Using Population Health Indicators for Global Health and Development

By Raywat Deonandan

Concepts like life expectancy, poverty, and the demographic transition seem easy and obvious. But there's actually some nuance to them. This book is an easy introduction to the use of these traditional measures, indicators and models of population health. It's ideal for use by students, researchers, policy makers, NGOs, and funders.

 

Raywat Deonandan, holds a PhD in Epidemiology & Biostatistics and is a faculty member of the Interdisciplinary School of Health Sciences at the University of Ottawa. He is a multi-award winning writer, educator, and scientist, as well as a well published scholar.

• Language: English
• Publisher: Raywat Deonandan
• Release date: Jun 26, 2024
• ISBN: 9780993676345

Raywat Deonandan

About The Author Raywat Deonandan Raywat Deonandan is a professor at the University of Ottawa, and a highly decorated scholar and writer. In 2000, his first book, "Sweet Like Saltwater," was awarded the Guyana Prize, which is the national book award of the nation of Guyana, in the "Best First Work" category. 

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INTRODUCTION

This volume is an extension of two of my previous books, Introduction to International Health Theory: An Interdisciplinary Perspective [1] and Nothing To Do With Skin: the Fundamentals of Epidemiology and Population Health Research. [2]  I’ve distilled and expanded upon elements from those books that many students found particularly useful, specifically around how population health issues are measured quantitatively. The astute reader will find substantial overlap between this volume and those earlier texts. This is an intentional attempt to focus on specific items from those books and to offer them in a lighter, less expensive package.

Policymakers and media increasingly blindly rely upon reported statistics both for shaping public opinion and for making official policy on important health matters. Yet often they remain unaware of the extent to which assumptions, agendas, and biases dictate the nature and content of those statistics.  This is not to suggest that such statistics are developed in bad faith, but rather that their implementation requires a more nuanced understanding of their intent and foundation, such that they are not misused or misunderstood.

A good example is the oft heard mantra in Western countries, that we have an ageing population. What exactly does this mean? Many feel that the phrase suggests that Western peoples are experiencing a dramatically longer lifespan. Others understand that it means that the average population age is higher than in previous generations, which further suggests that reproduction rates are declining.  In other words, the phrase deftly avoids drawing a needed distinction between life expectancy and lifespan, which in turn can cause a skewed public understanding of the current demographic reality.

Measures of mortality and morbidity are similarly misunderstood. The distinction between incidence and prevalence, while largely inconsequential in everyday lay parlance, can have a dramatic impact on program evaluation and long term health planning. Similarly, competing indices of mortality—-proportionate mortality rate, case fatality rate (CFR), crude mortality rate, etc.-—each offers a particular perspective on the lethality of a given health condition, and none can individually convey the full thrust and import of that condition. Yet the scary estimates of a virulent disease’s extremely high CFR can capture the public’s imagination and profoundly overestimate that disease’s importance. The single case of Ebola in the USA in 2014 is a fine example of this phenomenon.

While my larger goal is to enhance the knowledge and perspective of those engaged in population health research or policymaking, this volume is directed to a general lay audience with a very basic familiarity with health sciences terminology and issues. It is meant to offer a more rounded appreciation of some of the issues surrounding indicator development and usage. My intent is not to convey upon the reader expertise in population health measurement, but rather to empower the reader to begin to interrogate and question cited statistics in order to ascertain their limitations and underlying assumptions.

As always, I invite readers to inform me if any errors are found, or if there are any suggestions for any future editions.  I can be reached via my website (www.deonandan.com) or Twitter (@deonandan).

With gratitude,

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Raywat Deonandan, PhD

Ottawa, Canada

May, 2015

INDICATORS OF POPULATION HEALTH

Resources are always limited, and opportunities for expending those resources are constantly multiplying. In the practice of population health, those resources might be medicines, health care workers, research dollars, or a public health education budget. The setting