The document discusses various mortality measures such as age-specific mortality rates, case fatality rates, and years of potential life lost (YPLL) as a means of assessing premature mortality. It highlights the importance of mortality data in indicating disease severity, especially when incidence data is hard to obtain. Additionally, it explains direct and indirect age adjustment methods for comparing mortality rates across populations, using the U.S. and Mexico as a real-life example.

1. EPIDEMIOLOGY-3

2. MORTALITY MEASURES

4. MORTALITY RATES

5. AGE SPECIFIC MORTALITY RATES

6. CAUSE SPECIFIC MORTALITY RATES

7. CASE FATALITY RATE

8. COMPARISON OF MORTALITY AND CASE
FATALITY RATES

9. PROPORTIONATE MORTALITY RATE

10. COMPARISON OF MORTALITY RATE VS
PROPORTIONATE MORTALITY

12. YPLL-YEARS OF POTENTIAL LIFE LOST
• measure of premature mortality or early death
• Death occurring in same person at a younger age –
greater loss of future productive years than death occurring at an
older age

13. YPLL CONTINUED
• Two steps for a cause
• First step= Standard age of dying in the population – Actual age at
death for each individual who died of that particular cause
• Second Step= Add the years lost in step 1 for each individual to get
Total YPLL from that cause

14. YPLL

15. YPLL FOR PEOPLE<65 YEARS FOR ALL CAUSES

17. WHY USE MORTALITY DATA
• Index of severity of disease
• Easier to obtain than incidence data
• However, if disease is mild/not fatal, mortality data is of no use.
• It is good when: CFR is high, Duration/Survival of disease is short

18. INCREASE IN INCIDENCE
• True
• Apparent

19. COMPARING MORTALITY IN DIFFERENT
POPULATIONS

20. DIRECT AGE ADJUSTMENT

21. DIRECT AGE ADJUSTMENT

22. DIRECT AGE ADJUSTMENT
• Hypothetical Standard Population is created and used in order to
eliminate the effect of differences in age structure between two or
more populations
• Both death rates are applied to the standard population in each age
group

23. REAL LIFE EXAMPLE
• When mortality in the United States and in Mexico was compared for
1995 to 1997, the crude mortality rate for all ages in the United
States was 8.7 per 1,000 population and in Mexico only 4.7 per 1,000
population.
• But for each age group, the age-specific mortality rate was higher in
Mexico than in the United States (aside from the over 65 group in
which the rates were similar).

24. REAL LIFE EXAMPLE
• Could the considerably higher crude mortality rate in the United
States be due to the fact that there was a difference in the age
distributions of the two populations, in that the U.S. population had
a greater proportion of older individuals than did the population in
Mexico?

26. INDIRECT AGE ADJUSTMENT
• To study Mortality when age specific death rates are not available
• Also used for mortality in occupationally exposed population

27. STANDARDIZED MORTALITY RATIO

29. COHORT EFFECT

30. COHORT EFFECT

31. CAUSES OF CHANGE IN MORTALITY DATA