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CHAPTER I
OBJECTIVES:
This report shall help the students to be able to:
1.
2.
3.
4.
CHAPTER II
INTRODUCTION TO PUBLIC HEALTH
Just as doctor monitors the health of a patient by taking vital signs like blood
pressure, heart rate, and so forth, public health workers monitor the health of the community
by collecting and analyzing health data. These data are called Health Statistics. Statistics are
a vital part of a public healths assessment function used to identify special risk groups,
detect new health threats, plan public health programs, and prepare government budgets.
Since, Public Health is concerned with population, it relies on Statistics to provide and
interpret data. The term Statistics of public health refers to both the numbers that describe
the health of population, and the science that helps to interpret these numbers. The science
of Statistics is a set of concepts and methods used to analyze data in order to extract
information. Statistics makes possible the translation of data into information about cases
and effects, health risks and cures.
Collection of data
Different agencies collect data which is used by Government in assessing the need
for public health programs and evaluating public health progress. The Statistics collected by
local, State and Central Governments are the raw materials for research on environmental
health, social and behavioral factors in health and the medical care system.
Information on public health includes collection data through vital statistics
(i.e. number of births, deaths, infant mortality and etc.) Vital Statistics and their analysis are
considered as the eye and ears of the public health administrator and serves as powerful
and valuable indicator. The data collected through Vital statistics system and other methods
must be converted into rates if they are to be useful for many public health purposes.
Department of Health
The Philippine Department of Health (abbreviated as DOH; Filipino: Kagawaran ng
Kalusugan) is the executive department of the Philippine government responsible for
ensuring access to basic public health services by all Filipinos through the provision of
quality health care and the regulation of all health services and products. It is the
government's over-all technical authority on health. It has its headquarters at the San Lazaro
Compound, along Rizal Avenue in Manila.
The department is led by the Secretary of Health, nominated by the President of the
Philippines and confirmed by the Commission on Appointments. The Secretary is a member
of the Cabinet. The current Secretary of Health is Paulyn Ubial.
The following agencies and councils are attached to the DOH for policy and program
coordination:
CHAPTER III
STATISTICS- Is the science of conducting studies to collect, organize, summarize, analyze,
and draw conclusions from data.
TWO BRANCHES OF STATISTICS
DESCRIPTIVE STATISTICS - consists of the collection, organization, summarization, and
presentation of data.
INFERENTIAL STATISTICS - consists of generalizing from samples to populations, performing
estimations and hypothesis tests, determining relationships among variables, and making
predictions.
POPULATION AND SAMPLE
A POPULATION consists of all subjects (human or otherwise) that are being studied.
A SAMPLE is a group of subjects selected from a population.
FOUR BASIC METHODS USED TO OBTAIN SAMPLES:
RANDOM SAMPLING
Random samples are selected by using chance methods or random numbers.
SYSTEMATIC SAMPLING
Researchers obtain systematic samples by numbering each subject of the population and
then selecting every kth subject.
STRATIFIED SAMPLING
Researchers obtain stratified samples by dividing the population into groups (called strata)
according to some characteristic that is important to the study, then sampling from each
group.
MEASUREMENT SCALES
The NOMINAL LEVEL OF MEASUREMENT classifies data into mutually exclusive (nonoverlapping), exhausting categories in which no order or ranking can be imposed on the data.
The ORDINAL LEVEL OF MEASUREMENT classifies data into categories that can be ranked;
however, precise differences between the ranks do not exist.
The INTERVAL LEVEL OF MEASUREMENT ranks data, and precise differences between units
of measure do exist; however, there is no meaningful zero.
The RATIO LEVEL OF MEASUREMENT possesses all the characteristics of interval
measurement, and there exists a true zero. In addition, true ratios exist when the same
variable is measured on two different members of the population.
FREQUENCY DISTRIBUTION
A FREQUENCY DISTRIBUTION is the organization of raw data in table form, using classes and
frequencies.
TYPES OF GRAPHS
5
SCATTERPLOTS
A scatterplot displays data that is paired by using a
horizontal axis (the x axis), and a vertical axis (the y axis).
The statistical tools of correlation and regression are
then used to show trends on the scatterplot.
TIME-SERIES GRAPHS
A time-series graph displays data at different points in time,
so it is another kind of graph to be used for certain kinds of
paired data. The horizontal axis shows the time and the vertical
axis is for the data values. These kinds of graphs can be used to
show trends as time progresses.
+
2
MEASURES OF VARIATION
RANGE
The range is the highest value minus the lowest value. The symbol R is used for the range.
R =highest value - lowest value
VARIANCE
The variance is actually the average of the square of the distance that each value is from the
mean. Therefore, if the values are near the mean, the variance will be small. In contrast, if
the values are far from the mean, the variance will be large.
STANDARD DEVIATION
The standard deviation is the square root of the variance.
CHAPTER IV
BIOSTATISTICS is the application of statistics to a wide range of topics in biology. The science
of biostatistics encompasses the design of biological experiments, especially in medicine,
pharmacy, agriculture and fishery; the collection, summarization, and analysis of data from
those experiments; and the interpretation of, and inference from, the results. A major branch
of this is medical biostatistics, which is exclusively concerned with medicine and health.
VITAL STATISTICS
VITAL STATISTICS are statistics on live births, deaths, fetal deaths, marriages and divorces.
VITAL STATISTICS RATES
AGE-SPECIFIC BIRTH RATE is the number of resident live births to women in a specific age
group for a specified geographic area (country, state, county, etc.), divided by the total
population of women in the same age group for the same geographic area (for a specified
time period, usually a calendar year). This figure is multiplied by 1000 to give a rate per
1000 population.
AGE-SPECIFIC DEATH RATE is the total number of deaths to residents of a specified age or
age group in a specified geographic area (country, state, county, etc.) divided by the
8
CAUSE-SPECIFIC DEATH RATE is the number of deaths from a specified cause per 100,000
person-years at risk. The numerator is typically restricted to resident deaths in a specific
geographic area (country, state, county, etc.). Cause-specific death rates may be adjusted for
the age and sex composition, or other characteristics of the population. When that is done,
for instance, in the case of age adjustment, it is called an age-adjusted rate.
CRUDE BIRTH RATE refers to the number of live births, of a given geographic area in a given
year, per 1000 mid-year total population of the same geographic area in the same year.
Crude birth rate is expressed as the number of births per 1000 population.
CRUDE DEATH RATE is the total number of deaths to residents in a specified geographic area
(country, state, county, etc.) divided by the total population for the same geographic area (for
a specified time period, usually a calendar year) and multiplied by 1,000
FERTILITY RATE is the ratio of live births in an area to the population of that area; expressed
per 1000 population per year.
INFANT MORTALITY RATE (IMR) is the number of deaths of infants under one year old per
1,000 live births.
9
LOW BIRTH WEIGHT RATE is defined as a ratio of birth weight of a liveborn infant of less than
2,500 g (5 pounds 8 ounces) regardless of gestational age to the total number of live births.
MATERNAL DEATH RATE: the ratio of the number of maternal deaths during a given time
period per 10,000 live births during the same time-period.
NEONATAL DEATH RATE is the number of neonatal deaths per 1000 live births. A neonatal
death is defined as a death during the first 28 days of life (0-27 days).
PERINATAL DEATH RATE is the number of perinatal deaths per 1000 total births. A perinatal
death is a fetal death (stillbirth) or an early neonatal death.
Stillbirth is typically defined as fetal death at or after 20 to 28 weeks of pregnancy.
Morbidity is a term used to describe how often a disease occurs in a specific area or is a
term used to describe a focus on death.
10
CHAPTER V
PROCESS OF COLLECTING DATA
A. SOURCES OF DATA
Notifiable Disease Statistics Data on Notifiable Diseases is based on
information submitted by health personnel of different Rural Health Units (RHUs), City
Health Offices (CHOs) or Provincial Health Offices (PHOs) and Municipal Health
Offices (MHOs). The Law on Reporting of Notifiable Diseases (Act 3573) mandates
the immediate reporting of any Notifiable Disease to the nearest health officer. All
field health officers, by means of established reporting mechanism (Memorandum
Order No. 51-a.s. 1960) submit weekly morbidity reports (Forms W1-a and W1-b) to
the National Epidemiology Center (NEC) where such data received are then classified,
compiled, analyzed and interpreted. The complete report is presented in Field Health
Service Information System (FHSIS) Annual Report.
B. CLASSIFICATION OF DATA
1. Geographic Classification
Data on Notifiable Diseases have been classified by place of occurrence.
First by region which is a geographical division created as a result of the
reorganization of the Department of Health (DOH), then, by province and city that
were political divisions of the country. There are seventeen (17) regions, eighty
(80) provinces and one hundred twenty-one (121) cities. The National Capital
Region (NCR) has one (1) more municipality which is Pateros. There is no
classification as to whether it is rural or urban because of the lack of established
criteria.
2. Age
There is no valid information with regard to the accuracy of age of a reported
morbid case. Regarding the registered deaths, the age of deceased is fully
determined by the date of birth. However, some of the vital records are submitted
with the age not recorded or the date of birth not indicated. Thus, misstatement
of age on vital records may be assumed to some degree. The age classification or
age groupings used in this report are consistent with those recommended for
international use by the World Health Organization.
3. Diseases and Causes of Death
The Mortality statistics was tabulated based on the underlying cause of
death documented on the medical certificate of cause of death. The underlying
cause has been defined as the disease or injury which initiated the train of
morbid events leading directly to death; or the circumstances of the accident or
violence which produced the fatal injury. The selected cause of death does not
include symptoms and modes of dying, such as heart failure or respiratory failure.
11
CHAPTER VI
EXAMPLES OF STATISTICAL ANALYSIS IN PUBLIC HEALTH
Dengue (pronounced DENgee) fever is a painful, debilitating mosquito-borne disease
caused by any one of four closely related dengue viruses. Dengue fever is transmitted by the
bite of an Aedes mosquito infected with a dengue virus. The mosquito becomes infected when it
bites a person with dengue virus in their blood. It cant be spread directly from one person to
another person.
12
13
Geographic Distribution.
14
Profile of Cases
Ages of cases ranged from less
than 1 month to 100 years old
(median = 13 years). Majority of
cases were male (52.4%). Most
(38.8%) of the cases belonged to
the 5 to 14 years age group.
There were 422 deaths (CFR = 0.42%). The age group that has the highest CFR is 1 to 4 years old
(0.82%).
Case Fatality Rate (CFR) - is the proportion of deaths within a designated population of "cases"
(people with a medical condition), over the course of the disease.
15
CHAPTER VII
REVIEW QUESTIONS:
1.
2.
3.
4.
What are the different bureaus under DOH? What are their objectives?
What is the relationship of Biostatistics to Public Health?
What is the definition of statistics?
What is the difference between descriptive statistics and inferential
statistics?
5. In your own understanding why statistics is essential in public health?
CHAPTER VIII
SUMMARY:
Public health is the science of protecting and improving the health of families
and communities through promotion of healthy lifestyles, research for
disease and injury prevention and detection and control of infectious
diseases. Overall, public health is concerned with protecting the health of
entire populations.
Statistics is the science of conducting studies to collect, organizes,
summarize, analyze, and draw conclusions from data. The two major areas of
statistics are descriptive and inferential. Descriptive statistics includes the
collection, organization, summarization, and presentation of data. Inferential
16
CHAPTER IX
QUESTION AND ANSWER:
TEST I- IDENTIFICATION:
CFR=
100
100
19
Region
I
II
III
IV-A
IV-B
V
VI
VII
VIII
IX
X
XI
XII
ARMM
CAR
CARAGA
NCR
Total
*2016
59
22
69
30
11
25
71
10
7
11
38
20
6
0
13
8
110
510
Cases
2015
% Change
61
-3.3
33
-33.3
119
-42.0
20
50.0
6
83.3
40
-37.5
86
-17.4
27
-63.0
37
-81.1
16
-31.3
29
31.0
35
-42.9
6
0.0
5
-100.0
9
44.4
12
-33.3
165
-33.3
706
-27.8
*2016
9
0
4
3
0
1
10
3
0
1
2
3
2
0
0
0
6
44
Deaths
CFR(%)
2015
15.25
3
0.00
3
5.80
7
10.00
2
0.00
0
4.00
6
14.08
7
30.00
2
0.00
3
9.09
1
5.26
5
15.00
3
33.33
1
0.00
1
0.00
1
0.00
2
5.45
21
8.63
68
CFR(%)
4.92
9.09
5.88
10.00
0.00
15.00
8.14
7.41
8.11
6.25
17.24
8.57
16.67
20.00
11.11
16.67
12.73
9.63
20