WHO - Indicators for Crude Death Rate Assessment Answer

Question 1

The WHO indicators for crude death rate, disease prevalence, and incidence are expressed per 100,000 population however, data for the crude birth rate is expressed per 1,000 population. Does the crude birth rate include stillborn babies What would be considered a high birth rate Or a low one Provide an example of each and outline some factors that affect the birth rate.

Ans

The crude birth rate (Cp) is defined as the number of live births in a year divided by the total midyear population with the ratio multiplied by 1,000 to get the number of births per 1000 individuals. No, it does not include stillbirth.

The birth rate in a population is affected by many factors, some include the following

Religious Religion has an important role to play as in some religions the concept is Go forth and multiply regarding birth. Catholicism prohibits sex before marriage and thus promotes late childbearing and to be in the marriage for childbirth. Religions also bear varied views regarding modern contraception use and clinical abortions which have an impact on the CDR of countries. In some religions, abortion and use of contraception are prohibited such as Islam. In some countries, these people are responsible for high birth rate.

Poverty In underdeveloped nations, children are believed to be the workforce and thus contribute to family income by working in farms and factories as child labor. Thus such families with poor background bear more children in the expectation of more hands in family contribution.

Women empowerment Countries where women have lower status, low level of education and lower age at marriage, they have a high birth rate. In many cultures and societies, women are believed as insignificant until they bear children. In such cultures, women have no freedom and the choice to govern their lives and control their fertility. Though in cultures where they are empowered they can control the fertility through the use of contraceptives or marrying late. The research shows that woman with a minimum of seven years of education, and the one who works outside the household and who marry at a late age have reduced fertility and Cp (Upadhyay et al 2014).

Educational attainment Level of education and wealth impacts birth rate as more educated and empowered women are likely to be aware of the benefits of family planning. This can be shown by nations such as the Netherlands, UK, Canada, Japan, and Hungary where high educational attainment have (Upadhyay et al 2014)

High infant mortality High infant, as well as child mortality rate, are also responsible for high Cp. Countries where the infant mortality rate is high, the birth rate is also high as people want to ensure some living children.

Age at marriage Lower the age at marriage higher the birth rate (Westoff et al 1992).

Knowledge, awareness, and attitude about family planning The populations where people lack awareness about the benefits of family planning have high birth rates.

Family planning policies of the country All countries have their own policies to control population growth. For example, in China couples can have only one child. Third world countries do not have enough commitment and resources to offer efficient family planning services, health services, or contemporary contraceptives.

Development Developed nations like the UK, USA, and Japan have low CDR compared to less developed and underdeveloped nations. Recently industrialized nations are in the middle with a modest level of CDR.

The average global birth rate is 18.5 births per 1,000 total population in 2016.

Highest birth rate 48.13 in Niger in 2016.

Japan has one of the lowest birth rates in the world with 8 per thousand people.

Question 2

Consider a situation in which 500 people work in the same building. Twenty had a head cold on 1 June 2014, which conferred immunity for 3 months. How many people were at risk of head colds on 1 August 2014 10 marks

ANS

480 people were at risk.

Question 3

What would be the cumulative incidence of head colds if a further 50 people became infected between 1 June and 1 August 2014 How did you arrive at this conclusion

Ans

Total 70 cases of disease appeared among 500 people between 1 June and 1 August 2014, so the rate is 1.4000000000000005e69.

Question 4

Using the table above and the ABS data from Table 1.9 describing deaths per age group,

calculate

The crude death rate in Australia for 2012

The age-specific death rate for Australians aged 0-4 years

The age-specific death rate for Australians aged gt85 years

4th Ans

Crude death rate (CDR) defines the number of deaths within a population. It is calculated for a population over a unit of time.

CDR is the number of deaths in a year per 1000 population of a country. It is estimated at mid-year.

CDR is calculated using the following formulae

(Total resident deaths / Total population) X 100,000

1. CDR in Australia for 2012

Numver of deaths in 2012 in Australia 22,728,254

Total population

CDR 22,728,254100,000/Total population

The age-specific death rate for Australians aged 0-4 years

1,489,345100,000/total population

The age-specific death rate for Australians aged gt85 years

(279,664111,55525,7533295)100,000/total population

Question 5

Question 5 Explain why age adjustment can be useful to compare different population groups. What are the two most common methods of performing adjustments

Ans

In demography and epidemiology age adjustment or standardization of age, is a method to compare populations when in these populations age profiles are very different.

Example

For instance, in 2004 and 2005, two health surveys in Australia found the rate of chronic circulatory health diseases for example heart disease, in the common Australian population, and particularly in the Indigenous people. In every age group more than age 24, Indigenous people had remarkably high rates of circulatory ailments compared to the general Australian population 5 compared to 2 in age category 2534, 12 compared to 4 in age category 3544, 22 compared to 14 in age category 4554, and 42 compared to 33 in age category 55. Nevertheless, from these surveys it has been found overall barely 12 of all Indigenous people had chronic circulatory ailments compared to 18 of the total Australian population. This contradiction can be explained by the fact that in Australia the indigenous population is relatively younger with a median age 21 years, in comparison with the non-indigenous population with a median age of 37. Indigenous people have comparatively high birth as well as high death rates. As a result of this Indigenous people are represented by the younger individuals who have a low rate of circulatory ailments this, however, conceals the fact that their disease risk at every age group above 25 is higher compared to non-Indigenous people in the same age category.

To unmask this effect weighting approach can be used

Weighting To get a comprehensive and informative comparison between these two population groups in Australia weighting method can is utilized. Higher age groups in the Indigenous people can be weighted heavily to match their high prevalence in the reference population that is the total general Australian population. In the same line younger age groups less heavily weighted. This offers an age-adjusted morbidity rate about 30 higher in comparison to the general population, showing that Indigenous Australians have a high risk of circulatory problems. This is a direct method.

References

Ahrens, W. and Pigeot, I. eds., 2014. Handbook of epidemiology. New York, NY Springer.

Bhopal, R.S., 2016. Concepts of epidemiology integrating the ideas, theories, principles, and methods of epidemiology. Oxford University Press.

Coale, A.J. and Hoover, E.M., 2015. Population growth and economic development (Vol. 2319). Princeton University Press.

Giesecke, J., 2017. Modern infectious disease epidemiology. CRC Press.

Inskip, H., Beral, V., Fraser, P. and Haskey, J., 1983. Methods for ageadjustment of rates. Statistics in Medicine, 2(4), pp.455-466.

Upadhyay, U.D., Gipson, J.D., Withers, M., Lewis, S., Ciaraldi, E.J., Fraser, A., Huchko, M.J. and Prata, N., 2014. Womens empowerment and fertility a review of the literature.Social Science amp Medicine,115, pp.111-120.

Westoff, C.F., and Mundial, B., 1992. Age at marriage, age at first birth, and fertility in Africa(No. 169). Washington, DC World Bank.

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