1. The Measures of Mortality
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2. Outline Components of Mortality Mortality measures
Years of potential life lost
Sources of statistics on mortality
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3. Components of Mortality
There are two biological aspects of mortality:
1. Lifespan: refers to the oldest age to which human beings can survive (how long a person can possibly be alive).
2. longevity : refers to the ability to remain alive from one year to the next.
The proportion of people who are actually able to approach that upper age limit is governed by a combination of biological (e.g. genetics, vital organs strength .. ) and Social ( e.g. lack of stress) factors.
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4. - Mortality is a term which means “death” or describes death and related issues.
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5. Why look at mortality rates?
1. Expressing mortality in quantitative terms allow comparison of death:
A. Between people in different geographic areas or different countries.
B. Between subgroups in the a population or country.
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6. 2- Mortality rates can serve as a disease Severity, and can help to determine of whether the treatment for a disease has become more effective over time.
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7. Refer to as crude because:
Crude rates:
How are they calculated?
Crude rates are calculated for the entire population.
Refer to as crude because:
They ignore factors which may affect death rate such as: gender, age, race, economic status ….
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8. Mid-year population for the same year and same locality
Crude Death rate (CDR):
Number of all deaths due to all causes in a certain year and within certain locality
x 1000
Mid-year population for the same year and same locality
Example:
Suppose area X in 1438 H, we have:
deaths, all causes.
2- The area's mid year population was 150,000.
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9. 3-Find crude death rate in 1438H?
Numerator: number of deaths all causes
= 1200
Denominator: Mid-year population =150,000
CDR = x = 8/1000;
150,000
that is, 8 deaths per 1000 population.
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10. CMR By Sex And Nationality In The KSA (2004 to 2010)
السنة
سعوديون
غير سعوديين
الجملة
SAUDI
NON-SAUDI
TOTAL
YEAR
ذكور
اناث
جملة
MALE
FEMALE
2004
4.7
3.9
4.3
3.4 3
3.3
3.8 4
2005
2.9
4.2
3.7
2006
4.6
3.2
2007
2.8
3.6
2008
4.5
4.1
3.5
2009
2.7
2010
4.4
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11. Maternal mortality rate
Country
Crude death rate
Crude birth rate
Infant mortality rate
Maternal mortality rate
Per 1000
Per 100,000
Saudi Arabia
3.8
22.1
18.5 16
Yemen
7.0
38.6
53.3
200
Palestine
3.6
35.9
22.2
32 
Iraq
6.3
36.6
34.6 63
Bahrain
2.8
20.7 20
Emirates
1.4
14.0
10.9 12
Oman 11
Qatar
1.6
14.1
9.0 6
Jordon
26.4
4.1
21.0
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12. Why Mid-year population?
For example, for the crude death rate the number of persons exposed to the risk of dying (denominator): includes: Persons alive in Muharram 1 of the year previous year.
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13. adjustments made for persons who moved in or out.
plus all persons born during year minus all persons who die during year,
adjustments made for persons who moved in or out.
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14. The population at risk will be the population on Rajab1.
A common solution to this problem of determining the population at risk is to estimate the population at mid-year.
In our example (1438H):
The population at risk will be the population on Rajab1.
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15. Cause-specific Mortality Rate
• Is Mortality from a specified cause for a population during a specified time period.
• The numerator is the number of deaths from that cause.
The denominator remains the size of the population at the mid-point of the time period.
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16. Calculate mortality rate due to TB.
Example:
In the previous example: suppose the tuberculosis death in 1438H was 5.
Calculate mortality rate due to TB.
Numerator: number of deaths due to TB = 5
Denominator: Mid-year population 150,000
Mortality rate due to TB =
(5/150,000) x 100,000 = 3.3/100,000

17. The Age Specific Death Rate
Where:
ASDR= The Age Specific Death Rate.
Dx= Deaths for population at age x during
the year.
Px= Mid year Population for the population at age x
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18. Deaths Mid year Population Age Group 4143 73795 19 – 15 4740 48764
Deaths during the year and the population at the mid year for the different age groups
Deaths
Mid year Population
Age Group
4143
73795
19 – 15
4740
48764
24 – 20
4304
43635
29 – 25
3883
63337
34 – 30
4062
34423
39 – 35
4597
26983
44 – 40
5085
24548
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19. The age Specific Death Rates
ASDR
Death
Mid year Population
Age Group 56
4143
73795
19 – 15 97
4740
48764
24 – 20 99
4304
43635
29 – 25 61
3883
63337
34 – 30
118
4062
34423
39 – 35
170
4597
26983
44 – 40
207
5085
24548
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20. Why Age Specific Death Rates?
Can compare mortality at different ages.
Can compare mortality in the same age groups over time and/or between countries and areas
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21. 3- Infant mortality rates (IMR):
Are the most common used rates for measuring the risk of dying during the first year of life.
These rates are the most frequently used measures for comparing health services among nations.
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22. Infant Mortality Rate , Saudi Arabia (2000-2011)
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23. IMR = High infant mortality rates are:
1- Reflection of poor economic conditions
2- unmet health care needs and
3- other unfavorable environmental factors.
IMR =
number of infant deaths age days X
1000
Number of live births during year
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24. Country Saudi Arabia Yemen Palestine Iraq Bahrain Emirates Oman Qatar
Infant mortality rate
Per 1000
Saudi Arabia
18.5
Yemen
53.3
Palestine
22.2
Iraq
34.6
Bahrain
7.0
Emirates
10.9
Oman
Qatar
9.0
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25. Suppose at KKU hospital, 20 infants died during 1438H
Suppose at KKU hospital, 20 infants died during 1438H. The number of live births for the same year was Calculate IMR
Numerator: number of infants died = 20
Denominator: Number of live births = 2600
IMR =
x 1000 = 7.7/1000
2600
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26. Neonatal mortality rate (NMR):
That is; 7.7 infant deaths per 1,000 live births in 1438H.
Neonatal mortality rate (NMR):
Measures risk of dying among new born infants under the age 28 days.
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27. NMR = x 1,000 Example: In the previous example:
number of deaths for infants under 28 days of age
x 1,000
Number of live birth in the
same year
Example: In the previous example:
suppose out of the 20 who died, 12 died in the first 28 days. Calculate NMR for 1438H.
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28. NMR = 12 x 1,000 = 4.6/1000 2600 4.6 deaths per 1,000 live births.
Numerator: number died in ( 0- 28) days = 12
Denominator: Number of live births = 2600
NMR =
12 x 1,000 = 4.6/1000
2600
4.6 deaths per 1,000 live births.
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29. Postneonatal mortality rate (PNMR):
Number who died after 28 days of age.
For the previous example:
The number of infants who died after 28 days of age is 8. ( = 8).
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30. deaths for infants more than 28 days old through the age of 1 year
PNMR =
deaths for infants more than 28 days old through the age of 1 year
x 1,000
Number of live birth in the same year 12
x 1,000 = 3.1/1000
PNMR =
2600
3.1/1000 deaths per 1,000 live births.
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31. Maternal Mortality Definition: ‘Maternal death’ is death of a woman
while pregnant ,or
within 42 days of termination of pregnancy.
Irrespective of the duration or site of the pregnancy.
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32. Not from accidental causes
From any cause related to, or aggravated by the pregnancy or its management
Not from accidental causes
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33. Maternal Mortality Indicators
Maternal mortality ratio (per 100,000 live births -or per 1000 live births)
Maternal mortality rate (per 100,000 women of childbearing age)
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34. Maternal Mortality Ratio
Number of women who die as a result of complications of pregnancy or childbearing in a given year per 100,000 live births in that year
Represents the risk associated with each pregnancy, i.e., the obstetric risk
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35. The denominator is the number of live births during the same year.
The numerator is the number of deaths in a year from puerperal causes. (complications of pregnancy, childbirth).
The denominator is the number of live births during the same year.
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36. Total maternal deaths for a period (year) Number of live birth in the
MMRatio =
Total maternal deaths for a period (year)
x 100,000
Number of live birth in the
same year
Example:
The year-end of 1438H report from the obstetrical ward:
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37. MMRatio= 1- was 3 deaths (2 abortions, 1 pregnancy complications).
2- The number of live born was as before (2600).
Numerator: number of mothers died = 3
Denominator: Number of live births = 2600 3
x 1,000 = 1.15/1000
MMRatio=
2600
1.15/1000 maternal deaths per 1,000 live births
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38. Maternal Mortality Rate
Number of women who die as a result of complications of pregnancy or childbearing in a given year per 100,000 women of childbearing age in the population
Represents both the obstetric risk and the frequency with which women are exposed to this risk.
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39. Maternal mortality rate
Country
Maternal mortality rate
Per 100,000
Saudi Arabia 16
Yemen
200
Palestine
32 
Iraq 63
Bahrain 20
Emirates 12
Oman 11
Qatar 6
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40. Total maternal deaths for a period (year)
MMRate =
Total maternal deaths for a period (year)
x 100,000
Number of women age
Example:
The year-end of 1438H report from the obstetrical ward:
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41. 1- was 10 deaths (2 abortions, 8 pregnancy complications).
2- The number of women aged was: (250000). 10
MMRate =
x 100,000
250000
= 4/100,000
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42. Number of individuals with the specified disease
Case- fatality rate (CFR):
(expressed usually as percent):
CFR =
Number of deaths during a specified period of time after disease diagnosed
x 100
Number of individuals with the specified disease
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43. Example 1: At X city:
1) 110 cases of cancer in 1433H
2) 29 died in 1433H.
Find CFR:
Numerator: # died of cancer = 29
Denominator: Number with cancer = 110
CFR = x = 26.4%
110

44. Proportionate Mortality (PM):
The proportionate of mortality from specified disease is defined as:
PM =
Number of deaths from a disease during a specified period of time
x 100
Total deaths in the same time period
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45. 1) 10 deaths from cardiovascular disease in 1427
Example 1: At X city:
1) 10 deaths from cardiovascular disease in 1427
2) 500 deaths from all diseases in 1427
Find PM:
PM = x = 2%
500
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46. Years of potential life lost (YPLL) Is a measure of early deaths.
Death occurring in the same person at a younger age involves a greater loss of future productive years than death occurring at an older age.
Steps in calculation of YPLL:
1- subtract each person’s death from predetermined age (differs according to country).
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47. For example a person died at age 32, and suppose the predetermined age is 65, then this person has lost (65 – 32) = 33 years of life.
The younger the age at which death occurs, the more years of potential life are lost.
2- ‘YPLL’ for each individual are then added together to yield the total YPLL.
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48. 5 workers died because of exposure to toxic chemical.
Example:
5 workers died because of exposure to toxic chemical.
The ages of death were 20, 25, 30, 35, and 40 years.
Use age 65 as the predetermined age.
Calculate the YPLL for these 5 workers. And so find the mean YPLL.
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49. YPLL = (65 – 20) + (65 – 25) + (65 – 30) + (65 – 35) + ( 65 – 40) = 175.
2- The mean YPLL = 175/5 = 35
On average, the number of years of premature death among those workers who died is 35 years.
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50. Country
Sex ratio
Life expectancy
Total fertility rate
Male
Female
Saudi Arabia
105 : 100 71 75
3.03
Yemen 61 60
5.48
Palestine
106 : 100 73 77
4.65
Iraq 70
4.86
Bahrain
103 : 100 76 81
2.63
Emirates 80
2.36
Oman
2.52
Qatar
102 : 100 74
1.92
Jordon 79 82
3.27
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51. Sex differentials:
The average life expectancy of females is greater than that of males, partly due to biological factors and partly because of behavioral differences.
Men smoke more tobacco, drink alcohol, have more motor vehicle accidents, engage in more
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52. dangerous occupation and are more prone to suicide.
There is an Excess male mortality in many countries.
Comparing the number of male deaths with the number of female deaths can be misleading due to sex ratio (more male babies being born and hence more deaths.
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53. Male excess mortality = x 100 Male death rate at age x
To avoid the effect of sex ratio in mortality rate comparisons, the sex ratio of the age specific death rate, which is used to measure male excess mortality.
This is obtained as:
Male excess mortality =
x 100
Male death rate at age x
female death rate at age x
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54. For example, a male excess mortality of 150 would denote that the male death rate was 50% higher than the corresponding death rate for females.
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55. Male excess mortality Deaths Mid year Population females Males Females
females
Males
Females
2.85 12 36
8651
9103
3.09 15 48
9345
9676
2.83 21 60
10617
10696
2.69 27 72
10986
10877
2.59 33 84
10061
9902
1.98 45 90
8924
8692
1.80 57 99
7062
6811
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56. Sources of statistics on mortality 1- Death certificate:
Specifies a number of demographic and social characteristics of the deceased and details about the cause of death.
Death certificate can also include:
birth place, marital status, education, residence, occupation.
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57. 3- Cross-national data:
2- Vital statistics:
Include mortality data on the number and causes of deaths, together with the age and sex of the deceased.
3- Cross-national data:
Comparative data on mortality are published in the United Nation Yearbook and WHO Health Statistics Annual.
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