Study Set Content:
is a mortality rate related to a specified racial group. Both numerator and denominator are limited to the specified race.
Race-specific mortality rate
Mortality rates can be further stratified by combinations of cause, age, sex, and/or race. For example, in 2002, the death rate from diseases of the heart among women ages 45–54 years was 50.6 per 100,000.9 The death rate from diseases of the heart among men in the same age group was 138.4 per 100,000, or more than 2.5 times as high as the comparable rate for women. These rates are a cause-, age-, and sex-specific rates, because they refer to one cause (diseases of the heart), one age group (45–54 years), and one sex (female or male).
Combinations of specific mortality rates
. However, because mortality rates obviously increase with age, a higher mortality rate among one population than among another might simply reflect the fact that the first population is older than the second.
Age-adjusted mortality rates
is the number of deaths attributed to a particular disease during a specified time period divided by the number of new cases of that disease identified during the same time period. The death-to-case ratio is a ratio but not necessarily a proportion, because some of the deaths that are counted in the numerator might have occurred among persons who developed disease in an earlier period, and are therefore not counted in the denominator.
Death-to-case ratio
The proportion of individuals who die from a disease out of all those diagnosed with it.
Case Fatality Rate (CFR):
describes the proportion of deaths in a specified population over a period of time attributable to different causes. Each cause is expressed as a percentage of all deaths, and the sum of the causes must add to 100%. These proportions are not mortality rates, because the denominator is all deaths rather than the population in which the deaths occurred.
Proportionate mortality
is one measure of the impact ofpremature mortality on a population. Additional measures incorporate disability and other measures of quality of life. () is calculated as the sum of the differences between a predetermined end point and the ages of death for those who died before that end point. The two most commonly used end points are age 65 years and average life expectancy.
Years of potential life lost YPLL
represents years of potential life lost per 1,000 population below the end-point age, such as 65 years. YPLL rates should be used to compare premature mortality in different populations, because YPLL does not take into account differences in population sizes.
YPLL rate
A combined measure of years of life lost due to premature death and years lived with disability
Disability-Adjusted Life Years (DALYs)
The Code of Hammurabi – Rules governing medical practice
1700 BC
Mosaic Law – (Book of Leviticus)Personal, food and camp hygiene, segregating lepers, overriding duty of saving of life
1500 BC
Greece – Personal hygiene, fitness, nutrition, sanitation, municipal doctors, occupational health; Hippocrates –clinical and epidemic observation and environmental health.
400 BC
Europe – destruction of Roman society and the rise of Christianity; sickness as punishment for sin, mortification of the flesh, prayer, fasting and faith as therapy; poor nutrition and hygiene pandemics; antiscience; care of the sick as religious duty. Spiritual era of public health.
500 – 1000 Dark Ages
Black Death – origins in Asia, spread by armies of Genghis Khan, world pandemic kills 60 million in fourteenth century, 1/3 to 1/2 of the population of Europe
1348 – 1350
Pandemics – bubonic plague, smallpox, leprosy, diphtheria, typhoid, measles, influenza, tuberculosis, anthrax, trachoma, scabies and others until eighteenth century
1300
Spanish Colonization – Hospital Real (first healthcare facility in the Philippines)
1565-1898
Antony van Leeuwenhoek – microscope, observes sperm and bacteria.
1673
Edward Jenner – first vaccination against smallpox.
1796
Sanitary and Social Reform, growth of scienc
1830
Modern era of Public Health: Lemuel Shattuck outlined boards of health, collection of vital statistics and implementation of sanitary measures and research on public health needs
1850-present
