b7074d18cf0f653704dab0dc386f9f92.ppt
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MEDICAL DEMOGRAPHY & HEALTH CARE Elena A. Abumuslimova Ph. D. , Associate Professor Department of Public Health and Health Care, Northern-West State Medical University named after I. I. Mechnikov, Saint-Petersburg
Demography is the scientific study of human population Demography studies 3 aspects of a population Changes in population size Composition of population Distribution of population on the territory
Before we plan any health intervention or programs for the community we should know the size and composition of the community We also need to know the changes that will occur to the size and composition to the population
IMPORTANCE OF DEMOGRAPHIC STATISTICS: Estimation of health indices of the population (birth rate, death rate, average life expectancy, final parameters of reproduction); Estimation of laws and regularity of population reproduction forming structure; Planning, accommodation and forecasting of staff network of public health service on the basis of amount and structure of the population; Estimation of efficiency of planning and forecasting of medico social actions; Deep statistical analysis of its health condition, activity of medical institutions, precisely to plan their work.
DEMOGRAPHY DYNAMICS MECHANICAL MOVEMENT STATICS NATURAL MOVEMENT
STATICS studies amount and structure of population according to age, gender, profession, etc.
Sources of Demographic information Population census Vital statistics Migration
POPULATION CENSUS is the main method for estimation of population static. POPULATION CENSUS is the special scientifically organized state statistical operation for account and analysis the size of the population, its structure and distribution around the territory.
Features of population census Periodicity (in the majority of the countries PCs are carried out in every 10 years, in economically advanced in 5 years). Generality (scope of all population). Unity of a technique (presence of the uniform program of census as census sheet). Single character (the population is taken into account for the certain moment when the population conducts the most settled way of life). Collecting data by method of interrogation by means of copyists without obligatory documental confirmation. Centralized method of data processing.
Importance of population census perspective population calculations; planning development of branches of national facilities (economy), including public health service; estimation of sanitary condition of the population and calculation of various parameters of health; estimation of sanitary epidemic condition of area, for development of forecasts of an epidemic situation, etc.
Population size refers to the number persons in the population. By the beginning of the 21 st century, world population reached 6 billion. Most of the growth has occurred in the past 200 years.
World population About ¾th of world population lives in the developing countries China and India are the two most populous countries in the world The world population growth rate was at the peak in 1970 About 95% of the population growth is occurring in the developing countries
Amount of World-Population 500 CE-2150 (United Nations Statistics Division)
Total population in Russia
World Population Growth
The unprecedented population growth of modern times heightens interest in the notion of doubling time. Calculation of population doubling time is facilitated by the Law of 70. 70
Low of 70 If a population is growing at a constant rate of 1% per year, it can be expected to double approximately every 70 years If the rate of growth is 2%, then the expected doubling time is 70/2 or 35 years.
Structure is the distribution of population among its sex & age groupings
Age-sex composition of a population Depicted by the Population Pyramid “Young” population: pyramid is triangular “Ageing” population: pyramid becomes more and more rectangular
Age-Sex Composition of a population Refers to the proportion of males & females in different age-groups. It has a direct bearing on social, economic, health needs of communities or countries. In an “old” population, for example, the society population has to arrange for the care of the elderly, & the country’s health system must be organized accordingly. In a “young” population, on the other hand, the population country has to provide more schools, immunizations, & economic support for the young
Age-sexual structure of the population The ages groups Till 14 years (A) The type of age structure of population Regressive Stationary Progressive A<C A=C A>C ~ 50% C>A A=C C<A From 15 to 49 years (B) 50 years old and older (C)
Distribution refers to the arrangement of the population in space at a given time
Global population density
DEMOGRAPHY DYNAMICS MECHANICAL MOVEMENT STATICS NATURAL MOVEMENT
Mechanical movement It is understood as a process of population migration. Depending on duration, migration is divided into constant and seasonal It includes: Emigration; Immigration; Urbanization; Movement of population in depend on socio political and others courses
Migration Involuntary: slavery, ethnic persecution, wars, Involuntary natural disasters, famines Voluntary: to seek jobs (skilled or unskilled), to get Voluntary an education, because of marriage, upon retirement Internal migration: within a country e. g. rural to migration urban International migration: skilled professionals to migration other countries
Migration & Health Migrants (workers, prostitutes, truck drivers) may spread infectious diseases e. g. HIV/AIDS, TB, diphtheria Jet travel speeds up disease transmission Migrants often live in urban slums and experience adjustment problems (these can affect their physical or mental health)
Urbanization It is a demographic process which is characterized by growth of number of cities; increasing in their capacity; prevalence of a share of city dwellers among all population.
Urbanization level in the world
Natural movement of the population It is a set of such demographic phenomena as birth rate, death rate, a natural increase of the population, infantile death rate, the data on marriages, divorces, average duration of a forthcoming life, which registered in medical institutions and establishments of civil registration.
Index of average duration of a forthcoming life / life expectancy It is hypothetical number of years which should be lived by the given generation born or to number of contemporaries of the certain age if on all extent of their life death rate in each age group will be the same it was that year for which calculation was made.
Life expectancy is the average number of years which a person of a particular age may expect to live It is one of the best indicators of a country’s level of development and overall health status The life expectancy of people all over the world has been increasing
Life expectancy This parameter characterizes viability of the population as a whole: it does not depend on features of age structure of the population and is suitable for the analysis in dynamics and comparisons of the data of different countries.
Life expectancy ≠ middle age of died people Life expectancy ≠ middle age index of the population
Parameters of reproduction of the population Birth rate Death rate Index of natural increase
Birth rate is the major component of natural movement of the population. Recently was marked significant decrease of birth rate level in all economically advanced countries that entails a lot of undesirable consequences: consequences q increase of deficiency of a manpower, q decrease in rate of population growth, q change of its age structure (population ageing and reduction of a share of fertile age women), q increase the quantity of the single child families, etc.
Developed countries have low birth rates because It is expensive to look after large families More women prefer to concentrate on their careers Increasing sexual equality has meant women have more control over their own fertility There is a ready availability of contraception and family planning advice
Profound characteristic of birth rate General birth rate Fertile index Age specific birth rate Factor of total prolificacy Gross – factor Net factor
THE FACTORS INFLUENSING BIRTH RATE social position of women, their employment in manufacture, level of satis faction of their material needs, cultural level, living conditions, degree of legislation security, level of children's death rate, provision of pensions, urbanization, national features, psychological and religious factors, ageing of population, State demographic policy, ets.
T. R. Malthus, 1766 -1834 English clergyman, Thomas Robert Malthus, was the first person to draw Malthus widespread attention to the two components of natural increase, births and deaths (fertility and mortality).
In his “Essay on the Principle of Population”, initially published in 1798, Malthus postulated that population tended to grow geometrically while the means of subsistence (food) grew only arithmetically. The Malthusian Trap: Trap Arithmetic growth (food): 1, 2, 3, 4, 5, 6, 7, 8, 9, 10… Geometric growth (population): 1, 2, 4, 8, 16, 32, 64, 128, 256, 512…
Malthus argued that the difference between geometric and arithmetic growth caused a tension between the growth of population and that of the means of subsistence. This gap could not persist indefinitely. Owing to war, disease, hunger, and vice, mortality would serve as a positive check on population growth.
Definition of Key Words ØSize refers to the number persons in the population ØDistribution refers to the arrangement of the population in space at a given time ØStructure is the distribution of population among its sex & age groupings
Solution to the Malthusian Trap Preventive checks: birth control through o later age at marriage. o abstinence from sex outside marriage. (Malthus opposed artificial methods of birth control on moral grounds. Viewed contraception as a vice)
Population Explosion Contrary to Malthus’s prediction, mortality has not yet risen to curb world population growth. < 1 billion people in 1800 / 6 billion by the end of the 20 th century Why was Malthus unable to foresee the population explosion (also known as the population bomb)? bomb
He did not recognize the force of the Industrial Revolution, which produced Revolution exponential growth in the means of subsistence.
The demographic transition This refers to the change from: High rates (births and deaths) to Low rates (births and deaths) Death rates drop before birth rates: therefore, there is a period of rapid population growth. This ends when birth rates finally drop.
The demographic transition Falling death rates are due to better nutrition and higher standards of living Falling birth rates are due to social and economic changes: 1) Women stay in school longer 2) More women work outside the home 3) Women marry later 4) Women postpone childbearing 5) People choose to have fewer kids
Demographic Transition Framework Source: Ian R. H. Rockett. Population and Health: An Introduction to Epidemiology. Second edition. Population Reference Bureau 54(4); 1999: 9
Death rate of the population is regarded as the major demographic index revealing sanitary conditions of the population.
Medical death certificate Medical registration of the reasons of death is physician responsibility. The medical death certificate is the legal and medical document certifying the fact and the reason of death.
Developing countries have high death rates because Dirty, unreliable water supplies Poor housing conditions Poor access to medical sevices Endemic disease in some countries Diets that are short in calories and/or protein Developed countries have low death rates because Good housing conditions Safe water supplies More than enough food to eat Advanced medical services which are easy to access Some developed countries have a high death rate as they have an ageing population with many older people.
Structure of the death reasons Blood circulation system. Malignant tumours. Traumas and poisoning
Infantile death rate Index of infantile death rate is considered as operative criterion for an estimation of sanitary well being of the population, level and quality of the medical social help, an overall performance obstetrical and pediatric service.
Criteria of foetus (newborn) viability recommended by the WHO term 22 weeks and more, body weight 500 g and more, body height – 32 sm and more.
Live-born criteria: extra uterine lung breath, palpitation, pulsation of large vessels, reduction of separate groups of muscles.
Infant mortality rate
Infantile death rate during the various periods of child Early neonatal death rate Late neonatal death rate Neonatal death rate Post neonatal death rate, etc.
The structure of reasons of infantile death rate some causes of perinatal period , mainly intrauterine hypoxia of a fetus congenital developmental of anom alies respiratory organ diseases infection diseases traumas and poisoning otheres
b7074d18cf0f653704dab0dc386f9f92.ppt