Question

1. A politician wants to cut a rural health initiative because the mortality rate of rural residents (13.75 per 1000) is lower than the mortality rate among city dwellers (20.77 per 1000). Observe the age-specific rates for each population and comment if he is justified in cutting spending based on crude rates.

*Age-specific rates: An age-specific rate is calculated in the same manner as the crude rate except that both the number of events and the mid-year population are restricted to a given age group.

Answer 1

Crude death rate is defined as the number of deaths per thousand persons in the population in the given region at given time. It is a crude measure, easy to calculate but deals with various drawbacks like it does not take into consideration the age and sex composition of population under study and this is huge factor in determining mortality rate in a given region. People of all ages are not at equal exposure to risk of mortality ,say as infants are born there is high risk of mortality, as he grows the risk reduces, the youngsters have least at risk of mortality (death due to natural causes), whereas persons of higher age group are more prone to mortality condition. So crude death rate cannot be used to compare the mortality situation in the two regions unless they are uniform with respect to age and sex composition. As in our example , the mortality rate of region A is less than that of region B, this can be due to persons belonging to middle age group are there more in Region A whereas elderly people are more present in region B.So the politician is not justified in cutting the services.

Age specific death rate overcomes the drawback of crude death rate with respect to age composition. Age specific death rate is defined as number of deaths between the age group i to i+n per 1000 persons belonging to same age group in the given region in the given time period. The politican should look for age specific death rate than crude death rate for allocation of health initiatives.

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