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Mortality
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  • 1. 1
  • 2.  The frequency with which deaths occur  The relevant event in mortality is death  Not including fetal death  Death occurs only once  Determinants of mortality  socioeconomic status  public health  behaviors  medical technology 2
  • 3. Source: CIA World Data Book, 2008 3
  • 4.  CDR  World = 8 per 1000 population  MDCs = 10 per 1000 population  LDCs = 23 per 1000 population  Least developed countries = 36 per 1000 population 4
  • 5.  CDR by region  Africa= 14 per 1000 population  Sub Saharan = 15 per 1000 population  Northern America = 8 per 1000 population  Latin American = 6 per 1000 population  South America = 6 per 1000 population  Asia = 7 per 1000 population  Europe = 11 per 1000 population  Oceania = 7 per 1000 population 5
  • 6. Country Name Death Rate Ecuador Algeria France Japan Ethiopia Ukraine Source: www.prb.org 6
  • 7. % of the Country population Name Death Rate > 65 yrs Ecuador 6 Algeria 4 France 8 Japan 9 Ethiopia 15 Ukraine 16 Source: www.prb.org 7
  • 8. % of the Country population Name Death Rate > 65 yrs Ecuador 6 6% Algeria 4 5% France 8 17% Japan 9 22% Ethiopia 15 3% Ukraine 16 16% Source: www.prb.org 8
  • 9. GNI PPP Infant Country per capita Mortality Name 2007 Rate (IMR) $34600 $33470 $6810 $5490 $7040 $780 Source: www.prb.org 9
  • 10. GNI PPP Infant Country per capita Mortality Name 2007 Rate (IMR) Japan $34600 France $33470 Ukraine $6810 Algeria $5490 Ecuador $7040 Ethiopia $780 Source: www.prb.org 10
  • 11. Infant Country GDP per Mortality Name capita Rate (IMR) Japan $34600 2.8 France $33470 3.6 Ukraine $6810 11 Algeria $5490 27 Ecuador $7040 25 Ethiopia $780 77 Source: www.prb.org 11
  • 12.  Life Expectancy  It is an AVERAGE  Pollution levels, conflict, occupation, shelter, food, medical facilities, income, literacy 12
  • 13.  Life Expectancy  You can divide the total population into different groups (cohorts) to compare some of these differences within a population.  Rich vs poor, urban vs rural, male vs female, ethnic groups, age groups.  Life expectancy figures can be affected by high IMR. If you survive infancy you could live much longer than the life expectancy figures suggest. 13
  • 14. 14
  • 15.  The gender gap in life expectancy has been growing until the recent past  Before the epidemiologic transition  Females in MDCs had higher mortality 15
  • 16.  Why the gender differential in life expectancy?  Improvements in conditions  Economic  Social  Health  Decline in maternal mortality  Female deaths associated with  Pregnancy  Labor  Puerperium  Change in the dominant immediate causes of death in the MDCs  Affected sexes differently 16
  • 17.  Death Rate  The problem with using the CDR is that it is affected by the age structure of the population of a country  If all other things are equal the CDR goes up as the average age of the population goes up 17
  • 18.  Age Sex Specific Death Rate  The death rate for a particular age group within the population (male/female)  Death is most common in the youngest and oldest cohorts 18
  • 19.  Age Sex Specific Death Rate  Also called age-sex adjusted mortality rates  Age-specific death rate: ASDR = Da x 1000 Pa 19
  • 20.  MDCs  2% of deaths are among children < 5yrs  2/3 of deaths are among those > 75 yrs  LDCs  50% of all deaths are among children < 5yrs  5% of all deaths are among those > 75 yrs 20
  • 21.  MDCs main decrease in death rates occurred in the late industrial revolution  Due to improved  sanitation  water  housing  reduction in pollution  improved medical care 21
  • 22.  LDCs main decrease in death rates occurred  more recently  more rapidly  and were due to  Spatial diffusion of medical technologies 22
  • 23.  Improved nutrition  Less death from infectious disease  Advances in agriculture  Improvement in personal cleanliness  Hand washing  Clothes washing  Public health interventions  Improved housing  Ventilation  Waste disposal  Social reforms  Advances in medicine  Reduction in reproductive risks 23
  • 24.  Malaria continues to kill between 1 and 3 million people a year mainly in Sub Saharan Africa.  HIV AIDS has had a huge impact on populations.  Emerging diseases? 24
  • 25.  Epidemiologic transition  Infant Mortality  Medical Geography 25