Vital Statistics-URD.pptx VITAL EVENTS STATS

BIRTH DEATH AND OTHER VITAL STATISTIVS

1. Vital Statistics Dr Umesh R Dixit, Associate Professor, Department of Community Medicine, SDM Medical College, Dharwad

2. What are vital statistics? They are conventionally numerical records of marriages, births, sickness and death by which the health and growth of a community may be studied That branch of biometry which deals with data and law of human morbidity, mortality and demography . Vital events are collected, compiled and the resulting statistics are known as Vital Statistics 2

3. Vital Events 3

4. Purpose of Vital Statistics To describe the level of community health, to diagnose community illness and to discover solutions to health problems. To create administrative standards of health activities. Evaluation of public health works To promote health legislation at local, state & national level. To develop policies, procedures at state & central level. 4

5. Demographic Data Demographic data: Those variables that describe the characteristics of a population. Population Statistics: Those that explain population size Vital Statistics: Those that explain changes over time 5

6. Factors affecting Vital Statistics Factors affecting Demographic indicators Age Sex Income Occupation Health services use Geographic location Geographic density 6

7. 7 Human Population Levels Throughout History ADD FIG. 4.2

8. Current Birth and Death Rates Every second: about 4 children are born, while about 2 other people die Net gain: 2.3 humans added to the world population every second, 72 million added every year 8

9. Population Growth -Opposing Factors Pro- natalist pressures Factors that increase people's desires to have children Birth reduction pressures Factors that tend to reduce fertility 9

10. Demographic Transition Optimistic view - world population will stabilize during this century Pessimistic view - poorer countries of the world are caught in a "demographic trap" - helping poor countries will only further threaten the earth's resources Social justice view - overpopulation due to a lack of justice, not resources 10

11. Demographic Transition Accompanying Economic and Social Development

12. Sources of Vital Statistics Population Census Civil Registration System Hospital records Sample Registration System Sample Surveys 12

13. Census Census (Latin): Sensere  (value/ tax) Total process of collecting, compiling and publishing demographic, economic and social data pertaining at a specified period of time or times, to all persons in a country or delimited territory United Nations 10 year interval Important source of health information 2 types 13

14. Civil Registration System Continuous, permanent, and compulsory recording. Legal basis to the records and certificate made from system (Births & Deaths Registration Act, 1969) Who should register? Time limit? Lay reporting Reliable only if complete and accurate 14

15. Sample registration System Continuous enumeration of births & deaths in a sample of villages/ urban blocks by a resident part-time enumerator Independent six-monthly retrospective survey by full time supervisor Covers entire country More reliable information than civil registration system 15

16. Notification of diseases/ Hospital Records Primary purpose is to prevent and control Also valuable source of morbidity/ mortality List of Notifiable Diseases – variable Drawbacks Ice-berg phenomenon of diseases Under-reporting Atypical/ subclinical cases No denominator Variable hospital admission policy 16

17. Registration and record linkage More comprehensive information about the patient Followable address Medical record linkage 17

18. Sample Surveys Launched from time to time. National Family Health Surveys (NFHS) Provides estimates of Fertility, Child mortality, other parameters related to MCH at state level District Levels Household Surveys (DLHS) Provides info on indicators related to children, RCH and quality of services available at district level Frame Errors, Measurement Errors, Non-response errors 18

19. Vital Statistics System Live births Deaths Fetal deaths Marriages Divorces Annulments Judicial separations Adoptions Legitimation Recognition Health services Certification of cause of death Authorized institutions Courts Judicial institutions Civil Registration, including population registers Principles: Compulsory Universal Continuous Confidentiality Vital Statistics Compilation Processing Validation Quality control Dissemination Complementary/ Interim sources Population census Surveys Sample registration areas Additional administrative sources Coronary Police Registries Health records National IDs’ Electoral lists Passports … 19

20. Analysis of Vital Stats

21. Terminologies Fecundity - physical ability to reproduce Fertility - the actual production of offspring Zero population growth (ZPG) - occurs when births + immigration =deaths + emigration Mid year population : As on July 1 st of that year Census population : As on 31 st March of that year 21

22. Statistics Applied to Vital Statistics Measurement of Population Morbidity Statistics Mortality Statistics Fertility indicators 22

23. Measurement of Population Natural Increase Method Geometrical method   23

24. Mortality Statistics Sources Autopsy records Financial records (insurance, pension) Hospital records Occupational records Death Certificates Mortality Studies Distribution of mortality in populations Time: Trend in mortality rates - secular trends - trends over time Place: Migrant studies - helps to establish an environmental contribution to disease Person: Age, gender, race & ethnicity, social class, birth cohort 24

25. Annual Crude Death Rate Generalized indicator of a population’s health. May not be truly reflective without accounting for age, race, or sex. Unit of time must be specified Example: AP, 2004 – population: 5000; deaths: 25 CDR = = 5 deaths per 1000 per year in AP   25

26. Age-Specific Death Rate (ASDR) Example : India, 1921, age group: 25-34 yrs; population:5,000,000 ; deaths: 200,000 = 40 deaths per 1000 population per year for age-group 25-34   26

27. Cause-Specific Death Rate Useful to analyze the deaths by cause Example : Austria, 2012, Cause : accidents; population : 50L; deaths: 4,000 Cause-specific death rate= = 80 accidental deaths per 100,000 population per year   27

28. Proportional Mortality Ratio Not rates Example : UK, 2002- total deaths from all causes: 15L; deaths from cancer: 6.75L Proportional mortality ratio= = 45% of total deaths per year from cancer   28

29. Case Fatality Rate Represents the risk of dying during a defined period of time for those who have a particular disease Actually a ratio Example : USA, 2016; total cases TB: 1,500; deaths from TB: 750 Case fatality ratio = = 50% of TB patients die every year   29

30. Infant Mortality Rate (IMR) Example : WB, 2011 - live births: 325,000; infant deaths: 1,750 IMR= = 5.4 infant deaths per 1000 live births per year Sensitive indicator; useful for comparison of communities Reflect the SES & level of health of the country Also reflect the medical and health facilities in a population   30

31. Neonatal Mortality Rate It occurs basically due to the endogenous factors of death Example : TN, 2005 - deaths at <28 days=2,750; live births: 325,000 Neonatal mortality proportion = 8.5 neonatal deaths per 1000 live births   31

32. Post-Neonatal Mortality rate (PNMR) It is affected by the exogenous factors (environments, sanitation, health facilities, etc ) Example : MH, 1986- deaths at 1m-12m=2,750 ; live births: 325,000 = 8.5 post-neonatal deaths per 1000 live births   32

33. Perinatal Mortality Proportion Example : J&K, 1578 - fetal deaths: 3,250; early neonatal deaths: 5750 ; live births: 4.75L Perinatal mortality proportion = 18.8 perinatal deaths per 1000 fetal deaths plus live births   33

34. Maternal Mortality Ratio Deaths due to the cause realted to maternity within 42 days of birth Sensitive and important indicator of maternal health There is no system for gathering information for all pregnancies - the closest useful measure is the number of live births.   34

35. M easures of morbidity

36. Morbidity Data Sources Disease control programs Tax-financed public assistance programs School & employment records Insurance data Special research programs Morbidity surveys on population samples for illness in general and for specific diseases 36

37. Morbidity statistics: Surveillance Systems Focused on identification of infected individuals, with the goal of isolation to minimize disease transmission Ongoing collection of data by a data center, analysis, dissemination and implementation of a response based upon analyses Sentinel Surveillance 37

38. Morbidity Studies Time – Incubation period ; Time & Space clusters Place – Area Map Person – age, gender, ethnicity and social status can influence morbidity. 38

39. Morbidity Indicators Incidence and prevalence Notification rates Attendance rates at OPDs Admission, Re-admission and discharge rates Duration of hospital stay Spells of sickness/ absence from work/ schools 39

40. Adjustment of Rates (or, Rate Adjustment) Adjusting, or standardizing, rates is used to make valid comparisons between populations that may differ in some significant way (i.e., age distribution). Standardized rates have no meaning in isolation, since adjusted rates are artificial. Depending on type of data - there are two methods to adjust rates - direct (preferred) and indirect. The numerical values of the adjusted rates depend on the choice of the standard population. 40

41. Fertility Indicators 41

42. Fertility influenced by Age at marriage Duration of married life Spacing of children, Family Planning Education Economic status Caste & religion Nutrition 42

43. Measures of Fertility- Uses In addressing population control problems. For planning maternal and child health services, For planning for school services. 43

44. Crude Birthrate (CBR) Example : KA , 2015 - live births: 2.5L; population: 3 Cr. = 8.3 live births per 1000 population per year   44

45. General Fertility Rate Example: India, 2004 - live births: 75L; number of women aged 15-44: 3.5Cr = 214.3 live births per 1000 women ages 15-44 per year GMFR   45

46. Specific Fertility Rate Age-specific fertility Rate (ASFR) Useful for family planning program point of view Age-specific Marital fertility Rate (ASMFR)   46

47. Total Fertility Rate Total fertility Rate (TFR) The physical meaning of TFR is that it is the expected number of children that a women will bear in her life time, passing through the reproductive age and bearing children according to fixed schedule of fertility     47

48. Gross Reproduction Rate (GRR) Is a measure of population which describe the rate of increase of population over a generation   48

49. Net Reproduction Rate (NRR) Number of daughters a newborn girl will bear during her lifetime assuming fixed ASFR and mortality rates Is a demographic indicator NRR = 1 means attaining two child norm NRR <1 means population is below replacement levels 49

50. Other rates Child Woman Ratio Indicator of fertility where birth registration statistics are inadequate Pregnancy rate   50

51. F ertility trends 51

52. Population statistics of India Population Growth rate: 1.2% Crude Birth rate: 20.22 Crude death rate: 7.4 Sex ratio: 934 (Karnataka: 973) Literacy: 73% TFR: 2.48 IMR: 40 per 1000 LB (2014) MMR 212 (2009) Life expectancy: 68.45 years 52

53. Population statistics of India Access to Improved source of water 92% Access to improved sanitation 35% (U-60; R 24) Average age of marriage Men 26 Women 22.2 CPR 40.4% 53

54. 54 The Future of Human Populations

55. Thank You !! 55