Introduction to Epidemiology Lecture 1 PDF

Welcome to Epi 101! PH 101 Introduction to Epidemiology September 26, 2024 Kimberly C. Brouwer, Ph.D. (she/her) Professor & Associate Dean for Education & Student Affairs H.W. School of Public Health [email protected]  Teaching Assist...

Welcome to Epi 101! PH 101 Introduction to Epidemiology September 26, 2024 Kimberly C. Brouwer, Ph.D. (she/her) Professor & Associate Dean for Education & Student Affairs H.W. School of Public Health [email protected]  Teaching Assistant Hannah Battey, MS Joint Doctoral Program in Public Health EpidemiologyTrack she/her Undergraduate Instructional Assistants Sandy Lian La Matthew Gregory Lam Public Health Public Health (Health Policy & Mgmt) Minor: General Biology & Psychology/Human Health Undergraduate Instructional Assistants Sandy Lian La Matthew Gregory Lam Public Health Public Health (Health Policy & Mgmt) Minor: General Biology & Psychology/Human Health  Introduce self Share an interesting thing that happened this summer  Learning Objectives 1. Identify the structure, strengths and weaknesses of various epidemiologic study designs for application in studies of various health outcomes. 2. Define and calculate measures of disease occurrence and measures of association that quantify the relationship between exposures or risk factors and health outcomes. 3. Describe random error & major sources of bias in epidemiologic studies, including confounding, selection bias, and measurement error. 4. Gain familiarity with the major public health domains of epidemiology.  Canvas Course Site Announcements Syllabus Lecture handouts Readings Assignments (or via Gradescope) Discussion board Contact info Required Materials Readings: provided through canvas.ucsd.edu course site Calculator, separate from your phone Pencil/Pen Yourself  Assessment & Grading Component Weight Midterm exam 20% Final exam 30% Class participation 10% (post-lecture mini-quizzes) Quizzes 10% Homework 10% Lab 20% TOTAL: 100% Participation points start next week. To receive full participation points you must complete at least 90% of mini-quizzes/evaluations No extra credit  Homework Turn in before the lab starts (no later than 1:59 pm via the Gradescope site) Readings & homework are relevant to the labs Homework is expected to reflect individual work – do not work in groups  Lab Sessions Individual review of assignment ~ 45 min – lab assignment (group discussion/completion) Turn in assignment (1 per group) ~ 25 min – discussion  Expectations Actively listen/don’t multi-task Respectful to guest speakers, teaching assistants, instructor, and peers Zoom – Mute yourself, unless asking a question – Ideally, show your video when asking questions or working in groups – Use your real name when logging in – Do not share zoom details with those outside of class  Keeping Everyone Safe Stay current with your vaccinations Take advantage of free testing, monitor symptoms, stay home if you’re sick Keep your hands clean Cover your cough and don’t touch your face When in doubt, wear a mask  Getting Help Assignment structure Problem solving labs Discussion board Office “student” hours  Welcome to Epi 101! PH 101 Introduction to Epidemiology September 26, 2024 Kimberly C. Brouwer, Ph.D. (she/her) Professor & Associate Dean for Education & Student Affairs H.W. School of Public Health [email protected]  Overview Defining Epidemiology Prevention Determinants of disease transmission Origin and history of epidemiology  What is Epidemiology?  The study of the distribution and determinants of health-related states in human populations, and the application of this study to prevent and control health problems  Epidemiology is the study of how often diseases occur in different groups of people and why  Populations  People grouped by a common characteristic (or characteristics) Data Informs Prevention/Control Interventions often population-based Screening at health fairs (blood pressure) Vaccination of school children Dietary guidelines Relevance to clinical practice? What is normal cholesterol? Survival from cancer Appropriate therapy  Why focus on prevention? Determine the modifiable and non-modifiable risk factors. Population-based, relatively inexpensive and non-invasive Identify subpopulations with high risk  Primary Prevention Preventing disease before it happens: Healthy individuals Prevent exposure – Tobacco, pesticides Immunize against a disease Promote healthy behaviors Most effective but often most difficult to implement, especially for chronic diseases  Secondary Prevention Catching disease at an early, asymptomatic stage Requires knowledge of the natural history of the disease Screening – Colonoscopy, PAP Smear Good idea when early treatment is more effective – Breast cancer screening Helps stem transmission Downsides – Costly – Invasive – Over-treatment  Tertiary Prevention Prevention of health deterioration in those already diagnosed with a disease Requires clinical data and patients May involve pharmacological, behavioral, or other interventions Prevention StompOnStep1.com  For people with diabetes, medications and dietary changes help prevent the damaging effects of high blood glucose levels A) Primary B) Secondary C) Tertiary  Wearing a mask to prevent a person from getting a respiratory infection is an example of what type of prevention? A) Primary B) Secondary C) Tertiary  What is Epidemiology?  The study of the distribution and determinants of health-related states in human populations, and the application of this study to prevent and control health problems Epidemiologic Triad  Age Sex Genotype Epidemiologic Triad Weather Behaviour Housing Nutritional status Geography Health status Occupation Air quality Host Environment Food Social env. Disease Infectivity Pathogenicity Virulence Agent Immunogenicity Stability  Public Health Detective Work Who: person What: diagnosis or health event Where: place When: time Why/how: causes, risk factors, and modes of transmission Endemic - Epidemic - Pandemic R>1 R=1 R220 books Compared outcome of patients with meningitis treated with blood-letting with the outcome of those without it 'If the dullness in the head is greater than the pain, and there is no insomnia, but rather sleep, then the fever will abate, but the throbbing will be immense but not frequent and he will progress into a stupor. So when you see these symptoms, then proceed with bloodletting. For I once saved one group [of patients] by it, while I intentionally neglected [to bleed] another group. By doing that, I wished to reach a conclusion. And so all of these contracted meningitis.'  Fracastoro (1478-1553) Italian physician, poet, astronomer, and geologist Infection spread by tiny, self replicating seeds that were specific for each disease (but also influenced by planetary movements) “Seminaria” transmitted by: Direct contact Fomites Air Quinto Tiberio Angelerio - new measures for controlling plague in 16th-century Sardinia First? written use of the term Epidemiology 1598  1662 John Graunt – Father of Demography Published landmark analysis of mortality data “Natural and Political Observations Made upon the Bills of Mortality” – Developed early statistical/census methods Quantified patterns of birth, death, disease: Males/females Infant mortality Urban/rural Seasonal  Early Epidemiologists James Lind 1716-1794 Observed and wrote about scurvy among sailors Initially attributed to dampness Explored diet & carried out a dietary intervention  Sailors with Scurvy Divided into groups of 2 1 Same diet + 1 quart of cider daily 2 Same diet + 25 drops of elixir of vitriol (sulfuric acid) 3 Same diet + 6 spoonfuls of vinegar 4 Same diet + half a pint of seawater 5 Same diet + 2 oranges & 1 lemon 6 Same diet + a spicy paste plus a drink of barley water Who is considered the “Father of Epidemiology”??? https://www.youtube.com/watch?v=1jlsyuc Uwpo&t=193s  Cholera epidemic and water sources: London, 1854* Rate per Water Cholera Houses 10,000 supplier deaths houses Southward & Vauxhall 40,046 1253 315 Co. Lambeth 26,107 98 37 Co. Others 256,423 1422 59 *Gardner M. Arch Environ Health 1988;43:102-8  “Father of Epidemiology” - John Snow - Map of 1854 cholera epidemic in London William Edward Burghardt (W.E.B.) Du Bois Editor, historian, sociologist, novelist, civil rights leader First black person to get PhD from Harvard Contributed to development of social epidemiology Countered Eugenics and proponents claiming certain races were inherently unhealthy or prone to crime https://www.youtube.com/watch?v=P6_EM_W0CN4 Modern Epidemiology  Fields of Epidemiology Exposure based: Environmental, nutritional, tobacco, pharmacology, behavior, social, Disease based: Cancer, cardiovascular, perinatal, neurology, Discipline based: Clinical, molecular, genetic Used for: Public policy, legal cases, social norms Professional Societies: Society for Epidemiologic Research, American College of Epidemiology, International Epidemiological Association, International Society for Environmental Epidemiology, APHA, AACR,