Measures of Disease Frequency in Epidemiology
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Questions and Answers

What is the main focus of epidemiology?

  • Analyzing the economic factors affecting healthcare access
  • Studying the frequency and distribution of health-related states and events in human populations (correct)
  • Exploring the impact of climate change on health outcomes
  • Determining why diseases occur in specific populations

    • Which population type is defined by being in or out of a state?

  • Baby boomers
  • Dynamic population (correct)
  • Students in a school
  • Fixed population

    • What does a proportion involve dividing by?

  • The smaller of two quantities
  • The sum of itself with another quantity (correct)
  • The larger of two quantities
  • The product of two quantities

    • What does a rate measure in epidemiology?

    <p>The occurrence of an event per population</p> Signup and view all the answers

    How is ratio different from proportion in epidemiology?

    <p>Proportion involves dividing by another quantity, while ratio divides one quantity by another</p> Signup and view all the answers

    What does prevalence measure?

    <p>How much disease is present in a population</p> Signup and view all the answers

    When is point prevalence calculated?

    <p>At a specific moment in time</p> Signup and view all the answers

    What is period prevalence?

    <p>A proportion within a range of time</p> Signup and view all the answers

    What is not useful for determining what caused the disease?

    <p>Prevalence</p> Signup and view all the answers

    Why is prevalence information relevant for health service planning?

    <p>To assess the burden of disease in populations</p> Signup and view all the answers

    Which measure is more accurate for exploring causes of a disease?

    <p>Incidence Rate</p> Signup and view all the answers

    What does the Cumulative Incidence measure?

    <p>New cases of a disease divided by the population at risk</p> Signup and view all the answers

    Why is Cumulative Incidence less accurate than Incidence Rate?

    <p>It requires complete follow-up for all subjects</p> Signup and view all the answers

    Which population type is Incidence Rate more useful for?

    <p>Dynamic populations</p> Signup and view all the answers

    What does Person-Time Rate involve?

    <p>Accrual of total time in which subjects were at risk</p> Signup and view all the answers

    If incidence and cure rates are steady while treatment prolongs the life of individuals with a disease, what is the expected impact on prevalence?

    <p>Increase</p> Signup and view all the answers

    In a fixed population with steady incidence and death rates, what happens to prevalence if the treatment cures the disease?

    <p>Decrease</p> Signup and view all the answers

    What does the Mortality Rate measure?

    <p>Proportion of deaths from a disease over total population</p> Signup and view all the answers

    Which rate is calculated as the proportion of cases of a disease without deaths divided by the total population?

    <p>Morbidity Rate</p> Signup and view all the answers

    What does the Attack Rate measure?

    <p>Proportion of exposed people developing a disease</p> Signup and view all the answers

    What is the purpose of Measures of Association in epidemiology?

    <p>To determine the relationship between a disease and potential risk factors</p> Signup and view all the answers

    What is the Prevalence Ratio used for in epidemiological studies?

    <p>To calculate the ratio of prevalence between exposed and unexposed groups</p> Signup and view all the answers

    In a 2x2 Table for Summarizing Epidemiological Data, what is typically compared?

    <p>Whether or not people have the disease with whether or not people are exposed to a specific risk factor</p> Signup and view all the answers

    What does the Prevalence Ratio value of 2.85 indicate?

    <p>There is a higher prevalence of the disease in the exposed group compared to the unexposed group</p> Signup and view all the answers

    What aspect of groups is compared when using Measures of Association?

    <p>Exposure or characteristic</p> Signup and view all the answers

    What does a Rate Ratio (RR) less than 1.0 indicate?

    <p>Negative association</p> Signup and view all the answers

    In epidemiological terms, what does a Rate Difference (RD) of 0 imply?

    <p>No association between exposure and disease</p> Signup and view all the answers

    If the Rate Ratio (RR) is near 1.0, what does this suggest about the association?

    <p>Weak association</p> Signup and view all the answers

    What does it signify if a Rate Difference (RD) is greater than 0?

    <p>Positive association</p> Signup and view all the answers

    How is the Rate Ratio (RR) different from the Rate Difference (RD)?

    <p>RR measures strength of association, while RD measures public health impact</p> Signup and view all the answers

    What does a Rate Difference (RD) less than 0 signify?

    <p>Negative association</p> Signup and view all the answers

    What is the main purpose of Descriptive Studies in epidemiology?

    <p>Generating hypotheses</p> Signup and view all the answers

    In Descriptive Studies, what is a major limitation that affects the ability to establish causal relationships?

    <p>Inherent limitations in study design</p> Signup and view all the answers

    Which type of study design follows the results as they develop from present time forward?

    <p>Prospective Studies</p> Signup and view all the answers

    What is a key advantage of Case Reports in epidemiology?

    <p>Ease in generating a hypothesis</p> Signup and view all the answers

    When considering Individual studies, what is a significant disadvantage of Case Reports?

    <p>They can't test a hypothesis</p> Signup and view all the answers

    What is a key advantage of a Case Series compared to Case Reports?

    <p>Provides more evidence for hypotheses</p> Signup and view all the answers

    In a Cross-Sectional Study, what is a common limitation that makes it hard to establish causality?

    <p>Hard to determine relationship between cause and effect</p> Signup and view all the answers

    What is a significant advantage of a Repeated Cross Sectional Study over a simple Cross-Sectional Study?

    <p>Observes the same population at different moments in time</p> Signup and view all the answers

    Which of the following is NOT an advantage of a Cross-Sectional Study?

    <p>Can establish causal relationships</p> Signup and view all the answers

    What is a primary disadvantage of a Case Series in terms of hypothesis testing?

    <p>Cannot test a hypothesis</p> Signup and view all the answers

    Which of the following is an important use of a Cross-Sectional Study in epidemiology?

    <p>Monitoring health status in a population</p> Signup and view all the answers

    What is a primary disadvantage of an Ecological Study?

    <p>Tries to create facts about individuals through group results</p> Signup and view all the answers

    Why is it challenging to establish causality in an Ecological Study?

    <p>It looks at aggregate data rather than individual-level data</p> Signup and view all the answers

    Which factor makes Ecological Studies susceptible to inaccurate associations?

    <p>Uses aggregate data from a whole population</p> Signup and view all the answers

    What is a significant limitation of Ecological Studies in terms of association establishment?

    <p>Dependence on group-level data rather than individual data</p> Signup and view all the answers

    Why do Ecological Studies struggle to ensure the exposure and disease development are linked in the same person?

    <p>Inability to track individual-level information in aggregate analysis</p> Signup and view all the answers

    What type of study is indicated for diseases that take a long time to develop?

    <p>Retrospective Study</p> Signup and view all the answers

    What measure can be used to assess the strength of the association between an exposed cohort and an unexposed cohort in a Longitudinal Study?

    <p>Relative Risk (RR)</p> Signup and view all the answers

    Which type of Cohort Study involves exposure occurring before the disease and compares the disease development over time between exposed and unexposed cohorts?

    <p>Prospective Study</p> Signup and view all the answers

    What is a common characteristic of Longitudinal Studies that makes them advantageous for certain types of diseases?

    <p>Exposure preceding disease development</p> Signup and view all the answers

    Which characteristic of Ambi-Directional Studies makes them vulnerable to bias and limits their internal validity?

    <p>Prospective and retrospective aspects</p> Signup and view all the answers

    What is an advantage of Cohort Studies when used to study multiple effects of exposure?

    <p>Can establish causality</p> Signup and view all the answers

    What does an Odds Ratio (OR) value of 1.0 signify in a case-control study?

    <p>No association between the exposure and the disease</p> Signup and view all the answers

    Which of the following is a disadvantage of a case-control study?

    <p>Establishing causality</p> Signup and view all the answers

    In a case-control study, being unable to calculate cumulative incidence is primarily due to:

    <p>Unattainable time at risk for cases</p> Signup and view all the answers

    Why are case-control studies not useful for rare exposures?

    <p>Lack of statistical power</p> Signup and view all the answers

    What is a key advantage of using a control group in a case-control study?

    <p>Balancing confounding variables</p> Signup and view all the answers

    If an Odds Ratio (OR) is significantly greater than 1.0, what interpretation can be made regarding the exposure and disease relationship?

    <p>There is a causal relationship</p> Signup and view all the answers

    What is the primary purpose of random allocation in a Randomized Control Trial (RCT)?

    <p>To minimize bias and eliminate selection bias</p> Signup and view all the answers

    Why is double-blinding considered the most preferred study design to establish causality in RCTs?

    <p>It provides great internal validity by keeping both subjects and investigators unaware of group allocation</p> Signup and view all the answers

    What is the key advantage of maintaining frequent contact as a method to increase compliance in RCTs?

    <p>It can enhance compliance by regularly engaging with study participants</p> Signup and view all the answers

    In what way does using a dispensing device contribute to increased compliance in RCTs?

    <p>It guarantees that all participants receive the same treatment dose</p> Signup and view all the answers

    Why does noncompliance lead to inaccurate results in RCTs?

    <p>Because it increases differences between groups and affects data analysis</p> Signup and view all the answers

    What is a significant disadvantage of randomization in RCTs?

    <p>It increases internal validity but decreases external validity</p> Signup and view all the answers

    Which of the following is NOT a component of the evidence of causality in epidemiology?

    <p>Cessation of Exposure</p> Signup and view all the answers

    If a study's findings cannot be replicated by independent investigators or in different populations, what aspect of evidence of causality is compromised?

    <p>Replication of the Findings</p> Signup and view all the answers

    What does the term 'Specificity of the Association' imply in the context of determining causality?

    <p>The exposure should have a specific effect on only one disease</p> Signup and view all the answers

    Why is biologic plausibility considered a crucial element in establishing causality in epidemiology?

    <p>It provides a biological mechanism to explain the relationship between exposure and disease</p> Signup and view all the answers

    In epidemiology, what does the 'Dose-Response Relationship' indicate regarding exposure and disease?

    <p>A stronger exposure is always associated with a higher risk of disease</p> Signup and view all the answers

    What distinguishes a Quasi-Experimental Study from an Experimental Study?

    <p>It does not require random allocation.</p> Signup and view all the answers

    In a Posttest-Only with Control Group type of study, what differentiates group B from group A?

    <p>Group B is analyzed after the intervention happens.</p> Signup and view all the answers

    What is a primary disadvantage of Natural Experiments compared to Randomized Control Trials (RCTs)?

    <p>Natural Experiments struggle to rule out alternative explanations.</p> Signup and view all the answers

    What is the significance of a P-Value less than 0.05 in hypothesis testing?

    <p>The results are considered statistically significant</p> Signup and view all the answers

    In hypothesis testing, what does it mean if a study has a P-Value greater than 0.05?

    <p>The null hypothesis (H0) is accepted</p> Signup and view all the answers

    What are the disadvantages of using P-Value in hypothesis testing?

    <p>Does not imply medical significance</p> Signup and view all the answers

    How can random error be reduced in a study?

    <p>Increasing sample size and repeating the study</p> Signup and view all the answers

    What is the purpose of hypothesis testing in epidemiological studies?

    <p>Determining the significance of random error</p> Signup and view all the answers

    Why is it important to understand that P-Value is probabilistic and not deterministic in hypothesis testing?

    <p>To interpret results correctly</p> Signup and view all the answers

    What is a potential limitation related to the width of a Confidence Interval?

    <p>Determines public health significance</p> Signup and view all the answers

    How can bias be avoided in research studies?

    <p>Blinding</p> Signup and view all the answers

    What type of bias is created during the assembly process of placing subjects into groups?

    <p>Selection Bias</p> Signup and view all the answers

    When is bias likely to occur during the research process?

    <p>During the analysis stage</p> Signup and view all the answers

    What is the primary purpose of a Confidence Interval in epidemiological studies?

    <p>To quantify random error</p> Signup and view all the answers

    What does it mean if a Confidence Interval includes the null value?

    <p>The P-Value is Ӥ0.05</p> Signup and view all the answers

    The Sensitivity of a screening test is calculated by:

    <p>Dividing the true positive cases by the total amount of cases of the disease</p> Signup and view all the answers

    What is the primary reason why Sensitivity and Specificity are inversely proportional in screening tests?

    <p>To maintain a balance between detecting true positives and true negatives</p> Signup and view all the answers

    Positive Predictive Value (PPV) in screening tests is defined as:

    <p>The probability that a positive test result will be the disease</p> Signup and view all the answers

    What is Negative Predictive Value (NPV) in screening tests primarily based on?

    <p>The probability that a negative test result will not be the disease</p> Signup and view all the answers

    What aspect of a disease does Detectable Pre-Clinical Phase (DPCP) aim to address?

    <p>Diagnosis before symptoms develop</p> Signup and view all the answers

    In the context of screening tests, High Reliability refers to:

    <p>The possibility of reproducible test results</p> Signup and view all the answers

    What is the primary purpose of Reflective Listening in patient interactions?

    <p>To reinforce the patient's strengths and commend goals</p> Signup and view all the answers

    Which level of Reflective Listening involves the provider inferring the meaning and reflecting it back to the patient?

    <p>Paraphrasing</p> Signup and view all the answers

    In Reflective Listening, what does 'Reflections of feeling' entail?

    <p>Inferring and reflecting the implied meaning with emotional emphasis</p> Signup and view all the answers

    What is a common misconception about the Goals of Reflective Listening?

    <p>It focuses on repeating what the patient says word for word</p> Signup and view all the answers

    How does Reflective Listening aim to diffuse resistance in patients?

    <p>By emphasizing positive statements about change made by the patient</p> Signup and view all the answers

    What is a key element to consider in order for motivational interviewing to work effectively?

    <p>Patient's ability to admit having a problem</p> Signup and view all the answers

    Which type of motivation is influenced by personal desires and those close to the patient?

    <p>Intrinsic motivation</p> Signup and view all the answers

    What is one of the goals of eliciting permission, providing feedback in a non-threatening manner, and eliciting the person's interpretation in motivational interviewing?

    <p>To keep the conversation non-threatening</p> Signup and view all the answers

    Which type of questions form the foundation of motivational interviews by encouraging open communication?

    <p>Open-ended questions</p> Signup and view all the answers

    What should be avoided according to the principles of motivational interviewing?

    <p>all of the above</p> Signup and view all the answers

    What characterizes a patient in the 'High Confidence' stage of change?

    <p>Having a strong belief in the decision</p> Signup and view all the answers

    During the Clinical Discovery Phase of Community Water Fluoridation, why did Frederick McKay DDS find brown intrinsic teeth stains (mottled enamel)?

    <p>Only in long-term residents of Colorado Springs</p> Signup and view all the answers

    What level of water fluoridation was determined as the balance between caries prevention and fluorosis during the Epidemiological Phase?

    <p>0.7-1.2 ppm</p> Signup and view all the answers

    In what stage of change is a patient who is unsure of their decision to change or not change?

    <p>Low Confidence</p> Signup and view all the answers

    What was the main source of the brown intrinsic teeth stains discovered by Frederick McKay DDS?

    <p>Drinking water from deep artesian wells</p> Signup and view all the answers

    Which stage of change involves a patient who is stuck between wanting to change and not wanting to change?

    <p>'Ambivalent' stage</p> Signup and view all the answers

    During the Clinical Discovery Phase, what type of residents did Frederick McKay DDS find to have brown intrinsic teeth stains due to mottled enamel?

    <p>Long term residents</p> Signup and view all the answers

    In the Epidemiological Phase, what was the determined range of water fluoridation levels for the best balance between caries prevention and fluorosis?

    <p>0.7-1.2 ppm</p> Signup and view all the answers

    What was the primary goal of the Demonstration Phase in conducting clinical trials in pairs of cities?

    <p>To determine the results of water fluoridation</p> Signup and view all the answers

    What is considered one of the 10 great public health achievements of the 20th century according to the text?

    <p>Water fluoridation</p> Signup and view all the answers

    Why was 0.7 ppm of fluoride determined as the balance for water fluoridation regardless of the ambient temperature zone?

    <p>Toothpaste and mouthwash containing more fluoride</p> Signup and view all the answers

    What role did deep artesian wells play in causing mottled enamel according to Frederick McKay DDS?

    <p>They contained high levels of fluoride</p> Signup and view all the answers

    What is the main difference between Topical [Post-Eruptive] Effects and Systemic [Pre-Eruptive] Effects of fluoride, as described in the text?

    <p>Topical effects involve remineralizing tooth enamel, while systemic effects focus on making enamel resistant to demineralization</p> Signup and view all the answers

    What is the role of fluoride in tooth formation according to the Systemic [Pre-Eruptive] Effects concept?

    <p>Fluoride is built into the enamel to resist demineralization</p> Signup and view all the answers

    What has been the general trend in tooth decay rates due to water fluoridation?

    <p>Water fluoridation has led to a 25% reduction in tooth decay</p> Signup and view all the answers

    What is one potential danger highlighted in the text regarding fluoride toxicity?

    <p>Fluoride toxicity can be achieved by ingesting excessive fluoridated water within a short time frame</p> Signup and view all the answers

    What is a major argument presented against community water fluoridation as discussed in the text?

    <p>It is considered forced mass medication of the public</p> Signup and view all the answers

    What economic benefit does the text mention regarding savings from investing in fluoridation?

    <p>$1 invested in fluoridation saves $38 in avoided dental treatment costs</p> Signup and view all the answers

    What is a major challenge faced by the Dental Care Delivery System's Safety Net System?

    <p>Underfunding and limited capacity</p> Signup and view all the answers

    Which segment of the US population is mentioned to have the highest level of health disparities in terms of access to dental care?

    <p>Hispanics</p> Signup and view all the answers

    What characterizes the Traditional Dental Workforce according to the information provided?

    <p>Includes dental hygienists and laboratory technicians</p> Signup and view all the answers

    What is a significant advantage of the Private Practice Model in terms of payment methods?

    <p>Diverse payment options including private insurance and out-of-pocket payments</p> Signup and view all the answers

    What is a critical need highlighted in the text that necessitates the existence of an Alternative Dental Workforce?

    <p>Addressing the shortage of dentists in certain areas</p> Signup and view all the answers

    Why does the text emphasize the importance of the goal of health equity in relation to access to dental care?

    <p>To address disparities and promote the highest level of health for all</p> Signup and view all the answers

    Which aspect of an association makes causality more likely according to the text?

    <p>The strength of the association</p> Signup and view all the answers

    What did W. Hunter discover in 1911 regarding infections in the mouth?

    <p>Infections in the mouth can cause problems in other parts of the body</p> Signup and view all the answers

    What is the primary benefit of nonsurgical periodontal therapy according to the text?

    <p>No improvement in patient outcomes</p> Signup and view all the answers

    When considering causality, what should happen in relation to cause and effect?

    <p>Cause should happen before the effect</p> Signup and view all the answers

    Which type of infection theory suggests that infections in the mouth can lead to problems in other parts of the body?

    <p>Focal Infection Theory</p> Signup and view all the answers

    What is the association between periodontal disease and coronary heart disease based on studies?

    <p>There is a proven link between periodontal disease and coronary heart disease</p> Signup and view all the answers

    Study Notes

    Measures of Disease Frequency

    • Epidemiology: the study of factors affecting health and illness in human populations, focusing on frequency, distribution, and determinants of health-related states and events.
    • Types of populations:
      • Fixed population: permanent membership, defined by an event (e.g. baby boomers)
      • Dynamic population: transient membership, defined by being in or out of a state (e.g. students in a school)

    Disease Frequency

    • Prevalence: proportion of people with a disease at a point in time, divided by the total population
      • Types:
        • Point prevalence: proportion of people with a disease at a specific moment in time
        • Period prevalence: proportion of people with a disease within a range of time
    • Incidence: ratio of new cases of a disease, divided by the population at risk
      • Types:
        • Cumulative incidence (CI): proportion of new cases within a range of time, divided by the population at risk at the beginning
        • Incidence rate (IR): proportion of new cases within a range of time, divided by the total time each member of the population is at risk
      • Person-time rate: involves accruing total time each member of the population is at risk

    Measures of Association

    • 2x2 table: comparison of disease presence and exposure to a risk factor
    • Prevalence ratio: ratio of prevalence between exposed and unexposed groups
    • Rate ratio (RR): ratio of cumulative incidence between exposed and unexposed groups, showing the strength of the association
    • Rate difference (RD): difference in cumulative incidence between exposed and unexposed groups, measuring public health impact

    Study Designs

    • Descriptive studies: generate hypotheses, communicate clinical observations, and serve as the first step for analytical studies
      • Case reports: detailed report of a single case, identifying new diseases or risk factors
      • Case series: detailed report of a group of cases with similar problems
      • Cross-sectional studies: observe exposure and disease at a single point in time
      • Ecological studies: observe aggregate data from an entire population

    Analytical Studies

    • Observational studies: test hypotheses, comparing groups, and observing what occurs naturally
      • Cohort studies: groups are determined by a common characteristic, and the development of disease is examined over time
      • Case-control studies: determine the differences between those with and without a disease, analyzing their exposure history
    • Experimental studies: healthy subjects are randomly placed into two groups, one exposed and one not, and followed to determine disease development
      • Randomized control trials (RCTs): the most preferred study design to establish causality, with high internal validity
        • Steps: enroll participants, random allocation, blinding, follow-up, and determine the outcome
      • Quasi-experimental studies: similar to experimental studies, but occur naturally, without random allocation
        • Types: posttest-only, pretest-posttest, and interrupted time series

    Concepts of Studies

    • Validity:
      • Internal validity: determined by study design and analysis, confirming whether study conclusions reflect the study sample
      • External validity: determined by the applicability of study results to the larger population
    • Bias: any systematic error in the study design, data collection, or analysis that can lead to incorrect conclusions### Research Study Design
    • Reproducibility: determines if recreating the study will yield the same results
    • Causality: determines the association between the exposure and the disease
      • Works well for infectious diseases
      • Evidence of causality includes:
        • Relationship in time: exposure should come before the disease
        • Strength of association: calculate RR, RD, and OR to determine the association
        • Dose-response relationship: the stronger the exposure, the higher the yield of cases of disease
        • Replication of the findings: similar results should be reproducible with a similar study
        • Biologic plausibility: must make sense from a biologic point of view
        • Consideration of alternative explanations
        • Cessation of exposure
        • Specificity of the association
        • Consistency with other knowledge

    Error in Research

    • Type 1 error (False Positive): observing a difference between groups that is not there
    • Type 2 error (False Negative): missing a difference between groups that is there
    • Sources of error:
      • Random error: false results derived from the observation of things that happened by chance
      • Reducing random error: increasing sample size, repeating the study and measurements, and hypothesis testing
      • P-Value: determines the probability of the results and H0 being related
        • If P-Value ≤ 0.05, then the results are considered statistically significant
        • If P-Value > 0.05, then the results are considered statistically insignificant
      • Disadvantages of P-Value:
        • Does not rule out bias
        • Does not rule out confounding
        • Does not imply medical significance
        • Does not imply biological significance
        • Does not imply public health significance
      • Confidence Intervals: involves a curve on a graph whose width determines the random error
        • Wide CI indicates high random error
        • Narrow CI indicates low random error

    Screening for Disease

    • Detectable pre-clinical phase (DPCP): includes the time span after the disease is detectable by a screening and before symptoms develop
    • Characteristics of a good screening test:
      • Simple
      • Acceptable
      • Cheap
      • No risk of morbidity
      • High reliability
      • High validity
      • Test validity: ideally, sensitivity and specificity would each be 1.0
      • Sensitivity: probability that a diseased person will test positive
      • Specificity: probability that a non-diseased person will test negative
      • Positive predictive value (PPV): probability that a positive test will be the disease
      • Negative predictive value (NPV): probability that a negative test will not be the disease

    Motivational Interviewing

    • Goal: build motivation for change and sustain that change over time
    • Patient-centered approach
    • Types of motivation:
      • Intrinsic: derived from personal desires
      • Extrinsic: influenced by the environment
    • Goals for health behavior change:
      • Treatment entry
      • Treatment adherence
      • Treatment engagement
      • Treatment response
      • Maintenance of treatment
    • OARS: open-ended questions, affirmations, reflective listening, and self-motivational statements
    • Levels of reflective listening:
      • Repeating
      • Rephrasing
      • Paraphrasing
      • Reflections of feeling
      • Complex reflections of meaning

    Community Water Fluoridation

    • History:
      • Clinical discovery phase (1901-1933)
      • Epidemiological phase (1933-1945)
      • Demonstration phase (1945-1954)
      • Technology transfer phase (1950-present)
    • Mechanisms of action:
      • Topical [post-eruptive] effects
      • Systemic [pre-eruptive] effects
    • Safety and benefits:
      • Reduced tooth decay by at least 25%
      • Especially benefits children, the poor, and those with limited access to dental care
      • Provides overall decrease in oral health problems
    • Regulations:
      • Environment Protection Agency (EPA)
      • The Safe Drinking Water Act
      • FDA
      • DHHS
    • Fluoride toxicity:
      • Can be achieved by ingesting large amounts of fluoridated water
      • Babies and children are more susceptible to fluoride toxicity
    • Arguments against fluoridation:
      • Not FDA approved
      • No RCTs have been conducted
      • Considered a forced mass medication of the public
      • Fluoride used is not pharmaceutical quality
    • Savings:
      • $1 invested in fluoridation saves $38 in avoided costs for dental treatment
      • Average of $1 per person per year is spent on fluoridation

    Access to Dental Care

    • Disparities:
      • Poor populations
      • Racial-ethnic minorities
      • Special needs individuals
      • Uninsured
      • Public insurance
      • Individuals living far from a dental practice
      • Fear of the dentist
      • Oral health ignorance
      • Not enough dentists in an area
    • Dental care delivery system:
      • Private practice model
      • Safety net system
      • Alternative dental workforce
    • Oral systemic disease associations:
      • Life in general is less satisfying due to condition of mouth and teeth
      • Oral health affects the quality of life
      • Physically, socially, and psychologically
    • Criteria for causality:
      • Strength
      • Consistency
      • Specificity
      • Temporality
      • Biological gradient
      • Plausibility

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    Description

    Explore the basics of epidemiology with a focus on measures of disease frequency. Learn about the importance of studying factors affecting the health and illness of human populations, including frequency, distribution, and determinants of health-related states and events. Understand the concepts of fixed and dynamic populations, along with the differences among ratio, proportion, and rate.

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