Epidemiology Defined:
The study of the distribution and determinants of disease frequency in human populations
To improve the health of a population, we need to know:
who is getting sick
what is making them sick
when/where/how they are getting sick
if what we are doing is making people better?
Epidemiology uses special tools to
to examine these relationships; they are different than statistics, though statistical methods are
incorporated.
From the following information, epidemiologists can infer why a disease is occurring
Who is getting the disease?
When did they get the disease?
Where is the disease occurring?
,Other information...?
The goal is to use this knowledge to control and prevent the spread of disease.
Epidemic Surveillance
Is a major line of defense in protecting the public against disease.
-System was created to control spread of known disease but also aids in recognizing new disease.
-Importance has increased with threat of bioterrorism.
endemic
native or confined to a particular region or people
epidemic
A widespread outbreak of an infectious disease.
notifiable diseases
diseases for which health officials request or require reporting for public health reasons
Shoe Leather Epidemiology
practice of working in the field to conduct research. Snow practiced this type of research when he asked
around the community about the deaths.
,outbreak investigation
Verify the diagnosis.
Construct a working case definition.
Find cases systematically.
---Apply active surveillance.
Ask who, where, when and how questions to describe the epidemic by person, place, and time.
---Consider the incubation period.
Look for a common source of exposure.
Epidemiology and Chronic Diseases
Identify risk factors.
Observe long-term trends.
Epidemiologic studies of chronic diseases are more complicated and difficult than for infectious diseases
or toxic contamination.
Heart disease is leading cause of death in the U.S.
Framingham study (started in 1948)
Lung cancer and smoking studies followed in the early 1950s.
, British study of physicians
Hammond-Horn study in the U.S.
Define the Disease
Death is easy to determine
---A death certificate states cause of death.
A blood test or stool sample is needed to diagnose certain diseases.
Some diseases are hard to define.
---EMS and SARS.
Sometimes a definition changes as more is learned. ---AIDS and COVID
Z
Other health outcomes include injuries and risk factors.
Disease Frequency
Count the number of people with a disease and relate that to the population at risk (PAR).
PAR (denominator) may be the total population or exposed population, or one gender or age group.
---PAR often comes from a census.
Population at risk
those in the population who are susceptible to a particular disease or condition