General vital statistics. Basic demographic statistical indicators and methods of their calculation
Fertility- the process of childbirth in a specific population of people over a certain period of time.
Speaking about fertility in human society, it should be remembered that in this case it is determined not only by biological, but also by socio-economic processes, living conditions, everyday life, traditions, religious attitudes and other factors.
Live birth is the complete expulsion or removal from the mother's body of a product of conception, regardless of the duration of pregnancy, which after such separation breathes or shows other signs of life (heartbeat, pulsation of the umbilical cord or obvious movements of voluntary muscles, regardless of whether the umbilical cord is cut and whether the placenta is separated).
Viable(according to WHO definition) is considered a child born at 20-22 weeks of gestation and later with a body weight of 500 g and above, in which at least one of the signs of live birth is determined after birth.
Stillbirth is the death of the product of conception before it is completely expelled or removed from the mother’s body, regardless of the duration of pregnancy. Fetal death is indicated by the absence of breathing or any other signs of life, such as heartbeat, pulsation of the umbilical cord, or voluntary muscle movements.
Organization of birth registration |
According to the law, within a month from the date of birth, all children must be registered with the registry office at the place of their birth or the place of residence of their parents. Registration of the birth of a found child, whose parents are unknown, is carried out within 7 days from the date of his finding at the request of the guardianship and trusteeship authority, the administration of the child care institution where the child is placed, the territorial body of the Ministry of Internal Affairs or the person with whom the child is located. Along with the application, documents (act, protocol, certificate) indicating the time, place and circumstances of the discovery of the child and a certificate from the medical institution about the child’s age are provided to the registry office.
The main document for registering a child with the registry office is the “Medical Birth Certificate” (f. 103/u-08). It is issued upon discharge of the mother from the hospital by all health care institutions where the birth took place, in all cases of live birth. In the case of a home birth, the “Medical Birth Certificate” is issued by the institution whose medical worker delivered the birth. In case of multiple births, a “Medical Birth Certificate” is filled out for each child separately.
IN populated areas and medical institutions where medical personnel work, a “Medical Birth Certificate” must be drawn up by a doctor. IN rural areas in health care institutions where there are no doctors, it can be issued by the midwife or paramedic who attended the birth.
In the event of the death of a child before the mother leaves the maternity hospital or other medical institution, a “Medical Birth Certificate” must also be filled out, which is submitted along with the “Perinatal Death Certificate” to the registry office.
A record of the issuance of a “Medical Birth Certificate” indicating its number and date of issue must be made in the “History of the Development of a Newborn” (f. 097/u), in the case of stillbirth - in the “History of Childbirth” (f. 096/u). To take into account the birth rate and calculate a number of demographic indicators, it is extremely important to determine whether the child was born alive or dead, gestational age, term, etc.
Live birth statistics |
Health care institutions register in the medical records all live and stillborn births with a birth weight of 500 g or more. The following are subject to registration with the registry office:
- born alive with a body weight of 1000 g or more (or, if birth weight is unknown, a body length of 35 cm or more or a gestation period of 28 weeks or more), including newborns weighing 1000 g in multiple births;
- those born alive with a body weight from 500 to 999 g are also subject to registration with the registry office as live births in cases where they lived more than 168 hours after birth.
Premature Children born at a gestational age of less than 37 weeks and showing signs of prematurity are considered.
Full term Children are considered to be born between 37 and 40 weeks of gestation.
Post-term Children are considered to be those born at a gestational age of 41 to 43 weeks and showing signs of overmaturity. In addition, the concept prolonged or physiologically prolonged pregnancy, which lasts more than 42 weeks and ends with the birth of a full-term, functionally mature child without signs of overmaturity and danger to his life.
Due to the peculiarities of obstetric tactics and nursing of children born at different gestational ages, it is advisable to distinguish the following intervals:
- premature birth at 22-27 weeks (fetal weight from 500 to 1000 g);
- premature birth at 28-33 weeks (fetal weight 1000-1800 g);
- premature birth at 34-37 weeks (fetal weight 1900-2500 g).
The highest percentage of premature births occurs at 34-37 weeks of pregnancy (55.3%); during pregnancy 22-27 weeks, abortions occur 10 times less often (5.7%).
Risk factors for premature birth are both socio-demographic (unsettled family life, low social level, age under 20 or over 35 years old) and medical (previous abortions and premature births, spontaneous miscarriages, urinary tract infections, inflammatory diseases of the genitals, endocrine violations).
Every year more than 40 thousand births registered in Russian Federation, are premature. The proportion of normal births in 2002 was 31.7% (2000 - 31.1%).
Total fertility rate- calculated as the ratio of the absolute number of births to average number population over a period, usually a year. For clarity, this ratio is multiplied by 1000 and measured in ppm.
Scheme for estimating the total fertility level | |
Crude birth rate (per 1000 population) | Birth rate |
To 10 | Very low |
10-15 | Short |
16-20 | Below the average |
21-25 | Average |
26-30 | Above average |
31-40 | High |
More than 40 | Very tall |
The value of the total fertility rate depends not only on the intensity of the birth rate (the average number of live births), but also on demographic and other characteristics, primarily on the age, sex and marriage structure of the population. Therefore, it gives only the very first, approximate idea of the birth rate. To eliminate the influence of these demographic structures on fertility rates, other, clarifying indicators are calculated.
Calculated in relation to the number of women of reproductive age (15-49 years).
General and special fertility rates are related to each other by the ratio:
Age-specific birth rates (fertility) measure the birth rate in a specific age group of women and are calculated as the ratio of the number of births to women of a certain age group to the average annual number of women in this age group.
When calculating special and age-specific fertility rates (fertility), it is customary to assign all births to mothers under 15 years of age to the age of 15 years or to the interval 15-19 years. Births to mothers whose age exceeds 49 years are attributed, respectively, to the age of 49 years or to the interval 44-49 years. This does not reduce the accuracy of determining age-specific coefficients for these ages due to the very small number of births in the youngest (under 15 years) and in the oldest (50 years and older) ages. However, if the purpose of the study is to study the fertility of these particular age groups, then, of course, age-specific coefficients for them are calculated according to the general rule.
Age-specific fertility rates (fertility) make it possible to analyze the level and dynamics of fertility intensity in a conventional generation, free from the influence of the age structure of both the population as a whole and women of reproductive age. This is their advantage over general and special fertility rates. However, the inconvenience of age-specific coefficients is that their number is too large: if these coefficients are calculated for one-year intervals, then there are 35 of them, and if for 5-year intervals, then 7. To overcome this difficulty and be able to analyze the level and dynamics of fertility using one indicator, also free from the influence of the age structure, the so-called cumulative fertility rates are calculated, of which the total fertility rate (fertility) is the most famous and widespread.
Cumulative birth rate (fertility) characterizes the average number of births per woman in a hypothetical generation over her entire life while maintaining existing birth rates at each age, regardless of mortality rates and changes in the age composition. The value of the total fertility rate (fertility) above 4.0 is considered high, less than 2.15 - low. Thus, in 2002, the total fertility rate in the Russian Federation was 1.32 children per woman, which does not even ensure simple generation replacement.
Partial fertility rates are calculated to remove the influence of other demographic structures. In particular, where out-of-wedlock births occupy a significant place among all births, they calculate
- marital birth rate (fertility) rate
- out-of-wedlock birth rate (fertility)
In 2002, in the Russian Federation, 411.5 thousand children were born outside of a registered marriage, or 29.5% of the total number of births.
In addition to the age of the mother, the number of children a woman has given birth to in the past, or the order of birth, is important in fertility analysis. In demography, the following fertility indicators are used by birth order for a conventional generation:
- special fertility rate (fertility) by birth order;
- age-specific fertility rate by birth order.
It is a very informative indicator when analyzing the process of declining fertility, since among a population with low fertility, the values of this coefficient for higher birth orders are practically equal to zero.
Complements the previous indicator taking into account the age structure of women of reproductive age.
Indicator name | Calculation method | Initial forms of stat. documents | ||
Total fertility rate | = | x 1000 | f. 103/у-08 | |
Average annual population | ||||
Special birth rate (fertility) rate | = | Total number of live births per year | x 1000 | f. 103/у-08 |
Average annual number of women of reproductive age (15-49 years)* | ||||
Age-specific birth rate (fertility) | = | Number of births to women of a certain age group | x 1000 | f. 103/у-08 |
Average annual number of women in this age group | ||||
Total birth rate (fertility) | = | Sum of age-specific fertility rates (for ages 15 to 49 years) | f. 103/у-08 | |
1000 | ||||
Marital birth rate (fertility) | = | Number of children born in marriage | x 1000 | f. 103/у-08 |
Number of women of reproductive age (15-49 years old) who are married | ||||
Out-of-wedlock birth rate (fertility) | = | Number of children born out of wedlock | x 1000 | f. 103/у-08 |
Number of women of reproductive age (15-49 years) who are not married | ||||
Special fertility rate (fertility) by birth order | = | Number births i priority | x 1000 | f. 103/у-08 |
Number of women of reproductive age (15-49 years) | ||||
Age-specific fertility rate by birth order | = | Number of births i-th priority in women of a certain age group | x 1000 | f. 103/у-08 |
The number of women in this age group |
*According to WHO definition, reproductive age is considered to be 15-45 years.
3. What are non-financial assets?
4. Composition of financial assets of the country's national wealth.
5. Options for assessing fixed assets.
6. Name the methods for calculating depreciation for fixed assets.
7. Indicators of movement and condition of fixed assets.
Basic concepts:
Population statistics;
Average population;
Overall growth;
Natural growth;
Mechanical gain;
General growth rate;
Fertility rate;
Mortality rate;
Pokrovsky coefficient;
Infant mortality rate;
Coefficient mechanical gain population;
Working capacity rate of the entire population;
Resident population size;
Labor resources;
Working population.
Population statistics (demographic statistics) studies patterns of quantitative changes in population. In accordance with this main task, it studies: the size, composition and movement of the population; causes and factors of population changes, migration, fertility, mortality, life expectancy. It studies the composition of the population according to various criteria - gender, age, social status, education.
Objectives of population statistics:
1. Study of the number, location, demographic and socio-economic composition;
2. Analysis of reproduction and population dynamics;
3. Determination of the future size of the entire population and its individual contingents.
Population is the starting point for calculating many indicators and is of great economic and social importance. Knowledge of it is necessary for management, economic planning and social development countries. The size of a country is usually judged by its population.
The population is constantly changing due to birth and death rates, as well as due to spatial movement of the population.
The population size is determined by the state at a certain point in time, i.e. as a result of censuses. The census is currently the main method precise definition population size. However, population censuses are relatively rare, and population data is constantly required. Therefore, in the periods between censuses, statistical authorities carry out the so-called current population assessment, i.e. carry out calculations based on the latest census data and current statistics on population movements. Its calculations are updated based on the results of the next census.
There are two categories of population taken into account during population censuses: permanent settlement and existing population. TO permanent population include persons who usually live in a given locality, and cash- all persons who were in a given territory at the critical moment of the census, regardless of whether they reside here permanently or temporarily. To determine the size of the permanent population, the census process takes into account those temporarily absent and temporarily residing. Temporarily absent are permanent residents of a given locality who have temporarily left it. Thus, those temporarily absent are part of the permanent population. Temporary residents make up part of the current population.
The resident population can be determined:
Where is the current population;
Temporarily absent;
Temporary arrivals;
The average population indicator is of great importance in population statistics. Average number population can be calculated using different methods. The most accurate method is the person-years lived by the population. In this case it is determined total number person-years lived by a given population during the period of time being studied and divided by the length of this period. Often the average annual population is determined as half the sum of its size at the beginning and end of the year.
where is the population at the beginning of the year;
Population at the end of the year.
If data is available for several dates that are equal to one another, the calculation can be made using the average chronological simple formula:
If the time distance between the dates is unequal, then the calculation is carried out using the arithmetic (chronological) weighted average formula:
To calculate population changes over time, dynamics indicators are calculated.
The population is the main material component of society and the study of the patterns of its development is of great importance for the country's economy.
For each individual country, the total population can change due to two factors:
Natural movement (fertility and mortality);
Migration (mechanical) movement.
However, not only the total population size is changing, but also the composition.
Currently, statistics use four complementary sources of population data:
Population Censuses;
Current accounting of the natural movement of the population and its migration;
Sample and special demographic surveys;
Registers and various population records.
Data from these sources is used for different purposes and cannot replace each other. However, there is a close connection between them: each source complements or continues the other.
The main source of population data is the census, which is conducted once every 10 years. During this process, the population census is carried out in settlements at a certain point in time, which is called the critical moment.
When characterizing population dynamics, two circumstances must be taken into account:
1) you can compare the population of only one category (either permanent or existing);
2) if there were administrative-territorial changes, then the population data should be comparable in relation to the territory.
Total absolute population growth ()
Where - natural increase;
Mechanical gain.
S in - S out
where is the number of births;
Number of deaths;
approx. - number of arrivals;
Select - number of people leaving;
Natural growth.
Then approx. - select
Both general and natural, and migration growth can be positive or negative. Absolute increases are interval indicators; they are calculated for certain periods of time (annual indicators are of greatest importance).
Population data is presented on a territorial basis (within administrative-territorial units). Structural indicators are used to characterize the distribution of the population.
This:
1) the share of the population living in certain regions;
2) an indicator of physical population density, which is calculated as the ratio of the population to the area it occupies.
One of the main characteristics of population distribution is its division into urban and rural.
According to the accepted classification, cities are divided into:
Small - with a population of up to 50 thousand;
Medium - 50-100 thousand;
Large - 100-250 thousand;
Large - 250-1 million;
The largest - more than 1 million.
When studying fertility, mortality and natural population growth, statistics first of all determines their absolute sizes, i.e. establishes the number of births, the number of deaths and the difference between these numbers, called the absolute indicator of natural population growth. These indicators are calculated for a certain period of time - a year, a month, etc.
They also calculate relative indicators by these quantities, called coefficients.
Birth rate per 1000 people:
where is the number of births;
Average population.
Death rate per 1000 people:
where M is the number of deaths.
Natural increase rate:
or equal to the difference between the birth rate and death rate:
Natural population growth.
Population vitality rate(Pokrovsky):
shows how many newborns there are per one deceased.
Infant mortality rate (Raths formula):
where - those who died before 1 year of age;
Born;
Born in the year preceding this one.
Specific fertility rate calculated as the ratio of the number of births () to the average number of women of reproductive age (15-49 years old)
Total fertility rate(n) is equal to the product of the special fertility rate and the share of women 15-49 years old in the entire population ()
Balance of migration approx. - select
Overall absolute growth .
FERTILITY RATES, measures of the birth rate, defined as the ratio of the number of live births to the corresponding population size. Like other intensity factors demographic processes, fertility rates are classified into general, special (male and female) and private (age-specific, cumulative, etc.) rates.
The most common crude birth rate ( n ), which is calculated as
n = N/(T*P)*1000,
where T is period (years); P - population at the middle of the period (average annual population); N is the number of children born during this period. It is usually calculated in ppm (o/oo). According to the approximate rating scale proposed by B. Ts. Urlanis and V. A. Borisov, overall coefficients of less than 16 o/oo are considered low, from 16 to 24 o/oo - average, from 25 to 29 o/oo - above average, with 30 to 39o/oo are high, and 40o/oo and more are very high. The value of the total fertility rate depends not only on the intensity of the birth rate process, but also on the age, sex and marriage structure of the population, so it gives only an approximate idea of the birth rate.
Special Fertility Rate(F) - the ratio of the number of births (N) to the number of women of reproductive age, usually 15-49, sometimes (in countries with low level fertility) 15-44 years (W):
F = N/(TW) * 1000.
The general coefficient is related to the special following relationship:
where k is the share of women 15-49 years old in the entire population. The parameter k ranges from 20 to 30o/oo, so the analytical value of the special coefficient is approximately the same as the general one; the ratio between them is almost unchanged. The magnitude of the coefficient depends on the age structure of women 15-49 years old. The birth rate at 15 years of age is close to zero, between 20 and 30 years of age it reaches a maximum and tapers off by age 50. The special fertility rate is sometimes calculated for men - (FM) as the ratio of the number of births (N) to the number of men 15-49 years old (M):
FM = N/(t*M)*1000
It usually turns out to be higher than the normal special fertility rate, since there are generally fewer men than women aged 15-49 due to their higher mortality rate. The age interval for men is sometimes taken as 15-54 or 15-59 years, since the upper limit of the reproductive age of men is very arbitrary. In such cases, the special coefficient for men and women is not comparable.
More accurate measures of the birth rate are partial ratios. Most often, age-specific birth rates Fx/x+y are used, i.e. the number of births to mothers from x to x + y - 1 years inclusive (Nx/x+y), related to the average number of women of this age (Wx/x+ y):
Fx/x+y = Nx/x+y/(T*Wx/x+y) * 1000.
To calculate age-specific fertility rates for men, the distribution of births by paternal age is necessary: such data are usually not available, and corresponding indicators are rarely calculated. The values of age-specific fertility rates depend on the proportion of women of age x who are married, and on the levels of marital and extramarital fertility (and, respectively), therefore
This coefficient characterizes the average number of births per year, and over Y years, i.e. throughout the entire age interval, there will be Y times more. The age coefficient increased by Y times is called the birth rate in the age interval Fyx/x+y and is equal to Fyx/x+y = y * Fx/x+y.
In the USSR in 1978-1979, the birth rate for women 15-19 years old (inclusive) was 39.4 o/oo. This means that by the age of 20, 39.4 * 5 = 197 children are born per 1000 women. Since births before 15 years of age are very rare, this coefficient can be considered the cumulative (accumulated) fertility rate at age z = 20 years (Fz). It represents the number of births to women of a hypothetical generation who have reached z years of age over their entire previous life. Cumulative fertility rate equal to the sum age coefficients in intervals, the first of which begins at 15 years, and the last ends with age z. For Y-year intervals
For one-year intervals
The total fertility rate (Fcyм) is equal to the sum of age-specific fertility rates in all age intervals or the cumulative fertility rate by the end of the reproductive period.
Age and cumulative fertility rates in the USSR for 1978-1979
In 1978-1979 in the USSR, the total fertility rate was 2285, or 2,285 births per woman. By Y-year intervals:
at 1-year intervals:
The total fertility rate is a more accurate measure of the birth rate, since it characterizes the average number of births per woman in a hypothetical generation over her entire life, maintaining existing birth rates at each age, regardless of mortality and changes in the age composition. Total odds above 4.0 are considered high, and below 2.15 - low. The total coefficient calculated at 1-year age intervals does not depend on the age structure of the population, but it is influenced by the marriage rate. The special and partial fertility rates described above are calculated for a hypothetical generation and characterize its level in a given calendar period. Their calculations for a real generation can be carried out according to a different scheme: by summing, for example, age-specific birth rates for women 15 years old in 1945, 16 years old in 1946,..., 49 years old in 1979, one can obtain an approximate estimate of the relative number of children , born to women born in 1929-1930, i.e. women of the real generation that has completed childbearing. In practice, such calculations are rarely made due to lack of data. Therefore, the fertility characteristics of real generations are obtained by asking women during a census or population survey about the number of children born to them at the time of the survey. If the year of birth of the woman and the years of birth of each child are taken into account, it is possible to obtain cumulative fertility rates at certain ages for women of several generations.
To eliminate the influence of the marital structure, the marital fertility rate (Fm) is used, i.e. the ratio of the number of people born in marriage (Nm) to the number of married women aged 15-49 (Wm):
Fm = Nm/(T*Wm) * 1000.
The coefficient is also calculated. out-of-wedlock birth rate (Fs), i.e. the ratio of the number of people born outside of a registered marriage (Ns) to the number of unmarried women 15-49 years old (Ws):
Fs = Ns/(T*Ws) * 1000.
If the share of out-of-wedlock births depends on what part of women of reproductive age are not married and cannot serve as a characteristic of fertility, then the out-of-wedlock birth rate correctly characterizes the intensity of childbearing among unmarried women.
Fertility rate by order of birth of a child's mother (ni) - the ratio of the number of births of the i-th order (Ni) to the total population (S):
ni = Ni/(T*S) * 1000.
The total fertility rate is equal to the sum of the rates for all birth orders:
n = n1 + n2 + ... +nk,
where k is the order of last birth. To more accurately estimate such a distribution, the probability of family increase (an) is often calculated.
In addition to partial coefficients for one characteristic (mother’s age, her marital status, order of birth of the child, etc.), if appropriate data is available, partial coefficients can be calculated for several characteristics: age-specific rates of marital and extramarital fertility, marital fertility rate by duration marriage and birth order, the marital fertility rate by combination of the ages of the father and mother, etc. Since the calculation of each of these coefficients eliminates the influence of several structural factors at once, they serve valuable characteristics demographic behavior of families. At the same time, the multiplicity of these characteristics makes it difficult to obtain a general indicator. Because of this, for an in-depth study of the fertility process, not just one, but a system of interrelated indicators is used.
An analysis of all fertility rates is necessary for a correct assessment of the demographic situation and for making demographic forecasts.
L. B. Sinelnikov.
Demographic encyclopedic dictionary. - M.: Soviet Encyclopedia. Editor-in-Chief D.I. Valentey. 1985.
Calculation of demographic indicators (fertility, mortality, natural increase).
1.The age structure of the population is determined by the following formula (1.1):
B= number of persons of a certain age group: average annual populationx100%(1.1)
WhereIN - the proportion of people in the corresponding age group.
2. The sex structure of the population is calculated using formula (1.2):
P= number of persons of a certain gender: average annual population x100% (1.2)
WhereP - the proportion of persons of the corresponding gender.
3. Total fertility rate (birth rate) represents the total number of children born alive during the year per 1000 population, and is calculated using formula (1.3):
TDA = total number of births during the year: average annual population x1000 (1.3)
WhereODA - total fertility rate (birth rate).
4. Fertility rate calculated using the following formula (1.4):
P = total number of births during the year: average annual female population of fertile age (15-49years)x1000 (1.4)
WhereP - general fertility rate.
5. Overall mortality rate calculated using formula (1.5):
OPS = total number of deaths during the year: average annual population x1000 (1.5)
WhereOPS
6.Natural increase rate , determined by the difference between the birth rate and total mortality rates (formula 1.6).
EP= OPR-OPS,(1.6)
WhereEP - rate of natural increase,
ODA - total fertility rate (birth rate),
OPS - overall mortality rate.
Using the above formulas, you can determine the main demographic indicators on the territory of the region, city, in the service area of the clinic or at a specific therapeutic site.
Example. The average annual population under the supervision of a family doctor is 1,500 people, of which 225 people are under the age of 14 years, 300 are people over 50 years old, 780 are women, 15 children were born in families during the year, and 18 people died. Thus, using formulas 1.1-1.6, we can determine:
* age type of the population;
*fertility;
* mortality;
* natural population growth.
1) determination of the age type of the population:
share of persons under 14 years old = 225: 1500x100% = 15%
proportion of people over 50 years old = 300: 1500 x 100% = 20%
2) population structure by gender:
proportion of women = 780:1500 x100% =52%;
proportion of men =100% - 52% =48%
3) general birth rate:
OPR =15:1500 x 100% =10%
4) overall mortality rate:
OPS = 18:1500 x 100% = 12%
5) natural growth:
10-12=-2 (%)
Thus, characterizing demographic situation Among the families under observation, it can be noted that the age type of the population is regressive with a predominance of the female population, the birth rate is at a low level, the mortality rate is at an average level, the natural population growth is negative, that is, we can talk about an unnatural population decline. Based on these data, we can conclude that it is necessary to strengthen the activities of nurses in family planning, and attention should also be paid to protecting the health of women and the elderly.
Demographics and situation in Russia
Demography(from Greek demos- people and grapho- write) - population Science, patterns of its reproduction in connection with socio-economic and historical conditions.
Population(population) - a set of people united by a community of residence within a country or part of its territory (province, land, region, region, region, specific locality), as well as a group of countries or the whole world.
The issues that demography studies include:
Territorial distribution of the population;
Analysis of the impact on the population of various factors (ecological, medical, legal, socio-economic, living conditions, everyday life, traditions, etc.);
Identification of trends and processes occurring among the population in connection with these factors.
One of the most important characteristics of the population is its health status. Medical demography, which emerged in the early 70s of the 20th century, is engaged in identifying the relationship between demographic processes of population reproduction from the perspective of medicine and healthcare and developing, on this basis, medical and social measures aimed at ensuring the most favorable development of demographic processes and improving the health of the population. at the intersection of general demography and social medicine. The study of population is carried out using statistical methods in two main directions - the study of population statics and dynamics.
Population statics
This is the numerical composition of the population at a certain (critical) point in time.
The composition of the population is studied according to a number of basic features that characterize its structure.
These signs include:
floor;
age;
social and professional affiliation;
Family status;
the level of education;
location;
population density.
Static indicators population are needed for:
Calculation of vital statistics;
Planning of the entire healthcare system, healthcare of individual regions and treatment and preventive institutions;
Calculation of the need for outpatient, inpatient care (general and specialized);
Definitions necessary resources healthcare and a specific medical and preventive institution;
Calculation of quantitative indicators characterizing the activities of health authorities and institutions;
Organization of anti-epidemic measures.
Data on the population size and its composition are especially important for the outpatient clinic. It is the size, age and sex composition of the population that underlie the organization of local services and the organization of general medical practice.
Basic demographic statistics and methods of their calculation.
The main indicators characterizing population statics are the total number, population structure (by gender, age), population density.
Since 1992, Russia has experienced a population decline.
A very important demographic indicator is age structure of the population, allowing, in particular, based on calculating the proportion of persons aged 0-14 years, 15-49 years, 50 years and older, to determine the age type of the population.
Depending on the distribution of the population among these age groups, there are progressive, regressive and stationary types of population.
Progressive type of population is considered in those territories, regions or countries in which the proportion of persons aged 0 to 14 years exceeds the proportion of persons aged 50 years and older.
At regressive type of population On the contrary, the proportion of people aged 50 years and older exceeds the proportion of people in the age group from 0 to 14 years.
Stationary population type, in which there is equality in the number of people in these age groups.
According to this classification, the population of Russia, like most economically developed countries, belongs to regressive type .
However, due to the fact that the period of childhood includes the age from 0 to 18 years, and the age of 50 years for most countries is the age working population, many researchers consider it inappropriate to take the boundaries of 14 and 50 years as a basis for determining the age type of the population. Therefore, they believe that it is necessary to determine the level of demographic “old age” of the population according to specific gravity persons aged 60 years and older. According to this criterion, the demographically old type of population is the population of territories, regions, countries in which the proportion of people of these age groups is more than 12%.
Currently in Russia the proportion of people over working age exceeds 20%, which indicates an aging population and requires certain approaches to demographic policy country and poses a number of tasks for the organization of geriatric and gerontological care.
Population structure by age and gender:
Population dynamics
represents population movement, mobility, changes in its numbers, which can occur as a result of various processes. Due to the movement of the population, its size, age, gender, nationality, social composition, the share of the employed population and other indicators change.
There are:
social mobility, i.e. the transition of people from one social group to another, as a result of changes in financial situation, level of education, etc.;
Mechanical movement of the population ( migration) - the movement of people across the borders of certain territories associated with a change of place of residence, study or work;
natural population movement, which determines the change of generations as a result of births and deaths.
The result of these processes is, in the first case, a change in the number of people by social groups, professions, level of education, etc., in the second - changes in the settlement of people across the territory, in the third - a change in the number and age-sex structure.
Migration divided into:
Irrevocable (relocation with change of permanent residence);
Temporary (relocation for a fairly long but limited period);
Seasonal (movement during certain periods, seasons of the year);
Pendulum (regular movements outside one’s locality to the place of study or work). There are also external and internal migration.
External migration, i.e. moving outside your country is divided into:
Emigration - the movement of citizens from their country to another for a long period or permanent residence;
Immigration is the movement of citizens from another country to a given one.
Internal migration represents the movement of villages from one area of residence to another, from one territory to another, as well as the movement of residents from villages to cities - part of the urbanization process. Data on migration and departure, filled in during registration at the place of stay and received from the internal affairs bodies. Thus, population reproduction in the broad sense of the word is characterized by all three types of population changes. In a narrower sense, reproduction is understood as the process of generational change due to fertility and mortality.
The sources for obtaining factual data for demography are the results of accounting for the size and composition of the population, obtained by:
Censuses regularly conducted in economically developed countries;
Sample studies, including both demographic and social-hygienic, sociological and other types of surveys;
Current accounting of changes in the size and composition of the population based on the registration of certain demographic phenomena (births, deaths, marriages, divorces, etc.). The most accurate and reliable source for studying the size of the population, its composition, and structure are the general population censuses regularly conducted in most countries.
Dynamics indicators population allow:
Assess the health status of the population;
Forecast the needs for certain medical institutions and medical personnel;
Assess the social, demographic and medical well-being of the population;
Characterize population growth or decline;
Assess migration processes in the country and region;
Judge changes in the social status of the population.
For medical workers, the natural movement of the population and migration, which have a significant impact on the level of health, and to a lesser extent social mobility are of greater importance, although moving from one social group to another can have an adverse effect on health.
Very valuable information, including for health authorities and institutions, can be obtained by studying the dynamics of the population, in particular its migration (mechanical movement) and natural movement.
The main indicators characterizing migration processes are:
Number of arrivals to a given territory (in absolute numbers and per 1000 population);
The number of people leaving the territory (in absolute numbers and per 1000 population);
Migration increase;
Migration efficiency indicator.
Indicators are of greater importance for medical workers, health authorities and institutions natural population movement, the main types of which include:
fertility;
mortality;
natural population growth.
In addition to the main indicators characterizing the natural movement of the population, additional indicators are used that clarify the main ones (fertility, maternal mortality, infant mortality, structure of mortality by cause, age, etc.).
Fertility is a process of renewal of new generations associated with biological factors that determine the body’s ability to reproduce offspring (conception, fertilization, gestation, childbirth). When studying and analyzing fertility in human society, it should be remembered that it is determined not only by biological conditions, but also by socio-economic processes, working conditions, living conditions, marriageable age, traditions, religious attitudes and a number of other factors that determine intra-family relationships and influence to regulate the number of children born.
The birth rate is determined based on the calculation and analysis of various indicators, which include:
total fertility rate (birth rate);
general and marital fertility rates;
total fertility rate;
age-specific fertility indicators.
Total fertility rate(fertility) is the total number of live births per 1000 population during the year and is calculated using the formula.
To obtain objective and accurate data on the birth rate in a country or any of its regions, a high-quality record of absolutely all births is necessary, which is achieved by registering each newborn.
In accordance with current legislation registration of the child is carried out within a month from the date of birth by the civil registry office at the place of birth of the child or place of residence of the parents on the basis of a “Medical birth certificate” issued by the health care institution in which the birth took place.
A “medical birth certificate” is drawn up by a doctor, and in 30 settlements (usually in rural areas), where health care institutions employ paramedics - a paramedic or midwife who attends births. If a child is born outside a medical institution, a “Medical Birth Certificate” is issued by the institution whose medical worker delivered the child; When giving birth at home, the fact of birth is certified by two witnesses.
The total fertility rate is not only an important demographic, but also a medical and social criterion for the viability and reproduction of the population.
In combination with other indicators, fertility can be used as one of the indicators of the health status of the population, although it does not fully reflect the level of well-being of the population.
When assessing the birth rate, it is customary to consider the level:
Fertility rates in different regions of the country, in rural areas and cities, differ from each other. Thus, in rural areas there was a sharper decline in the birth rate.
Over the past 25 years, in about 30 economically underdeveloped countries, the birth rate has also declined, but in many countries in Africa, Latin America, as well as in India and Bangladesh, this has not happened.
However, the general birth rate indicator gives only a general characteristic of the process, but does not allow one to accurately judge the intensity of this phenomenon, therefore, for more accurate estimates of the birth rate, special indicators are used - general and marital fertility rates, which are calculated per 1000 women of childbearing age (from 15 to 49 years). The number of births before and after this age is not significant, and therefore it is neglected in calculations.
The total fertility rate is the number of live births per 1,000 women aged 15 to 49 years, and the marital fertility rate is the number of births per 1,000 married women of fertile* age.
In addition to these coefficients, fertility is specified according to age-specific fertility indicators, for which the entire period of childbearing age is divided into separate intervals (1 5 -1 9, 2 0 -2 4, 2 5 -2 9, 3 0 -3 4, 3 5 -3 9, 40 -4 4, 4 5 -4 9 years) and determine the number of live births per 1000 women of the corresponding age group.
The most important indicators of vital statistics include mortality rates, the interaction between which and fertility indicators characterizes the replacement of one generation by another, population reproduction.
The overall mortality rate of the population in a country or region is characterized using overall mortality rate, which represents the number of deaths (M) per 1000 population to the average annual population (S):
Obtaining accurate data on mortality depends on the correct recording of each death, which is registered in the civil registry office on the basis of a “Medical Death Certificate” issued in health care institutions by the doctor who determined the death of the patient or treated the deceased. A “medical death certificate” can also be issued to secondary medical worker(paramedic) based on observation of the patient and records in the medical documentation.
During the 20th century. in Russia as a whole there was a decrease in overall mortality. Thus, if at the beginning of the century the overall mortality rate was 35-50%, then already in 1940 it dropped to 18%, and in 1969 it reached its lowest value for the entire period of observation and amounted to 6.9%. After this, there was a gradual increase in the overall mortality rate with periods of its relative decrease (from 1985 to 1989, from 1996 to 1998), and by the end of 2003 it reached 16.4%.
The overall mortality rate in economically developed countries is at the average level, and no sharp increase has been observed. The overall mortality rate provides only an approximate estimate of mortality and allows us to identify general trends, but its age-sex indicators more accurately characterize the mortality process.
Mortality rate of the corresponding age group (from 0 to 1 year, from 1 year to 4 years, from 5 to 9 years, ..., from 50 to 54 years, from 55 to 60 years, ..., 85 years and older) calculated by the formula:
The age-specific mortality rate among men and women is calculated similarly. The highest age-specific mortality rate is observed at the age of 85 years and older (207.2%o), and the lowest - in the age groups 5-9 and 10-14 years (0.5%o). The mortality rate for males is higher than that for females, not only in general, but also in certain age groups, and more intensive growth This indicator is observed among men.
Among age-specific mortality rates, a special place is occupied by infant mortality rate, the calculation of which has its own characteristics.
This indicator quite accurately reflects the level of healthcare development in the country, in particular the maternal and child health care system, the effectiveness of measures taken to reduce child mortality, and makes it possible to plan and take measures to reduce it.
Indicators of maternal death are also taken into account, which are calculated using the formula:
Among the vital statistics indicators, an important place belongs to the indicator natural population growth, which serves as the most general characteristic of population growth in a country or region. Natural population growth can be expressed in absolute numbers as the difference between the number of births and deaths in given year, but more often it is calculated as an indicator of natural increase, determined by the difference between the birth rate and total mortality rates:
Since 1992, Russia - for the first time in the entire history of the country (with the exception of periods of war) - has experienced negative natural growth (unnatural population decline), which in 1999 reached a level of 6.8%0 (see Table 1.3). Many economically the developed countries pass through periods of negative natural population growth (Austria in 1975-1985, Germany in 1970-1994, Hungary in 1980-1994, Denmark in 1981-1987, Italy in 1993-1994).
Negative natural growth is one of the unfavorable demographic phenomena, indicating a reduction in the population, its depopulation , or extinction. Negative natural growth is evidence of obvious disadvantage in society and reflects the unfavorable socio-economic situation in the country. In recent years, there has been a certain tendency in Russia to reduce the unnatural population decline, and in some regions (17 in 2003) natural population growth has been recorded. However, natural population growth itself does not always reflect the demographic situation. Since the same growth rates can be obtained with different indicators of fertility and mortality, natural increase is assessed taking into account these indicators.
Studying the structure of causes of death, as well as determining the average life expectancy indicator, is important for characterizing the health of the population and planning measures to protect it.
Structure of causes of mortality:
among the adult population
Average life expectancy (ALE) represents the hypothetical number of years that a generation of simultaneously born or peers of a certain age will live, provided that age-specific mortality rates remain at the level of the year for which the calculation was made.
In addition to demographic indicators characterizing the level of health of the population, other indicators (morbidity, disability, physical development) are also used to assess it. The leading indicator for assessing the health of the population is morbidity.
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