due to the significant impact of age in mortality data and Age-adjusted mortality rates should be used for different age distributions in different populations. comparative analysis. Why we use the CDR: Requires the least amount of Helps us understand mortality’s Easy to understand. information. “contribution” to population growth.  Mortality Rates Crude Death Rate Example: Average number of deaths in 2022 is 2,500 Our midpoint is July 1, 2022. (Why?) Population was 150,645 on July 1, 2022.  Demographic Age/Sex 4) Lifestyle Factors; composition of the Distribution; population;  Abuse of alcohol and tobacco; Immunization Programs, 5) Work-Related Dangers; Factors Quality and utilization of Maternal/Child Influencing health/medical Health Care, services; 6) Exposure to events outside individual control; Population Primary Health Care,  Natural Disasters,  War; Mortality Housing, 7) Socio-economic status;  Income, Water Supply, Environmental  Education. conditions and availability of infrastructure; Sanitation, Waste Disposal;  Mortality Rates Infant Mortality Rate (IMR):  An important National Health indicator; because;  It is sensitive to general structural factors; 1) Socio-economic developments 2) Level of Living Conditions. 3) Health status of a community. 4) Effectiveness of MHC services.  The most common causes in Yemen are; 1) Low Birth Weight 2) Prematurity IMR is defined as;  The number of deaths of children under one year of age, expressed per 1,000 live births. Infant Mortality Rate = Deaths of infants under 1 year of life *1000 Live Births Infant Mortality Globally Yemen 2022 Yemen 2023 Rate 29 per 1000 live birth 42 per 1000 live birth 41 per 1000 live birth Infant Mortality Rate:  Mortality Rates  Neonatal Mortality Rate: Neonatal Mortality Rate = Deaths under 28 days of life * 1000 Live Births  Mortality Rates Stillbirth Rate: Stillbirth = Fetal Deaths after 28 Gestational Weeks * 1000 Live Births  Mortality Rates Fetal Death Ratio: Fetal Death Ratio = Fetal Deaths * 1000 Live Births  Mortality Rates Under 5 Mortality Rate (U5MR): Under 5 Mortality Rate = Deaths Under 5 Years * 1000 Under 5 Population Child Survival Index = 1000 – U5MR 10  Mortality Rates Example In a town with a population of 50,000, there were;  2000 births,  200 infant deaths in the year 2018.  80 infants died in the first month of life.  110 stillbirths in the same year. Calculate; 1) Infant Mortality Rate, 2) Neonatal Mortality Rate, 3) Stillbirth Rates. 1. Crude Death Rate = Total Deaths in specific place and time *1000 Total Population 2. Cause-specific Death Rates = Deaths due to specific diseases *1000 Total Population 3. Proportional Mortality Rate = Deaths from specific diseases * 100 All Deaths 4. Case Fatality Rate = Deaths from specific diseases *100 New cases of the same diseases 5. Neonatal Mortality Rate = Deaths under 28 days of live * 1000 Live Births 6. Post Neonatal Mortality Rate = Deaths from 28 days to one year *1000 Live Births 7. Perinatal Mortality Rate = Fetal Deaths after 28 weeks of pregnancy + Deaths during the first 7 days of life *1000 Live Births + Still Births 8. Infant Mortality Rate = Deaths of infants under 1 year of life *1000 Live Births 9. Maternal Mortality Ratio = Maternal Deaths due to Pregnancy, Labor, Peripartum *100,000 Live births 10. Age-adjusted Mortality Rate Population Health Indicators Measurements of Fertility Measurements of Fertility  Fertility The Age of Fertility is; Generally taken as 15 – 49 years. Some people prefer to regard the fertile period as 15 – 45 years. The study of population change starts with fertility: The number of births that occur to an individual or in a population. In 2019; 140,108,052 people were born, This works out to about 267 babies per minute.  Fertility Globally; Women have an average of 2.3 children each, This number varies considerably by country; Ranging from an average of; 7.1 children per woman in Niger, TO; A low of 0.9 children per woman in South Korea The current fertility rate for Yemen in 2023 is; 3.427 births per woman Fertility  How We Measure Fertility? There are several different ways of measuring and analyzing fertility. Crude Birth Rate;  The most easily obtained,  The most often reported fertility measure.  It is calculated from; The number of babies born in a given year divided by the total midyear population and multiplied by 1,000; Crude Birth Rate = Total No of Live Births *1000 Mid-Year Population  How We Measure Fertility? High Crude Birth Rate and Fertility Rate indicate; 1) A rapid increase in population, which calls for birth control measures. 2) If the birth control measures are effective; there should be a fall in the birth rate and fertility rate. 3) Some indices may indicate a fall in birth rate when other vital statistics are lacking or are not reliable.  How We Measure Fertility? There are several different ways of measuring and analyzing fertility. Total Fertility Rate;  Considered a more refined measure than the crude birth rate,  Commonly, used because it is easy to visualize what it means: Average number of children that would be born to a woman if she experiences the current fertility pattern throughout her reproductive span (15-49 years).  How We Measure Fertility? There are several different ways of measuring and analyzing fertility. General Fertility Rate; Number of live births per 1000 women in the reproductive age group (15-49 years) in a given year; General Fertility Rate = Live Births reported during specific period *1000 Women at 15 – 49 Years  How We Measure Fertility?  Net Production Rate:  “Average number of daughters that would be born to a woman if she experiences the current fertility and mortality patterns throughout her reproductive span (15- 49 years)”. A Net Reproduction Rate of 1 means that;  Each generation of mothers has exactly enough daughters to replace themselves in the population.  A Net Reproduction Rate of less than 1 means that;  The reproductive performance of the population is below replacement level. Population Health Indicators Life Expectancy  Life Expectancy Life Expectancy is:  “The average number of years a newborn child would live if prevailing patterns of mortality at the time of its birth were to stay the same throughout their life”.  A pure measure of the mortality conditions faced by a population; Unaffected by that population’s age structure.  The numerical value of life expectancy also has; An intuitive interpretation, conditional on some assumptions, as the expected age at death of an average newborn. This intuitive interpretation gives life expectancy a broad appeal.  Changes in life expectancy are routinely used to assess mortality trends.  Health Life Years At Birth Health Life Years At Birth (HLY):  “The average number of years that a newborn child can expect to live in a healthy condition and free from disability”. Life Expectancy at Birth Globally Yemen 2022 72 64 Male: 70 Male: 60 Female: 75 Female: 67 Life Expectancy  Life Expectancy Demographers tend to favor life expectancy because;  It is a pure measure of the mortality conditions faced by a population during its reference period.  It is unaffected by that population's age structure.  It is a mortality indicator that describes the overall health status and development of a particular place.  Life expectancy at older ages is especially important for wellbeing.  However, it also influences the finances of retirement income systems.  Dependency Ratio Definition:  The average number of economically dependent populations per 100 economically productive populations, for a given country, territory, or geographic area, at a specific point in time.  Economically Dependent Population is defined as;  The sum of the population under 15 years of age plus the population 65 years of age and over, for a given country, territory, or geographic area, at a specific point in time.  Mid-Year; Economically Productive Population is defined as;  The population between 15 and 64 years of age, for the same country, territory, or geographic area, at the same specific point in time. Unit of Measurement: Per hundred persons aged 15-64.  Dependency Ratio Purpose:  Dependency ratios indicate; o The potential effects of changes in population age structures for social and economic development, pointing out broad trends in social support needs. Measurements Methods:  The dependency ratio refers to; o “The number of children aged 0 to 14 years plus the number of persons aged 65 years or over per 100 persons aged 15 to 64 years” Dependence Ratio = Children aged (0 –14 years) + Elderly (65+) *100 Working Age Group (15 – 49 Years)  Dependency Ratio The Dependency Ratio can be disaggregated into: 1) The Youth Dependency Ratio which is;  The number of children aged 0-14 per 100 persons aged 15-64. 2) The Old-age Dependency Ratio, which is;  The number of persons aged 65 or over per 100 persons aged 15-64. The Dependency Ratio, also referred to as; o Total dependency ratio, is the sum of the youth and old-age dependency ratios.  Some studies employ other age groups in calculating dependency ratios;  For instance; o 0-19 years to represent the population of children, o The population aged 60 or over to represent the population of older persons.  Limitation of Dependency Ratio  Limitations of the Dependency Ratio 1) Only considers age when determining whether a person is economically active. 2) Other factors may determine if a person is economically active aside from age including; 1) Status as a student, illness or disability, 2) Stay-at-home parents, 3) Early retirement, 4) The long-term unemployed. 5) Additionally, some people choose to continue working beyond the age of 64. Dependency Ratio in Yemen 74.1% (2023)  Brainstorming Q.1Which of the following is the best indicator of the health status of the community: a) Infant Mortality Rate. b) Crude Birth Rate. c) Crude Death Rate. d) Fertility Rate.  Brainstorming Q2.What is the denominator in GFR (General Fertility Rate): a) Crude Birth Rate. b) Married Women. c) Women in the Reproductive Age Group (15-49). d) Married women in the age group of 15-49. e) All Women.  Brainstorming Q3.Total Fertility Rate refers to: a) No. of women between 15 – 44 years. b) No. of births per thousand women. c) No. of children per woman. d) No. of children in the population.  Brainstorming Q3.The simplest measure of fertility requires only total births and total population; a) Specific Birth Rate. b) Crude Birth Rate. c) General Fertility Rate. d) Net Reproductive Rate.  Reference 1 2 3 4 Mahajan & Gupta, Sartorius, B.K., Sartorius, K. DEMOGRAPHIC AND ECONOMIC Patrick Heuveline, Reflection Global infant mortality trends CONTEXT Interpreting changes in life Textbook of preventive and attributable determinants PENSIONSATAGLANCE 2017: expectancy during temporary and social medicine, – an ecological study using OECD AND G20 INDICATORS mortality shocks. 4th edition,2013, data from 192 countries for ©OECD2017 120 LIFE DEMOGRAPHIC RESEARCH the period 1990–2011. EXPECTANCY; VOLUME 48, ARTICLE 1, PAGES Jaypee Brothers 1-18 PUBLISHED 6 JANUARY Population Health Metrics 12, https://www.oecd- Medical Publishers, 29 (2014); ilibrary.org/life- 2023; India https://doi.org/10.1186/s129 expectancy_5jfjdfvnvrnr.pdf https://www.demographic- 63-014-0029-6 research.org/Volumes/Vol48/1 /; DOI: 10.4054/DemRes.2023.48.1