Epidemiology 101 Chapter 1 – Flashcards
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Epidemiology
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Concerned with the distribution and determinants of health and diseases, morbidity, injuries, disability, and mortality in populations. Epidemiologic studies are applied to the control of health problems in populations.
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Epidemic
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Occurrence in a community or region of cases of an illness, specific health-related behavior, or other health-related events clearly in excess of normal expectancy.
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Pandemic
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An epidemic occurring worldwide, or over a very wide area, crossing international boundaries, and usually affecting a large number of people. A worldwide influenza pandemic is an example.
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5 characteristics of epidemiology
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Population focus Distribution Determinants Disease outcomes Disease quantification
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Distribution
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Variations in the occurrence of diseases and other health outcomes in populations, with some subgroups of the populations more frequently affected than others.
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Determinants
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A collective or individual risk factor (or set of factors) that is causally related to a health condition, outcome, or other defined characteristic.
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Disease outcomes
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All the possible results that my stem from exposure to a causal factor. Types of measures of morbidity/mortality.
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Disease quantification
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The counting of cases of illness or other health outcomes; the use of statistical measures.
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Exposures
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Contacts with disease-causing factors; the amounts of the factors that impinge upon a group or individuals.
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Epidemiology aids with control of health problems via:
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Health promotion Alleviation of adverse health outcomes Prevention of disease
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Natural history of disease
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The time course of disease from its beginning to its final clinical endpoints.
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Primary prevention
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Activities designed to reduce the occurrence of disease and that occur during the period of prepathogenesis (i.e., before an agent interacts with a host).
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Secondary prevention
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Intervention designed to reduce the progress of a disease after the agent interacts with the host; occurs during the period of pathogenesis.
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Tertiary prevention
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Intervention that takes place during late pathogenesis and is designed to reduce the limitations of disability from disease.
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Observational Science
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A branch of knowledge that capitalizes on naturally occurring situations in order to study the occurrence of disease.
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Descriptive epidemiology
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Epidemiologic studies that are concerned with characterizing the amount and distribution of health and disease within a population.
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Analytic epidemiology
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Examines causal (etiologic) hypotheses regarding the association between exposures and health conditions. Proposes and evaluates causal models for etiologic associations and studies them empirically.
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Natural experiments
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Naturally occurring circumstances in which subsets of the population have different levels of exposure to a hypothesized causal factor in a situation resembling an actual experiment. The presence of persons in a particular group is typically nonrandom. Example: John Snow's natural experiment.
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Hippocrates (460 BCE-370 BCE)
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Departed from superstitious reasons for outbreaks; suggested disease might be associated with environmental factors; Wrote "On Airs, Waters, and Places.
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John Snow (1813-1858)
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Anesthesiologist; Father of Epi; cholera in water pump-Broad St., London. Contributions: powers of observation and written expression, epi methods, mapping, data tables to describe outbreaks, prevention
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Miasmatic Theory of Disease
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John Snow-disease was transmitted by a misam, or cloud, that hung low on the surface of the earth.
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Robert Koch (1843-1910)
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German physician-"Die Aetiologie der Tuberkulose"; identified TB cause, 1882; demonstrated assoc. between microorganism/disease; cholera and anthrax bacteria.
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Kochs postulates
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observed, cultured, injected, recovered
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John Graunt (1620-1674)
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Natural and Political Observations Mentioned in a Following Index; Made Upon the Bills of Mortality; first to employ quantitative methods, known as "Columbus of Statistics."
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Paracelsus (1493-1541)
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Founder of toxicology; dose-response relationship, notion of target organ specificity of chemicals.
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Bernardino Ramazzinni (1633-1714)
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Founder of field of occupational medicine; wrote De Morbis Artificum Diatriba (Disease of Workers).
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Edward Jenner(1749-1823)
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Developed method for smallpox vaccine.
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Sir Percival Pott (1714-1788)
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London surgeon thought to be 1st to describe an environ. cause of cancer-chimney sweep soot/scrotal cancer.
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Alexander Fleming (1881-1955)
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Discovered the anti-microbial properties of the mold Penicillium notatum, 1928; treats syphilis, gangrene, TB, gonorrhea. Available end of WWII.
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William Farr (1807-1883)
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Developed system for codifying medical conditions. Examined linkage between mortality rates/pop. density, Used census reports for occupational mortality.
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Black Death (middle ages/1346-1352)
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Thought to be caused by Yersinia pesitis bacteria via flea bites. Claimed 1/3 of Europe pop. (20-30 mil/100 mil); swollen lymph nodes, fever, black splotches on skin.
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Pandemic Influenza 1918
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"Spanish Flu"' killed 50-100 mil globally; 1/3 of world pop infected and developed clinically observable illness.
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Recent epidemiology contributions
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HPV and cervical cancer Bacteria and peptic ulcers Genetic factors and cancer
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Framingham Study
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Begun in 1948; investigates risk factors for coronary heart disease.
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Uses of Epidemiology
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Historical community health Health services Risk assessment Disease causality
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Epidemiologic transition
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A shift in the pattern of morbidity and mortality from causes related primarily to infectious and communicable diseases to causes associated with chronic, degenerative diseases; is accompanied by demographic transition.
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Demographic transition
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Historical shift from high birth and death rates found in agrarian societies to much lower birth and death rates found in developed countries.
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Operations research
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A type of study of the placement of health services in a community and the optimum utilization of such services.
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Cholera (1800-1899)
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Bacterial disease of the small intestine, from infected water, causing severe vomiting and diarrhea. Infected thousands in Haiti, Kenya, Zimbabwe; still today.
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Risk assessment
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A process for identifying adverse consequences of exposures and their associated probability.
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Disease causality use
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To search for cause by computing the experience of groups defined by their composition, inheritance, and experience, behavior and environment.
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U.S. Public Health Service Syphilis Study at Tuskegee
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An investigation of untreated syphilis among black men begun in 1932 that spanned 40 years with the purpose to record the natural history of syphilis in hopes of justifying treatment programs for blacks.
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American College of Epidemiology (ACE)
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Developed ethics guidelines for epidemiologists.
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Salmonella outbreak
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2008-affected 1400 people; suspected cause by Mexican jalapenos and Serrano peppers.
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Adherence to ethical norms in research
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-promotes aims of research -promotes values essential to collab. work -accountability to the public -promotes moral support and social values
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Ethical violation at Willowbrook State School
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-home for children with mental retardation -unsanitary conditions -intentionally infected with hepatitis -test for possible vaccine
