Age Specific Death Rates

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Age Specific Death Rates

• asdr deaths during year of persons aged x
• mid year population aged x
• Normally calculated for 5 or 10 year age groups
  except ages 0-11 months 1-4 years

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Estimates of historic and prehistoric expectation
of life

• Neolithic 17
• paleolithic 19
• India (1900) 23
• China rural 1930 23
• Hungary 1830 25
• Spain 1797 27
• France 1750-9 29

• Russia 1897 29
• Italy 1862-7 32
• England 1650-1700 33
• Rural Congo 1950s 34.5
• Urban Congo 1950s 49.8
• Angola 1950 27
• Mozambique 1950 32

Source Livi-Bacci 1992 Fig 1.8b Brass et al
Demography of Tropical Africa
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Expectation of Life at birth (eo)

• Male Female Diff (M-F)
• Burkina Faso 45.6 48.9 3.3
• Mali 46.9 49.7 2.8
• India 52.5 52.1 -0.4
• Kenya 56.5 60.5 4.0
• Zimbabwe 56.5 60.1 3.6
• Bangladesh 56.9 56.0 -0.9
• Mexico 62.1 66.0 3.9
• China 68.0 70.9 2.9
• UK 71.9 77.6 5.7
• Sweden 74.2 80.2 6.0
• Source UN Demographic Year book 1989

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• Neonatal mortality rate
• Deaths 0-27 days in year t X 1000
• Births in year t
• Infant mortality rate
• Deaths 0-11 months in year t X 1000
• Births in year t
• Child mortality rate
• Deaths aged 1-4 yrs in year t X 1000
• mid year population aged 1-4

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Components of mortality variation

• 1. Overall level
• 2. Ratio child adult
• 3. Old age
• 4. Infant mortality
• 5. Sex differences

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Determinants of mortality patterns and levels

• BIOLOGICAL characteristics
• modified by
• SOCIO-ECONOMIC FACTORS
• PLUS
• ENVIRONMENT
• itself modified by socio-economic factors

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Determinants of Mortality

• EXPOSURE to illness
• SUSCEPTABILITY to illness
• degree of MORBIDITY
• OUTCOME
• life
• death

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Determinants of Mortality
SOCIO - ECONOMIC FACTORS Education Wealth Househol
d Position Availability Accessibility of
health services Production system
ENVIRONMENTAL FACTORS Climate Water
Supply Parasites Sanitation
LIVING CONDITIONS HOUSING, CLOTHING WATER
SANITATION
PREVENTATIVE HEALTH IMMUNISATION HEALTH
PRACTICES
PHYSICAL ENVIRONMENT PARASITES
VECT
EXPOSURE to Infection / Pathogens Parasites /
Injury
NUTRITION
Age Birth Weight
Genetic Background Previous Infection
Resistance
NUTRITIONAL STATUS
SUSCEPTABILITY
CARE Maternal Medical Medical
technology Nutrition
MORBIDITY
SURVIVAL
DEATH
OR
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Determinants of mortality

• Prehistoric Hunter-Gatherer Bands
• Chance - pathogens encountered
• genetic make-up
• nutritional status
• physical environment

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Modern Populations

• Socio-economic factors
• differentiation
• hence
• variability

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Causes of mortality decline

• Nutrition - quality quantity
• McKeown - historical evidence
• Medical technology
• immunisation / drugs
• Living conditions - sanitation / housing
• Knowledge education
• ..