MEDICAL DEMOGRAPHY & HEALTH CARE

1. 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

2. 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

3. 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

4. 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.

6. STATICSstudies amount and structure of population according to age, gender, profession, etc.

7. Sources of Demographic information • Population census • Vital statistics • Migration

8. 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.

9. 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.

10. 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.

11. Population size • refers to the number persons in the population. • By the beginning of the 21st century, world population reached 6 billion. Most of the growth has occurred in the past 200 years.

12. 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

13. Amount of World-Population 500CE-2150(United Nations Statistics Division)

14. Total population in Russia

16. World Population Growth

17. 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.

18. 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.

19. Structureis the distribution of population among its sex & age groupings

20. Age-sex composition of a population Depicted by the Population Pyramid • “Young” population: pyramid is triangular • “Ageing” population: pyramid becomes more and more rectangular

21. 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 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 country has to provide more schools, immunizations, & economic support for the young

22. Age-sexual structure of the population

23. Distribution refers to the arrangement of the population in space at a given time

24. Global population density

26. 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

27. Migration • Involuntary: slavery, ethnic persecution, wars, natural disasters, famines • Voluntary: to seek jobs (skilled or unskilled), to get an education, because of marriage, upon retirement ------------------------------ • Internal migration: within a country e.g. rural to urban • International migration: skilled professionals to other countries

28. 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)

29. 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.

30. Urbanization level in the world

31. 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.

32. 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.

33. Life expectancy • 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

34. 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.

35. Life expectancy ≠ middle age of died people • Life expectancy ≠ middle age index of the population

36. Parameters of reproduction of the population • Birth rate • Death rate • Index of natural increase

37. Birth rate • 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: • increase of deficiency of a manpower, • decrease in rate of population growth, • change of its age structure (population ageing and reduction of a share of fertile age women), • increase the quantity of the single-child families, etc.

39. 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

40. Profound characteristic of birth rate • General birth rate • Fertile index • Age-specific birth rate • Factor of total prolificacy • Gross – factor • Net - factor

42. THE FACTORS INFLUENSING BIRTH RATE • social position of women, • - their employment in manufacture, • - level of satis­faction 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.

43. English clergyman, Thomas Robert Malthus, was the first person to draw widespread attention to the two components of natural increase, births and deaths (fertility and mortality). T.R. Malthus, 1766-1834

44. 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: • 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…

45. 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.

46. Definition of Key Words • Size refers to the number persons in the population • Distribution refers to the arrangement of the population in space at a given time • Structure is the distribution of population among its sex & age groupings

47. Solution to the Malthusian Trap • Preventive checks: birth control through • later age at marriage. • abstinence from sex outside marriage. • (Malthus opposed artificial methods of birth control on moral grounds. Viewed contraception as a vice)

48. 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 20th century • Why was Malthus unable to foresee the population explosion (also known as the population bomb)?

49. He did not recognize the force of the Industrial Revolution, which produced exponential growth in the means of subsistence.

50. 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.