Pop Health Final Exam 1

Describe what information is used to derive the wealth index from the Demographic and Health Survey questionnaire data.  Name 3 items included.

Wealth index is derived from asset indicators such as having a refrigerator, TV, car/motorcycle

Name two essential features of a census.

 1. Individual enumeration (every person counted), 2. Universality (everyone included), 3. Simultaneity (certain reference date), 4. Periodicity (taken every X years)

Give one reason why surveys can generally yield more accurate information than censuses.

You can better train the interviewers. There is better supervision and qualification.

What are the three main types of sources of demographic data?

Vital registration, censuses and surveys

Why was 1790 census of USA not a census by definition?

Didn’t have individual enumeration

What does GDP stand for?

Gross domestic product. The total market value of all final goods and services produced within the country in a given period of time.

Why might study of cemetery records give a biased picture of mortality in the past?

Not everyone could afford to buy a plot to be buried in

When did the world reach 1 billion people, 2 billion, 7 billion?

1800, 1930, 2011

Name 1 country in the top 10 with highest natural increase rate

Niger, Uganda 

Why do scientists talk of a demographically divided world?

 Some regions have below replacement fertility while others have high growth rates. Countries have differing growth rates. 

Define the crude birth rate, crude death rate, and crude rate of natural increase

Crude birth rate: number of births in a given year per 1000 mid-year population

Crude death rate: number of deaths in a given year per 1000 mid-year population

Crude rate of natural increase: crude birth rate - crude death rate, it does not take into account immigration.

In what decade was the peak of the world population growth rate?

60s

What is the bookkeeping equation of population growth?

Pt = Po +B -D +I  -O

Where B=births, D=deaths, I= In-migrants, 0=out-migrants

Approximately what percent of world population growth is occurring in developed countries?

5%

How can the absolute number of births increase if the birth rate is declining?

The denominator of the birth rate is increasing (population size). So even though the number of births is increasing, the portion of people eligible to give birth is also increasing, resulting in a decreasing birth rate overall.

Which subregion has quite a few countries with negative natural increase?

Eastern Europe

Describe the stages of the demographic transition and draw a graph of same.

1. High birth and death rates (zero to low growth)

2. High birth rate, declining death rate (high growth)

3. Death and birth rates declining

4. Both death and birth rates low (zero to low growth)

By approximately how many persons is the world population growing each year?

76 million

Name 2 of the five largest urban agglomerations in 1950.

Tokyo, Moscow, Paris, New York

In what region do  most of the people of the world live?

Asia

Which region has the highest population growth rate?

Sub-Saharan Africa

What is the estimated world population size in (mid-)2022?

7.9 Billion

What is the estimated world population size in (mid-)2023?

8.0 billion

What is the simple rule to find doubling time given the rate of growth?

Rule of 70. # years to double = 70/growth rate (ex 2% takes 35 years to double)

Why is population momentum an important concept for countries concerned about population growth in the future?

Higher population growth is associated with a lower rate of economic growth. We live on a finite planet, with limited resources.

population increase that continues even after a fall in birthrates because of a large youthful population that widens the population's parent base

About what percentage of world population lives in urban areas now?

 50-57%

Name 3 countries among the top 10 contributors to world population growth (numbers of persons added per year)

India, China, Nigeria, USA, Ethiopia

About how many years did it take to add the last billion persons to the planet?

11 years

What is the only sustainable population growth rate in the long term?

0, because we live on a finite planet

What can be done to decrease high wanted fertility in Sub-Saharan Africa?

 Invest in human capital (educate girls)

If unwanted you would strength family planning

Why is the 1-child family norm important for stabilizing human population size in the not-to-distant future?

To counteract the effect of momentum, the one child family norm is below replacement fertility

What is the shape of the age specific death rate?

J-shaped curve

Define in words the expectation of life at birth

expected years a newborn will live according to survival rates in the population

Name one public health intervention that led to declines in mortality in 19^th century Europe.

Sewage management, clean drinking water

Describe the epidemiological transition

Change in patterns of mortality and morbidity by cause of death; from infectious diseases to non-communicable diseases. Shift in age structure from younger age groups to older. 

Is malaria transmitted by female mosquitos, male mosquitos or both?

Female mosquitos only

What has been the main intervention to eliminate polio from most of the world?

Vaccines

Name 2 of the major causes of death of children under 5 in the world

Pneumonia, preterm, birth complications, diarrhea

Define the infant, neonatal and post-neonatal mortality rates

Neonatal mortality rate: number of deaths of newborns in the first month (28 days) of life per 1000 births = D0-3weeksB*1000 or D<1 monthB*1000

Postneonatal mortality: # deaths of children 1-11 months / # births for a given time period (usually one calendar year

Infant mortality: number of infant deaths in a year *1000number of life births in a year neonatal mortality + postneonatal mortality

What is a simple low-cost treatment for diarrhea?

Oral rehydration treatment. ORT includes ORS (oral rehydration solution/salts) (salt, sugar, water.. have to get portions right).

Why is malnutrition very important even though it is rarely a cause of death in children?

Malnutrition refers to the imbalance between the amount of food and other nutrients that the body needs vs the amount that is receiving. Could result in under or over nutrition. It can cause increased risk of infection and disease associated with development and death. 

Why is CDR a poor measure to compare the  health of populations?

CDR is affected by the population age structure.  Very young populations will have lower CDRs. Needs to be adjusted for differences in age compositions. 

Name one way to prevent malaria

Mosquito net, vaccine

What is the intervention that prevents polio and measles?

Vaccine early

The sum of cause-specific death rates in a  population gives what rate?

Crude death rate

Why did the expectation of life at birth decline in Southern African countries in the 1990s?

HIV/AIDS

What is the definition of low birth weight?

Babies who were  born less 2500 grams

Why is it nearly impossible to isolate persons infected with polio as a public health strategy?

90% of polio infections cause no symptoms. You don’t know who the cases are 

What is the definition of fecundability?

probability that a women will conceive during a menstrual cycle (monthly)

What is the definition of parity?

number of children born alive to a woman

What is the definition of gravidity?

number of pregnancies a woman has had

Sketch a typical pattern of age specific fertility

What is replacement fertility:

number of births per woman so the population exactly replaces itself in the long run  (around 2)

Why is replacement level fertility (for TFR) about at least 2.1 births per woman instead of 2.0?

Ensures replace of a woman and her partner to counteract infant mortality and up to that child’s age of reproductive age

Name 3 of the intermediate fertility variables.

Married/in union, contraceptives, induced abortion

In what circumstances can a woman’s parity be higher than her gravidity?

Twin birth

Why/how does age at marriage affect TFR in a population?

younger marriage = early exposure to sexual intercourse = more pregnancies in their lifetime =  higher total fertility rate 

What are the two types of unintended births?

Mistimed (wanted pregnancy but later), unwanted (did not want another pregnancy) 

What is the difference between a background or distal variable and an intermediate or proximate variable vis a vis fertility?

Distal (underlying) determinants of fertility result in changes in reproductive behaviors in populations (socioeconomic, cultural, health, and programmatic factors)

Proximate (intermediate) → the biological determinants of fertility

What is the most important intermediate determinant of fertility; distal determinant of fertility?

Immediate… use of contraceptives.  Distal….education of women.

Why is the duration of postpartum amenorrhea associated with the duration of breastfeeding?

breastfeeding serves as a natural form of contraception → a woman cannot get pregnant if she is exclusively breastfeeding

How long is the potential reproductive life span of a woman (on average)?

15-49 years (~35years)

Without any contraception, what percentage of sexually active women will become pregnant in one year?

85%

Name two countries with below replacement fertility

China, Singapore 

Name two countries with TFR above 5.0

Niger, Mali

What approximately is the global value of TFR in 2022 or 2023?

 2.3 births per woman

Why in the plot of TFR vs contraceptive prevalence, do many countries lie off the fitted line?

Method mix is different, each country has a different failure rate..example Paraguay above line (Catholics Church does not approve) 

What is the difference between primary and secondary sterility?

Primary sterility: never able to conceive or produce a live birth, Secondary: sterility after one or more children born

Name one hormone whose level spikes at midcycle and is a signal of impending ovulation

Luteinizing hormone (LH)

Approximately how many sperm are there per ejaculate?

150-300 million sperm per ejaculate

At what time during the menstrual cycle is a woman fertile?

Ovulation

During which part of the menstrual cycle is progesterone high?

Luteal Phase

Briefly describe one of the fertility awareness methods

Standard Days method: identifies a 12-day fertile window during which women with regular menstrual cycles (26–32 days long) should abstain from sex or use a barrier method to prevent pregnancy.

Name one reason why fertility awareness methods have a high failure rate in typical use

Requires constant modification and attention, does not work with irregular cycles. 

Name 2 advantages of male sterilization over female sterilization for couples who wish to have no more births

Safer, cheaper, and reversible in most cases

In what organ does sperm production begin?

Testes

Why is the withdrawal method not very effective?

Human error and pre-ejaculation can contain sperm 

What does LARC stand for?   What does it include?

Long acting reversible contraceptive, it includes the copper IUD and implant

From what organ does most of the fluid in the man’s ejaculate come from?

Seminal vesicles

Rank these contraceptive methods in order of effectiveness from low to high: IUD, condom, pill, and fertility awareness methods

Fertility awareness methods < condom < pill<  IUD

How often is the DepoProvera shot given?

Every 3 months

In what region are infant and child mortality the highest?

 Sub-saharan africa

In which sub-region is low birth weight the highest proportion of births?

Southern Asia

What is exclusive breastfeeding?

Feeding the baby only breast milk, not any other liquids including formula or water. (provides antibodies to the infant, promotes monding, has a contraceptive effect)

Name 2 interventions to prevent neonatal deaths

Skilled care at birth, postnatal care for mother and baby

Name 3 vaccines recommended by WHO for children 0-6 years of age.

DTaP, Rota, PCV, Hep A, Hep B

What is a treatment for bacterial pneumonia?

Antibiotics

What therapy saves children with diarrhea from dying?

Oral rehydration therapy

What are treated bed nets for?

malaria prevention.

What immunization is important for the mother to receive before or during pregnancy?

Tetanus Tdap

What is ORS?

 Oral rehydration solution. Contains sugar, salt, and other minerals.

Name 2 preventive interventions for child mortality

Breastfeeding, vaccination, water and sanitation

Name 2 therapeutic interventions for child mortality

ORT and antibiotics

What is the definition of unmet need for contraception?

Women have unmet need if they are sexually active, do not want to have a child soon or at all, are not using any contraceptive methods, and are able to conceive. 

Name one modern contraceptive method that also protects against sexually transmitted infections

Condoms

What is “dual protection”?

Use of methods that prevent both unwanted pregnancy and HIV/STDS during intercourse (ex. condom and pill)

In what region is contraceptive use the lowest?

Africa

Name 3 reproductive health components

Sexual behavior, infertility, contraception, STIs, breastfeeding, abortion

What is the rationale for the statement “development is the best contraceptive?”

Higher quality of education and income will decrease fertility rate. Countries developed had lower fertility.

Are neonatal deaths as a proportion of all under-five deaths increasing or decreasing?  Why?

Increasing ….. Harder to prevent neonatal deaths