Module: Epidemiology and Statistics

Topic 3


Topic 3: How do we measure the health of populations?

Objectives

When you have completed the reading and participated in the taught components for this week, we hope you will be able to

  • Describe commonly used sources of routinely collected data and their limitations
  • Explain and interpret commonly used measures of mortality and morbidity in a population
  • Critically appraise numerical morbidity and mortality data from low and middle income countries

Lecture Notes and Powerpoint

Lecture: How do we measure the health of a community

Data for births, deaths, cause of death and size of populations are essential for planning services, setting priorities and formulating policies. This lecture will start by looking at some of the data presented in the Report of the Commission on the Social Determinants of Health 2005-8 chapter 2. The lecture will describe sources of vital statistics in industrialised, middle and low incomes countries; other sources of routinely collected health data; common methods to compare communities allowing for differences in population age/sex profile; sources of bias. 

 

Seminar

In this seminar, you will present information on your own country. This will draw on principles covered in session 2, and the lecture.

You will review the paper on ‘Health Transition In Africa’ and role of cause of death notification.

Preparation for the week

For the lecture

Rosling uses child mortality and life expectancy as health indicators, published by WHO. Read the paper by Setel and pages 42-46 of the WHO report for 2012.

 

For the seminar

Read the paper by Maher

 

MSc students

Prepare a 3 minute presentation to the rest of your group on the data sources available in your own country. Use information from your own country’s websites, or from websites listed below. If you are from the UK, please liaise with the other UK members of your seminar group. One of you should describe the UK as below, the others can either choose another country or look at other sources of routinely collected data available in the UK.

Include in your presentation a description of the age and sex distribution of the country, infant mortality rates and life expectancy. Describe the source of the raw data used (including the date) and consider the limitations of these sources. You are not expected to describe the details of any models used by UN or WHO. Briefly describe any other sources of information on health or healthcare use.

 

BSc students.

Read the paper by Maher. In groups of 3 or 4 divide up the following tasks. Identify the sources of data used in Table 1 and their limitations. How could the presentation of the data in Table 1 be improved and create a graph to illustrate the data in table 1 using what you learnt in the previous week.  Apart from death registration what other sources of routinely collected information are available in the UK on the burden of cardio-vascular disease. Explain what is meant by age-standardisation and why is it important to compare age-standardised rates rather simply divide the number of deaths by the size of the population. Prepare a 10 minute presentation between the members of the group summarising what you have found.

 

Set Reading

BOOK CHAPTERS

  • Barker D, Cooper C, Rose G. Epidemiology in medical practice. (1998) Churchill Livingstone; 5th edition. Chapters 2 and 3 (read it here)

ACADEMIC PAPERS

  • Mahapatra P, Shibuya K, Lopez AD, et al. Civil registration systems and vital statistics: successes and missed opportunities. Lancet 2007; published online Oct 29. DOI:10.1016/S0140-6736(07)61308-7. (read it here)
  • Maher D, Smeeth L, Sekajugo J. Health transition in Africa: practical policy proposals for primary care. Bull World Health Organ 2010:88:943-948, (read it here)
  • Setel PW, Macfarlane SB, Szreter S, et al. A scandal of invisibility: making everyone count by counting everyone. Lancet 2007; published online Oct 29. DOI:10.1016/S0140-6736(07)61307-5. (read it here)

Additional Reading

  • Commission on Social Determinants of Health, 2005-2008 Report chapter 2 (read it here)
  • Hill K, Lopez AD, Shibuya K, et al. Interim measures for meeting health sector data needs: births, deaths and causes of death. Lancet 2007; published online Oct 29. DOI:10.1016/S0140-6736(07)61309-9. (read it here)
  • Ester Romeri, Allan Baker and Clare Griffiths. Office for National Statistics Mortality by deprivation and cause of death in England and Wales 1999-2003 Health Statistics Quarterly 2006 (read it here)
  • AGE STANDARDIZATION OF RATES:A NEW WHO STANDARD. Omar B. Ahmad, Cynthia Boschi-Pinto, Alan D. Lopez, Christopher JL Murray, Rafael Lozano, Mie Inoue.GPE Discussion Paper Series: No.31EIP/GPE/EBD World Health Organization 2001 (read it here)

 

WEBSITES

For individual country information the following websites will be useful