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   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
Source: CIA World Data Book, 2008   3
   CDR
       World =                    8 per 1000 population
       MDCs =                     10 per 1000 population
       LDCs =                     23 per 1000 population
       Least developed countries = 36 per 1000 population




                                                             4
   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
Country
Name             Death Rate
Ecuador
Algeria
France
Japan
Ethiopia
Ukraine
Source: www.prb.org


                              6
% 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
% 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
GNI PPP     Infant
Country          per capita Mortality
Name             2007        Rate (IMR)
                      $34600
                      $33470
                       $6810
                       $5490
                       $7040
                        $780
Source: www.prb.org

                                          9
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
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
   Life Expectancy
       It is an AVERAGE

       Pollution levels, conflict, occupation, shelter, food,
        medical facilities, income, literacy




                                                                 12
   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
   The gender gap in life expectancy has been
    growing until the recent past
   Before the epidemiologic transition
       Females in MDCs had higher mortality




                                                 15
   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
   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
   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
   Age Sex Specific Death Rate
       Also called age-sex adjusted mortality rates
   Age-specific death rate:


    ASDR = Da x 1000
           Pa



                                                       19
   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
   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
   LDCs main decrease in death rates
    occurred
       more recently
       more rapidly
       and were due to
         Spatial diffusion of medical technologies




                                                      22
   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
   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
   Epidemiologic transition
   Infant Mortality
   Medical Geography




                               25

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Mortality

  • 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