PHAR 658 Foundations of Epidemiology I - Merrill Chapter 1 - January 14, 2025 PDF

PHAR 658 Foundations of Epidemiology I Merrill Chapter 1 January 14, 2025 Preeti Pushpalata Zanwar, PhD, MPH, MS OBJECTIVES Define epidemiology and understand the basic vocabulary used in epidemiology. Define descriptive and analytic epidemiology. Identify selected...

PHAR 658 Foundations of Epidemiology I Merrill Chapter 1 January 14, 2025 Preeti Pushpalata Zanwar, PhD, MPH, MS OBJECTIVES Define epidemiology and understand the basic vocabulary used in epidemiology. Define descriptive and analytic epidemiology. Identify selected activities performed in epidemiology. Explain the role of epidemiology in public health practice and individual decision making. WHAT IS HEALTH?  The absence of illness  Six dimensions of health  WHAT ARE THE SIX DIMENSIONS OF HEALTH? Physical Ability of the human body to function properly; includes physical fitness and activities of daily living. Social Ability to have satisfying relationships; interaction with social institutions and societal mores. Mental Ability to think clearly, reason objectively, and act properly. Emotional Ability to cope, adjust and adapt; self-efficacy and self- esteem. Spiritual Feeling as if part of a greater spectrum of existence; personal beliefs and choices. Environmental Comprises external factors (one’s surroundings such as habitat or occupation) and internal factors (one’s internal structure such as genetics). WHAT IS PUBLIC HEALTH?  Public health is the science and art of promoting health and extending life on the population level.  Public health is concerned with threats to health in the population (a group of people sharing one or more characteristics).  The mission of public health is to ensure conditions that promote the six dimensions of health in the population as a whole. WHAT IS THE MEANING OF POPULATION?  Population refers to a collection of individuals that share one or more observable personal or observational characteristics from which data may be collected and evaluated.  Social  Economic  Family (marriage and divorce)  Work and labor force  Geographic factors HOW DOES PUBLIC HEALTH RELATE TO EPIDEMIOLOGY?  There are many subfields of public health, including epidemiology, biostatistics, and health services.  Because of its central role in public health, epidemiology is commonly referred to as the foundation of public health. WHAT IS EPIDEMIOLOGY?  Epidemiology is the study of the distribution and determinants of health-related states or events in human populations, and the application of this study to prevent and control health problems. KEY TERMS IN THE DEFINITION  Health-related states or events  Disease states  cholera, influenza, pneumonia, mental illness  Conditions associated with health  physical activity, nutrition, environmental poisoning, seat belt use, and provision and use of health services  Events  injury, drug abuse, and suicide WHY IS EPIDEMIOLOGY THE FOUNDATION OF PUBLIC HEALTH?  Because of its central role in carrying out the three core public health functions: 1. The assessment and monitoring of the health of communities and populations at risk to identify health problems and priorities. 2. The formulation of public policies designed to solve identified local and national health problems and priorities. 3. To assure that all populations have access to appropriate and cost-effective care, including health promotion and disease prevention services, and evaluation of the effectiveness of that care. EPIDEMIOLOGY AND THE SCIENTIFIC METHOD  Epidemiology uses the scientific method to describe and analyze health-related states or events. WHAT IS THE SCIENTIFIC METHOD?  The scientific method involves using appropriate study designs and statistical techniques for investigating an observable occurrence and acquiring new knowledge.  The health problem  Hypotheses  Statistical testing  Interpretation  Dissemination STUDY DESIGNS IN EPIDEMIOLOGY  Descriptive epidemiology  Involves study designs used to answer: Who? What? When? Where?  Analytic epidemiology  Involves study designs used to answer: Why? How?  Later modules will focus on describing these study designs THE IMPORTANCE OF DESCRIPTIVE EPIDEMIOLOGY  A means to characterizing the distribution of health-related states or events by:  Person – who?  Place – where?  Time – when?  Clinical criteria – what? THE IMPORTANCE OF ANALYTIC EPIDEMIOLOGY  A means to identifying and quantifying associations, testing hypotheses, and supporting statements about causality  Explains why and how health-related states or events occur SELECTED ACTIVITIES PERFORMED IN EPIDEMIOLOGY  Identifying risk factors for disease, injury, and death  Describing the natural history of disease  Identifying individuals and populations at greatest risk for disease  Identifying where the public health problem is greatest  Monitoring diseases and other health-related events over time  Evaluating the efficacy and effectiveness of prevention and treatment programs  Providing information useful in health planning and decision making for establishing health programs with appropriate priorities  Assisting in carrying out public health programs  Being a resource person  Communicating public health information SELECTED TYPES OF EPIDEMIOLOGIC INFORMATION  Public health assessment  Causes of disease  Completing the clinical picture  Program evaluation  Efficacy – the ability of a program to produce a desired effect among those who participate in the program compared with those who do not.  Effectiveness – the ability of a program to produce benefits among those who are offered the program. QUESTIONS THAT NEED EPIDEMIOLOGY (1 OF 2)  Diagnosis  Is there such a problem as myalgic encephalitis?  Is prostate-specific antigen a good test for prostate cancer?  Causes  Why did this patient suffer a stroke?  Is obesity the cause of metabolic syndrome?  Treatment  Is this the best treatment for Parkinson's disease?  Is my surgery as good as that of everyone else?  Prognosis  What are the chances of a recurrent heart attack?  How long will this knee joint prosthesis last?  QUESTIONS THAT NEED EPIDEMIOLOGY (2 OF 2)  Health promotion and protection  Do current school meals harm children's future health?  Will the Irish smoking ban in public places work better than the English policy?  Health and disease surveillance  Why are there 10-fold international differences in suicide rates?  When will the next influenza pandemic occur?  Health inequalities  Why should life expectancy be nearly 5 years lower in unskilled manual workers?  Do health services reduce or increase health inequalities? PREVALENCE OF SELF-REPORTED OBESITY AMONG U.S. ADULTS BY STATE AND TERRITORY, BRFSS 2011 2017