Mortality and Its Measures
Mortality and Its Measures
Mortality and Its Measures
Mortality analysis begins with good quality data on deaths and population. These data
are conventionally obtained from vital registration systems and population censuses
respectively. The crude death rate and the specific death rates (age, sex, age-sex, age-
sex-cause of death specific) are simple measures of mortality. The other measures are
based on the life tables.
Measures of Mortality
The crude death rate is calculated by dividing the number of registered deaths
in a year by the mid-year population for the same year. The rate is expressed as per
1,000 population.
This rate has a simple interpretation, for it gives the number of deaths that
occur, on the average, per 1,000 people in the community. Further, it is relatively easy
to compute, requiring only the total population size and the total number of deaths.
Besides, it is a probability rate in the true sense of the term. It represents an estimate
of the chance of dying for a person belonging to the given population, because the
whole population may be supposed to be exposed to the risk of dying of something or
the other.
However, it has also some serious drawbacks. In using the CDR, we ignore
the fact that the chance of dying is not the same for the young and the old or for males
and females, and the fact that it may also vary with respect to race, occupation or
locality of dwelling.
The crude death rates for specific causes of death are calculated in a similar
way by selecting deaths due to specific cause as the numerator and mid-year
population as the denominator. Thus,
The rates could be made specific to sex by selecting the numerator and the
denominator for each sex of the population.
The age-specific death rates are calculated from deaths and population both
specific to each age (or age group) of the population. Thus,
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!"#
Where 'x' indicates the age and 'n' the class interval of age.
It should be noted that the sum of the cause-specific rates over all causes
equals the crude death rate. Similarly, the sum of the age-cause-specific death rates
equals the age-specific death rate at a given age.
Data Needed
(1) For one compositional variable (say age) standardization, age distribution of
the standard population, and
Calculations
If M(i, x) represents the age-specific death rate at age (i) for population (x),
and P (i,s) is the standard population at age (i), P(s) is the total standard population.
(All the calculations are done with the rates per person. Finally, the
standardized death rate is multiplied by the constant 1,000).
B. If the standardized death rate is required after controlling for the two
characteristics of the population, say age and sex, the data needed will be the same as
on the previous page but split by sex as well.
Thus, the standardized death rate for population x will be:
∑i
P(i, s, males). M(i, males) + P(i, s, females. M(i, females)
C. If the death rates of males and females are to be compared, these are two
different populations, and the method given under A is to be used. Thus,
The selection of the standard population is, in theory, arbitrary. However, this
population should be similar to the ones for whom the rates are being compared. The
population of India at a most recent census date is appropriate for measuring state-
differentials in mortality, or for comparing mortality trends over time for India. If two
country's rates are to be compared either one country's age distribution or the
average of the two country's distributions is appropriate.
This method is used when the age-specific death rates for the populations to be
compared cannot be calculated because of the distribution of the number of deaths by
age is unavailable or not reliably available, but the total number of deaths and the age
distribution of populations whose rates are to be compared are available.
Data Needed
(1) Observed number of deaths in all populations whose death rates are to be
compared.
(2) Age distribution of all populations whose death rates are to be compared.
Calculations
A. If P(i,x) represents the population ‘x’ at age (i), M(i,s) is age-specific death
rate at age ‘i’ in standard population, M(s) is the crude death rate in the standard
population, O(x) is the observed number of deaths in population ‘x’, and E(x) is the
expected deaths in population ‘x’, then
O( x )
The standardized death rate for population x = . M ( s)
E( x )
(All the calculations are done with the rates per person. Finally, the standardized
death rate is multiplied by the constant 1,000).
DP
MMR= 1,000 × ,
B
where DP = Total number of deaths from puerperal causes occurring within 42
days of delivery among the female population aged 15-49 in the given
period in the given community.
INCIDENCE RATE
This rate measures the annual incidence of a disease. The numerator of the rate is the
number of times attacks of a certain disease are reported in a year, and the
denominator is the population exposed to the disease during the same year. Note that
the rate can exceed 1, as there could be repeated attacks of the disease to the same
person.
Incidence rate =Number of new cases of specialized disease during a give time
period / population at risk * 1000
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= ! 1000
!"#$%&'(") !" !"#$
PREVALENCE RATE
This rate is the proportion of the number of people reported as having a disease at a
specific point in time. The numerator is the number of people with a disease and the
denominator is the total population.
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= !!
!"#$%&#'( !"!#$%&'"( !" !ℎ! !"#$ !"#$% !" !"#$
k= 1000
Infant Mortality Rate
The infant mortality rate (IMR), too, is an alternative to, and in a sense an
improvement upon, the age-specific death rate for age 0, in other words, upon the
death rate for infants (i.e. children under 1 year of age). It is defined as
D0
IMR = 1,000 ×
B (5.17)
Where D0 = number of deaths among children of age 0, 1.b.d. (last birth day)
Child Mortality Rate: It is define as the total number of deaths of children aged 1 to
4 in the given year and geographical region and to the 1000 population of the same
age in that year and same geographical regions.
Under 5 Mortality
Number of deaths of children aged 0 to 4 year in the given year and region
= ! 1000
Total population aged 0 to 4 in the given year and region
Neonatal Mortality Rate (NMR): NMR measures the Number of infants dying
within the first month (4 weeks)/(Upto 28 days) of life in a year and geographical
region per thousand live births of same year and geographical region.
Post Neonatal Mortality Rate (PNMR): Number of infant deaths after 28 days to
less than one year (between 4 weeks to 52 weeks) of age per thousand live births in a
given year.
!"#$
Number of deaths of newborns between 4 weeks and less than one year of age
= ! 1000
!"#$%& !" !"#$ !"#$ℎ! !"#$%& !ℎ! !"#$ !"#$
Foetal Death: It is known as the death prior to the complete expulsion or extraction
from its mother of a product of conception at any point of time of pregnancy.
Still Birth: It is used for death of foetus after completing 28 weeks and till the time of
birth.
Lexis Diagram:
In the Lexis diagram, the time of occurrence of event is shown on the X- axis and the
duration since an initial reference data (eg. Age since birth) on the Y-axis. In the
diagram above, time refers to the exact time of occurrence, and age, the exact age of
the person.
If we know the population at exact age X during time t- t+1 (say PX) and at exact age
X+1 (say PX+1) during time t+1- t+2, and the deaths occurring to this cohort in the
parallelogram abcd (say DX),
The probability of dying between exact ages X and X+1 will be= Dx /P
!!
!! + !!!! 2
(Px +Px+1)/2 will be the average or mid - year population (represented by the vertical
line ‘db’) on the assumption that the deaths have occurred uniformly over the
parallelogram ‘abcd’. However, this is not true for deaths, which occur at very early
ages, especially among the infants in their first 12 months of life. The mid-year
population is estimated by the use of the separation factors.