Introduction to Epidemiology

The Basic Science of Public Health Practice

Basic Science of Public Health

1. A quantitative basic science built on a working knowledge of 2. probability statistics sound research methods

A method of causal reasoning pertaining to the occurrence and prevention of morbidity and mortality. developing and testing hypothesis

3.

A tool for public health action to promote and protect the publics health.

. . .and a dose of common sense !

The Meaning of

Epidemiology
Greek words:

epi demos logos

on or upon people - the study of

Epidemiology

is the study of the distribution and determinants of healthrelated states or events in specified populations, and the application of this study to the control of health problems.

The Anatomy of the Definition

Distribution

frequency and pattern of health events in a population rate or risk of disease

Pattern refers to: Time - annual, seasonal, daily or hourly. Place - urban, rural, location of worksites or schools. Person - age, race, sex, marital, etc..

Distribution means:

Descriptive Epidemiology

it provides the What, Who, When, and Where of healthrelated events. description of the population involved and the profile of the disease or any health-related event under investigation.

Determinants
causes and other factors that influence the occurrence of

disease or any health-related events. are identified through

Analytic Epidemiology

comparison of different groups of people with regards to the following: rates of disease occurrence genetic, behaviors, environmental exposures and other potential risk factors

it provides the why and how

Health-related States or Events

Epidemiology covers

the following areas of concern: communicable and noncommunicable diseases chronic diseases, injuries, birth defects, maternal-child health, occupational and environmental health behaviors and well-being (exercise, seat-belt use, etc.)

Specified Populations

The people in a community or other area. Epidemiologists focus on the exposure (source that caused the illness). Other persons who may have been similarly exposed. The potential for further spread in the community. Interventions to prevent additional cases or recurrences.

Uses of Epidemiology

Population or Community Health Assessment It answers the following questions:

What are the actual and potential health problems in the community? Where are they? Who is at risk? Which problems are declining over time? Which ones are increasing or have the potential to increase? How do these patterns relate to the level and distribution of services available?

Uses of Epidemiology

Identify Factors that Cause Disease Establish a Clinical Diagnosis of Disease

HIV-AIDS

Evaluate the Effectiveness of Health Programs Explain How and Why Diseases and Epidemics Occur Predict the Future Health Needs of a Population

Epidemiology in Public Health Practice

Public Health Surveillance

systematic collection, analysis, interpretation, and dissemination of health data in an ongoing basis. Information for Action

Disease Investigation
to identify additional unreported cases in order to control spread of the disease. to identify a source or vehicle of infection which can be controlled or eliminated. to learn more about the disease itself - clinical spectrum, risk factors, etc..

Evaluation

Effectiveness - the ability of the program to produce the intended or expected results in the field. Efficacy - the ability to produce results under ideal conditions. Efficiency - ability of the program to produce the intended results with a minimum expenditure of time and resources.

The Epidemiologic Triad

 it is the traditional model of infectious disease causation.

Agent

Host Agent

Environment Host

the three components must be investigated if we search for causal relationships.

Level of Disease Occurrence

Expected Level

the amount of a particular disease that is usually present in a community.

Sporadic
irregular pattern of occurrence, with, occasional cases occurring at irregular intervals.

Endemic
persistent level of occurrence with a low to moderate disease level.

Hyperendemic
a persistently high level of occurrence.

Epidemic or Outbreak
the occurrence of a disease within an area clearly in excess of the expected level for a given period.

Pandemic
epidemic which spreads over several countries or continents, affecting a large number of people.

Causes of Epidemic
a recent increase in amount or virulence of the agent. the recent introduction of the agent into a setting where it has not been before. an enhanced mode of transmission so that more susceptibles are exposed. some change in the susceptibility of the host response to the agent. factors that increase host exposure or involve introduction through new portals of entry.

Synopsis
Epidemiology includes the study of the frequency, patterns, and causes of health-related states or events in populations, and the application of the information gained to public health issues. Patient - is the public at large. Mode of Treatment - involves public health surveillance, disease investigation, analytic epidemiology and evaluation.

We use
Descriptive Epidemiology approach to portray the characteristics and health of a population or community. Analytic Epidemiology approach to sort out and quantify potential risk factors and causes.

In order to be more effective, the practice of epidemiology must be part of the larger team of institutions and individuals.