Epidemiology: basic science of public health
correct sequence of dishes to excite the palate without
Because:
the science that describes the relationship of
health and/or disease with other health-related
factors in human populations, such as human
pathogens
used to generate much of the information
required by public health professionals to
develop, implement, and evaluate effective
intervention programs for the prevention of
disease and promotion of health
Maxcys definition:
Epidemiology is that field of medical science
which is concerned with the relationship of
various factors and conditions which determine
the frequencies and distributions of an
infectious process, a disease, or a physiologic
state in a human community. (Lilienfeld 1978, p.
88)
John Lasts definition:
The study of the distribution and determinants
of health-related states or events in specified
populations, and the application of this study to
the control of health problems. (Dictionary of
Epidemiology)
Causal inference process of providing an
accumulation of increasingly convincing indirect
evidence of a relationship between health or disease
and other factors
Predisease stage early intervention may avert
exposure to the agent of disease (e.g. microbes, trans-
fatty acids, lead) PRIMARY INTERVENTION
Latent stage screening for disease and providing
appropriate treatment may prevent progression to
symptomatic disease SECONDARY PREVENTION
Symptomatic stage intervention may slow, arrest, or
reverse the progression of disease TERTIARY
PREVENTION
Applying the epidemiological method to resolve a
health question successfully can be compared to
constructing a memorable Chinese banquet. It is not
enough to have the best ingredients and to know the
various Chinese cooking methods. The truly great
chefs must be able to select the appropriate ingredients
and cooking methods to bring out the flavors of each
dish, and further, must know how to construct the
overwhelming it. Thy create a memorable banquet by
adding their creative genius to the raw ingredients and
the established cooking methods.
B. Mechanism and Causes of Disease
EXAMPLE: Osteomalacia bone dse that may have both
social and biologic causes; social: Muslin custom of
purdah; biologic deficiency of vitamin D (prevention of
irradiation of ergosterol in the skin, may develop
osteomalacia as a result of insufficient calcium
absorption. Osteomalacia can adversely affect future
preganancye by causing the pelvis to become distorted
(more pear shaped), making the pelvic opening too
small for the fetus to pass through that may lead to
infant mortality.
C. Host, Agent Environment, and Vector
Example: Measles: host (human), agent (rubeola virus),
the environment (population of unvaccinated
individuals)
Host factors responsible for the degree to which the
individual is able to adapt to the stressor produced by
the agent
Host resistance is influenced by: genotype, nutritional
status and BMI, immune system, and social behavior
Agents of disease divided into several categories
(biologic, chemical, physical agents)
Environment influences the probability and
circumstances of contact between the host and the
agent; also includes social, political, and economic
factors
Vectors include insects, arachnids, and mammals; can
be applied more widely to include human groups
(vendors of heroin, cocaine, and meth), and inanimate
objects (fomites)
Time-place-person
Describe disease or disease factors occurring in the
population to elucidate the causative agent:
Time (e.g. trends, outbreaks, etc.)
Place (the geographic area in which the disease is
occurring)
Person (the characteristics of the affected individuals;
e.g. age, gender, etc.)