Biostatistics & Demography - Lecture 5 (2024) PDF

BIOSTATISTICS & DEMOGRAPHY NURSING ADMINISTRATION & PSYCHIATRIC NURSING Ministry of Health & Wellness In-Service Education Unit LECTURE # 5 Presented by: Hank Williams March 8, 2024 WHAT IS DEMOGRAPHY? Scientific study of human populations primarily with respect to their size, their structure and th...

BIOSTATISTICS & DEMOGRAPHY NURSING ADMINISTRATION & PSYCHIATRIC NURSING Ministry of Health & Wellness In-Service Education Unit LECTURE # 5 Presented by: Hank Williams March 8, 2024 WHAT IS DEMOGRAPHY? Scientific study of human populations primarily with respect to their size, their structure and their development. It takes into account the quantitative aspects of their general characteristics. WHAT IS DEMOGRAPHY? Demography is literally translated from the Greek: 'demography' means 'description of the people’ DEFINITION OF DEMOGRAPHY The study of the size, structure, distribution, and composition of populations, the principal determinants of changes in these parameters, namely, fertility, mortality, and migration, and the determinants and consequences of changes in these factors of population change. TYPES OF DEMOGRAPHY Formal Demography Measures the population processes. Social Demography deals with questions of population composition and change and how they interact with sociological variables at the individual and contextual levels. Applied Demography focuses on practical applications of demographic methods and materials for decision-making purposes. John Grant analyzed vital statistics and fashion a life table from burial records. OBJECTIVES OF DEMOGRAPHY To achieve knowledge about the size, population, organization and distribution of the population. To study the trend of population growth which describes the past evolution present distribution and future changes in the population of an area. OBJECTIVES OF DEMOGRAPHY To study the trend of population growth and the population distribution, which describes the trends of population and its relationships with the different aspects of social parameters in an area such as education level, extent of urbanization, employment, living standard etc. To protect the future demographic evaluation and its possible consequences. IMPORTANCE OF DEMOGRAPHY Economic Economic Planning Society Government Political System FOR THE ECONOMIC Understand the growth rate of the economy and growth rate of the population. Population is increasing at a faster rate – pace of development of the economy will be slow. Rapid growth reduces per capita income, lowers the standard of living, resulting in mass unemployment and underemployment. FOR THE ECONOMIC PLANNING Data relating to the present trend in population growth help the planners in formulating policies for economic plan. It is used in formulating a policy to control certain rates. FOR THE SOCIETY Rapidly population growth reduces per capita income, lowers the standard of living, resulting in mass unemployment and underemployment. May also result in migration and unplanned urbanization which further lead to unavailability of civic amenities and the law and order problem. FOR THE GOVERNANCE Almost all social and economic problems are associated wit the growth of population. The government has to tackle and find solutions to the problems arising from the growth of population. FOR POLITICAL SYSTEM Election commissions use information to the demarcation of constituencies. Political parties normally frame their policies and election manifestos at the time of elections. DEMOGRAPHY & HEALTH STATISTICS Biostatistics is the study of statistics as applied to biological areas. Develop the analytical tools necessary to derive the most appropriate conclusions based on the collected data. Support assertions about health and what people can do to improve their health. ROLE OF BIOSTATISTICS IN PUBLIC HEALTH Assessment, to identify problems related to the health of populations and determine their extent; Policy development, to prioritize the identified problems, determine possible interventions and/or preventive measures, set regulations in an effort to achieve change, and predict the effect of those changes on the population; and Assurance, to make certain that necessary services are provided to reach the desired and to monitor how well the regulators and other sectors of the society are complying with policy. POPULATION IN DEMOGRAPHY Collection of persons alive at a specified point in time who meet certain criteria Kind of collectivity that persists through time even though its members are continuously changing through attrition and accession. DEMOGRAPHIC PROCESSES AREAS OF FOCUS Population Size Population Density Age Structure Fecundity (birth rates) Mortality (death rates) Sex Ratio FACTORS THAT INFLUENCE POPULATION SIZE Births Deaths Net Migration COMPONENTS OF POPULATION GROWTH P = P0 + (B – D) + (I - E) t Population Population Natural increase at time t at time 0 (Births – Deaths) Net migration (immigration – Emigration) COMPONENTS OF POPULATION GROWTH Population growth can occur only if: 1. Natural increase is positive B > D ⇒ B increases or D declines and/or 2. Net migration is positive I > E ⇒ I increases or E declines In history, the first case is more important to understand the impressive population growth >> Demographic transition DEMOGRAPHY TRANSITION One of demography’s main theoretical preoccupation in 20th century More a generalization from observed trends than a theory Descriptive and pedagogic value Many patterns of transition, with different timing and explanations DEMOGRAPHY TRANSITION >> Movement of death and birth rates in a society, from a situation where both are high (in the pre-transition stage) to one where both are low (in the post-transition stage). >> Transition is the interval between these two stages during which the population increases oftentimes rapidly, as births exceed deaths. DEMOGRAPHIC CYCLE DEMOGRAPHIC CYCLE GROWTH RATE OVER THE DEMOGRAPHIC TRANSITION SOURCES OF POPULATION DATA Main sources Census Vital Registration Sample surveys Some other sources Population Register Demographic Surveillance System (DSS) MAIN SOURCES – CENSUS "The total process of collecting, compiling, evaluating, analysing, and publishing or otherwise disseminating demographic, economic and social data pertaining to all persons in a country or in a well delineated part of a country at a specified time.” (United Nations 2008). MAIN SOURCES – CENSUS  Total process Not sufficient to simply collect and collate information in a census, but also analyze, publish and disseminate the data.  Demographic, economic and social data To collect more than just a simple headcount of the population.  Universality To enumerate all people in a population.  Simultaneity To produce a snapshot of the population at a point in time. MAIN SOURCES – CENSUS The oldest, most demanding, and most important source of demographic information. Among the most complex and massive peacetime exercises a nation undertakes Requires the mapping the entire country, mobilizing and training an army of enumerators, conducting a massive public campaign, canvassing all households, collecting individual information, compiling vast amounts of completed questionnaires, and analysing and disseminating the data MAIN SOURCES – CENSUS The Jamaica 2011 Census of Population and Housing was the fourteenth to be conducted. It collected information via a household and individual questionnaire on a variety of housing characteristics and demographic subjects. Data collected at both nationally and by parish. The total population of Jamaica in 2011 was enumerated at 2,697,983. MAIN SOURCES – VITAL REGISTRATION The second main source for demographers Collect information on individuals when (or shortly) after they experience the vital events (birth, marriage, death, (sometimes) migration) In almost all developed countries, registration of births, deaths, and marriages is compulsory. MAIN SOURCES – VITAL REGISTRATION Vital data collected are tabulated totals from individual records Sometimes more extensive information collected (e.g. statistics for birth could include sex, birth weight, place of birth etc…) Despite progress, civil registration systems still deficient in many countries. MAIN SOURCES – SAMPLE SURVEYS More and more important as statistical science has developed. Collect vital statistics where the official registration system is inadequate or nonexistent and for intercensal period. Collect supplementary demographic and other data, where it is not feasible to collect the same from the population census. MAIN SOURCES – SAMPLE SURVEYS Since the 1950s, STATIN coordinated demographic surveys have been taken in Jamaica: Consumer Price Index (first week of each month) Producer Price Index (second week of each month) Labour Force Survey (January, April, July and October) Inflation Expectation Survey (ongoing: contracted by BOJ but viewed as routine) Production Survey (Monthly & Quarterly) Survey of Employment, Earnings and Hours worked (Monthly) Consumer Price Index (first week of each month) Annual National Income Survey Central Register of Establishments SOME OTHER SOURCES Population Register >> If country has a system of continuous registration it is possible to maintain a separate card for each individual from the time of his birth (or immigration) to his death (or emigration) and to continually update the record by recording such additional registration data as marriage, divorce, birth of children, etc. SOME OTHER SOURCES Demographic Surveillance System >> STATIN monitors demographic, social, economic, environment and health characteristics of a population living in a well-defined geographic area. A baseline census is followed by regular update of key demographic events such as birth, death, migration, marriage and heath events. HEALTH INDICATORS WHAT IS A HEALTH INDICATOR? An estimate (a measurement with some degree of imprecision) of a given health dimension in a target population. CHARACTERISTICS OF A GOOD HEALTH INDICATOR Indicators play a critical role in turning data into relevant information for decision makers in public health. Health indicators are relevant to define the health-related goals to be pursued by national health authorities. S - Specific M - Measurable A - Attainable R - Realistic T - Timeliness POSITIVE AND NEGATIVE HEALTH INDICATORS Positive Health Indicators A direct relationship (association, correlation) with healthiness. The higher the indicator value, the better the state of health of the people in the population being studied. Negative Health Indicators An inverse relationship (association, correlation) with healthiness. The higher the indicator value, the worse is the state of health of the people in the population being studied. USES OF HEALTH INDICATORS Description Describe health care needs in a population, and the disease burden in specific population groups. Forecast or Prognosis Anticipate results with regard to the state of health (forecast) of a population or a group of patients (prognosis). Explanation Health indicators can facilitate an understanding of why some individuals in a population are healthy and others are not. USES OF HEALTH INDICATORS System management and quality improvement The production and regular monitoring of health indicators can also provide feedback to improve decision-making in various systems and sectors. Evaluation Health indicators can show the results of health interventions. The monitoring of such indicators can detect the impact of health policies, programs, services, and actions. Advocacy Indicators can serve as tools to support or oppose particular ideas and ideologies in different historical and cultural contexts. USES OF HEALTH INDICATORS Accountability Health indicators can provide needed information on risks, disease and mortality patterns, and health-related trends over time for a wide range of audiences and users. Research Simple observation of the temporal and spatial distribution of health indicators in population groups can facilitate analysis and lead to a hypothesis to explain observed trends and discrepancies. Measure Gender Gaps. Gender-sensitive indicators measure gaps between men and women resulting from differences or inequalities in gender roles, norms, and relations. TYPES OF HEALTH INDICATORS Morbidity Mortality Behavioral risk factors Health services EXAMPLES OF HEALTH INDICATORS Births, such as teen, non-marital, multiple, preterm, and low birth-weight births. Diseases and health conditions such as obesity, diabetes, hypertension, cancer, heart disease, stroke, HIV/AIDS, lung diseases, osteoporosis, asthma, allergies, ADHD, arthritis, and pain. Other health status measures including injuries, disabilities, environmental exposures, oral health, vision, hearing, and mental health. EXAMPLES OF HEALTH INDICATORSHEALTH INDICATORS Health-related behaviors such as smoking, physical activity, and alcohol use. Nutrition and growth charts. Preventive services such as immunizations and cancer screening. Reproductive health including fertility, contraceptive use, and sexual behaviors. Health insurance coverage and access to care. EXAMPLES OF HEALTH INDICATORS Health care use and services delivered by hospitals, hospital emergency and outpatient departments, physicians’ offices, nursing homes, home and hospice care agencies, and residential care facilities. The health care system including the use of health information technology and electronic medical records, changing patterns of service delivery, medications prescribed, and complications of care. Deaths, such as life expectancy, leading causes of death, fetal deaths, and infant mortality. REFERENCES Centre for Disease Control. United Nations Statistics Division (2014). Overview of Demographic Concepts and methods: United Nations: USA. Siegel, JS. The demography and epidemiology of human health and aging. Springer: UK van Belle, G; et.al. Biostatistics: A methodology for the Health Sciences (2th ed.). John Wiley & Sons, New Jersey: USA. Pan American Health Organization. Health Indicators: Conceptual and Operational Considerations. www.paho.rg.