1. Infant Mortality: Annual number of children under 1 year of age who die per 1,000 live births Under 5 Mortality/5 yr Child Survival Life Expectancy at birth (in years) Prevalence (disease) : proportion of a population afflicted at a given point in time Incidence (disease): number of new cases in a population during a specified time period (usually per year) Disability Adjusted Life Years (DALY ) Total Fertility Rate Maternal Mortality: number of deaths from pregnancy- related causes per 100,000 live births Crude Birth Rate Crude Death Rate Population Growth Rate Health Indicators Health Indicators

2. World 1960 126/1,000 live births World 2002 56/1,000 live births Good measure of overall health and community well-being. Structural factors affecting the health of entire populations have an impact on the mortality rate of infants. Especially useful in low income and middle income countries Infant Mortality: Infant Mortality: Annual number of children under 1 year of age Annual number of children under 1 year of age who die per 1,000 live births who die per 1,000 live births

3. World 1960 197/1,000 live births World 2002 82/1,000 live births Under-five Mortality: Under-five Mortality: Annual number of children dying between birth and Annual number of children dying between birth and 5 years of age who die per 1,000 live births 5 years of age who die per 1,000 live births

4. World 1960 48 years World 2002 63 years Lowest in Sub-Saharan Africa (46) and highest in Japan (78) for 2002. Good measure of socio- economic development. Life Expectancy at Birth: Life Expectancy at Birth: Number of years a newborn would live subjected Number of years a newborn would live subjected to the present mortality risks prevailing for each to the present mortality risks prevailing for each age group in the population age group in the population

5. Indicator that measures disease burden in a population, taking into account premature mortality, and disability caused by disease or injury Disability-adjusted life years (DALY ) Disability-adjusted life years (DALY )

6. Using 107 diagnoses, and 95% of the causes of disability “Gold Standard” is living in a healthy state (Level of health =1, Death=0), dying at 80 years old (men) or 82.5 years old (women) Years of Lost life (YLL)= years lost by premature death, ex. 64 for a boy who dies at age 16yo Time in which disability is experienced is given a severity rating (ex. Schizophrenia is a 0.8 loss, knee injury is a 0.1 loss) and that time added to YLL Age weights: value of a year lost rises steeply from birth (0.1) to 25 years old (1.4) and then decreases progresively: so for death as a newborn= 32.5 DALY value, at 30 years 29 =DALY value and death at 60 =12 DALY value. Years lost in the future are discounted, so that years lost now are worth more that years lost in the future, at a discount of 3% per year. Calculating DALYS

7. 1. Built in gender difference 2. Built in age preference 3. Discounting future years 4. Weighting severity of disability Criticism of the DALYs

8. Leading Causes of the Global Burden of Disease 2002 1.Perinatal conditions 6.5 2.Lower respiratory infections 6.1 3.HIV/AIDS 5.7 4.Depression4.5 5.Diarrhoeal diseases 4.2 6.Ischaemic heart disease3.9 7.Cerebrovascular disease 3.3 8.Malaria 3.1 9.Road traffic accidents 2.6 10.Tuberculosis2.3 DALYs % Source: World Health Report, 2004

9. Attributable Disease Burden of 20 Risk Factors

10. The number of years a newborn can expect to live in full health, based on current statistics of morbidity and mortality Japan =72 years Afghanistan=36 years Health Adjusted Life Expectancy (HALE)

11. Sao Tome & Prince Georgia Cuba Japan Malta USA

12. Fin