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Vital Statistics: Census & Fertility
Professor Michael Clarke
Dept of Epidemiology & Public Health
Uses of EpidemiologyJ.N. Morris
1. Size of Problem
2. Historical Perspective
3. Aetiological Factors
4. Planning and Evaluating Services
ObjectivesFollowing the session, you should be able
to:• Outline and distinguish between the
processes of birth registration and notification
• Discuss the main determinants of fertility in the UK over the last 30 years
• Define and illustrate the use of:a. The crude birth rateb. The general fertility ratec. Age-specific fertility rates
Objectives
• Outline the changes in fertility and mortality that have occurred in England during the last one hundred years
• Describe the uses and limitations of population estimates and projections
Objectives• Describe the characteristics of the
national census and outline the history of census taking in England
• List the major items of information collected in the English 1991 census and the relevance of these data to health and social services
• Illustrate how demographic characteristics of populations determine health and social service priorities
Birth Statistics
Registration
Notification
Birth Statistics
1. Registration of Births (1837)
Birth to be registered within six weeks with the Registrar of Births, Marriages and Deaths, by an informant (usually the parent).
Birth Statistics
2. Notifications of Births (1907)
Within 36 hours by the attendant at the delivery, to the District Medical Officer – so community services (health visitors) can be mobilised.
Birth Rate
• Live Births / 1000 population
Age -14 15-44 45+
Males
Females
Fertility Rate
• Live Births / 1000 female population aged 15 -
44 Age -14 15-44 45+
Males
Females
Total Period Fertility Rate
“ The average number of children that would be born to a hypothetical woman if she experienced the age specific fertility rates of a given year (or period) throughout her child bearing life.”
Ugh!!
E.g. England & Wales - 1992
aged 16 ……. have 3,800 .0126
aged 17 ……. have 8,882 .0294
aged 28 .1205
aged 44
Total Period Fertility Rate 1.7
N.B. There were 222 live births to women aged less than 15 yrs in 1992 in Wales
Women aged 15 (301,600) have 1,090 births .0036
Fertility & Abortions in England and Wales & Selected Health Authorities - 1985
TPFR TPAR TPCR
England & Wales 1.8 0.4 2.2
Leicestershire HA 1.8 0.3 2.1
Bradford HA 2.2 0.3 2.4
Islington HA 1.7 0.8 2.5
Tower Hamlets HA 2.6 0.8 3.5TPFR = Total Period Fertility Rate
TPAR = Total Period Abortion Rate
TPCR = Total Period Conception Rate
Determinants of Fertility
1. Fecundity – physiological ability to reproduce. (fertility - realisation of the potential) Increase in sterilisation & Hysterectomies
2. Sexual activity Economic climate
Determinants of Fertility
3. Contraception (Bone, 1978) Fecund, not preparing nor trying to conceive.
- pill - I.U.D. - C.I. - Condom - Cap - Other - None
42% 9% 7% 25% 3% 6% 11%
Contraception – Current use for women aged 16-49 in Great Britain, 1993
0 5 10 15 20 25 30
Pill
Condom
IUD
Withdrawal
Other non-surgical*
Male sterilisation
Female sterilisation
No sexual relationship
Pregnant
Other non-users
Percentage
* Includes the cap, safe period, spermicides and injection
Trends in contraceptive use 1970-1983
0
5
10
15
20
25
30
35
Perc
enta
ge
Sterilisation
IUD/ Cap
Withdrawal
Pill
Condom
1970
Family planning: changes and effects (England & Wales), M Bone
1976
Family formation survey 1976 (GB), K Dunnell
1983
General Household Survey 1983 (GB)
Determinants of Fertility
4. Abortion - 179,590 England and Wales 1997
Population Estimates & Projections
• Estimates Apply what is known from deaths, births, migration – to the present.
• Projections Future orientated given certain assumptions.
Population Estimates – E.g. Leicestershire
1981 858.8 Census Base
1989 Migration
+ 9.4 excess inflow over outflow
+23.8 excess births over deaths
892.0
Actual & Projected Live Births, 1966-94 England and Wales
450
550
650
750
850
950
1966 1977 1986
Low variant
Principal
High variant
Actual
Actual & Projected Live Births, 1966-94 England and Wales
450
550
650
750
850
950
1966 1977 1986
Actual
High variant
Principal
Low variant
The Decennial Census
• A census is (United Nations definition)
‘the simultaneous recording of demographic data by the government at a particular time, pertaining to all persons who live in a particular territory’
Therefore a census is:
• Run by government
• Covers a defined area
• Personal enumeration (or a person in each household)
• Simultaneous
• Universal
• Regular intervals (10 yrs England & Wales)
The census describes
• Households and
• People
See 1991 specimen form in Handbook
Census data provides information of value to health workers:1. Population structure, young, old, very old,
ethnic minorities, household amenities – which in turn determine the structure of services.
2. Base populations for the calculation of fertility and mortality rates.
3. Deprivation measures e.g. DoE Index unemployment, overcrowding, lone pensioners, single parents, born in the new commonwealth, lacking basic amenities
Europe: population by age and sex, 1950 - 2040
030 20 10 0Population (000s)
>8075-7970-7465-6960-6455-5950-5445-4940-4435-3930-3425-2920-2415-1910-14
5-90-4
10 20 30
1950Male Female
Europe: population by age and sex, 1950 - 2040
030 20 10 0Population (000s)
>8075-7970-7465-6960-6455-5950-5445-4940-4435-3930-3425-2920-2415-1910-14
5-90-4
10 20 30
2000Male Female
Europe: population by age and sex, 1950 - 2040
030 20 10 0Population (000s)
>8075-7970-7465-6960-6455-5950-5445-4940-4435-3930-3425-2920-2415-1910-14
5-90-4
10 20 30
2040Male Female
70-74
65-69
60-64
55-59
50-54
45-49
40-44
35-39
30-34
25-29
Population of Asians and Non-Asians in Leicester in 1988
0
Percentage
5101520 0 5 10 15 20
FemalesMales
AsiansNon Asians
70-74
65-69
60-64
55-59
50-54
45-49
40-44
35-39
30-34
25-29
Projected sub-populations in Leicester in 2008
0
Percentage
5101520 0 5 10 15 20
FemalesMales
AsiansNon Asians