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FPH exam > 3A Populations > Flashcards

3A Populations Flashcards

1
Q

What is a census

A

A snapshot enumeration survey of an entire population

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2
Q

What are the strengths and weaknesses of censuses

A

STRENGTHS
- most complete set of population data available
- allows comparison of areas and over time
- allows policy and service planning
- Provides a denominator for health statistics
- allows resource allocation

WEAKNESSES
- expensive
- data is always out of date
- under-enumeration (certain groups are hard to count: homeless, travellers, students and houses of multiple occupancy)
- mis reporting (particularly self-enumeration is prone to misunderstanding of questions or inaccurate answers ie incorrect age etc)

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3
Q

How a censuses conducted? (how often, how is data collected etc)

A
  • every 5-10 years in most developed countries
  • UK every 10 years

METHODS
- interviews (more expensive)
- self enumeration (forms completed by households) with post enumeration survey (ie interviews of sample in order to assess accuracy of self enumeration data)

  • questionnaires can be dropped off and picked up, posted, or completed online
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4
Q

How often is the UK census conducted, when did it start and who is responsible for conduct and analysis in England?

A
  • 10 yearly
  • 1801
  • Office for national statisitics
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5
Q

Discuss the stages in developing a UK census

A

PREPARATION
- initial consultation period
- parliamentary debate on the questions to be included
- publicity exercise
- generation and testing of questionnaire (including household questions ie type of house, number of bedrooms, household members) and individual questions (ie demographics, employment, health)

DELIVERY
- forms or links to online questionnaire posted out
- tracking system to target households which have not completed the questionnaire

ANALYSIS
- paper forms scanned and coded
- data coverage assessed, quality assured
- results tabulated by output area for analysis

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6
Q

By what areas are data aggregated in the UK and how has this changed

A
  • used to analysed at the level of electoral ward
  • however these varied greatly in population size and boundaries frequently changed
  • this made tracking changes over time difficult
  • output areas were therefore generated which are:
    1. coterminous with postcodes
    2. have roughly uniform population size
    3. are socially homogenous
    4. compact in shape
  • output areas can be aggregated into super output areas of varying population size
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7
Q

size of population in an output area

A

approx 300 people

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8
Q

size of population in an lower output area

A

approx 1500 people

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9
Q

size of population in an middle output area

A

approx 7000 people

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10
Q

size of population in an upper output area

A

approx 25 000 people

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11
Q

Name 3 alternatives to a traditional census

A
  1. rolling census
  2. population forecasts
  3. population registers

these can be used in preference for more up to date information

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12
Q

What are population registers?

A

individualised data systems that are a mechanism of continuous recording and/or co-ordinated linkage of selected information pertaining to each member of the resident population of a country in a way to provide the possibility of determining up to date information about the size and characteristics of that population at selected time intervals

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13
Q

Advantages (5) and disadvantages (5) of population registers

A

ADVANTAGES
1. more up to date information
2. linked statistical data allows multivariate analysis
3. more consistent statistics (rather than large shifts with each new census data giving new denominators)
4. data can support evidence based policy
5. improved efficiency and quality from permanent systems

WEAKENESSES
1. Depends on availability and quality of administrative data
2. not a snap shot so makes comparisons between areas more difficult
3. Actual risk of data breaches
4. perceived risk of data breaches
5. loss of census brand will lead to lower responses and results have less impact

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14
Q

Strengths (6) and weaknesses (7) of routinely collected data

A

STRENGTHS
- readily available
- cheap
- can be largely complete (eg birth registrations)
- large number of subjects
- particularly useful when data sources are linked
- can provide baseline data on expected levels of health and disease

WEAKNESSES
- Constrained by what data is collected and when
- Difficult to assess quality
- Often incomplete
- Access can be restricted
- Data linkage is often complex
- May be out of date due to delays in publication
- often poorly presented and analysed

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15
Q

Strengths (7) and weaknesses (6) of adhoc data

A

STRENGTHS
- can specify exactly what data is to be collected
- can target data collection to subgroup of interest
- can assess data quality
- can collect qualitative data
- can be responsive to emerging needs
- flexible mode of administration (ie face to face, telephone)
- enables greater statistical analysis

WEAKNESSES
- Expensive
- Time consuming
- May not know sampling frame
- Number of subjects usually smaller
- greater potential for selection bias
- validity/ reliability may be poor

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16
Q

define demography

A

The study of characteristics and dynamics of human populations

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17
Q

Fecundity

A

the number of offspring biologically possible per female

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18
Q

Demographic differences: Between england, scotland, wales and northern ireland

A
  • England has the highest population density
  • England has the highest population growth (2011-2021)
  • Scotland has the highest median age (2021) and N. Ireland the lowest
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19
Q

Demographic differences: Age differences (between UK 4 nations, withing England)

A

BETWEEN UK 4 NATIONS
- Scotland has the highest median age (2021) and N. Ireland the lowest

WITHIN ENGLAND
- London has the lowest median age and areas in the South West the highest

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20
Q

Demographic differences: Age differences (between countries)

A

Population pyramids can be described in 3 ways:

EXPANSIVE (high fertility, high mortality) gives a sharp pyramid sharp (wide at bottom and narrow at top) ie Sierra Leone

CONSTRICTIVE (low mortality, constant fertility) gives a pyramid that is wide in the middle ie Hong Kong

PILLAR/STATIONARY
(low mortality, low fertility) gives a pyramid that has relatively vertical edges Ie UK

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21
Q

Demographic differences: Gender differences UK

A
  • More boys are born than girls
  • however overall there are more women in UK population, likely due to a combination of factors:
    1. women longer life expectancy
    2. migration patterns
    3. Male risk taking behaviour
    4. Impact of wars
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22
Q

Demographic differences: UK gender differences by ethnicity

A

More men:
Bangladeshi
Pakistani
Chinese

More women:
White
Black
Indian

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23
Q

Demographic differences: Occupational differences between countries

A

Developed countries less on:
- Primary sector jobs (agriculture and raw materials)
- Secondary sector jobs (manufacturing and construction)

Developed countries rely more on:
- Tertiary sector jobs (services)
- Quaternary services jobs (research and development)

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24
Q

Demographic differences: Occupational differences UK trends

A
  • London has a high density of tertiary sector jobs (services)
  • Cambridge Fen has a high density of Quaternary sector jobs ( research and development)
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25
Q

Demographic differences: Ethnic diversity in the UK over time and between areas

A
  • Ethnic diversity has increased in the UK over time
    _ London is the most ethnically diverse region with 63.2 % of residents identifying as ethnic minority groups in 2021
26
Q

UK population estimates: who is responsible, what method is used

A
  • as UK census is only done every 10 years other methods have to be used to estimate population on intercensal years
  • this allows local service planning
  • this is done by the ONS which produce mid year estimates on 30th june each year
  • the cohort component method is used
27
Q

UK population estimation: what is the cohort component method?

A
  1. Take prev. year mid year estimate
  2. Add 1 year to ages
  3. Add births (ONS data)
  4. subtract deaths (ONS data)
  5. Adjust for external migration (international passenger survey)
  6. Adjust for internal migration (GP registration data)
  7. Conduct quality controls
28
Q

UK population estimation: what are the challenges with the cohort component method?

A
  • estimates may be inaccurate due to difficulty accessing reliable data particularly on migration
  • this is particularity pertinent as migration is now the major driver of UK population change
  • certain mobile subpopulations are not included in the general population calculation. Instead they are estimated and then added into the total end calculation (ie prisoners, boarding school pupils, armed forces)
29
Q

Population estimate: for what geographies do the ONS produce population estimates?

A
  1. UK
  2. 4 constituent nations
  3. Government office regions
  4. local authority
  5. CCGs

they are generally stratified by age, sex and martial status

30
Q

Population projections: who produces these in the UK and how often

A

-ONS
- core function of ONS is to produce 25 year population projections for UK and 4 constituent nations every 2 years
- figures are also used to produce subnational projections

31
Q

Population Projections: what factors are used in determining them

A
  1. birth sex ratio (stable at 1.05 men to every women)
  2. mortality (use historical trends)
    3 fertility (judgement)
  3. Migration (judgement
32
Q

Population Projections: what are probabilistic population projections

A
  • traditionally population projections were expressed as a range but now probabilistic population projections are normally displayed with 95% confidence intervals
33
Q

what is a life table and who produces them

A
  • AKA Mortality table
  • displays the probabilities that an individual will die before their next birthday based on age and sex
  • in the UK this is produced by the ONS
34
Q

How are life tables constructed

A
  • age specific mortality rates are applied to a hypothetical population
  • the probability of dying in that time period is applied to the population of people who survived until the beginning of that time period
  • the number surviving eventually declines to 0
35
Q

What can life tables be used to calculate

A
  1. the number of people in each cohort who would be expected to survive each year
  2. the number of people in each cohort who would be expected to die each year
  3. average number of years that some would live at each age (ie their life expectancy)
  4. proportion of people born in year who are still alive
  5. remaining life expectancy for people at a particular age
  6. probability of surviving until a particular age
  7. life expectancy can be used to derive health adjusted life expectancy (HALE), disability adjusted life years (DALYs), potential years of lost life (PYLLs)
36
Q

what are the 2 main types of life table?

A

-period life table
- cohort life table

37
Q

Life tables: what are period life tables

A
  • period life tables use the historical age specific mortality rate from a certain period (ie 2012).
  • they take no account of any projected or actual future changes in age specific mortality

Period life tables display the life expectancy of people of a given age in a given year if they experienced that years age specific mortality rate for the rest of their lives

( eg the mortality rate for 70 year olds in 2012, then the mortality rate for 71 year olds in 2012, then the mortality rate for 72 year olds in 2012)

38
Q

Life tables: cohort life tables

A
  • cohort tables use a combination of observed and projected data

A cohort life table displays the average life expectancy of a group of people of a given age in a given year if they experience the projected future age specific mortality rates from the series of future years in which they would actually live at each succeeding age if they survived (ie mortality rate for 70 year old in 2012, 71 year old in 2013, 72 year old in 2014)

  • therefore if mortality rates are projected to fall then cohort life expectancy would be higher than period life expectancy
39
Q

what can life tables be used for

A
  • life tables can be used to calculate various metrics (see other card)
  • they are particularly useful for pension and social insurance planning
  • used for international comparisons
40
Q

Affect of fertility on population structure: what is the total period fertility

A
  • the average number of children born to a women in her lifetime, assuming she experiences current age specific fertility rates and lives to the end of her reproductive life.
41
Q

Affect of fertility on population structure: what is the general fertility rate

A

(number of live births in a year/ number of women aged 15-49 years) x 1000

42
Q

Affect of fertility on population structure: what is replacement fertility

A
  • the level of fertility required to ensure the population replaces itself
  • to replace herself a women needs to have one female child who survives long enough to have a female child

so…

replacement fertility is the fertility rate at which new-born girls would have, on average, one daughter in their lifetime

this needs to be higher than 2 to account for:
- mortality before the end of reproductive age
- unbalanced birth sex ratio

43
Q

Affect of fertility on population structure: what is the UK total period fertility 2021

A

1.55

44
Q

Affect of fertility on population structure: what is the uk replacement fertility

A

2.08

45
Q

Affect of fertility on population structure: how do birth rates influence population structure

A
  • the the absence of migration , the growth or decline in the population depends on the sustained patterns of replacement fertility
46
Q

Affect of fertility on population structure: what is population momentum

A
  • the phenomenon that sees that despite reaching replacement fertility a populations size continues to increase for decades
  • this is because of population momentum
  • even though replacement fertility has been reached there is a still a large cohort of young people to enter the reproductive years
  • once this large cohort leaves the reproductive years population stablisation/ decline will be seen
47
Q

Affect of fertility on population structure: what are replacement fertility levels in different countries?

A
  • replacement fertility varies from country to country
  • often cited figure of 2.1 only applies to developed countries
  • replacement fertility in Sierra Leone is 3.43
  • international variation is mainly due to mortality differences
48
Q

Affect of fertility on population structure: total period fertility is below replacement fertility, why has population shrinking not been seen?

A
  • population age structure
  • changes in age specific mortality rates
  • childbearing postponement
49
Q

Affect of mortality on population structure: which group see highest mortality?

A
  • infants and older people
50
Q

Affect of fertility/mortality on population structure: what is the population time bomb?

A
  • the process of demographic transition can lead to a population time bomb
  • number of economically active people falling in relation to the number requiring care
51
Q

Economically, what is a countries optimum population?

A
  • the population at which productivity per capita is highest

underpopulated countries- could increase productivity by increasing population

overpopulated countries- could increase productivity by reducing population

52
Q

what is net migration?

A
  • difference between immigration and emigration
53
Q

What is the demographic transition model? who hypothesised it, when and what are the 5 stages?

A

-Thompson
-1929

  1. PREINDUSTRIAL- high birth rates and high mortality rates
  2. DEVELOPING death rate starts to fall due to improved sanitation and access to food. population growth climbs
  3. INDUSTRIALISATION
    birth rate starts to fall due to improved education and status of women, contraception. Population growth continues (population momentum)
  4. DEVELOPED low birth rate and death rate. Population growth begins to stabilise.
  5. DEINDUSTRIALISED switch from manufacturing economy to service based economy. Mortality rate begins to climb due to sedentary lifestyle. Predictions on birth rate vary.
54
Q

Historical changes in UK population

A

TOTAL POPULATION
- steadily grown since 1951
- fewer people aged <16 yrs and ore people aged >65 years

FACTORS
- underlying factors in population structure change include fertility, migration and urbanisation

FERTILITY
- more births than deaths for many years excluding 2020
- birth rates climbed after both world wars with a baby boom in the 1960s. Rates then fell until 1970 and there was a climb in 1980s and 1990s. Rates have been falling again since 2000.
- the average age of the first child has increased
- more women that historically now have no children

MIGRATION
- net immigration in UK is increasingly an important factor in population size
- particularly impactful since rates increased in mid 1990s

55
Q

World population forecasts

A
  • UN predicts work population will reach 10.4 billion by 2100 and continue to grow
  • European population is however predicted to fall
56
Q

Affects of changing demography on healthcare: changing population age structure

A

-Increasing population age
- increased need for geriatric care, social care and care for multiple comorbidities

57
Q

Affects of changing demography on healthcare: changing population ethnicity

A
  • increasing UK ethnic diversity
  • different disease risk factors and patterns of disease
  • changing service needs - ie language barriers, culturally sensitive provision
58
Q

Affects of changing demography on healthcare: changing population mobility

A

SHORT TERM TRAVEL
- can increase spread of acute infectious diseases
- ie COVID 19 pandemic

LONG TERM MIGRATION
- increase spread of emerging diseases ie TB
- healthcare worker migration can impact on the availability of healthcare workforce

59
Q

Affects of changing demography on healthcare: changing population size

A
  • population size increasing
  • increased urbanisation –> increased infectious disease spread
  • increased housing demand –> poor quality housing/ overcrowding –> infectious disease spread and respiratory conditions
60
Q

UK policies to tackle changing population structure

A
  • UK has an ageing population
  • there is therefore a relative shortage of working age adults
  • policy makers can increase the number of working age adults by:
  1. ENCOURAGING MORE BIRTHS ie through family friendly policies such as better maternity pay
  2. ENCOURAGING IMMIGRATION OF WORKING AGE ADULTS (managed migration)
  3. RAISE STATE PENSION AGE to delay peoples entry into retirement
60
Q

International population growth policies

A
  • many international countries have high birth rates and are looking to decrease these
  • China’s one child policy
  • Improved access to contraception and family planning
  • Education and employment of women (independent women have less children on average)

Can also look to tackle the issues of ageing population and increasing population:
- research into challenges of ageing (ie alzheimers disease)
- tackling environmental problems and natural resource demands (ie through international treaties)

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