Block 1: Preventive Medicine, Epidemiology & Public Health

Edward Via Virginia College of Osteopathic Medicine

Study Sheet
Note: The final is cumulative. The Final Exam will contain 50 questions you will
have two hours to complete it.
Session 1: Intro to Community Medicine/What is epidemiology
Preventive medicine/Public health: Review the definitions and understand the
distinctions between preventive medicine and public health.
Disease: Review the definitions of health as defined by WHO, an
epidemiologist, a clinician and patients.
Review Quality of life measures and activities of daily living
Definitions: Epidemiology/preventive medicine/public health/
morbidity/mortality/ADL
Session 2: History and uses
Name key players in the historic evolution of epidemiology and describe their
contribution. (ie: Hippocrates; John Graunt and William Farr-recorded vital
statistics; James Lind-scurvy; Edward Jenner-small pox vaccination;
Semmelweis-infection control; Snow-London Cholera; Germ Theory)
Describe the changes in disease patterns and in the 20 th century and the
differences in causes of morbidity from the early 1900s to 2000.
Definitions: none!
Session 3: Epidemiologic Approach
Epidemiologic Triad, web of causation, and Causal Pie:
What are the major components of each?
How do they relate to disease control and prevention?
Review the steps in the epidemiologic process and review epidemiologic tools
that an epidemiologist might use to define the problem and describe the
epidemiology of the problem. (for example establish a case
definition/counts/rates/epidemic curve)
Definitions: Infectivity, pathogenicity, virulence, attack rate, case definition/
incidence/prevalence/epidemic/endemic/pandemic/counts/rates/epidemic curve
Sessions 4 and 5: Epidemiologic Approach (continued)
Study design
-Review the continuum of epidemiologic investigation that was posted to
Blackboard. Understand the progression of study types, and when you might
use each one. For example, rare disease draws heavily on the retrospective,
case-control study design as it works with people who already have the disease,
and compares these cases to disease-free controls to investigate the potential of
suspected exposures.
-Understand the basic strengths and weaknesses of each design and its results.

Differentiate odds ratio and relative risk (AKA risk ratio) and interpret each one.
Be able to differentiate the three experimental designs discussed in class.
(randomized control trial/field trial/community trial)
Understand the importance of randomization to the experimental process i.e.,
that it gives all study participants an equal opportunity to be assigned to an
experimental group in the study. This helps equate the groups on extraneous
factors that might otherwise influence/bias the outcomes of the study.

Session 6: Rural Communities, Challenges to health

Differentiate various definitions of rural (US Census Bureau, Office of
Management and Budget, County-Level urban Influence, Rural-Urban Continuum
Codes)
What are some of the characteristics of people that live in rural areas as
compared to urban areas? (ie age, poverty, employment opportunities,
education)
Understand that health care is more than the formal health care infrastructure - it
encompasses other. systems such as transportation, social services, grocery
stores, etc.
Definitions: none other than the various definitions of rural
Session 7: Using epidemiology to Guide Community/Population Health: Healthy
People 2010
Describe the history of the Healthy People 2010.
What are the two overarching goals of Healthy People 2010.
Be familiar with the 10 leading Health Indicators.
Definitions: None!
Session 8: Community Health
HPSA: What is a HPSA? What are the major types of HPSAs? How does it
benefit health care in underserved areas?
What programs do governmental agencies use to improve access in HPSAs?
(National Health Service Corp, Rural Health Clinics, Critical Access Hospitals, J1
Visa Waiver/.)
What is the roll of the local public Health Department in improving a communities
health? Identify other community organizations involved in health promotion.
Definitions: Rural clinics/Critical access hospitals/J1 Visa Waiver/
Session 9: Osteopaths and Communities
Review the distribution of osteopathic physicians. ie rural vs. urban, primary care
vs. sub-specialization,
Identify organizations and strategies that osteopaths can rely on to promote
health and well being.
Definitions: none
Worksheet 1, Session 10 and 11:

Review the descriptions and purpose of listed congressional acts

Know the role and purpose for the listed federal departments or divisions
What are vital statistics and what are the essential components of a case
definition?
(Think broadly Ie will you be tested on the case definition for Domestic
Arboviral Diseases or the names of the New River Valley free clinics, the number
of VA rabies cases in 2002, or the name of the New River Valley Health director?
. NO!)

Session 12: Cardiovascular Diseases

Trends: Understand general trends in cardiovascular disease. What are the
leading causes of mortality from cardiovascular disease and who is
disproportionately affected (age/race/sex)?
Framingham Study: What is the purpose and design of the Framingham
Study? What are some of the risk factors identified by the Framingham Study?
Definitions: cardiovascular disease/direct costs/indirect costs
Session 13: Cancer
Review the leading causes of cancer death and cancer incidence for men and
women..
Understand the relationship between our ageing population and the inevitable
increase in incidence and prevalence of cancer.
Understand that the increase in cancer survivorship has meant that many
primary care physicians care for patients suffering from the long-term
complications of treatment.
Session 14: Obesity and Diabetes
Review the obesity trends in the United States since the 1960s and what areas
have the highest prevalence of obesity. Review potential causes for the
increased prevalence of obesity
Review the relationship between increasing obesity and the incidence of
diabetes.
Definitions: overweight/obese/BMI
Session 15: HIV/AIDS
Understand what surveillance information is collected and its purpose.
Review the changes in the trends of transmission of HIV.
What populations are increasingly at risk for HIV?
Definitions: active reporting/passive reporting/confidential testing/anonymous
testing
Session 16: Womens Health
WHI: What is the purpose and type of study design of the WHI?

Review contraceptive and unintended pregnancy trends. Ie. Use of contraception

has increased, while the rate of unintended pregnancy has decreased. Again,
think broadly..not what percent of the population has ever used the pill)
Definitions: menopause, measures of unintended pregnancy

Session 17 and 18: Worksheet 2

What are the steps in the investigation of an outbreak?
Be able to calculate food specific attack rates to determine possible vehicles
Definitions: outbreak/epidemic/vector/vehicle/line listing/epidemic curve
Session 19: Epidemiology of Childrens Health
What are the lead causes of infant mortality, childhood mortality (ages 5-14) and
adolescent mortality in the US?
What are the general trends for infant mortality as evidenced by data from 2002?
Understand the potential cause for the increase in the infant mortality rate.
What is the definition of overweight and obesity for children? What are some of
the potential complications of obesity for children.
Definitions: infant mortality rate/neonatal mortality rate/postneonatal mortality
rate/term birth/low birth weight rate/
Session 20: Substance Abuse
Which drugs are most commonly used by adolescents? Review the initiation of
use among adolescents of prevalence of abuse of which drugs among
adolescents has rapidly increased in the last 10 years?
What youth prevention related measures are most closely correlated with
decreased drug abuse among adolescents?
Identify populations most at risk for alcohol abuse.
Definitions: drug/dependence/substance abuse/Alcohol-current use, binge use,
heavy use
Session 21: Behavioral and Environmental Risks
Lead: Review the general trend of the prevalence of elevated blood levels of
children from 1960-present. What federal policy changes are most responsible
for the trend? What populations are most at risk for lead toxicity.
Radon: What is radon? How are people exposed? What areas are most at risk
and what are the associated health risks.
Mercury: Review the effects in infants and recommendations to limit control.
Recovery after natural disasters: Review the 4 major risk factors for disease
spread after a natural disaster, the essential components of disease surveillance
after a natural disaster, and measures to control disease after a natural disaster.
Definitions: Teratogen
Again - ask questions if you are still stumped. I want to try and help you as much
as I possibly can!!