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3. Researchers have revised the estimated number of deaths in Puerto Rico by conducting a door-to-door survey if a representative sample of 3299 households.

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3. Researchers have revised the estimated number of deaths in Puerto Rico by conducting a door-to-door survey if a representative sample of 3299 households. They found that the distribution of deaths was not even across the country and there were more deaths in the more remote areas of the country. The remoteness was given a value from 1 to 8 based on the services available and the distance from major cities. The 'Reported Deaths' were those reported in the surveyed data. The data below was adjusted for remoteness to estimate a more accurate overall mortality rate per 1,000 persons. Calculate the crude overall mortality rate per 1,000 persons and the adjusted overall mortality rate per 1,000 persons. Explain why these values are different. Remoteness Surveyed Population Reported Total Adjusted Expected Deaths Population Mortality deaths Rate 1 960 6 1,035,194 6.25 6470 2 1236 9 489,425 7.28 3564 3 1161 295,770 4.31 1274 4 1125 5 260,242 4.44 1157 5 1293 12 305,909 9.28 2839 6 1273 8 286,182 6.28 1798 7 1087 6 220,050 5.52 1215 8 1287 5 137,534 3.89 534 (Source: Kishore, et al., Mortality in Puerto Rico after Hurricane Maria, The New England Journal of Medicine 2018; 379: 162-179)

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