INTRODUCTION:- Mortality has been defined as the permanent disappearance of all evidence of life at any time after birth has taken place (United Nations,1953). Death can occur only after live birth has occurred .therefore, for the purposes of mortality, all deaths before births are to be excluded. Not all countries follow this definition recommended by United Nations.
Example:- In countries like Equatorial Guinea and Morocco, infants who die within 24 hours of birth are classified as still-births In countries like Algeria, French, Guinea, and Syria infants who are born alive but die before the end of the registration period, which may last, in some cases, for a few months, are considered a stillbirth.
Example:- In countries like Equatorial Guinea and Morocco, infants who die within 24 hours of birth are classified as still-births In countries like Algeria, French, Guinea, and Syria infants who are born alive but die before the end of the registration period, which may last, in some cases, for a few months, are considered a stillbirth.
UNDERLYING CAUSE:-
(1) Disease or injury that initiated the train of morbid events leading directly to death.
(2) Circumstances of the accident or violence that produced the fatal injury.
USE OF MORTALITY DATA:-
(1) Explaining trends in overall mortality.
(2) Indicating priorities for health action and resource allocation.
(3) Assessment of public health problems and programs.
(4) Give important clues for epidemiological research.
MEASUREMENT OF MORTALITY:-Various indices have been used for measures of mortality:-
(1) Crude death rate(CDR)
(2) Age-specific death rate (ASDR)
(3) Child mortality rate(CMR)
(4) Infant mortality rate(IMR)
(1)CRUDE DEATH RATE (CDR):-
It is one of the most commonly used measures for mortality. It expresses in terms of the number of deaths per 1000 estimated mid-year population, in a given place.
FORMULA:- CDR=(No. of death /mid-year population)*1000 Calculation = (261931/26551000)*1000 =9.87
Interpretation: CBR 9.87 refers to that there is around 10 death per 1000 population.
MERITS: -
(1) it is simple to understand and to calculate.
(2)CDR is perhaps the most widely used of any vital situations rate.
DEMERITS:-
(1) Most serious drawback of CDR is that it completely ignores the age and sex distribution of the population.
(2)AGE SPECIFIC DEATH RATE (ASDR):-Death rate computed for an age-specific section of the population is called age-specific death rate.
FORMULA:-ASDR= (No. of death in any age group(30-34)/Mid-year population in same age group)*1000
Calculation=(342/2322)*1000=147.29 OR =147
MERITS:-
(1) ASDR always takes into account the age distribution of the population and therefore
(2) For general analytical purposes the death rate specific for age is one of the most important and widely applicable types of death rates.
DEMERITS:-
(1)However, in addition to the age distribution of the population, social occupational factors may be considered.
(3)CHILD MORTALITY RATE(CMR):- CDR refers that the probability of death in the first year to the fourth year of life.
FORMULA: -CMR= (No. of death of age group(1-4)/No. of children of the same age)*1000 Calculation=(986/29580)*1000=33.33 OR 33
Interpretation: CMR 33.33 refers to that there is around 33 child death per 1000 children.
(4)INFANT MORTALITY RATE(IMR):- IMR refers that the probability of death in the first year of life. FORMULA: -IMR= (No. of death of age group 0-1/No. of infant 0-1)*1000 Calculation= (659/13180)*1000=50
Interpretation:- IMR 50 refers that there is 50 infant death per 1000 infants.
(A) Demographic determinants:- In demographic determinants, age structure sex composition level of urbanization are major factors that affect mortality.
(a) Age and sex composition:- Age structure of a population is considered the most significant determinant of mortality. The highest mortality rate is found within one year of age and tends to decline as age increases. The variations in mortality with maternal age and parity can not be explained in terms of any single cause of death, accident is the most important of them. Mortality risk increases considerably after 60 years. It is also noted that there are some diseases like heart stroke cancer etc are the causes of abnormal deaths. In developed countries, such diseases have become the dominant cause of death. Developing countries have a 30% population in age group 0-14 years due to high mortality rate.
In general, the mortality rate is high among the male population than the female. But in many developing countries the mortality rate among females has exceeded the male mortality rate because of poor conditions of medical care, the subordinate status of women, neglect of female children, etc.
In general, the mortality rate is high among the male population than the female. But in many developing countries the mortality rate among females has exceeded the male mortality rate because of poor conditions of medical care, the subordinate status of women, neglect of female children, etc.
(b) Level of urbanization:- The pattern of mortality in any country is considerably influenced by the level of urbanization. In less developed countries mortality rate in towns and cities is found considerably low than the mortality rate in rural areas. It’s happened due to poor medical facilities, lack of a better transportation system.
Moreover, the urban population in the less developed countries have high per capita income, high literacy rate, greater awareness of health hazards prevent the high mortality rate. In highly industrialized urbanized communities the mortality rates become comparatively high because of infection disease for over congestion in particularly slum areas, an environmental pollutant,s, etc.
(B) Socio-cultural determinants:-
(a) Social system and tradition:- In a traditional society, the mortality rate is influenced by the prevalence of infanticide in the society. In different parts of the world in the past adopted infanticide was used as a common technique to control the population. In India female infanticide had been practiced mainly due to the second status provided to women. In the past Hindu society had been practiced the Sati system whereby the wife used to sacrifice her life by burning herself with the pyre of her deceased husband.
(b) Literacy and education:- The level of literacy and education in a society governs people's knowledge of disease epidemics and health hazards. The illiterate and backward societies are characterized by a high rate of mortality because they suffer from common indifference and absence of knowledge.
(c) Social inhibition:- In traditional societies, several social and religious inhibitions control the mortality rate closed tribal societies and religious groups have been inhibiting the people from accepting modern medicines and healthcare methods. For this reason, the mortality rate is higher among the scheduled tribes than the other general caste.
(C) Economic determinants:- Per capita income, the standard of living, type of economy are much important among economic determinants of mortality. The standard of living and per capita income are positively corrected. The richness of diet and capacity to avail of medical facilities by a person are generally determined by his/her income. It is well known that the better income of a person can help in providing him medical facilities against the disease. There is a negative correlation between mortality rate and per capita income or standard of living That’s why the less developed countries show a high average mortality rate.
(D) Environmental determinants:- Natural disasters, calamities, epidemics drought, flood, volcanic corruption, earthquake, wars may cause large-scale death from time to time in affected areas. These factors were more effective in the historical past and no the present countries are trying to control the abnormal deaths by taking compatible movement. However, in different parts of the world, the role of environmental factors varies significantly. Like, in Japan abnormal deaths have taken place due to sudden earthquakes.
(F) Hygienic determinants:-Nutrition, sanitation, housing constitute the general hygienic conditions of an area. There is a very close relationship between the hygienic elements and mortality rate. According to the global health observatory (GHO) in the year of 2016 water, sanitation was responsible for 829000 annual deaths from diarrhea.
Apart from this, malnutrition, infections diseases, malaria, etc are the major cause of the high death rate in underdeveloped countries.
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