2. 2
DEMOS = PEOPLE
GRAPHOS = WRITE / RECORD / DRAWING
“Demography is the scientific study of human
populations, primarily with respect to their size,
structure and changes therein”.. ”
Population changes mainly affected by three
variables:
•Fertility (Births)
•Mortality (Deaths)
•Migration
3. 3
• Demography does not only study the current
population (for example, a group of people
in a football stadium or at a music concert),
but it works more with the factors that can
influence population change.
• Demographers look at the birth and death,
and what happens within this time individual
life courses, which means the time between
birth.
DEMOGRAPHY
4. • Age of death: A death within the first years of life and a death at
the age of 93 have very different consequences for the human
population. Both influence, however, the development of the
overall life expectancy of a population and its age structure.
• Age of mother at first birth: It makes a big difference if a woman
is a 22-year-old or a 36-year-old when she has her first child. The
chances that she will have more children in the course of her life
are much higher in the first case than in the second. In that
respect, populations where the average age of mothers at first
birth is low tend to have higher rates of fertility and larger family
sizes.
• Gender distribution among newborns: When there are inequalities
in the gender distribution among newborns for one or more
generations, meaning a clearly identified difference in the number
of new-born boys and girls, then this will have an impact on their
life courses later on. For example, there are fewer partners
available to start a family, which can then impact the birth rate.
4
5. 5
Study of human population
concerning their
• Size ( Total no. of persons in specific area in sp. time)
• Composition (breakdown according to age, sex,
literacy level, income etc.)
• Distribution (arrangement of people in space at a
given time e.g. urban % ,rural%, etc.)
• Structure ( distribution among age, sex grouping etc.
e.g.<5 yr. or >65yr male? , female?) etc.
• Changes / Behavior within them (pop. growth, pop.
decline, Positive growth, Zero growth, Negative growth
etc.)
• Ethnicity (race / language)
• Social characteristics (literacy, marital status,
educational attainment)
• Religion
6. 6
• Literacy: In Asia, Africa and Latin America the
number of illiterates are increasing with
growing population.
• Inflation: Population growth increases
demands and hence cause inflation.
• Income: Population explosion causes poverty,
through a reduction in income level.
• Unemployment: A three percent increase in
the population means a nine percent economic
growth rate to absorb the unemployed people.
• Energy: Every person requires energy for
food, fuel, shelter etc and more people means
more energy requirements.
7. 7
• Hunger and Poverty: Basic resources such as
land, water, energy and new technology must
expand with a growing population.
• Environment and sustainability: Increase
population causes disruption in the ecological
system. It is estimated that the Earth’s
carrying capacity is 8 billion and the present
population is about 7 billion, if population
continuous to grow at this rate then global
carrying capacity will be markedly disrupted.
• Individual Freedom: As more and more people
require space and resources, there is an
increase in their demands, requiring
enforcement of rules and regulations to
supervise the individual's use of earth’s
resources.
8. 8
DEMOGRAPHY
•
• In academia, demography is
multidisciplinary in nature, having several
branches such as descriptive demography,
economic demography , social demography,
medical demography.
9. 9
Medical Demography
Medical or Health demography uses demographic
methods to examine the impact of socio-cultural
characteristics such as marital status, income,
education, occupation and religion on the
distribution and availability of health and health
care services.
Health policy makers, program managers,
administrators and service providers are
confronted with the following questions:
•What is the magnitude of health problem in a
particular area?
•What is the priority in relation to other
diseases, deaths or high-risk births, etc?
10. 10
Medical Demography
• How effective are the existing programs in
dealing with the disease / problem?
• What are the socio-cultural and program
related factors closely associated with the
prevalence of the disease or the problem
under study?
• What are the action points at which
monitoring and evaluation of the program
should be under taken?
• What are the recommended new interventions
or modifications in the old interventions that
are already under implementation that are
needed to improve the effectiveness and
efficiency of the programs and what are the
financial and other resources needed for the
same?
11. 11
Major Sources of Population
Data
There are four major sources of population data
in a country:
1. Population Census
2. Demographic Sample Surveys
3. Registration system and administrative
statistics
• Vital registration (birth, deaths and marriage)
• Population registers
• Service statistics (form health and family
planning programs)
• International migration statistics
4. Qualitative Data
12. 12
Population Census
• “A census of a population may be defined as a
process of collecting, compiling, analyzing and
publishing demographic, economic and social
data pertaining to a specific time or times, from
all persons in a country.”
• Universality (complete coverage of the
population)
• Simultaneity (information is taken about each
individual present within defined geographical
area as well as at a defined point in time)
• Periodicity
13. 13
Concept of de-jure and de-facto in
census
• Counting of the population where a person was
present on the census date is de-facto.
• Counting is based on the usual residence is de-
jure.
• Pakistan has used both counting to reduce the
chances of misreporting.
• de-jure count can be taken as a close proxy of
the actual population.
14. 14
Census in Pakistan
After independence six censuses have been
undertaken first in 1951, 1961, 1972, 1981,
1998, 2017 and the last in 2023.
Census activities divided into three broad
groups
• Pre-enumeration activities
• Enumeration
• Post enumeration
15. 15
Pre-enumeration activities or census planning
• Delimitation and mapping work
• Development and designing of census
questionnaires
• Pre-testing and pilot census
• Recruiting of field staff
• Logistics requirement
Enumeration
• Training of field staff
• Fieldwork and its supervision
Post enumeration
• Data processing, tabulation, analysis and report
writing.
16. 16
16
TOPICS TO BE COVERED IN CENSUS
A) DEMOGRAPHIC & SOCIAL CHARACTERISTICS
Age - Sex - Relationship to the head - Marital
status - Religion - Mother tongue (language)
- Nationality
B) EDUCATIONAL CHARACTERISTICS (for 5 years +)
Literacy status - School attendance - Level of
education completed - Field of education
C) GEOGRAPHICAL / MIGRATION CHARACTERISTICS
Usual residence - District of birth - Duration of
continuous residence in district - District of previous
residence - Reason of migration
17. 17
17
D) ECONOMIC CHARACTERISTICS (for 10 years +)
Usual Activity - Part time Activity – Occupation
- Industry, Employment status - Reason of
unemployment
E) FERTILITY / MORTALITY (females 15-49 Years)
No. of children ever born by sex
No. of children still living by sex
No. of children born during last 12 months by sex
No. of children still living by sex
F) MISCELLANEOUS
Nature and Type of Disability if any
Holding of CNI Card by persons of 18 years plus
Member of a household living abroad for more than
6 months.
18. 18
18
G) HOUSING CHARACTERISTICS
• Information about living quarters; number of rooms,
sex of the owner, tenure status, period since
constructed and construction material used in outer
walls & roofs.
• Data on source of drinking water, source of lighting and
cooking fuel used.
• Availability of proper kitchen, bathroom, toilet facilities.
• Media of information such as T.V., Radio, Newspaper,
Telephone and Mobile.
Factors influencing census results
•Political influence
•Seasonal migrants
•Geographical inaccessibility of areas
19. 19
Demographic sample survey
• Federal Bureau of Statistics
• Provincial Bureau of Statistics
• Cheaper to conduct and provide high quality
information.
SAMPLE SURVEYS IN PAKISTAN
• NHSP (National Health Survey of Pakistan)
• PDS (Pakistan Demographic Survey)
• PIHS (Pakistan integrated Household Survey)
• HIES (Household Integrated Economic Survey)
• MICS (Multiple Indicator Cluster Survey of
Pakistan)
• NNS (National Nutritional Survey)
20. 20
Merits
• Allows much more
data gathering.
• Allows better data
quality control.
• Micro approach
/Qualitative research.
• Less expensive than
census.
• Objective oriented.
• To check the accuracy
of census or vital
registration.
Demerits
• No universal
coverage.
• Target oriented and
limited utility.
• Sampling errors.
• Biased by non
response.
Demographic sample survey
21. 21
Registration system and administrative
statistics
A Population register means a data collection
system in which the demographic and socio-
economic characteristics of all or part of the
population are continuously recorded.
•NADRA
•HMIS
Vital statistics
• Births
• Deaths
• Marriages
• Divorce
• Migration
23. URBANIZATION
• Urbanization refers to the process of
population concentration in urban
areas, accompanied by the growth
and expansion of cities and towns.
• It involves the movement of people
from rural to urban areas, leading to
the development of urban
infrastructure, industries, and
services.
23
24. In Pakistan, urbanization is driven by
various factors, including:
• Rural to urban migration
• Population growth
• Industrialization
• Infrastructure development
• Economic opportunities
• Education & Health care facilities
• Government policies & Urban planning
• Social factors
24
26. Urbanization and Public
Health Problems
• Poverty
• Inequality
• Environmental hazards
• Poor Nutrition
Can lead to many communicable and
non-communicable diseases
26
28. 28
Population Structure
• The classification and grouping of the population
with respect to any of its characteristics is called
‘structure’ and is defined by that characteristic,
eg sex structure, age structure of the population.
• The male and female composition of the
population can be measured as the sex ratio.
• The sex ratio is defined as the number of males
per hundred females.
• The masculinity proportion is defined as the
number of males or females in the total
population.
29. 29
• Sex ratio
(SR)= male / female * 100
• Masculinity proportion of males
MPm = Pm / Pt or (Pm+Pf) * 100
• Masculinity proportion of females
MPf = Pf / Pt or (Pm+Pf) * 100
Where Pm is male population
Pf is female population
Pt is total population
30. 30
• According to 1998 census the total population of
Pakistan was 132,352,279 of this
Male = 68,873,686
Female = 63,478,593
SR = 68873686 / 63478593 * 100
= 1.08 percent or 108.
MPm= 68873686/ 132352279 * 100
= 52
MPf= 63478593 / 132352279 * 100
= 48
31. 31
• According to 2017 census the population of
Pakistan is 207,774,520 of this
Male = 106,443,520
Female = 101,331,000
SR = 106443520 / 101331000 * 100
= 1.05 percent or 105.
MRm= 106443520 / 207,774,520 * 100
= 51
MRf= 101331000 / 207,774,520 * 100
= 49
32. 32
Age structure
• Most important demographic variable of the
population.
• Given by single year or by age group.
• The age structure of a population can reveal the
number of infants, children, adolescents, young
people and old people in a society, economically
active population, school going population etc.
• It greatly influences the demographic, social and
economical characteristics of the population.
33. 33
Age dependency ratio
• To estimate the age dependency ratio the
population can be divided into three broad age
groups.
• Children under 15 years (P 0-14)
• Persons between ages 15 to 65 years (P 15-64)
This group considered to be economically active or
productive
• Older people 65 years and over (P 65+)
34. 34
Age dependency ratio
• ADR = P 0-14 + P 65+ * 100
P 15-64
• ADR (for children) = P 0-14 * 100
P 15-64
• ADR (for older person) = P 65+ * 100
P 15-64
35. 35
• According to census the population of children
under 15 years = 56064747
• Population between 15-65 years = 68586126
• Population aged 65 years and over = 4525075
• ADR = 56064747+ 4525075 * 100
68586126
• ADR = 88.3
37. 37
POPULATION PYRAMIDS
• WHAT is a population
pyramid?
• HOW to read a
population pyramid?
• Recognize SHAPES of
population pyramids.
• IMPORTANCE of
population pyramids.
38. 38
•A visual representation of the population of a
country.
•Population pyramids are used to show information
about the age and gender of people in a specific
country.
•Show numbers or proportions of males and
females in each age group
• Reflects a country’s birthrate and death rate
•Reflects population growth or decline
•Proportion of children
•Proportion of working people
•Proportion of elderly people
39. 39
Male Female
Population in millions
In this
country
there is a
high Birth
Rate
There is
also a high
Death
Rate.
Horizontal Axis – Percentage / number
Vertical Axis - Age Groups
40. 40
How to read a population pyramid?
• Read the title e.g. country or city
• Comment on general shape of the
pyramid
• Note the proportion of people in various
age groups
• Note the sex ratio
• Interpret the data
41. 41
Types of Population Pyramid
1. Triangular-shaped
2. Beehive/ Barrel shaped Pyramid
3. Rectangular-shaped Pyramid
Shape of pyramids is controlled by
– births,
– deaths, &
– migrations.
45. 45
Broad-based Pyramid
Title: Pakistan
Shape: Broad Base - high birth rates
Narrow Top - small elderly pop
- high death rate
Proportion: - Large proportion of young
- high young dependency
ratio
Sex Ratio: Balance pyramid - Balance sex
ratio
48. 48
Interpret a Population Pyramids
A TRIANGLE SHAPED POPULATION PYRAMID MEANS:
Rapid growth
• Birth rate is high and Death rate is high
• Broad base and concave sides
• Fast growth of population and low proportion of older people
• Low quality of life, such as little medical care, inadequate food
supply or poor water quality
•Characteristics of most developing countries
51. 51
Beehive-shaped Pyramid
Title: Singapore,
Shape: Rocket-shaped / Narrow Base
– Low Birth Rates, Slow pop growth
Proportion: Large proportion of working
population, 15-59 yr old - large
group of economically active pop
Sex Ratio: Balanced pyramid
52. 52
Interpret a Population Pyramids
A BARREL SHAPED POPULATION PYRAMID MEANS:
Zero growth
• Low fertility and Low mortality
• Equal numbers of people in all age ranges, tapering off
gradually at the older ages.
• High quality of life, such as access to health care,
plentiful food supply and good water quality.
54. 54
Rectangular Pyramid
Title: USA
Shape: Rectangular-shaped
Narrow Base - Low Birth Rates
- Life-expectancy is high e.g. 80+
- Low death rates
Proportion: Bars of equal length - Balance
Proportion
Sex Ratio: Balance pyramid - Balance Sex
Ratio
56. 56
Interpret a Population Pyramids
A RECTANGULAR SHAPED POPULATION PYRAMID MEANS:
Slow growth
• Low proportion of children, low level of fertility and a
high proportion of the elderly
• Characteristics of most developed countries.
58. 58
Male Female
Population in thousands
This country has a large
number of temporary
workers. These are people
who migrate here especially
to find a job.
64. 64
Population Density
• It is measured as the number of persons living on
one square unit of land and generally a kilometer
is taken as a unit of measurement.
• It is an important indicator for determination of
land and population relationship in terms of
concentration of population.
• The population density of Pakistan is about 287
people per sq. km of land area.
(http://data.worldbank.org/indicator/EN.POP.DNST)
• In Pakistan, Punjab is the most densely
populated where 536 persons are living per
square kilometer of land.
65. 65
Population Change
• Population change has three
components: births, deaths and
migration.
• As people are born, die or move,
their total number in an area change.
• The most basic method of calculating
numerical population change over
time is the ‘Balancing equation’.
66. 66
Balancing equation
P1+(B-D)+(I-E)=P2
Where,
• P1 is the population at the beginning of the period
• B is births and D is deaths between the two dates
• I is immigration (or in migration) and E is emigration (or
out migration) between the two dates.
• P2 is the population at the end of the period
67. 67
• Natural increase is the surplus (or deficit) of
births over deaths in a population in a given time
period.
NI=B-D
• Rate of natural increase is the rate at which a
population is increasing (or decreasing) in a given
year due to a surplus (or deficit) of births over
deaths, expressed as a percentage of the base
population.
• This rate does not include the effects of
immigration or emigration.
Births in 2022-Deaths in 2022 * 100
Total population in 2022
68. 68
Growth rate
• The growth rate is the rate at which
a population is increasing (or
decreasing) in given year due to
natural increase and net migration,
expressed as a percentage of the
base population.
NI + Net migration * 100
Total population in given time period
69. 69
FERTILITY
• Fertility is one of the most important
components of population that can
bring changes in its age and sex
structures.
• Fertility is directly determined by a
number of factors that are affected
by many social, cultural, economic,
health and other environmental
factors.
70. 70
FERTILITY
• Actual reproductive performance
(behavior) of a women.
• It is generally confined to women
Indicators of fertility
• CRUDE BIRTH RATE (CBR)
• GENERAL FERTILITY RATE (GFR)
• AGE SPECIFIC FERTILITY RATE (ASFR)
• TOTAL FERTILITY RATE (TFR)
71. 71
Crude birth rate
• CBR is defined as the number of
births per thousand of the mid year
population in a year.
• CBR = Total no of births * 1000
Mid year population
72. 72
According to Pakistan demographic survey 1999
mid year population was 126449843 and births
from 1st Jan to 31st Dec were 3876658.
• CBR = Total no of births * 1000
Mid year population
• CBR = 3876658 * 1000
126449843
• CBR = 30.6
births per 1000 person
73. 73
Crude birth rate
• According to 2017 estimates,
population was 207,774,520 and
births from 1st Jan to 31st Dec were
5377410
• Calculate
• CBR = Total no of births * 1000
Mid year population
74. 74
GENERAL FERTILITY RATE
(GFR)
• It is defined as the number of births
in a year per 1000 women of
childbearing ages that is between
ages 15 to 44 or 49 years.
•GFR = Total no of births * 1000
Number of women
ages 15-49 years
75. 75
According to PDS, 1999 the total female population
aged 15-49 yr was 29066897 and total number of
births were 3876658
•GFR = Total no of births * 1000
Number of women
ages 15-49 years
•GFR = 3876658 * 1000
29066897
•GFR = 133
births per thousand females of ages
between 15-49 years.
76. 76
Age Specific Fertility Rate
• ASFR can be worked out by dividing
the number of births to women of
any specific age group in a year by
the corresponding number of females
of the same age group.
• ASFR = Bi / Fi * 1000
78. 78
Total Fertility Rate
The total fertility rate (TFR) is the average number
of children that would be born to a woman by
the time she ended childbearing age conforming
to the age specific fertility rate of a given year.
The TFR sums up, in a single number, the fertility
of all women at a given point in time.
TFR = 5 * ∑ ASFR
80. 80
Total Fertility Rate
TFR = 5 * ∑ ASFR
TFR = 5 * 0.88919 = 4.5
• TFR as calculated from PDS 1999, is
4.5 children born per woman by the
time she reaches 49 years.
81. Replacement level Fertility
• The average number of children born
per woman—at which a population
exactly replaces itself from one
generation to the next, without
migration.
• This rate is roughly 2.1 children per
woman for most countries.
• Although it may modestly vary with
mortality rates.
81
82. 82
• Mortality refers to deaths in a population
• It is linked to many factors such as age, race, sex,
occupation and social class
• The incidence of death can reveal much about a
population’s standard of living and health care
• Declining mortality instead of rising fertility is mainly
responsible for current world population growth
• Triumph over disease and early deaths is a major
achievement in the human history
• Wide variations exist in life expectancy among different
countries of the world as well as among different groups of
population within countries
MORTALITY
83. 83
LIFE SPAN
• It refers to the oldest age to which
human being can possibly live.
• Claims of long human lifespan are
common but their confirmations are
difficult.
• Advancements in medical science
may push the limits of human
survival.
84. 84
LONGEVITY
• It refers to the ability to survive from
one year to the next;
• Ability to resist death.
• Longevity is influenced by both
biological and social factors
85. 85
LIFE TABLE
• A life table is a demographic tool used
to analyze death rates and calculate
life expectancies at various ages.
• We calculate life tables separately for
males and females because of their
different mortality patterns
86. 86
LIFE TABLE
• The national life tables give period life
expectancies. A period life expectancy
is defined as:
• “The average number of additional
years a person can be expected to live
for if he or she experiences the age-
specific mortality rates of the given
area and time period for the rest of his
or her life.”
88. 88
SOURCES OF MORTALITY DATA
• Civil Registration system is that
best source of mortality data.
• However, in most LDC( Less
Developed countries) it is
deficient to provide reliable data.
89. 89
MEASURES OF MORTALITY
• Crude Death Rate = Total No. of deaths in a year x1000
Mid-year Population
• This gives the number of deaths per
1000 population in a given year
• Deaths in a year =405,000
• Mid-year population = 61,644,000
90. 90
• CDR = 405,000 X 1000
61,644,000
= 6.6 per 1,000 population
• Crude death rates are affected by many
population characteristics, particularly age
structure. Crude death rate is not a good
measure to compare the death rates among
different countries and for the same country
for widely different times.
• This rate is affected by the distributions of
people of differing mortality
• It is not safe to base very definite
conclusions on the evidence of CDR alone.
91. 91
AGE- SPECIFIC DEATH RATE
• Death rates can be calculated for specific
age groups in order to compare mortality
at different ages or at the same age over-
time. Comparisons also can be made
between countries or areas.
• Because mortality differs greatly by sex
and race, age-specific death rates are
often given separately for males and
females and for different racial groups.
92. 92
ASDR (40-44 years)= Deaths of people between
40-44yrs in a year
______________________*1000
Mid-year population (ages 40-44)
• Large differences of risks of death are related to
age.
• Separating the people according to age is a very
efficient means of reducing the hidden effect of this
diversity in a death rate.
93. 93
CAUSE – SPECIFIC DEATH RATE
• Deaths from cancer in a year x 100,000
Mid-year population
CASE FATALITY RATE
• Number of deaths from cancer in a year x 100
Total deaths in a year
• The causes of death vary greatly from population to
population and from period to another period and are
influenced by many factors, including health and
environmental conditions.
95. 95
The Demographic
Transition
• The demographic transition refers to the change
that population undergo from high rates of births
and deaths to low rates of births and deaths.
• Demographic transition has different stages
during which a slowly growing or stagnant
population growth gives way to period of rapid
population growth and then revert to slow or
stagnant growth.
• High levels of births and deaths kept most
populations from growing rapidly throughout
most of the time.
96. 96
• Many populations do not failed to grow but also completely
died out when births rate did not compensate for high
death rates.
• Death rates eventually fell as living conditions and nutrition
improved.
• The decline in mortality usually precedes the decline in
fertility, resulting in population growth during the transition
period.
• Fertility rates fell neither as quickly nor as dramatically as
death rates, and thus population grew rapidly.
99. 99
Stage 1: Pre transitional
• The death rate was extremely high
because of poor health and harsh living
conditions.
• A large number of births were necessary
to compensate for the large number of
deaths, especially maternal and child
deaths caused by poor diet, famine or
diseases like epidemic of influenza,
cholera, small pox etc, and the absence of
modern diagnostic and medical facilities.
100. 100
Stage 1: Pre transitional
• Epidemiologically, this period is referred to
as the Age of Pestilence and Famine.
• High birth rate, high death rate = little or
no growth.
101. 101
Stage 2: Early transitional
• This stage refers when death rate began
to drop as a result of improved living
conditions and health practices.
• Many epidemic diseases were bought
under control.
• The birth rate remain high may have been
increased because women were healthier.
• Technological and medical innovations
were readily accepted.
102. 102
Stage 2: Early transitional
• Epidemiologically, this period is referred to
as the Age of Receding Pandemics.
• High birth rate, falling death rate = high
growth.
103. 103
Stage 3: Mid transitional
• In the third stage of transition, the
birth rate moved downwards,
catching up with the death rates.
• Population growth remained
relatively high.
• This growth was helpful for under
populated nations, which needed
more manpower, expanding markets
and greater military potential.
104. 104
Stage 3: Mid transitional
• A characteristic feature of this stage
is the high proportion of the young
population having long term growth
potential.
• Many developing countries such as
Pakistan are in this phase of
demographic transition.
105. 105
• Epidemiologically, this period is referred to as the
Age of degenerative disease that are associated
with a more sedentary and affluent life style.
• Declining birth rate, relatively low death rate =
slowed growth.
106. 106
Stage 4: Late transitional
• In this stage of transition, the birth
rate and death rate are close
together again but they fluctuate
around a relatively low level.
• The USA and many industrialized
countries are in late transitional
stage in which personal behavior and
lifestyles influence the patterns and
levels of disease and injury.
107. 107
Stage 4: Late transitional
• Epidemiologically, this period is referred to
as the Hybristic stage.
• Low birth rate, low death rate = very low
population growth.
108. 108
Stage 5: Post transitional
• In this stage more deaths are
occurring than births and the
population growth rate is negative.
• The number of people is actually
decreasing.
• Some developed countries in Europe
have completed the four stages of
demographic transition.
