Vital Statistics

Dr. Maham Toqir

 Vital events

BIRTH DISEASE

MARRIAGE

DEATH MIGRATION
What is vital statistics?
• Quantitative data
concerning the
important events in
human life, such as
the number of
births, deaths,
marriages, health
and disease.
Why is it needed?
• An indispensible tool for researchers,
epidemiologists, health planners and health
professionals:
• To determine the health status of a community.
• To detect how best to provide a health service.
• To plan a public health program.
• To evaluate effectiveness of a public health
program.
Sources of Vital statistics
• Census:
• Enumeration of entire population
• Dejure,Defacto
• National Surveys- PDHS
• Collection of information from selected individuals or house holds in
a population
• Inference about demographic characteristics or trends for a larger
segment or entire population are then made
• Registration Of Vital event :
• Registration of births and deaths
• Grossly incomplete, inaccurate and unreliable in developing
countries
Tools for measurements-Frequency
measures OR Epidemiologist’s tool
• Frequency measures compare one part of
the distribution to another part of the
distribution, or to the entire distribution.
• Rate
• Ratio
• Proportion
Frequency measures
• All three frequency measures have the same basic form:
numerator x 10 n

denominator
• Numerator = upper portion of a fraction
• Denominator = lower portion of a fraction

• Recall that:
• 100 = 1 (anything raised to the 0 power equals 1)
101 = 10 (anything raised to the 1st power is the value itself)
102 = 10 × 10 = 100
103 = 10 × 10 × 10 = 1,000
• So the fraction of (numerator/denominator) can be multiplied by 1, 10, 100,
1000, and so on. This multiplier varies by measure.
 Rate
• It measures the occurrence of some particular
event in a population during a given time period
• It has a time dimension
• It is a statement of risk of developing a condition

x x 10 n
(100,1000,10,000,100,000)
(x + y ) t
Mid year population(MYP) - Frequently
used denominator for calculating rates
• It is mean/average of the population on 1
January and the population on 31 December of a
year.
• It is used to calculate annual rates.
• Example:
• Population in January 1999=225,361
• Population in December 1999= 327,348
• Midyear population for 1999=
225,361+327,348 = 276,354.5
2
Types of Rates
• Crude rate
• Specific rate
• Adjusted rate
Types of Rates- Crude rate
• Actual number of events(e.g. Birth, deaths or disease) in
a total population over a given time period .
• Computed for entire population
• Example:
• Crude birth rate=Total no. of births in a year x 1000
Total population in same year
• Crude death rate= Total no. of deaths in a year x 1000
Total population in same year
Types of Rates- Specific rate
• Actual observed rate
• Consider difference among subgroups
• Computed by age ,sex or some other sub groups
• Example:
• Age specific death rate(ages 25-34):

Number of deaths among residents aged 25-34 in

an area in a calendar year x 1000
Total population aged 25-34 in the
the area in that year
Types of Rates- Adjusted rate
• Not actual rates
• Hypothetical population used for standardization
• Rates undergo statistical transformation to
permit fair comparison between groups differing
in some characteristic that may affect risk of a
disease
• Example:
• Age –adjusted death rate
 Ratio
• The value obtained by dividing one quantity by another.
• A comparison of two numbers
x : y OR x/y
• Numerator and denominator are different
• Example:
• Male: Female
• RBC:WBC
• Vaccinated:Non-vaccinated
 Proportion
• An amount that is a part of a whole.
• Expressed as percentage
x / x+ y x 100
• Numerator is part of denominator
• There is no time dimension
• Example:
The number of children with scabies in a village x 100
Total number of children in the village
Basic measurements in epidemiology

• Measuring frequency of Disease:

• Measures of morbidity-
• incidence, prevalence
• Measuring population change
• Measuring births -Fertility measures
• Measuring deaths- Mortality Measures
• Measuring migration
Measuring population
change
Population Growth
• Population Growth :
• Natural Increase(B-D)
• Net Migration( IM-OM)
• Natural increase= Surplus(or deficit) of Birth over
Death in a population in a given time period (B-D)
• Net migration= Net effect of immigration and
emigration on an area’s population (IM-OM)
• Closed Population-A population with no migratory
flow either in or out.
Rate of natural Increase (RNI)
• Rate of natural increase (RNI) is the rate at which a
population is increasing (or decreasing) in a given year
due to surplus(or deficit) of births over deaths,
expressed as a percentage .
• Births in a year- Death in a year x100
Total mid year population
• Example:
1,600,550 births- 900,234 deaths = 0.0215 =2.15%
32,504,906
Population Growth Rate
• A rate at which a population is increasing (or
decreasing) in a given year due to natural
increase and net migration , expressed as a
percentage of base population:
• Natural Increase in a year – Net migration in a year x 100
Total Population in a year
• Pakistan ‘s growth rate is 2.2 percent which is higher
than average growth rate of South Asian countries.
Population Doubling time –Rule of
70
• Number of years it will take for population to double at current
growth rate

• Doubling Time = 70 ÷ Growth Rate

Country Growth rate Doubling Time

• Uganda 70/ 3.4% 21 years
• Afghanistan 70/ 2.5% 28 year
• Pakistan 70/2.2 % years
• United States 70/0 .5% 140 years
• United Arab Emirates 70/ 1.4% 50 years
Measuring Fertility
Crude rate- Crude Birth rate(CBR)
• # of births per 1,000 persons in a
population over a given period of time (i.e.
1 year).
• Crude birth rate= Number of births during the year x1000
mid-year population
• Data requirement:
• No of births in a population in a given year
• Mid year population of the same year
Calculating CBR
• In 2013,there were 16,000 births in a city with a
population of 2,000,000
• CBR = 16,000 x 1000
2,000,000
= 8/1000/year
There were 8 deaths for every 1000 population in
the city.
• CBR for Pakistan is 27.84/1000/year.
Replacement level fertility(RLF)
• The level of fertility at which a couple has only enough children
to replace themselves, or about two children per couple.
• Desired replacement level fertility-2.1( in developed countries):
• This can be translated as 2 children per woman to replace the
parents, plus a margin to make up for the higher probability of
boys born and early mortality prior to the end of their fertile life.
• Estimated on the basis of existing total fertility rate of a
population
• Current RLF for Pakistan:3.2
Specific Rate-General Fertility
Rate(GFR)
• Number of births in a year x 1000
Number of women aged 15–49

• It focuses on the potential mothers only, and takes the

age distribution into account.
Age-specific Fertility rate
• Number of live births in a year to 1000
women in any specified age group
• Age specific fertility rate (ASFR) at age “x”:
Number of births to women at age x in a year x 1000
Mid-year female population at age x
Calculation of age specific fertility
rate(ASFRs)
Specific rate-Total fertility Rate
• The total number of children a woman
would bear during her lifetime if she were
to experience the prevailing age-specific
fertility rates of women.
• It is the sum of ASFRs over different ages
15-49 years i-e
• TFR= sum of ASFRs
• TFR of Pakistan: 3.2
Computation of TFR from ASFRs
• When we know the total of all ASFRs then TFR can be
calculated as under
• TFR= Sum of ASFRs x5
• It is multiplied by 5 because each ASFRs has got a five
years interval.
• Therefore TFR from our previous data where sum of
calculated ASFRs was 0.39 will be
• TFR= 0.39 x5 = 1.95
Measuring mortality
Crude rate-Crude death rate
• Number of deaths from all causes per 1000 estimated
mid-year population in one year ,in a given place.

• Crude death rate= Number of deaths during the year x1000

mid-year population
• Data requirement:
• No of deaths in a population in a given year
• Mid year population of the same year
Calculating CDR
• In 2013,there were 4000 deaths in a city with a
population of 2,000,000
• CDR = 4000 x 1000
2,000,000
= 2/1000/year
There were 2 deaths for every 1000 population in the
city.
• CDR for Pakistan is 6.84/1000/year ( SOWC 2019)
Specific Mortality Rates
• Neonatal mortality rate
• Infant mortality rate
• Under five mortality rate
• Maternal Mortality rate/ratio
Neonatal mortality rate(NMR)
• The number of neonatal deaths per 1000 live births
• A neonatal death is defined as a death during the first
28 days of life(0- 27)
• # of neonatal deaths in a year x 1000
Total # of live births in a year
• Data requirement:
• No of neonatal deaths in a given population
• No of live births in the same population
• NNMR of Pakistan: 42/1000 live births
Infant mortality rate
• The death of a baby before his or her first birthday is called infant
mortality
• The infant mortality rate is an estimate of the number of infant deaths
for every 1,000 live births.
Number of deaths of infants in a year x 1000
Total number of live births in a year
• The IMR is a good indicator of the overall health status of a population
• Data requirement:
• No of infant deaths in a population in a year
• Total no of live births in a year
• IMR of Pakistan: 57/1000 live births
Under 5 mortality rate
• Annual number of deaths of children under 5 years,
expressed as rate per 1000 live birth
• No of deaths of children less than 5 years of age in a year x 1000
Total no of live births in the same year
• UNICEF consider this as single best indicator of social
development and well being rather than GNP per capita
as it reflects income, nutrition, health care and basic
education
• U5MR of Pakistan for male child: 74/1000 live births
• U5MR of Pakistan for female child:65/1000 live births
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
• From any cause related to, or aggravated by the
pregnancy or its management
• Not from accidental causes
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)
Maternal mortality indicators

• Maternal Mortality Ratio:

Number of maternal deaths in a year x 100,000
Number of live births in a year
• Represents the risk associated with pregnancy – obstetric risk
• MMR for Pakistan : 275/100,000 live births

• Maternal Mortality Rate :

Number of maternal deaths in a year x 100,000
Number of women age 15-49 years
• Represents both the obstetric risk and frequency with which women are exposed
to this risk