Chapter Calculations Based on

16 Vital Statistics

1. In a town with mid-year population of 150,000 following vital events occurred

Total live births 3200
Total deaths 1400
Infant deaths 270
Maternal deaths 10
Calculate (1) Crude birth rate (2) Crude death rate (3) Infant mortality rate and (4) Maternal mortality
rate.
Solution:
Number of live births during the year in the town
Crude birth rate (CBR) = × 1000
Mid-year population of the town

3, 200
= × 1000
150, 000
= 21.3 per thousand population per year

Number of deaths in given place duuring the year

Crude death Rate (CDR) = × 1000
Mid-year population of the same place and tiime

1, 400
= × 1000
150, 000
= 9.3 per thousand population per year

Number of deaths of infants under 1 year of age

Infant mortality rate (IMR) = × 1000
Number of live births

270
= × 1000
3, 200
= 84.4 per thousand live births
270 Section III: Exercises (Problems and Their Solutions)

Number of maternals deaths

Maternal mortality rate (MMR) = × 1000
Total live births

10
= × 1000
3, 200
= 3.1 per thousand live births

2. A primary health centre with 30,000 population, gives the following data of 1 year
Age groups Number of women Number of live births in 1 year
15 – 24 2000 500
25 – 34 1800 250
35 – 44 1400 90
Total 5200 840

Calculate the fertility rates, mention the validity of each rate.

Solution:
Number of live birth in the year
General fertility rate (GFR) = × 1000
Number of women of 15 to 44 year

840
= × 1000
5, 200
= 161.5 per thousand women

Number of live birth in 1 year

Crude birth rate = × 1000
Mid-year population

840
= × 1000
30, 000
= 28 per thousand population

Number of live births in speccific age group

Age specific fertility rate = × 1000
Mid-year population of same age

500
15–24 year = × 1000 = 250
2, 000
250
25–34 year = × 1000 = 138.8
1, 800
90
35–44 year = × 1000 = 64.3
1, 400
Note : In India, 15 to 44 year is considered for fertility related statistics ; 5 to 10 year of age grouping is adopted
 Calculations Based on Vital Statistics 271

Sum of all age specific fertillity rate*

Total fertility rate (TFR) = × 10 *Sum of age special ferility rate
1000
Age group Fertility rate
(10 is the age group interval in year)
15–24 250
453.1 25–34 138.8
= × 10 = 4.53 35–44 64.3
1, 000
Total 453.1
= 4.53
Thus, a woman would have 4.5 children, if she passes the same fertility rate in each age group.

Validity of rates
Crude birth rate : Unsatisfactory measure, since all population is not taking part in child bearing
General fertility rate : Better measure than crude birth rate, because it is restricted to female population of child
bearing age. However, not all women are exposed to pregnancy.
Total fertility rate : Gives average number of children a women would have, if she passes the same fertility
pattern. It gives a picture of complete family size.

3. Data computed in a primary health center is given to you. Calculate the all possible mortality rates.
Total live births 4500
Total still births (weighing 100 gm) 44
Death under 7 day 100
Death between 7 day and 28 day 75
Death between 28 day and 1 year 165
Solution:
Still births
Still birth rate = × 1000
Live births + Still births

44
= 4, 500 + 44 × 1000

= 9.68 per thousand total births

Number of deaths of < 28 daay children

Neonatal mortality rate (NMR) = × 1000
Live births

Number of deaths < 28 day = Number of deaths under 7 day + Number of deaths between even and 28 day
= 100 + 75 = 175
100 + 75
= × 1000
4, 500
= 38.8 per thousand live births
272 Section III: Exercises (Problems and Their Solutions)

Number of deaths between 28 day and 1 year

Post-neonatal mortality rate = × 1000
Number of live births

165
= × 1000
4, 500
= 36.6 per thousand live births

Still births + Perinatal deaths

Perinatal mortality rate (PMR) = × 1000
Number of live births

44 + 100 144
= × 1000 = × 1000
4500 4500
= 32 per thousand live births

Number of deaths of infants under 1 year of age*

Infant mortality rate (IMR) = × 1000
Number of live births *
Death < 1 year
340 < 7 day 100
= × 1000
4500 7 to 28 day 75
28 day to 1 year 165
= 75.5 per thousand live births
Total 340

4. Mid-year population of a city in 2001 was 1,020,000. The following events occured during 2001.
Total live births 30,000
Total deaths 12,000
Maternal deaths 120
Infant deaths 1600
Death within 28 day 850
Still births 280
Death within 1 week 500

Calculate relevant rates

Number of live births during the year in the town
Crude birth rate (CBR) = × 1000
Mid-year population of the town

30, 000
= × 1000
1, 020, 000
= 29.4 per thousand MYP
 Calculations Based on Vital Statistics 273

Number of deaths during the year in the town

Crude death rate (CBR) = × 1000
Mid-year population of the town

12, 000
× 1000
= 1, 020, 000

= 11.76 per thousand mid-year population (MYP)

Number of infant deaths

Infant mortality rate (IMR) = × 1000
Numberr of live births

1600
= × 1000
30, 000
= 53.33 per thousand live births

Number of maternal deaths

Maternal morality rate = × 1000
Number off live births

120
= × 1000
30, 000
= 4 per thousand live births

Infant deaths within 28 days

Neonatal mortality rate =
Totall live births

850
= × 1000
30, 000
= 28.3 per thousand live births

Post-neonatal mortality rate

Infant deaths - death < 28 day
(28 day up to 1 year) =
Total live births

1600 − 850
= × 1000
30, 000
750
= × 1000
30, 000

= 25 per thousand live births
274 Section III: Exercises (Problems and Their Solutions)

Early neonatal deaths

Early neonatal mortality rate = × 1000
Total live births
500
= × 1000
30, 000
= 16.6 per thousand live births

Late neonatal mortality rate

Neonatal deaths − Early neonatal
(1 week to 28 day) =
Total live births

850 − 500
= 30, 000 × 1000

350
= × 1000
30, 000

= 11.6 per thousand live births

Still births + Early Neonatal

Perinatal mortality rate =
Tottal live births

280 + 500
= × 1000
30, 000

780
= × 1000
30, 000

= 26 per thousand live births

5. A city with mid-year population of 10,00,000 in 2005 has reported following vital events. Calculate all
possible vital rates of the city. Comment on the results.
Births (live) 40,000
Infant Deaths 3600
Deaths within 28 day 1700
Death within first week of life 900
Still births 1000
Solution:
Number of live births during the year
Crude birth rate = × 1000
Midd-year population

40, 000
= × 1000
1, 000, 000
= 40 per thousand mid-year population (MYP)
 Calculations Based on Vital Statistics 275

Deaths of infants of under 1 year of age in a year

Infant mortality rate = × 1000
Total Number of live births in the same yeear
3600
= × 1000
40, 000
= 90 per thousand live births

Number of deaths of infants underr 28 day of age in a year

Neonatal mortality rate = × 1000
Number of live births in the samee year
1700
= × 1000
40, 000
= 42.5 per thousand live births

Late fetal + Early neonatal deatths

Perinatal mortality rate = × 1000
Total live births in the same year
1000 + 900
× 1000
= 40, 000

1900
= × 1000
40, 000

= 47.5 per thousand live births

Number of deaths after 28 daay up to 1 year

Post-neonatal mortality rate = × 1000
Number of live birth

3600 − 1700
= × 1000
40, 000
1900
= × 1000
40, 000

= 47.5 per thousand live births

Infant mortality rate = Neonatal mortality + Post-neonatal mortality rate

= 42.5 + 47.5

= 90 per thousand live births

Rates Maternal & child health services (MCH)

goal by 2010
90 < 30
42.5 35
40 21
276 Section III: Exercises (Problems and Their Solutions)

Comments
There is a high infant mortality rate (IMR) in this area
There is a high mortality rate among the neonates
Crude birth rate is also very high.

Advice
Maternal and child health (MCH) services should be made available to all mothers and children of the area.

6. Find the relevant rates from the data given below.

Total live births 9000
Total deaths under 1 year 1080
Total still births 80
Death under 7 day of age 200
Death between 7 day to 28 day 150
Death between 28 day to 1 year 730
Solution:
Number of late fetal and early neonatal deaths
Perinatal mortality rate = × 1000
Total live births

80 + 200
= × 1000
9000

280
= × 1000
9000
= 31.1 per thousand live births

Number of Infant deaths in the yearr

Infant mortality rate = × 1000
Number of live births in same year

1080
= × 1000
9000
= 120 per thousand live births
Still births
Still birth rate = × 1000
Total live births + Still biirths

80
= × 1000
9000 + 80

80
= × 1000
9088
= 8.81 per thousand total births
 Calculations Based on Vital Statistics 277

Number of deaths under 28 day of age in a year

Neonatal mortality rate = × 1000
Number of live births in same year

200 (< 1 week) + 150 ( 1 week to 28 day)

= × 1000
9000
350
= × 1000
9000
= 38.8 per thousand live births

Number of deaths after 28 daay up to 1 year in a year

Post-neonatal mortality rate = × 1000
Total number of live births in saame year

730
= × 1000
9000
= 81.1 per thousand live births

Comments
As all infant mortality rates are high, strengthening of MCH and general health services in essential.
Availability, utilization and effectiveness of the services should be monitored.

7. In a town with 1 lakh population, there were 2000 births, 200 infant deaths in the year 1992. 80 infants
died within 28 day of life, while 40 of them died in the 1st week of life. There were 110 still births in the
same year. Calculate all vital rates and ratio.
Population of the town 100,000
Live birth 2000
Infant death 200
Deaths within 28 day of life 80
Infant death in first week of life 40
Still births 110

Solution:
Number of deaths under 1 year of agge
Infant mortality rate = × 1000
Number of live births

200
= × 1000
2000
= 100 per thousand live births
Number of deaths below 28 day of life
Neonatal mortality rate =
Number of live births
80
= × 1000
2000
= 40 per thousand live births
278 Section III: Exercises (Problems and Their Solutions)

Still births + Death within one week

Perinatal mortality rate = × 1000
Number of live births

110 + 40
= × 1000
2000
150
= × 1000
2000
= 75 per thousand live births

Number of deaths between 28 day and 1 year of life

Post-neonatal mortality rate = × 1000
Number of live births
Number of Infant deaths − Deaths within 28 day of life
= × 1000
Number of live births

200 − 80
= × 1000
2000
120
= 2000 × 1000

= 60 per thousand live births

Number of still births

Still birth rate = × 1000
Number of still biirths + Live births

110
= × 1000
110 + 2000
110
= × 1000
2110
= 52.13 per thousand total births
Number of live births in the city duringg the year
Crude birth rate = × 1000
Mid-year population

2000
= × 1000
100, 000

= 20 per thousand mid-year population (MYP)

8. Mortality observed in villages of India, Japan and USA is given. Calculate the proportional mortality
rate. Give your remarks.
Place Total Deaths 0–5 year Death
India 500 156
USA 80 4
Japan 50 1
 Calculations Based on Vital Statistics 279

Number of deaths in 0 to 5 year

Proportional mortality (0-5 year) = ×100
Total number of deaths

156
Proportional Mortality (India) = × 100 = 31.2%
500
4
Proportional Mortality (USA) = 80 × 100 = 5.0%
1
Proportional Mortality (Japan) = × 100 = 2.0%
50

Proportional mortality of under fives in India is 15 times higher than in Japan and 6 times higher than in USA.

9. The census population of India in 2001 census was 1027 million, it was 844 million in 1991 census. Esti-
mate the mid-year population of India for 2009.

Solution:
Estimation of mid-year population
Census population is the actual (censused) population as on March 1st of the census year. Census is carried out once
in 10 year since 1881.
Mid-year population is the population estimated as on July 1st (Mid Point) of the year.
Population projection is estimation of population of any future year
Mid-year population is calculated by arithmetic progression mentioned using the formula.
 P2 − P1  1  P2 − P1 
P = P2 +  × d +  
 n  3 n 

Where, P = Population being estimated–Mid-year (June) population of 2009

P1 = Earlier census population—1991 census (March) population
P2 = Latest census population—2001 census (March) population
n = Number of year between earliest and latest census
= March 1991 to March 2001 = 10 year
d = Number of year between latest census (P2) and mid-year population
estimating year = 9 year
1/3rd* = Adding 4 month population (March 1st 2009 to June 31st 2009)
* It is necessary to add 4 month (1/3rd of year) population as we are calculating population up to census month
(March 1st) of the year. But mid-year population is as on July 1st, thus interval between March to June is 4 month
should be added.

Calculation of mid-year population of 2009

Population of India in 1991, P1 = 844 million
Population of India in 2001, P2 = 1027 million
Population of India in 2009, P = to be calculated
280 Section III: Exercises (Problems and Their Solutions)

 P2 − P1  1  P2 − P1 
P = P2 +  × d +  
 n  3 n 
 1027 − 844  1  1027 − 844 
= 1027 +  ×9 +  
 10  3 10 

 183  1  183 
= 1027 +  ×9 +  
 10  3  10 

1
= 1027 + 18.3 × 9 + 18.3
3

= 1027 + 164.7 + 6.1
= 1197.8
Therefore, mid-year population of 2009 is 1197.8 million

Calculation of mid-year population by arithmetic progression method

1. Rate of increase in population per year

Growth of population for 10 year (between 1991 and 2001)
Population of India in 2001 = 1027 million
Population of India in 1991 = 844 million
Population growth for 10 year =1027 − 844 = 183 million
183
So, growth of population in 1 year =
10
= 18.3 million

2. Time gap between March 2001 (census year) and July (mid-year) 2009 is 9 year and 4 month
Population growth for 1 year is 18.3 million.
So, what is the growth for 9 year and 4 month?
1
= 18.3 × 9 + (18.3)
3
= 18.3 x 9 + 6.1
= 164.7 + 6.1
= 170.8 million
Population of India in 2009 = Population in 2001 + growth in 9.25 year
= 1027 million + 170.8 million
= 1197.8 million

Therefore, mid-year population of India in 2009 is 1197.8 million.

 Calculations Based on Vital Statistics 281

10. A town reveals the following data,

Population of town in 1991 37,000
Population of town in 2001 40,000
Total live births during 2001 1,080
Total deaths during 2009 450
Infective hepatitis cases 180
Deaths due to hepatitis 10
Calculate the crude birth rate, crude death rate, case fatality rate, cause specific death rate and propor-
tional death rate due to hepatitis-B for 2009.
Solution:

Calculation of mid-year population of the town in 2009

Population of the town in 1991, P1 = 37,000
Population of the town in 2001, P2 = 40,000
Population of the town in 2009, P = to be calculated
n = number of year between earliest and latest census = 10
d = number of year between latest census and mid-year population = 9
 P2 − P1  1  P2 − P1 
P = P2 +  × d +  
 n  3 n 
 40, 000 − 37, 000  1  40, 000 − 37, 000 
= 40, 000 +  ×9 +  
 10  3 10 

 3000  1  3000 
= 40, 000 +  ×9 +  
 10  3  10 

1
= 40, 000 + 300 × 9 + (300)
3
= 40, 000 + 2, 700 + 100

= 42,800
Therefore, mid-year population of the town in 2009 is 42,800.

Number of births during the year 2009

Crude birth rate = × 1000
Midd-year population

1080
= × 1000
42, 800
= 25.23 per thousand mid-year population
Number of deaths during the year 2009
Crude death rate = × 1000
Midd-year population

450
= × 1000
42, 800
= 10.5 per thousand mid-year population
282 Section III: Exercises (Problems and Their Solutions)

Number of deaths from hepatitis-B durring the year 2009

Specific death rate = × 1000
Mid-year population

10
= × 1000
42, 800
= 0.2 deaths per thousand mid-year population
Total number of deaths due to particular disease (Hepatitis)
Case fatality rate (ratio) = × 100
Total number of same illnesss (Hepatitis)

10
= 1800 × 100

= 5.5 %

Proportional mortality rate from hepatitis

Total number of deaths due to a particular disease
= × 100
Total nuumber of deaths due to all cause

10
= × 100
450
= 2.2