Mortality refers to death and related issues. There are several ways to measure and compare mortality rates in different populations. Crude mortality rates provide the total number of deaths per population over a period of time but do not account for differences in age or sex. Specific mortality rates, like infant mortality rates, measure deaths from a particular cause or in a specific age group. Adjusted mortality rates like standardized mortality ratios allow for comparisons between populations while controlling for certain variable differences.

1. Measures of Mortality
&
Mortality in Different Populations
BY
DR MUHAMMAD TAUSEEF JAVED
CONSULTANT MINISTRY OF HEALTH
MAKKAH
&
IPH LAHORE

2. Mortality is a term which
means “death” or describes
death and related issues

3. Mortality Table

4. Selected Mortality Rates

5. Maternal Mortality

6. Rates
• With rates, the numerator is included
in the denominator
• Rate is the number of or frequency of
a disease per unit size of population

7. Ratio

8. Ratios
• Ratio – the relation in number,
degree or quantity existing between
two similar things
25 ♀ : 30 ♂
• Ratio as a fraction
25/30 or 5/6

9. Proportions
• Compare like populations or like
illnesses within a population
For example, 40 children are currently
ill with measles, while 80 children all
together have or have had the measles

10. Mortality
• Deaths; describes death; related
issues
• Graunt
 1600s – Bills of Mortality
• Farr (1807-1883)
 Registrar general; vital statistics
Causes
Registration

12. Types of Mortality Rates/Ratio
• annual death rate
• crude death rates
• infant mortality rates (ratio)
• neonatal mortality rates
• postneonatal mortality rates
• perinatal mortality rates
• fetal death rates
• fetal death ratios
• abortion rates
• maternal mortality rates
• adjusted mortality rates
• standardized mortality ratio
• specific death rates
• proportionate mortality rate- case fatality rate
• mortality crossover – mortality time trends
Your Assignment:
familiarize yourself
with the definitions
of these terms

13. Three Levels of Rates
• Crude rates
• Adjusted rates
• Specific rates/ratios

14. Annual Death Rates
• “General” (crude) mortality rate
 a population group exposed to risk of
death
 a time period
• Crude Mortality Rate = # of deaths
occurring in that population during
that period of time

15. Crude Death Rates
• Does NOT account for differences of
age, sex, etc. in any aspect of death
• Info needed:
 total deaths
 total population
 a given period of time

16. Crude Death Rates (cont’d)

17. Cause Specific Mortality Rate

18. Cause Specific Mortality Rate

19. Case Fatality Rate

20. Specific Death Rates
• For example: Early life mortality measures

21. Specific Death Rates
• For example: infant mortality

22. Infant Death Rates in the U.S.

23. Specific Death Rates
• Neonatal mortality rate
(cont’d)
• Postneonatal mortality rate

24. Neonatal & Postneonatal Death Rates

25. Specific Death Rates
• Perinatal mortality rates
(cont’d)

26. Specific Death Rates
• Fetal death rate
(cont’d)

27. Maternal Mortality Rates

28. Maternal Mortality Rates(cont’d)

29. Adjusted Death Rates
• Allows comparisons by controlling
for differences in some variables
Standardized Mortality Ratio (SMR)
Proportionate Mortality Ratio (PMR)
Specific Mortality Rates
• Does NOT account for differences of
age, sex, etc. in any aspect of death
• Info needed:
 total deaths
 total population
 a given period of time

30. Adjusted Death Rates
Age Adjusted Rates
• Direct Method

31. Adjusted Death Rates
Age Adjusted Rates
• Direct Method
(cont’d)

32. Adjusted Death Rates
Age Adjusted Rates
• Direct Method
(cont’d)

33. Adjusted Death Rates
Age Adjusted Rates
• Indirect Method
 Standard Mortality Ratio
(cont’d)

34. Standardized Mortality Ratio
(SMR)

35. Standardized Mortality Ratio
(SMR)

36. Standardized Mortality Ratio
(SMR)

37. Specific Mortality Rates
• Age specific mortality rate

38. Age-Specific Mortality Rates

39. Other Issues Related to Mortality
• Mortality Cross-over
 Death of a subject that started in one group
but “crossed over” to another group during
course of study
• Mortality Time Trends
• Years of Potential Life Lost (YPLL)
YPLL Rate

40. Years of Potential Life Lost