Measures of Central Tendency, Dispersion, and Location

Data Presentation
Vital Statistics
Emilio Q. Villanueva III, MD, MSPH (Biostat)(c), DPSP
Assistant Professor 3, School of Medical Technology, PWU-Manila
Measures of Central Tendency,
Dispersion, and Location
Summary Measures
• Methods of compressing a mass of data for better comprehension
and description of what it tends to portray
• Categorized into:
• Measures of central tendency
• Measures of dispersion
• Measures of location
Measures of Central Tendency
• Refers to the “center” of a distribution of observations
• Refers to “typical” values which may be utilized to represent a series
of observations
• Most common measures of central tendency include:
• Mean
• Median
• Mode
(Arithmetic) Mean
• Also known as the “average”

σ𝑛𝑖=1 𝑥𝑖 𝑥1 + 𝑥2 + 𝑥3 + ⋯ + 𝑥𝑛
𝑥ҧ = =
𝑛 𝑛
(Arithmetic) Mean
• Characteristics:
• Involves all observations in its composition
• Any change in the observation, even in just one value, will change the mean
• Sensitive to extreme observations
• Its unit is the same as that of the original set of observations from which it
was derived
(Arithmetic) Mean
• Characteristics:
• It can be calculated for any quantitative variable
• The sum of the deviations of the observations from the mean is equal to zero
– point of balance or center of gravity of the distribution
• Serves as the basis for the computation of higher statistical methods
• Easy to calculate manually if the observations are few
• SPSS can be used to compute the mean of a large set of observations
(Arithmetic) Mean
• Weight of a set of MSMT Students
Student Weight (Kg)
1 40 σ𝑛𝑖=1 𝑥𝑖 𝑥1 + 𝑥2 + 𝑥3 + ⋯ + 𝑥𝑛
𝑥ҧ = =
𝑛 𝑛
2 50
3 48 40 + 50 + 48 + 48 + 67 + 70 + 100 + 58 + 55 + 54 + 60
𝑥ҧ =
4 48 11

5 67 𝑥ҧ = 59.09 𝐾𝑔
6 70
7 100
8 58 INTERPRETATION: The average weight of the
9 55 MSMT students is 59.09 Kg.
10 54
11 60
Median
• The middlemost value in a set of observations put in an array

𝑥෤ = 𝑚𝑖𝑑𝑑𝑙𝑒 𝑚𝑜𝑠𝑡 𝑜𝑏𝑠𝑒𝑟𝑣𝑎𝑡𝑖𝑜𝑛, 𝑖𝑓 𝑛 𝑖𝑠 𝑜𝑑𝑑

𝑥෤ = 𝑚𝑒𝑎𝑛 𝑜𝑓 2 𝑚𝑖𝑑𝑑𝑙𝑒𝑚𝑜𝑠𝑡 𝑜𝑏𝑠𝑒𝑟𝑣𝑎𝑡𝑖𝑜𝑛𝑠, 𝑖𝑓 𝑛 𝑖𝑠 𝑒𝑣𝑒𝑛

𝑛+1
• Position of the median in an array can be computed as
2
Median
• Characteristics:
• Like the mean, it always exists and is unique
• Not influenced by outliers
• Does not make use of all the observations in its computation
• It can be calculated for quantitative variable and variable in the ordinal scale
• Easily determined if number of observations are few
• SPSS can be used to compute the mean of a large set of observations
 Student Weight (Kg) i
1 40 1
Median 3 48 2
4 48 3
4
• Weight of a set of MSMT Students 2 50
10 54 5
Student Weight (Kg)
9 55 6
1 40
8 58 7
2 50
11 60 8
3 48
5 67 9
4 48
6 70 10
5 67
7 100 11
6 70
7 100 𝑛 + 1 11 + 1
Position of the Median = = = 6𝑡ℎ
8 58 2 2
9 55
10 54 INTERPRETATION: 50% of the MSMT students weigh 55 Kg
11 60 or less, while the other half weighs more than 55 Kg.
Mode
• The most frequently occurring value in a set of observations
• It is possible to have:
• No mode
• One mode – Unimodal
• Two modes – Bimodal
• More than 2 modes – Multimodal
• No calculation needed
• May be determined for any type of variable/ level of measurement
Mode
• Easily determined if number of observations are few
• SPSS can be used to compute the mean of a large set of observations
 Student Weight (Kg) i
1 40 1
Mode 3 48 2
4 48 3
4
• Weight of a set of MSMT Students 2 50
10 54 5
Student Weight (Kg)
9 55 6
1 40
8 58 7
2 50
11 60 8
3 48
5 67 9
4 48
6 70 10
5 67
7 100 11
6 70
7 100 𝑀𝑜𝑑𝑒 = 48 𝐾𝑔
8 58
9 55
10 54 INTERPRETATION: The most usual weight of the
11 60 MSMT students is 48 Kg.
Location of the Measures of Central Tendency
• Symmetrical
𝑥ҧ = 𝑥෤ = 𝑥ො
Location of the Measures of Central Tendency
• Skewed to the right
𝑥ҧ > 𝑥෤ > 𝑥ො
Location of the Measures of Central Tendency
• Skewed to the left
𝑥ҧ < 𝑥෤ < 𝑥ො
Guidelines in Choosing the Measure of
Central Tendency to Use
• Nature of Distribution
• Normal distribution – any of the three
• If skewed distribution or with outliers – mean not desirable; may use median
instead
• Summary measure desired
• Depends on the objectives of the study
Measures of Dispersion
• Gives information as to the tendency of values to clump together
• Tools describing the variability of the observations
• Homogenous – with little difference between adjacent observations
• Heterogenous – observations are scattered around the mean
Measures of Dispersion
• May be used for quantitative variables only
• Most common measures of dispersion include
• Range
• Variance
• Standard deviation
• Coefficient of variation
Range
• The simplest measure of variability

𝑅𝑎𝑛𝑔𝑒 = 𝐻𝑖𝑔ℎ𝑒𝑠𝑡 𝑂𝑏𝑠𝑒𝑟𝑣𝑎𝑡𝑖𝑜𝑛 − 𝐿𝑜𝑤𝑒𝑠𝑡 𝑂𝑏𝑠𝑒𝑟𝑣𝑎𝑡𝑖𝑜𝑛

• It does not tell anything about the observations between these two
extreme observations
• May be used only for quantitative variables
• SPSS can be used to find the lowest and highest observation
 Student Weight (Kg) i
1 40 1
Range 3 48 2
4 48 3
4
• Weight of a set of MSMT Students 2 50
10 54 5
Student Weight (Kg)
9 55 6
1 40
8 58 7
2 50
11 60 8
3 48
5 67 9
4 48
6 70 10
5 67
7 100 11
6 70
7 100 𝑅𝑎𝑛𝑔𝑒 = 𝐻𝑖𝑔ℎ𝑒𝑠𝑡 𝑂𝑏𝑠𝑒𝑟𝑣𝑎𝑡𝑖𝑜𝑛 − 𝐿𝑜𝑤𝑒𝑠𝑡 𝑂𝑏𝑠𝑒𝑟𝑣𝑎𝑡𝑖𝑜𝑛
8 58
𝑅𝑎𝑛𝑔𝑒 = 100 − 40
9 55
10 54 𝑅𝑎𝑛𝑔𝑒 = 60 𝐾𝑔
11 60
Variance
• A measure of variability that takes the mean as the reference point

𝑛 2
2
σ𝑖=1 𝑥𝑖 − 𝑥ҧ 𝑠𝑢𝑚 𝑜𝑓 𝑠𝑞𝑢𝑎𝑟𝑒𝑑 𝑑𝑒𝑣𝑖𝑎𝑡𝑖𝑜𝑛𝑠
𝑠 = =
𝑛−1 𝑛𝑢𝑚𝑏𝑒𝑟 𝑜𝑓 𝑜𝑏𝑠𝑒𝑟𝑣𝑎𝑡𝑖𝑜𝑛𝑠 − 1
Variance
• Characteristics
• Involves all observations in its computation
• Its unit is the squared unit of the original set of observations
• Hard to interpret and is abstract in many instances
• Easily determined if number of observations are few
• SPSS can be used to compute the mean of a large set of observations
Variance
Student Weight Deviation from Mean Squared Deviation from the mean mean = 59.09
(Kg) (𝑥𝑖 − 𝑥)ҧ 𝑥𝑖 − 𝑥ҧ 2
1 40 -19.09 364.46
2 50 -9.09 82.64 σ𝑛𝑖=1 𝑥𝑖 − 𝑥ҧ 2

3 48 𝑠2 =
-11.09 123.01 𝑛−1
4 48 -11.09 123.01 2592.91
5 67 7.91 62.55 𝑠2 =
11 − 1
6 70 10.91 119.01
𝑠 2 = 259.29 Kg2
7 100 40.91 1673.55
8 58 -1.09 1.19
9 55 -4.09 16.74
10 54 -5.09 25.92
11 60 0.91 0.83
Standard Deviation
• Square root of the variance
• Unit is the same as that of the original set of observations
• Can be better interpreted than the variance

σ𝑛𝑖=1 𝑥𝑖 − 𝑥ҧ 2
𝑠= = 𝑠𝑞𝑢𝑎𝑟𝑒 𝑟𝑜𝑜𝑡 𝑜𝑓 𝑡ℎ𝑒 𝑣𝑎𝑟𝑖𝑎𝑛𝑐𝑒
𝑛−1

• SPSS can be used to compute the mean of a large set of observations

Standard Deviation
Student Weight Deviation from Mean Squared Deviation from the mean
(Kg) (𝑥𝑖 − 𝑥)ҧ 𝑥𝑖 − 𝑥ҧ 2
1 40 -19.09 364.46
2 50 -9.09 82.64 σ𝑛𝑖=1 𝑥𝑖 − 𝑥ҧ 2
𝑠=
3 48 𝑛−1
-11.09 123.01
4 48 -11.09 123.01
5 67 2592.91
7.91 62.55 𝑠=
6 70 11 − 1
10.91 119.01
7 100 40.91 1673.55 𝑠 = 16.10 𝐾𝑔
8 58 -1.09 1.19
9 55 -4.09 16.74
10 54 -5.09 25.92
11 60 0.91 0.83
Coefficient of Variation
• Measure of relative dispersion that expresses the standard deviation
as a percentage of the mean
• Most appropriate when:
• The units of measurement of the variables being compared are different
• The means being compared are markedly different

𝑠 𝑠𝑡𝑎𝑛𝑑𝑎𝑟𝑑 𝑑𝑒𝑣𝑖𝑎𝑡𝑖𝑜𝑛
𝑐𝑣 = =
𝑥ҧ 𝑚𝑒𝑎𝑛
Coefficient of Variation
Student Weight Deviation from Mean Squared Deviation from the mean
(Kg) (𝑥𝑖 − 𝑥)ҧ 𝑥𝑖 − 𝑥ҧ 2
1 40 -19.09 364.46 𝑠
2 50 𝑐𝑣 = 𝑥100
-9.09 82.64 𝑥ҧ
3 48 -11.09 123.01 16.10
4 48 𝑐𝑣 = 𝑥100
-11.09 123.01 59.05
5 67 7.91 62.55
𝑐𝑣 = 27%
6 70 10.91 119.01
7 100 40.91 1673.55
8 58 -1.09 1.19
9 55 -4.09 16.74
10 54 -5.09 25.92
11 60 0.91 0.83
General Interpretation of the Measures of
Dispersion
• If the value of the measure of dispersion is high or large, the
distribution of the observation are said to be heterogenous
• If the value of the measure of dispersion is low or small, the
distribution of the observations are said to be homogenous
Measures of Location
• Measures that aid in determining the relative position of a particular
value in an array of observations
• Provide more details about a part of the entire distribution of
observations in a given data
• May be used for both quantitative and qualitative variables
• Common measures of location include:
• Quartiles
• Deciles
• Percentiles
Quartiles
• Points in the distribution that divides the observations into four equal
parts
Decile
• Points in the distribution that divides the observations into ten equal
parts
Percentile
• Points in the distribution that divides the observations into one-
hundred equal parts
Relationship of Different Measures of
Location
Determining the Value of a Measure of
Location Using Cumulative Percentage
• Cumulative percentage
• The sum of the percentages on the same row and previous rows
• The last value will always be equal to 100%

• To find the value of a particular percentile, refer to the cumulative

percentage equal or higher than the percentile that you are after
• To find deciles and quartiles, first determine its equivalent percentile
65th Percentile, 4 th Decile, 3 rd Quartile
Stude Weight (Kg) i Percent Cumulative Percent
nt
1 40 1 6% 6%
3 48 2 7% 14% 65𝑡ℎ 𝑃𝑒𝑟𝑐𝑒𝑛𝑡𝑖𝑙𝑒 = 67 𝐾𝑔
4 48 3 7% 21%
4𝑡ℎ 𝐷𝑒𝑐𝑖𝑙𝑒 = 55 𝐾𝑔
2 50 4 8% 29%
10 54 5 8% 37% 3𝑟𝑑 𝑄𝑢𝑎𝑟𝑡𝑖𝑙𝑒 = 70 𝐾𝑔
9 55 6 8% 45%
8 58 7 9% 54%
11 60 8 9% 64%
5 67 9 10% 74%
6 70 10 11% 85%
7 100 11 15% 100%
Total 650
Data Presentation
Presentation of Data
• Textual Presentation
• Tabular Presentation
• Graphical Presentation

• Purposes:
• Display the data clearly and effectively
• Allow the viewer to think about what the data convey
• Encourage the reader to make comparisons
Presentation of Data
• Display the data
• Allow the viewer to think about what the data convey
• Avoid distortion of the data
• Encourage the reader to make comparison
• Serve a reasonably clear purpose:
• description, exploration or tabulation
• Be closely related to the statistical and verbal descriptions of the data
set
Textual
• Uses statements with few numbers in order to describe the data
purposely to get attention to some significant data

• Advantages
• Appropriate when there are few figures to be presented
• Gives emphasis to significant figures
• Disadvantages
• Data is incomprehensible when the large quantitative data are included in the
paragraph
• Paragraph involving many figures can be tiresome to most readers when the
same words are repeated many times
Tabular Presentation
• Data presented in a table is referred to as “tabular presentation”
• Table is an orderly arrangement of statistical data into rows and
columns with some predetermined aim or purpose
• The purpose of the table is to simplify presentation of related data
and make comparisons easy
Table
• Advantages
• Concise and easy to understand
• Facilitates analysis of categories of the given variable
• Presents data in more detail
• Aids in graph or chart construction

• Disadvantages
• Too many rows or columns could make it difficult for the reader to understand
the data
• Requires more time to construct
Prime Consideration in Table Construction
• Simplicity
• clean, professional and uniform look devoid of frills and unnecessary
markings
• Clarity
• jive with textual discussion and does not appear out of place; may be
achieved by having clear, concise headings, uncluttered footnotes, minimum
number of variables included, well-spaced columns or rows, etc.
• Directness
• Include only those that are necessary
Pointers to Achieve the Norms in Table
Construction
• Position of the table
• Position the table immediately after the text where it is first cited
• Uniformity of style
• Standardize a particular style for a single report to avoid unnecessary
confusion on the part of the reader
• Number of variables presented should be kept to a minimum (at most
3 variables in a table)
• Every table should be self-explanatory
Construction of Table
• Guidelines for aligning
• Align text in a table to the left
• Text that serves as a column label may be centered
• Numeric values should be aligned to the right
• If the numeric values contain decimals, they should be decimal-aligned
Construction of Table
• Check the table to be sure that
• All sources are specified
• Headings are specific for every column and row
• Row and column totals are checked for accuracy
• Cells are not left blank. Enter “0” or “-”
• Categories are mutually exclusive and exhaustive
Essential Components of Table
Number Relative position of the table. It is placed on the same line as the opening of the title,
separated from the title by a period
Title Brief statement about the table presented. The title would be as complete as possible
and should clearly relate the content of the table. What, Who, Where, When
Box Head The box head contains the captions or column heading
Stub The row captions are known as the stub. Items in the stub should be grouped to facilitate
interpretation of data
Body The main part of the table which contains the information
Footnotes Any statement inserted at the bottom of the table
Source The exact reference to the source should be given if the data presented are not original
Types of Table
• Master Table
• Dummy Table
• Tables by number of variables presented
• One-way table
• Two-way table
• Multi-way table
Master Table
• A single table which shows the distribution of observations across
many variables of interest in a given study; each observation is cross-
classified across the variables which may be quantitative or
qualitative in nature

• Purpose:
• Way of storing information with an aim of presenting detailed statistical data
• Facilitate generation and tabulation of smaller table
Dummy Table
• Dummy tables are skeleton tables which do not contain figures but
give a preview of what outputs may be expected from the study (i.e.,
it shows how the data will be organized and displayed)

• Uses
• help researcher clarify instrument
• help protocol reviewer
• help computer programmer
Frequency Distribution
• Classifies data into groups

• Class interval – a grouping defining a class

• Class limits – end numbers of a class interval
• lower limit
• upper limit
• Class boundaries – characterize the class intervals
• lower limit – half the last significant figure
• upper limit + half the last significant figure
Frequency Distribution
• Class mark 0 the midpoint of the class interval and is obtained by
(lower limit + upper limit) divided by 2
• Cumulative frequency – taking successive totals of given frequencies
Frequency Distribution
• Steps
1. Find the lowest and highest observations
2. Obtain the range
3. Decide on the number of class intervals
4. Determine the interval size by dividing step 2 by the desired number of class
intervals, unless specified;
5. Choose an appropriate lower limit for the first class interval
6. Write the lowest limit at the bottom and from it, develop the lower limits of
the next higher class intervals by adding the interval size to a preceding
lower limit until the highest observation is included. From the lowest limits,
develop also the corresponding upper limits
Frequency Distribution
• Steps
7. Read each observation in a given data and record a tally for it opposite the
class interval to which it belongs
8. Count the number of tallies falling within each class interval to get the
frequency of each class interval
9. Accumulate the frequencies to get the total number of observations
Frequency Distribution
• Systolic Blood Pressure (in mmHg) of 80 randomly selected patients at hospital X, 2005.

70 86 111 113 131 147 162 177

206 202 162 170 140 150 125 122
70 80 170 169 139 147 120 114
82 84 180 130 115 158 115 117
85 78 190 141 120 116 100 120
90 95 116 132 127 120 110 116
93 87 120 146 101 125 120 120
176 90 125 150 110 131 125 119
190 93 147 163 135 135 110 128
117 100 150 173 140 105 109 110
Frequency Distribution
SBP No. of Patients Class Class Cumulative
(mmHg) (Frequency) Boundary Mark Frequency
196-209 2 195.5-209.5 202.5 80
182-195 2 181.5-195.5 188.5 78
168-181 7 167.5-181.5 174.5 76
154-167 4 153.5-167.5 160.5 69
140-153 10 139.5-153.5 146.5 65
126-139 9 125.5-139.5 132.5 55
112-125 22 111.-125.5 118.5 46
98-111 10 97.5-111.5 14.5 24
84-97 9 83.5-97.5 0.5 14
70-83 5 69.5-83.5 76.5 5
Graph
• Pictorial representations of certain quantities plotted with reference
to a set of axes
• Visually summarize the variables
• Used for illustration purposes depending on the levels of
measurement, types of variables, and the issues of interest.
Graph
• Advantages:
• Easy viewing
• More attractive and appealing to a wider range of readers
• Simplifies concepts
• Shows trends and patterns of large set of data more apparently
• Comparisons could be made more striking
• Can readily clarify data; bring out hidden facts and relationships
Graph
• Disadvantages:
• Detailed information may not be shown
• Only show approximate values
• Require more time to construct
• May be used to misrepresent results
Graph
• Guidelines:
1. Should be self-explanatory
• have clear and concise title
• title may be placed at the top or bottom of the graph
2. Vertical and horizontal scales should be properly labeled
3. Properly identified with labels or legend trend lines or curves if there are
more than one of them
4. Grids or guide rulings should be appropriately used
Graph
5. Simple, neat, and business-like quality devoid of a unnecessary trimmings
and draftsmanship; simplest graph is usually the most effective
6. Proper use of the axes
7. Vertical scale always start with zero and zero point should be properly
identified
8. Use colors or degrees of shading for emphasis or to differentiate between
items
9. Equal distances between tick marks on an axis should represent equal
numerical units.
Bar Graph
• Consisting of bars of the same sizes, which are drawn horizontally or
vertically with gaps between them to emphasize discontinuities
• Heights of bars or rectangles show the quantity of the variables we
want to present and are proportional to the frequencies or rates of
the categories
• Width of bars or rectangles should all be equal
Bar Graph
• Percentages or rates must be used when the total number of
observations for the groups are not uniform
• When percentages are used, the sum of the heights of all the bars
must equal to 100%
• May be colored or shaded in different ways
• Used to compare absolute or relative counts, rates, etc. between
categories of a qualitative or a discrete quantitative variable
Horizontal Bar Graph
• Usually used for qualitative variables, i.e. categories of qualitative
variables may be arranged by magnitude of corresponding figures of
natural ordering
Horizontal Bar Graph
Vertical Bar Graph
• Used for discrete quantitative variables, i.e., categories of a discrete
quantitative variable must follow natural ordering say number of
pregnancies, number of prenatal visits, etc.
Vertical Bar Graph
Pie Chart
• Circle subdivided into “slices”
• Area of each slice represents the relative proportion data points
falling into a given category
• Angle of each wedge is determined by multiplying the percentage
contribution of the component by 3.6
• To highlight a specific component, a slice may be “exploded” or
slightly elevated
• Used to show how a whole is divided into its component parts which
could be breakdowns of groups or totals.
Pie Chart
Component Bar Graph
• Each bar is divided into smaller rectangles representing the parts
• The area of each smaller rectangle is proportional to the relative
contribution of the component to the whole
• Generally used for nominal data
• Different shades or colors can be applied to the components to
emphasize differences between parts of the whole
• Preferable over the pie chart in situations where the compositions of
two or more groups are to be compared
Component Bar Graph
• Similar to the pie chart – used to show how a whole is divided into its
component parts which could be breakdowns of groups or totals
• Useful for comparing the contributions of different groups to the total
value of a variable. They can also compare two identical nominal data
sets under different conditions, especially at different times.
Component Bar Graph
Line Graph
• Plot of dots (representing values of the variable) joined with lines
over some period of time in sequential series
• Used to visually represent trends over time (time-series charts)
• Time series – Horizontal axis
• Variable values – Vertical axis
• Portray trends (changes in the variable with time)
Line Graph
Histogram
• Rectangle/bar – used to depict number or relative frequencies of data
points falling into the given class
• Rectangles are drawn over the true limits of the classes or groupings – no
gaps exist between the rectangles
• Horizontal axis is a continuous scale showing the units of measurement of
the variable and the vertical axis shows the number of relative frequencies
• Are of rectangle is proportional to both the frequency and the width of the
class hence comparisons must be based on the area and not on the height
of the rectangle
• Graphical representations of the frequency distribution of a continuous
variable including age
Histogram
Frequency Polygon
• Similar to the histogram except that
• The frequencies are plotted against the corresponding midpoints of the
classes
• Adjacent points are joined with lines and the plot is tied down to the
horizontal axis resulting in a multisided polygon

• Function is same as the histogram

Frequency Polygon
Stem-and-Leaf Plot
• Relatively new method for graphing primarily for small set of
quantitative data
• Provides the rank-ordered lists and it is easier to restore the original
value of the observations
• Lines in a stem-and-leaf plot give more information than the bars in
the histogram
• Used to show the actual data values instead of using bars to
represent the height of an interval
Stem-and-Leaf Plot
Box Plot
• Useful tool for showing description of a large quantitative data which
include the center, spread, shape, tail length and outlying data
point(s)
• Like the bar graph, can be presented in either horizontal or vertical
• Height of the rectangle is usually arbitrary and has no specific
meaning
• Used for comparing the distributions of several variables or the
distribution of a single variable in several groups on the same scale.
Box Plot
Scatterplot
• Graphic technique used to display the relationship between two
continuous variables
• One variable is plotted on the x-axis and the other is plotted on the y-
axis
• Plotted points that appear to fall in a straight line indicate a linear
relationship between x and y, whereas widely scattered points
indicate no relationship between x and y
• Shows the relationship between two quantitative variables
• Gives a rough estimate of the type and degree of correlation between
the variables
Scatterplot
Vital Statistics
Health Indicators
• Quantitative measures
• Describe and summarize various aspects of health status of the
populations
• usually expressed as ratios, proportions, or rates
Terms for Population Measurements
• Ratio
• Relationship between two numbers in which one is divided by the other
• Proportion
• ratio of two numbers and numerator is a subset of the denominator, may be
expressed as:
• a number between 0 and 1
• a percentage
• a number per 1000
• a number per 100,000
Terms for Population Measurements
• Rate
• Refers to the occurrence of events over a given interval of time relative to the
total person-time of exposure/at risk
• Types of rates:
• Crude rates – denominator = total population
• Specific rates – denominator = population subgroups
• Adjusted (standardized) rates – constructed to permit fair comparison between 2 groups
which differ in some important characteristics
Common Health Indicators
• The most common health indicators are those related to birth and
death

• Fertility indicators
• Crude birth rate
• General fertility rate

• Morbidity indicators
• Incidence
• Prevalence
Common Health Indicators
• Mortality indicators
• Crude death rate
• Specific mortality rate
• Cause-of-death rate
• Infant mortality rate
• Neonatal mortality rate
• Post-neonatal mortality rate
• Maternal mortality ratio
• Proportional mortality ratio
• Case fatality rate
Morbidity Measures
• Measures the occurence of illness or conditions in a community
• Two types:
• Prevalence
• Incidence
Prevalence Proportion (Ratio)
• Measures the proportion of existing cases of a disease in the
population
• Reflects both incidence and the probability of surviving with disease
• More useful in describing chronic conditions such as congenital
defects, non-lethal degenerative diseases with no clear onset, mental
disease

# 𝑜𝑓 𝑐𝑎𝑠𝑒𝑠 𝑎𝑡 𝑎 𝑝𝑜𝑖𝑛𝑡 𝑖𝑛 𝑡𝑖𝑚𝑒

𝑃𝑅 = 𝑥 100
# 𝑜𝑓 𝑝𝑒𝑟𝑠𝑜𝑛𝑠 𝑒𝑥𝑎𝑚𝑖𝑛𝑒𝑑
Incidence
• Measures the development of a disease in a group exposed to the
risk of the disease in a period of time
• Gives information on the speed of development of a disease
condition
• ore appropriately used to describe acute conditions
Incidence
• Measure of choice in determining etiologic factors
• 2 types of incidence measures
• Incidence proportion
• Incidence density
Risk
• The probability that a person will develop the disease within a
specified period of time
• Difficult to ascertain an individual’s risk
• Epidemiology focuses on the average risk of a group of individuals
Incidence Proportion
• Proportion of “disease” free individuals who contract the “disease”
within a specified period of time
• Average risk of developing the “disease”
• Assumes a fixed population and no competing risks
• Called attack rate for infections when the implicit referent period is the
duration of the outbreak
• Sometimes referred to as cumulative incidence
Incidence Proportion
# 𝑜𝑓 𝑛𝑒𝑤 𝑐𝑎𝑠𝑒𝑠 𝑡ℎ𝑎𝑡 𝑑𝑒𝑣𝑒𝑙𝑜𝑝𝑒𝑑 𝑑𝑢𝑟𝑖𝑛𝑔 𝑡ℎ𝑒 𝑝𝑒𝑟𝑖𝑜𝑑
𝐼𝑃 = 𝑥 100
𝑃𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛 𝑎𝑡 𝑟𝑖𝑠𝑘 𝑜𝑓 𝑑𝑒𝑣𝑒𝑙𝑜𝑝𝑖𝑛𝑔 𝑡ℎ𝑒 𝑑𝑖𝑠𝑒𝑎𝑠𝑒 𝑑𝑢𝑟𝑖𝑛𝑔 𝑡ℎ𝑒 𝑠𝑎𝑚𝑒 𝑝𝑒𝑟𝑖𝑜𝑑
Rate
• Instantaneous change in one quantity per unit change in another
quantity
• The latter quantity is usually time
• In epidemiology, we focus on the concept of average rate for a given
period
Incidence Density
• Rate at which new case occur
• Deals with the dynamic population by using total person time as its
denominator
• Total person time is equal to the
• Sum of each individual’s time at rick, or
• Sum of times that each person remained under observation and free from
disease, or
• Product of the average population size and length of follow-up (n x t)
Incidence Density
# 𝑜𝑓 𝑛𝑒𝑤 𝑐𝑎𝑠𝑒𝑠 𝑡ℎ𝑎𝑡 𝑑𝑒𝑣𝑒𝑙𝑜𝑝𝑒𝑑 𝑑𝑢𝑟𝑖𝑛𝑔 𝑡ℎ𝑒 𝑝𝑒𝑟𝑖𝑜𝑑
𝐼𝐷 = 𝑥 100
# 𝑜𝑓 𝑝𝑒𝑟𝑠𝑜𝑛 𝑡𝑖𝑚𝑒 𝑎𝑡 𝑟𝑖𝑠𝑘

or

# 𝑜𝑓 𝑛𝑒𝑤 𝑐𝑎𝑠𝑒𝑠 𝑡ℎ𝑎𝑡 𝑑𝑒𝑣𝑒𝑙𝑜𝑝𝑒𝑑 𝑑𝑢𝑟𝑖𝑛𝑔 𝑡ℎ𝑒 𝑝𝑒𝑟𝑖𝑜𝑑

𝐼𝐷 = 𝑥 100
𝐴𝑣𝑒𝑟𝑎𝑔𝑒 𝑝𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛 𝑥 𝐷𝑢𝑟𝑎𝑡𝑖𝑜𝑛 𝑜𝑓 𝑓𝑜𝑙𝑙𝑜𝑤 − 𝑢𝑝

• Assumptions:
• The population is stable, i.e., no drastic changes in the size and age structure of the
population; and,
• The rate is more or less constant
Fertility Indicators
• Crude Birth Rate
# 𝑜𝑓 𝑙𝑖𝑣𝑒𝑏𝑖𝑟𝑡ℎ𝑠 𝑖𝑛 𝑎 𝑦𝑒𝑎𝑟
𝐶𝐵𝑅 = 𝑥 1000
𝑀𝑖𝑑𝑦𝑒𝑎𝑟 𝑝𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛

• General Fertility Rate

# 𝑜𝑓 𝑙𝑟𝑒𝑔𝑖𝑠𝑡𝑒𝑟𝑒𝑑 𝑖𝑣𝑒𝑏𝑖𝑟𝑡ℎ𝑠 𝑖𝑛 𝑎 𝑦𝑒𝑎𝑟
𝐺𝐹𝑅 = 𝑥 1000
𝑀𝑖𝑑𝑦𝑒𝑎𝑟 𝑝𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛 𝑜𝑓 𝑤𝑜𝑚𝑒𝑛 𝑎𝑔𝑒𝑑 15 − 44 𝑦𝑟𝑠
Morbidity Indicators
• Prevalence Proportion
# 𝑜𝑓 𝑐𝑎𝑠𝑒𝑠 𝑎𝑡 𝑎 𝑝𝑜𝑖𝑛𝑡 𝑖𝑛 𝑡𝑖𝑚𝑒
𝑃𝑅 = 𝑥 100
# 𝑜𝑓 𝑝𝑒𝑟𝑠𝑜𝑛𝑠 𝑒𝑥𝑎𝑚𝑖𝑛𝑒𝑑

• Incidence Proportion
# 𝑜𝑓 𝑛𝑒𝑤 𝑐𝑎𝑠𝑒𝑠 𝑡ℎ𝑎𝑡 𝑑𝑒𝑣𝑒𝑙𝑜𝑝𝑒𝑑 𝑑𝑢𝑟𝑖𝑛𝑔 𝑡ℎ𝑒 𝑝𝑒𝑟𝑖𝑜𝑑
𝐼𝑃 = 𝑥 100
𝑃𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛 𝑎𝑡 𝑟𝑖𝑠𝑘 𝑜𝑓 𝑑𝑒𝑣𝑒𝑙𝑜𝑝𝑖𝑛𝑔 𝑡ℎ𝑒 𝑑𝑖𝑠𝑒𝑎𝑠𝑒 𝑑𝑢𝑟𝑖𝑛𝑔 𝑡ℎ𝑒 𝑠𝑎𝑚𝑒 𝑝𝑒𝑟𝑖𝑜𝑑

• Incidence Density
# 𝑜𝑓 𝑛𝑒𝑤 𝑐𝑎𝑠𝑒𝑠 𝑡ℎ𝑎𝑡 𝑑𝑒𝑣𝑒𝑙𝑜𝑝𝑒𝑑 𝑑𝑢𝑟𝑖𝑛𝑔 𝑡ℎ𝑒 𝑝𝑒𝑟𝑖𝑜𝑑
𝐼𝐷 = 𝑥 100
# 𝑜𝑓 𝑝𝑒𝑟𝑠𝑜𝑛 𝑡𝑖𝑚𝑒 𝑎𝑡 𝑟𝑖𝑠𝑘
Mortality Indicators
• Crude Death Rate
# 𝑜𝑓 𝑑𝑒𝑎𝑡ℎ𝑠 𝑖𝑛 𝑎 𝑦𝑒𝑎𝑟
𝐶𝐷𝑅 = 𝑥 1000
𝑀𝑖𝑑𝑦𝑒𝑎𝑟 𝑝𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛

• Specific Mortality Rate

# 𝑜𝑓 𝑑𝑒𝑎𝑡ℎ𝑠 𝑖𝑛 𝑎 𝑠𝑝𝑒𝑐𝑖𝑓𝑖𝑒𝑑 𝑔𝑟𝑜𝑢𝑝 𝑖𝑛 𝑎 𝑦𝑒𝑎𝑟
𝑆𝑝. 𝑀𝑅 = 𝑥𝐹
𝑀𝑖𝑑𝑦𝑒𝑎𝑟 𝑝𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛 𝑜𝑓 𝑡ℎ𝑒 𝑠𝑎𝑚𝑒 𝑔𝑟𝑜𝑢𝑝

• Cause-of-Death Rate
# 𝑜𝑓 𝑑𝑒𝑎𝑡ℎ𝑠 𝑓𝑟𝑜𝑚 𝑎 𝑐𝑒𝑟𝑡𝑎𝑖𝑛 𝑐𝑎𝑢𝑠𝑒 𝑖𝑛 𝑎 𝑦𝑒𝑎𝑟
𝐶𝑜𝐷𝑅 = 𝑥𝐹
𝑀𝑖𝑑𝑦𝑒𝑎𝑟 𝑝𝑜𝑝𝑢𝑙𝑎𝑡𝑖𝑜𝑛
Mortality Indicators
• Infant Mortality Rate
# 𝑜𝑓 𝑑𝑒𝑎𝑡ℎ𝑠 𝑢𝑛𝑑𝑒𝑟 1 𝑦𝑜 𝑖𝑛 𝑎 𝑦𝑒𝑎𝑟
𝐼𝑀𝑅 = 𝑥 1000
# 𝑜𝑓 𝑙𝑖𝑣𝑒𝑏𝑖𝑟𝑡ℎ𝑠 𝑖𝑛 𝑡ℎ𝑒 𝑠𝑎𝑚𝑒 𝑦𝑒𝑎𝑟

• Neonatal Mortality Rate

# 𝑜𝑓 𝑑𝑒𝑎𝑡ℎ𝑠 𝑢𝑛𝑑𝑒𝑟 28 𝑑𝑎𝑦𝑠 𝑖𝑛 𝑎 𝑦𝑒𝑎𝑟
𝑁𝑀𝑅 = 𝑥𝐹
# 𝑜𝑓 𝑟𝑒𝑔𝑖𝑠𝑡𝑒𝑟𝑒𝑑 𝑙𝑖𝑣𝑒𝑏𝑖𝑟𝑡ℎ𝑠 𝑖𝑛 𝑡ℎ𝑒 𝑠𝑎𝑚𝑒 𝑦𝑒𝑎𝑟

• Post-neonatal Mortality Rate

# 𝑜𝑓 𝑑𝑒𝑎𝑡ℎ𝑠 𝑢𝑛𝑑𝑒𝑟 28 𝑑𝑎𝑦𝑠 𝑡𝑜 1 𝑦𝑜 𝑖𝑛 𝑎 𝑦𝑒𝑎𝑟
𝑃𝑁𝑀𝑅 = 𝑥𝐹
# 𝑜𝑓 𝑟𝑒𝑔𝑖𝑠𝑡𝑒𝑟𝑒𝑑 𝑙𝑖𝑣𝑒𝑏𝑖𝑟𝑡ℎ𝑠 𝑖𝑛 𝑡ℎ𝑒 𝑠𝑎𝑚𝑒 𝑦𝑒𝑎𝑟
Mortality Indicators
• Maternal Mortality Ratio
# 𝑜𝑓 𝑚𝑎𝑡𝑒𝑟𝑛𝑎𝑙 𝑑𝑒𝑎𝑡ℎ𝑠 𝑖𝑛 𝑎 𝑦𝑒𝑎𝑟
𝑀𝑀𝑅 = 𝑥𝐹
# 𝑜𝑓 𝑟𝑒𝑔𝑖𝑠𝑡𝑒𝑟𝑒𝑑 𝑙𝑖𝑣𝑒𝑏𝑖𝑟𝑡ℎ𝑠 𝑖𝑛 𝑡ℎ𝑒 𝑠𝑎𝑚𝑒 𝑦𝑒𝑎𝑟

• Proportionate Mortality Ratio

# 𝑜𝑓 𝑑𝑒𝑎𝑡ℎ𝑠 𝑓𝑟𝑜𝑚 𝑎 𝑝𝑎𝑟𝑡𝑖𝑐𝑢𝑙𝑎𝑟 𝑐𝑎𝑢𝑠𝑒 𝑖𝑛 𝑎 𝑦𝑒𝑎𝑟
𝑃𝑀𝑅 = 𝑥𝐹
𝑇𝑜𝑡𝑎𝑙 𝑑𝑒𝑎𝑡ℎ𝑠 𝑖𝑛 𝑡ℎ𝑒 𝑠𝑎𝑚𝑒 𝑦𝑒𝑎𝑟

• Case Fatality Rate

# 𝑜𝑓 𝑚𝑎𝑡𝑒𝑟𝑛𝑎𝑙 𝑑𝑒𝑎𝑡ℎ𝑠 𝑓𝑟𝑜𝑚 𝑎 𝑝𝑎𝑟𝑡𝑖𝑐𝑢𝑙𝑎𝑟 𝑐𝑎𝑢𝑠𝑒 𝑖𝑛 𝑎 𝑦𝑒𝑎𝑟
𝐶𝐹𝑅 = 𝑥𝐹
𝑇𝑜𝑡𝑎𝑙 𝑑𝑒𝑎𝑡ℎ𝑠 𝑖𝑛 𝑡ℎ𝑒 𝑠𝑎𝑚𝑒 𝑦𝑒𝑎𝑟
Exercises
Find the following Make the following
1. Mean 1. Frequency Distribution with 10
2. Median Classes
3. Mode
4. Range 2. Histogram
5. Variance 3. What is the symmetry?
6. Standard Deviation
7. Coefficient of Variation
8. 82nd Percentile
9. 2nd Decile
10. 3rd Quartile
Systolic Blood Pressure (in mmHg) of 90 randomly
selected patients at hospital Y, 2018.
70 86 111 113 131 147 162 177 180
206 202 162 170 140 150 125 122 86
70 80 170 169 139 147 120 114 116
82 84 180 130 115 158 115 117 148
85 78 190 141 120 116 100 120 196
90 95 116 132 127 120 110 116 124
93 87 120 146 101 125 120 120 144
176 90 125 150 110 131 125 119 75
190 93 147 163 135 135 110 128 132
117 100 150 173 140 105 109 110 72
Answers
Find the following Make the following
1. Mean = 127.07 1. Frequency Distribution with 10
2. Median = 121 Classes
3. Mode = 120
4. Range = 136 2. Histogram
5. Variance = 1031.50 3. What is the symmetry?
6. Standard Deviation = 32.12
7. Coefficient of Variation = 25.28%
8. 82nd Percentile = 162
9. 2nd Decile = 100
10. 3rd Quartile = 147
Frequency Distribution
SBP No. of Patients Class Class Cumulative
(mmHg) (Frequency) Boundary Mark Frequency
205-219 1 204.5-219.5 212 100%
190-204 4 189.5-204.5 197 99%
175-189 4 174.5-189.5 182 94%
160-174 7 159.5-175.5 167 90%
145-159 9 144.5-159.5 152 82%
130-144 12 129.5-144.5 137 72%
115-129 24 114.5-129.5 122 59%
100-114 12 99.5-114.5 107 32%
85-99 9 84.5-99.5 92 19%
70-84 8 69.5-84.5 77 9%
Histogram