Western Mindanao State University

COLLEGE OF NURSING
Zamboanga City

HEALTH STATISTICS
DEFINITION OF TERMS:

STATISTICS:
 Science which deals with the collection, classification and use of numerical facts or
data bearing on a subject or matter; the numerical facts or data themselves.

POPULATION:
 An aggregate or group of people under study.
 Ex. All persons living in the city of Zamboanga. All females in the reproductive age
group.

MID YEAR POPULATION:

 Population of the area under study as of July 1 st (mid year) of a calendar year.
 Can be considered as representative for the whole year.

POPULATION AT RISK:
 Population capable of acquiring a disease.
 Ex. outbreak of measles: those who have not had it and were exposed to it.

BIOSTATISTICS:
 Refers to the application of statistical methods to the life sciences.

VITAL STATISTICS: (BIOSTATISTICS)

 Statistical data which relate the total number of various kinds of biologic or vital
events (births, marriages, illnesses and deaths) to the size and characteristics of the
affected population.

 Concerned mainly with the study of births, illnesses and deaths occurring in a
defined population for a specified time period.

 Indispensable tool in the planning, implementation, and evaluation of any health

program.

 Serves as indices of the health conditions obtaining in a population group.

 It provides valuable clues as to the nature of health services/ actions needed. Ti

also serves as bases for determining the success or failure of health services.

 Application of statistical methods and techniques of vital facts (births, deaths and
illnesses)

 Statistical data which relate the total number of various kinds of biologic or vital
events to the size and characteristics of the affected population. (Abarquez, 1983)

VITAL STATISTICS are generally expressed as vital rates which may be grouped
under
3 categories.

A. Fertility or birth rates

B. Morbidity or sickness rates
C. Mortality rates

These rates serve as indices of the health of a population based on the birth, illness
and
death patterns obtained in a community.
Ex. High sickness rates can be viewed as unhealthy.
RATE:
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 A relation indicating the number of times a certain event occurs when a certain
number of exposures to the risks of occurrence is present in a given time period.

HEALTH INDICATORS:
 List of information which would determine the health of a particular community like
population, crude death rate, crude birth rate, infant/ maternal death rate, neonatal
death rate

A. BIRTH: A COMING INTO BEING; THE ACT OR PROCESS OF BEING BORN

1. CRUDE BIRTH RATE:

 Only a rough measure of fertility in a population since it makes use of mid year
population (which includes the number of men and women incapable of child
bearing) as its denominator.
 Rate gives the number of live births relative to the total population
 It is a crude rate since it is referred to the total population and does not take into
consideration variations in the population as sex and age.
 It measures how fast people are added to the population through births.
 It is used in determining population growth.
 It has the following formula:

CBR = Total live births in a calendar year X 1000

Mid year population for that year

2. GENERAL FERTILITY RATE:

 This is a more specific rate than the crude birth rate since births are related to the
segment of the population deemed to be capable of giving birth (women at the
reproductive age group)
 The formula would be:

GFR= Total live births in a calendar year ____________ X 1000

Mid year population of women of child- bearing age
(15-44 (48) for that year

3. AGE-SPECIFIC FERTILITY RATE:

 This rate permits a more in depth study of the differences in fertility at specific ages
throughout the reproductive period and the impact of birth control measures on
fertility.

ASFR= Total births to women age x years X 1000

Mid year population of women age x years

B. DEATHS: THE CESSATION OF ALL PHYSICAL AND CHEMICAL PROCESSES THAT

INVARIABLY OCCURS IN ALL LIVING THINGS.

1. CRUDE DEATH RATE:

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 Only a rough measure of the force of mortality or the probability of dying in a
population because death rates are largely influenced by age and sex composition
of the population.
 Rate measures the decrease of population due to death.
 It gives the speed with which mortality occurs in a given population.
 Formula:

CDR= Total deaths (all causes) in a calendar year X 1000

Mid year population for that year

 Crude death rate includes deaths from old age, degenerative diseases, other
causes not readily preventable.

2. AGE SPECIFIC DEATH RATE:

 This rate gives a better picture of the force of mortality in a given population since
the age factor is held constant.

ASDR= Total deaths, specific age group, calendar year X F

Mid year population, same age group, same year

(F) is not specified: It means any factor maybe used as long as it gives a whole number
when multiplied by the quotient.

3. AGE/ SEX SPECIFIC DEATH RATE:

A/S SDR= Total deaths, age group-sex, calendar year________ X 1000

Mid year population, same age group-sex, same year

4. CAUSE SPECIFIC DEATH RATE:

 This rate specifies the cause.

CSDR= Total deaths, from a particular cause in a calendar year X F

Mid year population for that year

5. PROPORTIONAL MORTALITY RATE:

 This rate denotes the percentage of all deaths attributed to a certain disease
 It is used in ranking the cause of death by magnitude of frequency. (The ten leading
causes of mortality is a popular means of showing the common health problems for
a given geographic are, age, & sex)
 It does not measure the probability of dying in a given population because the
denominator does not represent the population at risk.
 Proportion of total deaths occurring in a particular population group or from a
particular cause.
 Formula:

PMR= Total deaths from a particular cause in a calendar year X 100

Total deaths from all causes in the same year

It is always expressed in percentage since the factor used is 100.

SWAROOP’S INDEX:
 Another proportional mortality indicator. It gives the percentage of all deaths which
occur in persons 50 years and above.
 Formula:

Swaroop’s= Total deaths in persons 50 yrs. and above X 100

Total number of deaths for all ages
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 Swaroop’s index is directly proportional to the health status of a population.

 Ex. an index of 80% means that only 20& of the population are dying before age 50
years which is a good indication of the health of a population.
 A low index implies that life expectancy is short and people die more of acute and
communicable disease.

6. CASE FATALITY RATE:

 This rate measures the lethality of killing power of a disease or injury as expressed
in terms of percentage
 To determine CFR of a disease, it is necessary to follow up the cases for a defined
period such that deaths occurring beyond the period could not reasonably be
directly related to the disease under study. Otherwise, if the follow –up is indefinite,
all cases will ultimately die.
 This rate is useful in case of acute infectious diseases, assuming that all new cases
are reported and most deaths occurred in a relatively short time after diagnosis.
 CFR may be used to determine how well the treatment for a certain disease has
succeeded or is succeeding.

CFR= Total deaths from a particular cause during a specified time period_____ X F
Total cases of the same cause followed up during the same time period

7. INFANT MORTALITY RATE:

 The rate is one of the most sensitive indices of the health conditions of the general
population.
 It is closely linked with preventable or environmental factors
 Infant deaths are associated with acute communicable diseases; such factors as
poor environmental sanitation and personal hygiene; in general inadequate health
services.
 Defined as the number of deaths among infants under one year of age in a
calendar year per one thousand live births in the same year.

IMR= Total deaths, less than 1 year of age, calendar year X 100
Total live births in the same year

NOTE: Infant deaths are not actually divided by the actual population of that age
because census data are obtained only for certain years and are likely to fluctuate. So
the number of live births is more reliable and readily figured.

A LOW IMR suggests:

1. Adequate immunization program/ services

2. Sound infant-maternal nutrition
3. Satisfactory ante-post natal care
4. Good disease control program
5. Strict implementing laws governing administration of health programs.

From a sanitarian’s point of view:

1. Good environmental sanitation

2. Good water supply
3. Adequate insect/ vermin control
4. Good housing facilities

From the social worker’s point of view:

1. Illegitimate are not neglected

2. High standard of living
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A HIGH IMR suggests: means low levels of standards which maybe secondary to:

1. Poor environmental sanitation

2. Deficient health services delivery

8. FETAL DEATH RATE:

 Fetal deaths (include abortions and still births) are generally attributed to pre-natal
causes and influenced more by endogenous factors.
 Fetal death (WHO) is defined as death prior to complete expulsion or extraction
from the mother of a product of conception, irrespective of the duration of
pregnancy. The death is indicated by the fact that after such separation, the fetus
does not breathe nor show any evidence of life.
 Formula:

FDR= Total deaths, 20 weeks of gestation and over, calendar year X 1000
Total live births in the same year

9. MATERNAL MORTALITY RATE: MMR

 This rate measures the risk of dying from causes associated with child birth.
 Maternal death is defined as the death of a mother directly due to pregnancy, labor
and puerperium within 90 days of delivery.
 Formula:

MMR= Total deaths in a calendar year X 1000

Total live births in the same year

Note: Number of live births is used as a convenient approximation of the number of

pregnancies, in the absence of a system of reporting pregnancies.

C. MORBIDITY/ SICKNESS RATES

 Are generally set-up for particular causes of illness or disability or for groups of
allied illnesses.
 Measures the occurrence of illnesses or conditions in the community.
A. Incidence Rate
B. Prevalence Rate

1. INCIDENCE RATE:
 Measures the rapidity of occurrence of new cases.
 Answers the question “How frequently does a disease occur within a given period of
time (year)?
 Usually used in the study of acute diseases (when it is usually higher than
prevalence), in outbreaks- epidemic: study of causation; and secular trends
(changes in disease pattern over a short period of time).
 It can be made specific for age, sex, etc.
 Measures the development of disease in a group exposed to the risk of the disease
in a period of time.
 It measures the probability of a well individual contracting a particular disease
during the specific time period.

IR= Number of new cases during a specified time X F

Population in the area during that time

ATTACK RATE:
 Refinement of the incidence rate which is used only for a limited population, usually
during an outbreak or epidemic.

AR= Number of new cases of a disease in a time period X 100

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Population at risk during that time period

2. PREVALENCE RATE:
 A static count of the number of individuals suffering from a particular disease in a
particular instant time.
 It measures the number of people who have the disease in a population at a given
point in time.
 Measures of the status of a particular disease within a given point or interval of
time.
 It answers the question “ What proportion of the population are actually ill with a
particular disease or are infected with a particular agent?
 Used in the study of chronic diseases and in computing for carrier rates etc.

IR= Number of cases existing (old/ new) at a given interval of time X 100
Population (at risk) surveyed during that interval of time

A knowledge of these sources and methods of classification of data in a country will be helpful in the
interpretation of its vital statistics.

A. SOURCES OF DATA:

1. Vital Registration Records:

 Civil Registry Law (Act No. 3753) requires the registration of all births and deaths.
 National Census and Statistics Office undertakes the implementation of this
registration requirement.
 Each vital event is registered in the office of the local civil registrar of the locality
where the event took place and a copy of each document is sent to the office of the
civil registrar general within the first 10 days of the succeeding month.

2. Weekly reports from Field Health Personnel:

 Data on notifiable diseases are based on information gathered from field health
personnel.
 The Law on Reporting of Notifiable Disease (Act 3573) provides that any case of
notifiable disease shall be reported weekly thru the nearest provincial and city
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health officer to the RESU (Regional Epidemiology and Surveillance Unit) which
edits, classifies, analyzes, computes and interprets of reported data.

3. Population Censuses:
 Data on population are obtained from population censuses (done every 5 to 10
years) and population estimates computed by the NCSO.

CLASSIFICATION OF DATA:

In the classification of data, certain guidelines are followed for the sake of consistency:

1. Classification of Vital Events:

 All vital events are registered and reported by place of occurrence, not by place of
residence.
 The Philippines is geographically divided into regions and politically into provinces
and cities. These divisions are utilized in the reporting of births, deaths and
notifiable diseases.

2. Reckoning of Age:
 Age should be recorded as of the last birthday.

3. Classification of Disease and Causes of Deaths:

 Morbidity and mortality statistics are tabulated in accordance with the International
Classification of Diseases, Injuries and Causes of Death.

These factors should be taken into consideration in the interpretation of rates.

1. Definition/ Classification of the event in either numerator or denominator:

 Refers to the definition of certain terms like cause of death or maternal death and to
accuracy of diagnosis of certain diseases.
Example:
1. Pregnant woman who dies in a vehicular accident maybe classified as maternal.
2. A man who died of pneumonia in Pasay maybe registered as pneumonia death in
Manila where he was buried or Paranaque where he is residing.
3. Improper interpretation relating to antecedent, contributory and underlying causes
of death which appear in a death certificate may lead to errors in stating the cause
of death.

2. Accuracy of the Count of Event or Population Concerned

 Refers mainly to the completeness or adequacy of the coverage of the count.

In the Philippines, although the law provides for the compulsory registration, there are still
deficiencies in the observance of the law.

Certain factors that may affect the reporting/ registration of vital events: in relation to
morbidity.

EX.
1. Not all disease is notifiable/ reportable in the country, so that it is very difficult to obtain
data on those diseases which are not reportable.
2. STD carries a social stigma so that they are oftentimes not discovered/ reported easily.
3. Usually, only frank cases tend to be reported so that milder forms of certain disease
remain unnoticed.
4. Ignorance of or plain disregard for registration requirements- may result to under
registration.

3. Use of the Correct Numerator and Denominator:

 In the computation of statistical indices for the Philippines, standard formulas are used.

CBR/ CDR: per 1000 population

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IMR/ MMR/ FDR: per 1000 live births
Morbidity/ Mortality Rate: per 100,000 population

4. Magnitude/ Nature of the Rate:

 When comparing rates, one should be sure that the rates cover the same time period
and that the groups under study are comparable with regard to important factors that
may influence the magnitude of the rate.

IMPLICATIONS OF HEALTH STATISTICS TO INDIVIDUAL, FAMILY & COMMUNITY:

Vital statistics is concerned mainly with the study of births, illnesses and deaths occurring in a defined
population for a specified time period.

It is an indispensable tool in the planning, implementation and evaluation of any health programs,
because they serve as indices of the health conditions of a community, population group; provide
clues as to the nature of health actions needed and serve as bases for determining the success or
failure of such actions.

Health personnel share with the community the responsibility of planning and taking actions to resolve
health problems by utilizing these statistical data.

To be able to perform responsibilities effectively, the health worker should understand the significance
of vital statistics, how they are obtained and how to interpret them.

Furthermore, they are expected to be able to maintain accurate and updated statistical records and
reports.