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Mortality

Mortality is simply defined as death, and it is the end result of life. A mortality rate is the proportion of deaths in a given place over a specified period of time. The numerator includes the number of persons who died in a given geographic area over a period of time, and the denominator is the total population in the same geographic area. The mortality rate is generally reported as a proportion of deaths per 1,000, 10,000, or 100,000 individuals. In health services research, mortality rates are often used as general indicators of the health and well-being of groups and populations.

Overview

Mortality rates are based on death data that come from vital statistics registries. Vital statistics include all the prominent life events: births, marriages, divorces, and deaths. The registration of all these life events is required in the United States, and state health departments compile vital statistics summaries on deaths. The primary source of death information in the United States is the standardized death certificate, which is kept by individual state health departments and is completed by physicians or coroners at the local level. The major components of the death certificate include personal identifiers, demographic information, and the manner and cause of death.

Mortality Rates and Ratios

There are many types of mortality rates and ratios, for example, the crude mortality rate, age-standardized mortality rate, disease-specific mortality rate, and infant mortality rate. Each type of mortality rate and ratio has its specific uses and limitations. The following are the most common types of mortality rates.

The Crude Mortality Rate

A crude mortality rate represents a rough estimate of mortality and is seldom used because it does not take into account the variations in a group's or population's age composition. The crude mortality rate is calculated by taking the total number of deaths during a 1-year period divided by the total population midyear for a specified geographic area. The rate is usually presented as deaths per 100,000 individuals. Crude mortality rates can sometimes be misleading. For example, a developed country may have a higher crude mortality rate than a developing country because of the increased number of elderly who may die in a given year. Therefore, mortality rates generally should be standardized to reflect this difference in population characteristics.

The Age-Standardized Mortality Rate

An age-standardized mortality rate is determined by taking the number of deaths in a specific age cohort occurring during 1 year divided by the midyear population of the specific age cohort. The derived rate is usually presented in terms of deaths per 1,000 or 100,000 individuals. Age-specific rates are refinements on the crude mortality rates. Note that, in putting a limitation on age, the same restriction must be applied to both the numerator and denominator, so that every individual in the denominator group will be at risk for entering the numerator group.

The Disease-Specific Mortality Rate

The disease-specific mortality rate is specified for a certain disease, such as tuberculosis or HIV/AIDS. The numerator in this rate is the number of deaths from a specific cause or disease and the denominator is the total population at midyear. Again, these rates are usually expressed in terms of annual mortality figures from a specific cause per 1,000 or 100,000 individuals.

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