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Mortality

Mortality
• Refers to the occurrence of deaths in a
population
• The incidence of death is related to
many factors like age, sex, occupation,
economic, and social class
• Mortality reduces population size
Factors affecting mortality
• Direct factors
• Health care service utilization
• Accessibility and availability of
health care services
• Environmental contamination
• Environmental disasters/calamities
• Epidemics
• Sanitation
• Level and exposure to pollution
Factors affecting mortality
• Direct factors
• Injury and accident
• Dietary intake and nutrition
• Fertility (risky pregnancy)
• too close, too many, too
early/young, too old
• unwanted pregnancies and low use
of contraception
Factors affecting mortality
• Indirect factors
• Socio-economic factors (i.e.
income, education, employment)
• Institutional factors
• Low level of access to health
services (especially in remote
areas)
• Low quality health care
services
• Unskilled health service
providers
Factors affecting mortality
• Indirect factors
• Cultural and gender issues
• Poor health-seeking behavior
(especially among men)
• Unhealthy health beliefs and
traditions
• Unfavorable decisions of husbands
affecting women’s decision to seek
health care
• Lack of men’s participation in health
care
Measuring mortality
• Crude Death Rate (CDR)
• Rough measure of mortality
indicating the number of deaths per
1,000 population
Number of deaths in a
given year
CDR = x 1,000
Total mid-year population
of the same year

There were 35 deaths per 1,000 population in 2012


Measuring mortality
• Age Specific Death Rate (ASDR)
• The probability of death across age
groups highly varies, thus, the need
for death rate for specific age group

Number of deaths among specific


age group in a given year
ASDR = x 1,000
Total mid-year population of the
same age group during the
same year
There were 2 deaths per 1,000 population in age
group 20-24
Measuring mortality
• Infant Mortality Rate (IMR)
• The number of deaths under one (1)
year of age per 1,000 live births in a
given year

Number of deaths to infants aged


less than 1 year old in a given year
IMR = x 1,000
Total live births in the same year

There were 57 infant deaths per 1,000 live births in


the Philippines
Measuring mortality
• Difficulties in estimating IMR
• Under-registration of births and
deaths
• Late registration of births or infant
deaths (especially in remote areas)
Measuring mortality
• Child Mortality Rate (CMR)
• The number of deaths among age 1-4
years old per 1,000 population among
age 1-4 in a given year

Number of deaths to children


aged 1-4 years old in a given year
CMR= x 1,000
Total mid-year population of
ages 1-4 years old
There were 57 child deaths per 1,000 population
aged 1-4 in the Philippines
Measuring mortality
• Neonatal Mortality Rate/Neonatal
Deaths
• The number of deaths among newly
born babies during their first four
weeks of life per 1,000 live births in a
given year
Number of deaths to infants living
less than four weeks n a given year
NMR = x 1,000
Total live births in the same year

There were 57 neonatal deaths per 1,000 live births


in the Philippines
Measuring mortality
• Maternal Mortality Ratio (MMR)
• number of maternal deaths during given
time period per 100,000 live births during
the same time
• Deaths should be related to pregnancy and
childbirth

Total number of maternal


deaths in a given year
MMR = x 100,000
Total number of live births
in the same year
There were 100 maternal deaths per 100,000 live
births in the Philippines
Measuring mortality
• Maternal Mortality Rate (MMR)
• number of maternal deaths in a given time
period per 100,000 women of reproductive
age
• deaths should be related to pregnancy and
childbirth

Total number of maternal


deaths in a given year
MMR = x 100,000
Total number of women
aged 15-49
There were 100 maternal deaths per 100,000 women
of reproductive age in the Philippines
Measuring mortality
• Life Expectancy at Birth (eo)
• Measures the number of years a baby born
in a given year would expect to live
• This indicator is derived by generating a
life table which charts the mortality of a
hypothetical group of persons until all of
them would have died subject to a specific
mortality schedule (the age-specific –death-
rates) experienced by an actual population.
Exercise
• Your governor requested you to give him
an update on the status of mortality in
your province. You have the following
information, report to him the trends and
data in the form of mortality indicators.
Year Mid-year Total Total Number of Number of
Population number of Number of Maternal infant
live births deaths Deaths deaths
2012 223,098 3,567 1,200 48 56
2010 215,280 2,587 1,130 34 43
2008 200,234 2,356 1,420 26 31
Answer:
CDR = 1,200/223,098 x 1,000 = 5.4 (2012) –
Analysis: There were 5 deaths per 1,000 population in
the province of __________ in 2012.

IMR = 56/3,567 x 1,000 = 15.7 (2012)


Analysis: There were 16 infant deaths per 1,000
population in the province of __________ in 2012.

MMR (Ratio) = 48/3,567 x 100,000 = 1,345 (2012)


Analysis: There were 1,345 maternal deaths per 100,000
live births in the province of __________ in 2012.