Standardized mortality ratio Health Dictionary

Standardized Mortality Ratio: From 1 Different Sources

(SMR) the ratio of observed mortality rate to expected mortality rate (calculated using indirect standardization), expressed as an integer where 100 represents agreement between observed and expected rates. See standardized rates.

Health Source: Oxford | Concise Colour Medical Dictionary
Author: Jonathan Law, Elizabeth Martin

Mortality

Death. Used to describe the relation of deaths to the population in which they occur.... mortality

Mortality Rate

See “death rate”.... mortality rate

Odds Ratio

1 A measure of association which quantifies the relationship between an exposure and outcome from a comparative study; also known as the cross-product ratio. 2 Comparison of the presence of a risk factor in a sample.... odds ratio

Rationing

Limiting the availability of something (e.g. due to a shortage of the item itself or of resources with which to buy it).... rationing

Sex Ratio

The ratio of one sex to another. Usually defined as the ratio of males to females.... sex ratio

Occupational Mortality

Death due to work-related disease or injuries.

Annual death rates (deaths per million at risk) vary widely between occupations, ranging from 5 in clothing and footwear manufacture to about 1,650 in offshore oil and gas industries.

More than 1,000 per year are due to work-related diseases, mainly pneumoconiosis and cancers.... occupational mortality

Dependency Ratio

An indicator used in population studies to measure the portion of the population which is economically dependent on active age groups. It is calculated as the sum of the 0-14 year-olds and the over 60 or 65 year-olds, depending on the working age limit considered, divided by the number of people aged between 15 and 59 or 64, respectively.... dependency ratio

Infant Mortality Rate (imr)

The number of deaths of infants under one year of age. The IMR in any given year is calculated as the number of deaths in the ?rst year of life in proportion to every 1,000 registered live births in that year. Along with PERINATAL MORTALITY, it is accepted as one of the most important criteria for assessing the health of the community and the standard of the social conditions of a country.

The improvement in the infant mortality rate has occurred mainly in the period from the second month of life. There has been much less improvement in the neonatal mortality rate – that is, the number of infants dying during the ?rst four weeks of life, expressed as a proportion of every 1,000 live births. During the ?rst week of life the main causes of death are asphyxia, prematurity, birth injuries and congenital abnormalities. After the ?rst week the main cause of death is infection.

Social conditions also play an important role in infant mortality. In England and Wales the infant mortality rate in 1930–32 was: Social Class I (professional), 32·7; Social Class III (skilled workers), 57·6; Social Class V (unskilled workers), 77·1. Many factors come into play in producing these social variations, but overcrowding is undoubtedly one of the most important.

1838–9 146 1950–52 30 1851–60 154 1960–62 22 1900–02 142 1970–72 18 1910–12 110 1980–82 12 1920–22 82 1990–92 7 1930–32 67 1996 6·2 1940–42 59 1999 5.8 2000 5.6

It is thus evident that for a reduction of the infant mortality rate to the minimum ?gure, the following conditions must be met. Mothers and potential mothers must be housed adequately in healthy surroundings, particularly with regard to safe water supplies and sewage disposal. The pregnant and nursing mother must be ensured an adequate diet. E?ective antenatal supervision must be available to every mother, as well as skilled supervision during labour (see PREGNANCY AND LABOUR). The newborn infant must be adequately nursed and fed and mothers encouraged to breast feed. Environmental and public-health measures must be taken to ensure adequate housing, a clean milk supply and full availability of medical care including such protective measures as IMMUNISATION against diphtheria, measles, poliomyelitis and whooping-cough. (See also PERINATAL MORTALITY.)... infant mortality rate (imr)

Neonatal Mortality

Neonatal mortality is the mortality of infants under one month of age. In England and Wales this has fallen markedly in recent decades: from more than 28 per 1,000 live births in 1939 to 3.6 in 2002. This improvement can be attributed to various factors: better antenatal supervision of expectant mothers; care to ensure that expectant mothers receive adequate nourishing food; improvements in the management of the complications of pregnancy and of labour; and more skilled resuscitation at birth for those who need it.

Nearly three-quarters of neonatal deaths occur during the ?rst week of life. For this reason, increasing emphasis is being laid on this initial period of life. In Britain, in the last four decades of the 20th century, the number of deaths in the ?rst week of life fell dramatically from 13.2 to just over 2.7 per 1,000 live births. The chief causes of deaths in this period are extreme prematurity (less than 28 weeks’ gestation), birth asphyxia with oxygen lack to the brain, and congenital abnormalities. After the ?rst week the commonest cause is infection.... neonatal mortality

Perinatal Mortality

Perinatal mortality consists of deaths of the FETUS after the 28th week of pregnancy and deaths of the newborn child during the ?rst week of life. Today, more individuals die within a few hours of birth than during the following 40 years. It is therefore not surprising that the perinatal mortality rate, which is the number of such deaths per 1,000 total births, is a valuable indicator of the quality of care provided for the mother and her newborn baby. In 2002, the perinatal mortality rate was 7.87 in the United Kingdom compared with 11.4 in 1982 – and over 30 in the early 1960s.

The causes of perinatal mortality include extreme prematurity, intrapartum anoxia (that is, di?culty in the birth of the baby, resulting in lack of oxygen), congenital abnormalities of the baby, and antepartum anoxia (that is, conditions in the terminal stages of pregnancy preventing the fetus from getting su?cient oxygen).

The most common cause of perinatal death is some complication of placenta, cord or membranes. The next most common is congenital abnormality. Intrauterine hypoxia and birth asphyxia comprise the third most common cause.... perinatal mortality

Planning Ratio

Service provision targets established by an authority on a population basis.... planning ratio

Proportional Mortality Rate (pmr)

A measure of the relative contribution to total mortality by a specific cause and these are expressed as number of deaths assigned to the state cause in a calendar year per 1000 total deaths in that year.... proportional mortality rate (pmr)

Ratio

The value obtained by dividing one quantity by another: a general term of which rate, proportion, percentage, etc. are subsets. A ratio is an expression of the relationship between a numerator and a denominator where the two usually are separate and distinct quantities, neither being included in the other.... ratio

Ratio Scale

See “measurement scale”.... ratio scale

Infant Mortality

The number of infants who die during the 1st year of life per 1,000 live births, usually expressed as per year. About 2 in 3 of all infant deaths occur during the neonatal period (the 1st month of life). Most of those who die are very premature (born before the 30th week of pregnancy) or have severe birth defects.

infarction Death of an area of tissue due to ischaemia (lack of blood supply). Common examples include myocardial infarction, which is also known as heart attack, and pulmonary infarction, which is lung damage caused by a pulmonary embolism – a blood clot that has moved into a vessel in the lung and is obstructing the flow of blood. (See also necrosis.)... infant mortality

Maternal Mortality

The death of a woman during pregnancy, or within 42 days of childbirth, miscarriage, or an induced abortion, from any pregnancyrelated cause. Maternal mortality rate describes the number of such deaths per year per set number of pregnancies.

Maternal deaths may occur as a direct result of complications of pregnancy, or indirectly due to a medical condition worsened by pregnancy. Major direct causes include pulmonary embolism, antepartum haemorrhage, postpartum haemorrhage, hypertension, eclampsia, and puerperal sepsis. Indirect causes include heart disease, epilepsy, and some cancers.

Maternal mortality is lowest for 2nd pregnancies. It rises with age, being greatest for women over 40.... maternal mortality

Comparative Mortality Figure

see occupational mortality.... comparative mortality figure

Infant Mortality Rate

(IMR) the number of deaths of children under one year of age per 1000 live births in a given year. Included in the IMR are the neonatal mortality rate (calculated from deaths occurring in the first four weeks of life) and postneonatal mortality rate (from deaths occurring from four weeks). Neonatal deaths are further subdivided into early (first week) and late (second, third, and fourth weeks). In prosperous countries neonatal deaths account for about two-thirds of infant mortalities, the majority being in the first week (in the UK the major cause is prematurity and related problems). The IMR is usually regarded more as a measure of social affluence than a measure of the quality of antenatal and/or obstetric care; the latter is more truly reflected in the *perinatal mortality rate.... infant mortality rate

International Normalized Ratio

see INR.... international normalized ratio

Likelihood Ratio

the degree to which a test result will change the odds that a patient has a disease. The likelihood ratio for a positive test expresses the degree to which the odds that a patient has a disease increase following a positive test. The likelihood ratio for a negative test expresses the degree to which the odds that a patient has a disease decrease following a negative test. Likelihood ratios depend on the *sensitivity and specificity of the test.... likelihood ratio

Maternal Mortality Rate

the number of deaths due to complications of pregnancy, childbirth, and the puerperium per 100,000 live births (see also stillbirth). In 1952 concern about maternal mortality resulted in Britain in the setting up of a triennial *confidential enquiry into every such death to identify any shortfall in resources or care. The first triennial report was published in 1985. Since 2014 reports have been produced annually by MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries Across the UK). Levels of *maternal deaths are currently low: a report published in 2017 (covering 2013–15) counted 202 obstetric-related deaths (8.76 per 100,000 live births). Thromboembolism was the commonest direct cause of death (30 deaths, 1.13 per 100,000 live births), while heart disease was the commonest indirect cause of death (54 deaths, 2.34 per 100,000 live births).... maternal mortality rate

Microalbumin:creatinine Ratio

a laboratory measurement used as a screening test for the first signs of kidney damage in *diabetes mellitus. It detects an increase in the very small levels of the protein albumin present in urine, relative to the concentration of creatinine. It is best measured in an early morning urine sample. See microalbuminuria.... microalbumin:creatinine ratio

Neonatal Mortality Rate

see infant mortality rate.... neonatal mortality rate

Perinatal Mortality Rate

(PNM) the total number of babies born dead after 24 weeks gestation (*stillbirths) and of live-born babies that die in the first week of life, regardless of gestational age at birth (early neonatal deaths), per 1000 live births and stillbirths. See infant mortality rate. See also confidential enquiries.... perinatal mortality rate

Rationalization

n. (in psychology) the explanation of events or behaviour in terms that avoid giving the true reasons. For example, someone may claim to have been too tired to go to a party whereas in fact he or she was afraid of meeting new people.... rationalization

Waist To Hip Ratio

(WHR) the ratio of the circumference of the waist to that of the hips. It is used as a measure of obesity and is a more reliable predictor of obesity-related mortality than *body mass index alone.... waist to hip ratio

Standardized Rates

rates used to summarize the *morbidity or *mortality experience of a population. Age-specific rates and population structures from a study population and a reference or *standard population are used to produce a weighted average. Standardized rates can be used to compare the health experience of populations with different structures. Direct standardization requires application of age-specific rates from a study population to a reference population structure (e.g. the European standard population) to produce a (directly) standardized rate. Indirect standardization requires application of age-specific rates from a standard population (e.g. England and Wales) to a study population structure to produce an expected morbidity or mortality rate. Compare crude rate.... standardized rates

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Standardized mortality ratio Health Dictionary

Standardized Mortality Ratio: From 1 Different Sources

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