Demography and Vital Health Statistics PDF

 DEMOGRAPHICS ⚫ Demography- is the science of vital and social statistics like marriages, birth, deaths of the population (Webster Dictionary) ⚫ It is also the statistical study of the population specifically with reference to size, density and population (Encyclope...

 DEMOGRAPHICS ⚫ Demography- is the science of vital and social statistics like marriages, birth, deaths of the population (Webster Dictionary) ⚫ It is also the statistical study of the population specifically with reference to size, density and population (Encyclopedia Britannica) 9/23/2021 3  ETYMOLOGY The word was coined by John Grant Demographic Data ⚫ Since the ultimate aim of public health work is to control and prevent health problems, information on who are affected, and when they are found are also important in studying determinants or reason for the occurrence of such problems. 9/23/2021 9 1. Demographic features a. Population- number of males, females, and households b. Population density- number of persons per hectare c. Source of power/power supply d. Communication services- media facilities like TV, radio, newspapers and other telecommunication facilities like telephone services e. Land use- categorized as residential, commercial, industrial, agricultural, special, exempt and the area involved 9/23/2021 37 2. Physical infrastructure a. Road works- types (concrete, asphalt, gravel, earth fill), and length of roads and presence of farm-to- market roads b. Transportation- jeepneys, tricycles, buses, etc. c. Water supply- sources such as batis, deep well, chlorinated water supply 9/23/2021 38 3. Social features a. Health Status- i. 10 leading causes of mortality and morbidity ii. Infant mortality rate iii. No. And % of malnourished children (0- 11 mos., 1-4 yrs., 5-6 yrs.) b. Health facilities and services- presence of hospital, lying-in, clinics; their location, services offered and personnel c. Toilet facilities d. Garbage collection and disposal e. Education- presence of academic institutions, schools or universities 9/23/2021 39 VITAL HEALTH STATISTICS Definition of Terms ⚫ STATISTICS- refers to a systematic approach of obtaining, organizing and analyzing numerical facts so that conclusion may be drawn from them. ⚫ VITAL STATISTICS- refers to the systematic study of vital events such as births, illnesses, marriages, divorce, separation and deaths. Vital Statistics System ⚫ Is the total process of (a) collecting by registration, enumeration or indirect estimation of information on the frequency of occurrence of certain vital events, as well as relevant characteristics of the events themselves and of the person(s) concerned, and (b) compiling, analyzing, evaluating, presenting and disseminating those data in statistical form. ⚫ One of the basic premises of a vital statistics system is that every event should be reported for statistical purposes for all geographic areas and all population subgroups, and the data and their analysis need to be disseminated to be useful. Definition of Terms ⚫ HEALTH INDICATORS: - A list of information which would determine the health of a particular community - Information that help anybody in describing or in maintaining surveillance over the health status of the people or population - serve as basis for developing, implementing and evaluating public health programs and intervention strategies The Different Health Indicators 1. Marriage - This is considered as a healthy indicator of the health status of the community in the following instances: a. Intact and it exists for its own real purpose b. It is a planned marriage- right time, right persons marrying each other Marriage, however, becomes an indicator of an unhealthy community when it ends up in divorce or separation 2. Morbidity -The lesser the occurrence of illnesses in a particular locality, the healthier this locality is considered. 3. Migration or social mobility - The faster the migration, the faster the following effects on the health status of the community would occur. a. More congestion to the place where people will transfer b. More depletion or utilization of health resources intended for the expected population living in that community. c. More chances of transfer or spread of communicable diseases 4. Life expectancy 5. Mortality Cont’n Definition of Terms ⚫ FERTILITY/BIRTH: Bearing or coming into being of a new spring ⚫ MORBIDITY: refers to being sick or diseased, injuries and disabilities in a population. ⚫ MIGRATION/SOCIAL MOBILITY: act of transfer of a person/s from one locality to another ⚫ LIFE EXPECTANCY: - It is the average number of years that a person lives. - The number of years a person expects to live based on statistical averages. ⚫ MORTALITY/FATALITY: Cessation of physical and chemical processes that occur in all living things, of people ⚫ RATE- shows the relationship between a vital event and those persons exposed to the occurrences of said event, within a given area and during a specified unit of time, it is evident that the person experiencing the event must come from the total population exposed to the risk of same event. ⚫ CRUDE or GENERAL RATES- referred to the total living population. It must be presumed that the total population was exposed to the risk of the occurrence of the event. ⚫ SPECIFIC RATE- the relationship is for a specific population class or group. It limits the occurrence of the event to the portion of the population definitely exposed to it. ⚫ CRUDE BIRTH RATE- a measure of one characteristics of the natural growth or increase of a population. ⚫ Vital statistics derived from civil registration are useful for local and national authorities specifically for planning of human, social and economic development. ⚫ Birth and death registers derived from civil registration records serves the following purposes: ⚫ as input for population estimation/ projection for future planning; ⚫ as basis for forecasting requirements for food, housing, medical facilities, education and other needs of the population ⚫ to carry out policy making at local levels for planning health, education services, housing, etc.; ⚫ to address health inequities from communicable disease, chronic disease and injuries; ⚫ generate “life tables” and life expectancies for many health-planning purposes; ⚫ measure progress on the sustainable development goals and other international health goals; ⚫ prepare polling lists for eligible voters for election purposes; ⚫ calculate the number of members of parliament for each state or province; ⚫ allocate budgets for development and for human resources Sample Period Life Table, 2019 Male Female Exact age Death Number of Life Death Number of Life probability a lives b expectancy probability a lives b expectancy 0 0.006081 100,000 76.23 0.005046 100,000 81.28 1 0.000425 99,392 75.69 0.000349 99,495 80.69 2 0.000260 99,350 74.73 0.000212 99,461 79.72 3 0.000194 99,324 73.75 0.000166 99,440 78.74 4 0.000154 99,305 72.76 0.000137 99,423 77.75 5 0.000142 99,289 71.77 0.000122 99,409 76.76 6 0.000135 99,275 70.78 0.000111 99,397 75.77 7 0.000127 99,262 69.79 0.000103 99,386 74.78 8 0.000117 99,249 68.80 0.000098 99,376 73.79 9 0.000104 99,238 67.81 0.000095 99,366 72.79 10 0.000097 99,227 66.81 0.000096 99,357 71.80 ⚫ calculate the number of citizens each year for administrative areas by age and sex; ⚫ provide denominator data for calculating health-related indicators; ⚫ help guide efficient resource allocation; ⚫ other analytical studies which are important and useful to planners and policy-makers. ⚫ Vital and health statistics are used as indicators of the health status for a group or whole community. ⚫ Statistics of disease (morbidity) or death (mortality) indicate the state of health of a community and how successful or unsuccessful are its health services. ⚫ Statistics of disease (morbidity) and death (mortality) indicate the state of health of a community and the success or failure of health work or health services. - These statistics are collected by the Department of Health through its regional, provincial, and municipal agencies. The Rural Health Units (RHUs) in the municipalities are responsible for collecting and reporting data of vital statistics dealing with births, deaths and all reportable diseases.. ⚫ Registration of births and deaths and correction of errors in names, dates, etc. are done in the office of the local civil registrar of the municipality or city health department. ⚫ Statistics on population and its characteristics like age, sex and distribution can be obtained from the National Statistics Office (NSO) now PSA (Philippine Statistics Authority) where vital facts are registered Sources of Data 1. Vital registration records a. RA 3753 (Civil Registry Law) registration of births, deaths to local registrars (city health officer or municipal treasurer) b. Problems include: - Under registration and de facto registration - Unreported birth- unreported death ⚫ Civil registration is an ideal source of statistics on important demographic processes such as fertility, mortality and nuptiality, which in turn, are the basic information needed for monitoring population growth. ⚫ Civil registration is important in generating indicators useful in the formulation of health programmes, such as those on maternal and child health care and other health programmes such as vaccination and immunization for specific subgroups of the population. ⚫ Each type of registrable document serves a specific purpose to individual and society. Birth record or birth certificate is a source of vital information and provides legal proof of the identity of an individual. It can be used for the following purposes: ⚫ Proves the facts of his/her birth as regards to parentage which allows them to trace ancestry ⚫ Establishes identity and claim inheritance and rights due to legal dependency ⚫ The date of birth shown in the birth certificate establishes his/her age and rights to privileges accruing by virtue of meeting the required age qualifications such as the privilege to enter school, to vote, to enter the civil service, to contract marriage, to qualify for professional licenses, to drive motor vehicles, to carry firearms, to claim pension benefits and so on. ⚫ Place of birth, on the other hand, establishes one’s citizenship for obtaining passport, provide basis for immigration and naturalization claims, allows one to obtain exemptions from alien restrictions or, if an alien, allows him to obtain exemptions from tax or military service in the country. Death record or death certificate is a prerequisite for burial in the Philippines. Apart from this, it: ⚫ Provides legal evidence in claims of inheritance, pensions, insurance benefits and settlement of a deceased person’s estate. ⚫ Exempts the heirs from specific types of taxes at a certain date and establishes a widowed person’s right to a second or subsequent marriage. Collectively, death certificates provide the indicators of existing infectious diseases and epidemics that need immediate control measures. ⚫ They serve as the basis for designing programs that promote public safety and strategies that help the prevention and eradication of certain types of diseases. ⚫ Civil registration in the Philippines was made compulsory with the enactment of the Civil Registry Law (Act No. 3753) approved on November 26, 1930 and which took effect on Feb. 27, 1931. THE CIVIL REGISTRY LAW (ACT NO. 3753) ⚫ Act 3753 mandates the registration of all facts and acts concerning the civil status of persons from birth to death including the changes in civil status taking place therein in appropriate civil registry books. 2 Ways of assigning people during census De Jure- people are assigned according to the place where they usually live regardless of where they are during the time of census. De Facto- people are assigned to where they are physically present during the time of census regardless of where they usually live. Sources of Data 2. Weekly reports from field health personnel based on RA 3573 (Law on the reporting of notifiable diseases like dengue, rabies, leptospirosis, and HIV/AIDS to local and national authorities.) a. Report to provincial and duty health office b. Midwife reports- under supervision of the nurse  c. Report within 24h-measles or polio d. Report within a week- tetanus neonatorum, severe and acute diarrhea, HIV/AIDS 3. Population Census- accurate estimation 4. Individual health records/ family records a. Birth certificate, death certificate, school clinic records  b. Employment records c. Health center records, hospital records, healthy facility logbooks 5. Publications/ Studies and Researches Certificate of live birth- signed by the birth attendant, midwife, nurse, doctor, or even student nurse, must be filed within 30 days. ⚫ Death certificate- signed by a physician only, in place when certificate are not available, the mayor may sign the death certificate but should not sign the cause of death. ⚫ a. must be filed within 48 hrs from the occurrence of death ⚫ b. still birth: under death cert. (declared as born dead and must be burried), not birth cert. ⚫ c. Abortion: it depends on the parents' decision PRESIDENTIAL DECREE NO. 856 (CODE OF SANITATION OF THE PHILIPPINES APPROVED ON DECEMBER 23, 1975 The burial of remains is subject to the following requirements: ⚫ No remains shall be buried without a death certificate. This certificate shall be issued by the attending physicians. If there has been no physician in attendance, it shall be issued by the mayor, the secretary of the municipality where the death occurred. The death certificate shall be forwarded to the Local Civil Registrar within 48 hours after death. Different Ways of Data Presentation/ Tabulation 1. Narrative report- descriptive data (history, geographic data, cultural beliefs) 2. Tables/Graphical- for numerical data Types: a. Line graph b. Bar graph/pictograph c. Histogram/frequency polygon d. Proportional or component bar graph/pie chart e. Scattered diagram Commonly Used Rates & Formula in Health Statistics/ Descriptive Measures of Health 1. Birth/ Natality/ Fertility Rates This masures the number of times that a birth could occur within a period of time in a given community It measures the frequency of births (fertility rate) within a specific population and are calculated for a given time interval and place. BIRTH RATE or CRUDE BIRTH RATE (CBR): it is a rough estimate or measure of fertility or occurrence of birth within a period of time in a given community It is a measure of natural growth or increase of population indicates the number of live births per 1000 midyear population in a given year. FORMULA: CBR= Total No. of live births registered in a given calendar year________ x 1,000 Estimated mid-yr population(as of July 1 of same year) General Fertility Rate (GFR)- measure of one characteristic of natural growth compared to the fertility age group ⚫ Is the number of live births per 1,000 women ages 15-49 in a given year. The general fertility rate is a somewhat more refined measure than the birth rate because it relates births to the age-sex group at risk of giving birth (usually defined as women ages 15-49). FORMULA: GFR= Total no. of live births registered in a given year_________________x 1,000 Total mid-year population of fertility age group Fertility Age= 15-44 years 2. MORBIDITY RATES: measures the frequency of illnesses of a specific population 2.1 Incidence Rate (IR) or Sickness/Infection/Attack Rate It measures the frequency of addition of new cases of a disease. Deals only with new cases. FORMULA: IR= No. of new cases of a particular disease registered during a specified period of time______ x 1000 Estimated population as of July of same year 2.2 Prevalence Rate (PR)- measures the proportion of the population which exhibits a particular disease at a particular time. Deals with old and new cases. PR= No. of new and old of a certain disease registered at a given time x 1000 Total No. of persons examined at same given time Attack Rate- more accurate measure of the risk of exposure AR= No. of persons acquiring a disease registered in a given year_____ x 1000 No. of exposed to same disease in the same year 3. MORTALITY/ FATALITY/ DEATH RATE- measures the frequency of deaths within a given population and is calculatd for a given time interval and place 3.1 Crude Death Rate(CDR): it roughly measures the decrease of population due to deaths. CDR= Total no. of deaths, all causes registered in a given calendar year__ x 1000 Estimated mid-year population of same year 3.2 Proportionate Mortality Rate(PMR)- shows the numerical relationship between deaths from all causes (or group of causes), age( or group of age) etc. and the total number of deaths from all causes in all ages taken together FORMULA: PMR= No. of registered deaths from specific cause or age for a given calendar year x 1000 No. of registered deaths from all causes, all ages in same year Swaroop's Index: measures the proportion of deaths 50 years old up and over the total deaths. SI= Total no. of deaths 50 yrs above in a given year_______ x 100 No. of deaths, all causes as of July 1 of same year 3.3 Maternal Mortality Rate (MMR)- measures the risk of dying from causes related to pregnancy, childbirth and puerperium. An index of the obstetrical care needed and received by the woman in a community FORMULA: MMR= Total no. of deaths among women directly due to pregnancy, labor, delivery & puerperium x 1000/100000 Total no. of live births in same year 3.4 Infant Mortality Rate (IMR)- measures the risk of dying during the 1st year of life, a good index of the general health condition of a community since it reflects the changes in the environmental and medical condition of the community or gives idea on the following: a. immunization program b. infant and maternal nutrition c. perinatal care services d. disease control program and laws governing administration of health programs e. water supply  f. environmental sanitation g. insect and vermin control h. good housing facilitis i. care of illegitimate and unwanted pregnancies Commonly used formula for IMR: 1. IMR= Total no. of deaths under 1 yr of age in a given year______x 1000 Total no. of live births in same year 2. Fetal Death Rate (FDR)- measures pregnancy wastage. Death of the product of conception occurs prior to its complete expulsion, regardless of duration of pregnancy. FDR= total no. of fetal deaths in a given year______________ x 1000 total no. of live births in same year 3. Neonatal Death Rate (NDR)- measures the risk of dying the first month of life. May serve as an index of the effects of prenatal care and obstetrical management on the newborn. NDR= total no. of deaths under 28 days of age in a given year x 1000 total no. of live births Functions of a Health Professional in Vital Health Statistics 1. Collect data 2. Tabulate data 3. Analyze and interpret data 4. Evaluates data 5. Recommends redirection and/ or strengthening of specific areas of health programs as needed. LEADING CAUSES OF MORBIDITY MORBIDITY: 10 Leading Causes, Number and Rate 2010* Diseases Number Rate 1. Acute Respiratory 1,289,168 1371.3 Infection ** 2. Acute Lower Respiratory Tract Infection and 586,186 623.5 Pneumonia 3. Bronchitis/Bronchiolitis 351,126 373.5 4. Hypertension 345,412 367.4 5. Acute Watery Diarrhea 326,551 347.3 6. Influenza 272,001 289.3 7. Urinary Tract Infection** 83,569 88.9 8. TB Respiratory 72,516 77.1 9. Injuries 51,201 54.5 10. Disease of the Heart 37,589 40.0 Life Expectancy ⚫ According to the latest WHO data published in 2018 life expectancy in Philippines is: Male 66.2, female 72.6 and total life expectancy is 69.3 Philippines - Life expectancy at birth Life expectancy - Life expectancy - Date Life expectancy Women Men 2018 75.39 67.12 71.10 2017 75.27 66.97 70.95 2016 75.14 66.81 70.80 2015 75.01 66.64 70.64 2014 74.85 66.48 70.48 2013 74.67 66.33 70.32 2012 74.47 66.19 70.15 References: ⚫ Castro, C.E. (2012). Community health nursing and community health development (1st ed.). Manila : Educational Publishing House. ⚫ Civil Registration and Vital Statistics Handbook for Health Work ⚫ https://www.slideshare.net/patelsweta/dem ography-ppt ⚫ https://www.slideshare.net/ShaellsJoshi/de mography-13122258