Overview of Demography,

Vital Statistics, and

Population Dynamics
K11&12
21 Sept 2015

Learning Objectives
To understand the how demographic data
and vital statistics are used in Public
Health
To understand the measures of mortality,
fertility, morbidity that are based on vital
statistics
To understand the determinants of
population size and the demographics
transition

Performance Objectives
Basic understand the demography of
population: size, distribution, composition and
factors that determine demographic changes
Basic understanding of how to use the most
commonly available health statistics to
quantify disease in Public Health Practice
Basic understanding of the most common vital
statistical measures encountered in Practice
Basic understanding of population dynamics
and carrying capacity

Demography
Is the scientific study of human population

Size, distribution, composition and the

factors that determine their changes
Demography Covers 5 aspects of human
population;
1. Size

2. Distribution
3. Composition
4. Population dynamic
5. Socio-economic determinants and
consequences of population change

Demographic Data
Demographic data include those
variables that describe the
characteristics of a population
person,
place, &
time
Characteristics= Population Profiles:
(i.e., population size in an area and how it
changes over time)

Population composition and

Vital Statistics
Population
composition include:
Age
Sex or gender
Ethnicity
Income
Occupation
Health services use
Geographic location
Geographic density

Vital statistics
(Events)
include:
Births
Deaths
Marriages
Divorces

Why demographic data and

vital statistics are
important?
Environment more resources are
needed for more people
Demographic data and vital statistics
are useful tools in:
Determining a communitys health
status
Deciding whats the best way for
providing health services
Planning a public health program
Evaluating a programs effectiveness

Sources of Vital Statistics &

Demographic Data

Census
Registration of Vital
Events
Morbidity Surveys

Demographic Data:
NHMS Census
Malaysia conducts a 5 year census in the
National Health and Morbidity Survey. Each
household and resident is enumerated
(counted).
Person info: sex,age,race,marital status,
place of residence, and relationship to or
position as head of household
A systematic sample of households provides:
income, housing, number of children born,
education, employment status, means of
transportation to work, and occupation.

Statistics on Demographic Data

Department of statistics
Statistical Releases Social and Demography

Abridged Life Tables, Malaysia ( 1 Article )

Household Expenditure( 1 Article )
Household Income( 2 Articles )
Labour Force Survey Report( 1 Article )
Migration Survey Report( 1 Article )
Monthly Principal Statistics of Labour Force, Malaysia( 1 Article )
Population and Housing Census, Malaysia 2010( 5 Articles )
Population Projection, Malaysia( 1 Article )

States Census: tables are published for the entire

Malaysia by each state

Demographic Data:
Annual Registration of Vital Events

In the Malaysia that all vital events must be

registered.
Birth certificates serve as proof of citizenship,
age, birthplace and parentage.
Death Certificates - required as burial
documents and in settlement of estates and
insurance claims.

Demographic Data:
Vital Statistics Data
Vital Statistics
Annual - detailed tables of vital events by
various demographic characteristics and
major geographic subdivision.
Vital_Statistics_Malaysia_2012.pdf
Data on marriages and divorces are
collected and published in a separate
volume.

Demographic Data:
National Death Index
Prepared by Statistics Department- a nationwide,
computerized index of death records compiled
from each states vital statistics offices.
Mortality measures provide an indirect means to
assess a communitys health, underlying causes
of death are necessarily useful in capturing the
many diseases and illnesses that exist within any
given community.
Allows researchers to decide if persons in their
studies have died. Includes death certificate
number, state person died in and date of death.

Demographic Data:
Morbidity Surveys
Morbidity data (i.e., prevalence of disease)
Communicable disease reports are shared
through CDCs Morbidity and Mortality Weekly
Reports (MMWR) and CDCIS
More serious diseases are well reported (i.e.,
cholera,plague,yellow fever, rabies, paralytic
polio)

Morbidity measures are useful for program

planning and evaluation.

Demographic Data:
Sources of Morbidity Data

Reportable/ Notifiable diseases

National Health Morbidity Survey
Hospital records data
Industrial hygiene records
School health records
Medical care subgroups (i.e.,prepaid health
insurance plans)
Chronic Disease Registries (i.e., tumor registries)
Insurance industry data

Vital Statistics Rates, Ratios, and

Proportions

Three rates used in vital statistics:

Crude rates - computed for an entire population
Specific rates - consider differences among
subgroups, computed by age, race, sex or other
variables.
Adjusted (standardized) rates - to make valid
summary comparisons between two or more
groups with different age (or other)
distributions.

Measures of Mortality

Each rate is a measure of the relative frequency

of deaths that occurred in a given population
over a specific time period (time at risk).
Population size is usually defined as the
population at midyear (July 1).
These measures estimate the population at risk
(a+b)/time(t) of one year.
If this convention cannot be met, then the
calculation should really be considered a
proportion rather than a rate.

Measure of Mortality:
Annual Crude Death Rate

Universally used as generalized indicator of a

populations health.
May not be truly reflective without accounting for age,
race, or sex.
Example:
State, Yr - population: 5000; deaths: 25
Crude Death Rate = 25/5000 x 1000
5 deaths per 1000 per year

Measure of Mortality:
Age-Specific Death Rate

Defined as the number of deaths in a specific age group

in a calendar year, divided by the population of the same
age group on July 1 of that year, the quotient multiplied
by 1000.

Example:
Country, Yr - age group: 25-34 yrs; population:
5,000,000;
deaths: 200,000
Age-specific death rate= 200,000/5,000,000 x 1000
= 40 deaths per 1000 population per year for age
group 25-34

Measure of Mortality:
Cause-Specific Death Rate
Defined as the number of deaths assigned to a
specific cause in a calendar year, divided by the
population on July of that year, the quotient
multiplied by 100,000
Example:
Country, Yr - cause: accidents;
population: 5,000,000;
deaths: 4,000
Cause-specific death rate= 4,000/5,000,000 x 100,000
= 80 accidental deaths per 100,000 population per year

Measure of Mortality:
Proportional Mortality Ratio
Defined as the number of deaths assigned to a specific
cause in a calendar year, divided by the total number of
deaths in that year, the quotient multiplied by 100
Proportional mortality is very useful in occupational
studies for measuring the relative importance of a specific
cause of death.
Example:
Country, Yr - total deaths from all causes: 1,500,000;
deaths from cancer: 675,000
Proportional mortality ratio= 675,000/1,500,000 x 100
= 45% of total deaths per year from cancer

Measure of Mortality:
Infant Mortality Rate

Defined as the number of deaths of persons

age 0-1 in a calendar year, divided by the
number of live births in that year, quotient
multiplied by 1000
Example:
State, Yr - live births: 325,000; infant deaths: 1,750
Infant mortality= 1,750/325,000 x 1000
= 5.4 infant deaths per 1000 live births per year

Measure of Mortality:
Maternal Mortality Ratio*

Defined as the number of deaths assigned to

puerperal causes (i.e., childbearing) in a
calendar year divided by the number of live
births in that year, the quotient multiplied by
100,000.
Example:
Country, Yr - deaths due to puerperal causes: 275;
live births: 1,750,000.
Maternal mortality ratio: 275/1,750,000 x 100,000
= 15.71 maternal deaths per 100,000 live births per
year

Measure of Mortality:
Neonatal Mortality Proportion
Defined as the number of deaths of neonates (infants <28
days of age) in a calendar year, divided by number of live
births in that year, the quotient multiplied by 1000
Neonatal mortality is an important measure because the
majority of infant deaths occur during the short time
period following birth (first 28 days).
Example:
State, Yr -: deaths at <28 days=2,750;
live births: 325,000
Neonatal mortality proportion= 2,750/325,000 x 1000
= 8.5 neonatal deaths per 1000 live births

Measure of Mortality:
Fetal Death Ratio
Defined as the delivery of a fetus that shows no
evidence of life (no heart action, breathing, voluntary
muscle movement) if the 20th week of gestation has
been completed or if the period of gestation was
unstated.
Defined as the number of fetal deaths in a calendar
years, divided by the number of live deaths in that
year, the quotient multiplied by 1000.
Example:
State, Yr - fetal deaths: 2,450; live births: 525,000
Fetal death ratio = 2,450/525,000 x 1000
= 4.7 fetal deaths per 1000 live births

Measure of Mortality:
Perinatal Mortality Proportion

Defined as the number of fetal plus neonatal

deaths, divided by the number of live births plus
fetal deaths, the quotient multiplied by 1000
Example:
State, Yr - fetal deaths: 3,250; neonatal deaths: 5,750;
live births: 475,000
Perinatal mortality proportion= 3,250+5,750/475,000+
3,250 x 1000
= 18.8 perinatal deaths per 1000 fetal deaths plus live
births

Measure of Fertility:
Crude Birthrate

Defined as the number of live births in a

calendar year, divided by the population at
July 1 of that year, the quotient multiplied by
1000
Example:
State, Yr - live births: 250,000; population:
30,000,000
Crude birthrate= 250,000/30,000,000 x 1000
= 8.3 live births per 1000 population per year

Measure of Fertility:
General Fertility Rate

Defined as the number of live births in a

calendar year, divided by the number of
women ages 15-44 at midyear, quotient
multiplied by 1000
Example:
Country, Yr - live births: 7,500,000; number of women
ages 15-44: 35,000,000
General fertility rate= 7,500,000/35,000,000 x 1000
= 214.3 live births per 1000 women ages 15-44 per
year

Measure of Morbidity:
Incidence Rate

Defined as the number of newly reported

cases of a given disease in a calendar year,
divided by the population on July 1 of that
year, the quotient multiplied by either 1000,
100,000, or 1,000,000 (whatevers
convenient).
Example:
State, Yr - new cases of AIDS reported: 5,250;
population: 35,000,000
Incidence rate: 5,250/35,000,000 x 100,000
= 15 new AIDS cases per 100,000

Measure of Morbidity:
Prevalence Proportion

Defined as the number of existing cases of a

given disease at a given time, divided by the
population at that time, the quotient
multiplied by 1000, 100,000, or 1,000,000
(whatevers convenient)
Example:
Country, Yr - number of men alive with AIDS: 3,750;
population: 15,000,000 men
Prevalence proportion= 3,750/15,000,000 x 100,000
= 25 AIDS cases per 100,000 men

Measure of Morbidity:
Case-Fatality Proportion

Defined as the number of deaths assigned to a

given cause in a certain period, divided by
number of cases of the disease reported during
the same period, the quotient multiplied by
100.
Example:
Country, Yr - report number of male AIDS cases: 45,000;
deaths from the disease: 37,000.
Case-fatality proportion: 37,000/45,000 x 100
= 82.2% mortality among reported cases of AIDS

Adjustment of Rates
(or, Rate Adjustment)
Adjusting, or standardizing, rates is used to make
valid comparisons between populations that may
differ in some significant way (i.e., age
distribution).
Standardized rates have no meaning in isolation,
since adjusted rates are artificial.
Depending on type of data - there are two methods
to adjust rates - direct (preferred) and indirect.
The numerical values of the adjusted rates depend
on the choice of the standard population.