CRUDE, SPECIFIC

and
ADJUSTED RATE
CRUDE RATE
Definition:
Summary rates based on the
actual number of events (e.g.
births, deaths) in a total
population over a given time
period
Example:
CRUDE BIRTH RATE:
Number of live births to residents in an
area in a calendar year
Average population in the area in that year
CRUDE DEATH RATE:
Number of deaths among residents in an
area in a calendar year
Average population in the area in that year
CRUDE RATE
Ignore different risk of morbidity and
mortality among subpopulation
Different age group differ in risk of death
Different sex group differ in risk of disease
Differences between characteristics
composition will create differences in
crude rates even where rates specific for
those characteristics are the same
When we compare two conditions
using Crude rates
The results still confounded by some
characteristics (age, sex, level of
education, social economy etc)
SPECIFIC RATE
Definition:
Summary rates based on the
actual number of events (eg.
morbidity, deaths) in a
subpopulation over a given
time period

Example:
INFANT MORTALITY RATIO:
Number of deaths among 0-11 months children in
an area in a calendar year
Number of live births in an area in a calendar year
CAUSE SPECIFIC DEATH RATE FOR TBC:
Number of deaths among people with TBC in an
area in a calendar year
Number of people in an area in a calendar year
TBC Not TBC Total
Male

12
(4%)

300
( 96%)

312
(100%)


Female

20
(4%)

500
(96%)

520
(100%)

Total
32

800

832
(100%)
SPECIFIC PROPORTION OF TBC MORBIDITY
BASED ON SEX
37,5% 37,5%
62,5% 62,5%
100% 100%
TBC NOT TBC Total
0 35 y.o
10
(3,8%)
250
(96,2%)

260
(100%)
> 35 y.o
22
(3,8%)

550
(96,2%)

572
(100%)
32

800

832
(100%)
SPECIFIC PROPORTION OF TBC MORBIDITY
BASED ON AGE
31,5% 31,3%
68,5% 68,7%
100%
100%
SPECIFIC PROPORTION OF TBC
MORBIDITY BASED ON AGE AND SEX
TBC Not TBC
Total
Age Male Female Male Female
0 - 35
y.o
5
(4,8%)
(32,7%)
7
(4,5%)
(35%)
100
(95,2%)
(33,3%)
150
(95,5%)
(30%)
260
(100%)
> 35 y.o
7
(3,8%)
(58,3%)
15
(3,8%)
(65%)
200
(96,2%)
(66,7%)
350
(96,2%)
(60%)
572
(100%)
Total
12
(100%)
20
(100%)
300
(100%)
500
(100%)
832
(100%)
ADJUSTED RATE
DEFINITION:
Fictitious summary rates constructed to
permit fair comparison between groups
differing in some important
characteristics
Statistical procedures to remove
the effect of differences in
composition for any comparison
Examples of Characteristics
composition:
Age, Sex, Education, Social
Economy, Risk Behavior etc
Example in comparison using
Crude Rate
Mortality rates (CDR) in Indonesia and US
INDONESIA
5,8/1000 population
US
9,0/1000 population
Rate ratio = 5,8/9,0
= 0,64
Conclusion: ????
INDONESIA younger
US Older
Proportion of Indonesia Population based on
age specific mortality and crude mortality
Age group Number of
People
Proportion Mortality
specific
per 1000
Number of
Deaths
0 14 2000 0,4 2,0 4
15 44 2500 0,5 6,0 15
45+ 500 0,1 20,0 10
0 45+ 5000 1,0 9,0 29
CDR = 29/5000 x 1000 = 5.8 per 1000 population
Proportion of US Population based on age,
specific mortality and crude mortality
Age group Number of
People
Proportion Mortality
specific
per 1000
Number of
Deaths
0 14 1500 0,3 2,0 3
15 44 2000 0,4 6,0 12
45+ 1500 0,3 20,0 30
0 45+ 5000 1,0 9,0 45
CDR = 45/5000 x 1000 = 9.0 per 1000 population
Remove the effects of differences in
composition
Calculate the Adjusted Rate
DIRECT method INDIRECT method
Depend on the available data
Greenberg, p. 48 - 53
CONTOH:

Umur
Penduduk
standar
Angka kematian
spesifik per 1000
Jumlah kematian
expected

A B A B
0 - 14
3500 2 2 7 7
14 - 44
4500 6 6 27 27
45 +
2000 20 20 40 40
0 - 45 +
10000 9 5.8 74 74
Adjusted rate penduduk A = 74/10.000 X 1000
Adjusted rate penduduk B = 74/10.000 x 1000
Sources of error
1. Random error/sampling error

2. Systematic error/bias measurement
bias
primary data, secondary data,
acute diseases, chronic diseases,
prevalence, incidence
THANK YOU