Rates and Ratios

EHSM Skills

Importance RATIO
• Realize the implications of certain data in our practice
• Quotient of two numbers without taking into
particular considerations to time and place.
1. Approach to care for our patients.
2. Understanding the health and health resources
needs.

• Clear understanding of these rates and ratios and

their implications will better prepare us in starting and
managing our practice
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RATE
• Measures the probability of occurrence of some
particular events Index Numerator Denominator

• Count of measurement is observed over a period of Proportion People with the All People (with
time and then divided by its base or population of Disease and without
observation disease)
Ratio People with the People without
Disease the Disease
Rate People with the All people (with
disease in a and without
given period disease) in the
same period

CRUDE BIRTH RATE

• A measure of the natural growth or increase of a
population
• Rough measure of the fertility of the population

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 Rates and Ratios
EHSM Skills

ESTIMATES OF AGE-SEX DISTRIBUTION
Percentage distribution of the population as to age
• Young, intermediate, or old
• Provides important information for the priority
programs
• Pictorial Graph- generally referred to as Population
Pyramid
PREVALENCE RATE
• Measures proportion of the population or of a group
of persons who are actually ill with a particular
disease at a point in time
• Used when dealing with chronic conditions and
disabilities
• Number of cases, new and old

• High prevalence rate reflect increase in survival

perhaps due to medical care

• Low prevalence and low incidence rate reflect

rapidly fatal process or rapid cure of disease
INCIDENCE RATE
• Refers to newly diagnosed cases of a particular • Prevalence rate is dependent on:
disease 1. How often disease occur
2. How long it lasts
• Also known as
attack rate, Low Prevalence rate
case rate, 1. Illness is of short duration
sickness rate, 2. Recovery
morbidity rate 3. Death
4. Migration
• Shows how frequent cases of a particular disease
occur in a given period of time Importance of Prevalence Rate:
1. Determining workload, particularly in chronic
disease
2. Useful tool in planning of facilities and
manpower need
3. Monitoring control programs for chronic
conditions such as mental illness
4. Extent of disease problem

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 Rates and Ratios
EHSM Skills
CRUDE DEATH RATE
• A measure of one mortality from all causes which
result in a decrease of population
• Measures the risk of dying from all causes in a
population
Crude because:
• Does not take into account the differences in the
risk of dying among different age group
INFANT MORTALITY RATE
• Measures the risk of dying during the first year of life
• Good index of the general health condition of a
community
• Used to measure the adequacy of health services
as well as the state of environmental health
• Highest for babies with adolescent mothers and
women in their forties and older
• Decreases with increasing maternal educational
levels
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• IMR for unmarried mothers is often more than 83%
higher than the mortality rate for married mothers
• Higher for mothers who smoke than those who do
not smoke
Implications of Low IMR
1. Health Officer’s Point of View
a. Adequate immunization program
b. Sound Infant and Maternal nutrition
c. Satisfactory Pre- and Post-natal services
d. Good disease control program
e. Strict laws governing the administration of
health programs
2. Sanitarian’s Point of View
a. Good environmental sanitation
b. Good water supply
c. Good housing facility
3. Social Worker’s Point of View
a. Illegitimates are not neglected
b. Female babies are not unwelcome
c. High standard of living
• For WHO, an IMR of 50/1000 live births make a
country a priority for international aid
• Priority is given when it comes to programs for:
1. Sanitary improvement
2. Vaccination against diarrheal diseases
High IMR:
1. High incidence of communicable diseases
2. Poor state of sanitation
3. Inadequate health facilities
4. Shorter life expectancy
5. Young population
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 Rates and Ratios
EHSM Skills

MATERNAL MORTALITY RATE SPECIFIC DEATH RATE

• Measures the risk of dying from causes related to
pregnancy, childbirth and puerperium
• Index of the obstetrical care needed and received by
the women in a community
"Cause Specific Death Rate"
• Describes more accurately the risk of exposure of
certain classes or groups to a particular disease

• Both sex and cause specific and in a way age specific

death rate

"Age Specific Death Rate"

FETAL DEATH RATE "Sex Specific Death Rate

• Measure PREGNANCY WASTAGE

• Death of a product of conception occurs prior to its

complete expulsion (irrespective of duration of
pregnancy)

CASE FATALITY RATE

• Represents the risk of dying during a definite period of

time for those individuals who had the particular
disease

• Measures the KILLING POWER of the disease

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 Rates and Ratios
EHSM Skills

SWAROOP'S INDEX
• Proportionate Mortality indicator

• The higher this rate, the better is the health status of

the population because many are reaching older ages
before dying

• Good indicator in comparing health status of different

countries

High proportion of deaths 50 years and over

• Success in the control of preventable deaths

from communicable diseases
• Low IMR
• Better sanitation
• Longer life expectancy
• Better economic status

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 Rates and Ratios
EHSM Skills

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