Epidemiology: The Study of Disease, Injury, and Death in the Community – Flashcards
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An epidemiologist is to a __________ as a doctor is to a _________.
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population, patient
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Epidemiology
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Study outbreaks of disease, injury, & death in the human population
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Epidemiology has been called ________ _________.
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"population medicine"
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Epidemiology
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"the study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to control health problems" (Last, 2001)
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• Endemic Diseases
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diseases that occur regularly in a population as a matter of course (always there)
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• Epidemic
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An unexpectedly large number of cases of an illness, specific health-related behavior, or other health-related event in a particular population
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Epidemiologist
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"an investigator who studies the occurrence of disease or other health-related conditions or events in defined populations" (Last, 2001)
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Epizootic
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outbreak of disease that begins in animals and spreads to humans
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Epizootiologist
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one who studies disease outbreaks in animals
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Pandemic
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outbreak of disease over a wide geographical area such as a continent (flu pandemic of 1918-19 killed 25 million people worldwide) Dr.Ayad
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When did Hippocrates, "Father of Medicine," suggested a relationship between disease & environment
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300 b.c.
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After fall of Greece & Rome, there were few advancements in health & medicine, & diseases became linked to __________ _________.
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spiritual causes
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Yellow fever in Philadelphia; killed 4,044 people; cause (mosquito) discovered in 1901 by Major Walter Reed
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1793
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Cholera in London; Snow investigated & in 1854 removed Broad Street pump handle; 30 years before Louis Pasteur's "germ theory"
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1849
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Cases:
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people afflicted (those who are sick)
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How many cases can be called an epidemic?
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40
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Rates:
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number of events in a given population over a given period of time or given point in time - Natality (birth), morbidity (sickness), mortality or fatality (death) rates
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• Population at Risk:
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those susceptible to particular disease or condition
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Incidence rate
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the number of new health-related events or cases of a disease in a population exposed to that risk in a given time period
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Prevalence rate
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calculated by dividing all current cases of a disease (old ; new) by the total population at risk in a given time period
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Attack rate
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a special incidence rate calculated for a particular population for a single disease outbreak expressed as a percentage
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• Acute diseases
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those that last three months or less (sudden onset, severe manifestations, complete recovery)
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• Chronic diseases
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those that last three months or longer (insidious onset, moderate manifestations, incomplete recovery)
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Prevalence rate
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- can be used to measure amount of illness in a community - can be used to determine ' health care needs of community
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What two factors can influence prevalence rate?
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• Incidence Rate • Duration of illness
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Prevalence
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No. of pts. that have the dis. @ a specific time (OLD and NEW)
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Incidence
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No. of NEW cases during specific time
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Duration
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Prevalence / Incidence
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Crude rates
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those in which the denominator includes the total population
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• Age-adjusted rates
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those used to make comparisons of relative risks across group & over time when groups differ in age structure
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• Specific rates
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measure morbidity or mortality for particular populations or diseases
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Case Fatality Rate
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- The percentage of cases that resulted in death
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Case Fatality Rate =
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death due to disease/cases of same disease • expressed as %, measures severity of a disease • predicts risk of dying of a disease • Tetanus: CFR 30-90% depending on age, Rx
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• Proportionate mortality ratio
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- Describes the relationship between the number of deaths from a specific cause and the total number of deaths attributed to all causes
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Proportionate Mortality Ratio (PMR) =
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number of death due to cause/ total number of death - expressed as % - NOT a rate - does not measure probability of dying from a particular cause - used to determine RELATIVE importance in relation to all other causes within a certain population
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Notifiable diseases
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infectious diseases which health officials request or require reporting
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National Electronic Telecommunications System (NETS)
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the electronic reporting system used by state health departments and CDC
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Morbidity and Mortality Weekly Report
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(MMWR)- a report of CDC used to present notifiable disease data
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State Laws for disease
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under California Code of regulations, Title 17 (Section 2500), public health professionals, medical providers & others are mandated to report 84 diseases or conditions to their local health department (diseases of P.H. importance).
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DISEASE REPORTING cont
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Failure to report is a misdemeanor punishable by a fine of not less than $50 nor more than $1,000, or by imprisonment for a term of not more than 90 days, or both. • Each day the violation is continued is a separate offense • Medical Board of California has made failure to report in a timely manner a citable offense under California Business & Professions Code (Section 2234), "Unprofessional Conduct."
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Toxoid:
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is a modified bacterial toxin that has been rendered non-toxic but retains the ability to stimulate the formation of antitoxin.
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Commonly used toxoids include __________ and __________ toxoids.
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diphtheria, tetanus
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Case Fatality Rate
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- The percentage of cases that resulted in death
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Case Fatality Rate =
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death due to disease/cases of same disease
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Case Fatality Rate
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- The percentage of cases that resulted in death
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Herd Immunity
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Portrays the spread of a communicable disease within a group based on the percentages of susceptible and immune individuals in the group. Epidemics or outbreaks of disease occur when the proportion of susceptible individuals is high and disappear as the proportion of immune individuals increases.
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Mortality statistics
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As leading causes of death (single most reliable measure of population health) - 1900: Pneumonia & influenza, TB, diarrhea - 2010: Heart disease, cancer, COPD, stroke
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Life expectancy
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average number of years a person from a specific cohort (e.g., born in 2008) is projected to live from a given point in time (e.g., birth, age 65, age 75)
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Years of potential life lost (YPLL)
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number of years lost when death occurs before age 65 or 75
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U.S. Census
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- Conducted every 10 years; enumeration of population
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• Statistical Abstract of the United States
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- a book published annually that includes statistics on social, political, and economic organization
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• Morbidity & Mortality Weekly Report
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(MMWR)- Prepared by the CDC & reports cases of notifiable diseases in the U.S.; also includes articles on other public health problems
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National Health Surveys
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- Health interviews of people, many different ones; - Clinical tests, measurement, and physical examinations - Survey of places where people receive medical care
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4 types of epidemiological studies:
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1- Descriptive studies 2- Analytical studies a. Prospective studies (cohort) b. Retrospective studies (case control) 3- Experimental studies
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Descriptive Studies
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- Who (or person): Age, sex, ethnic, race, socioeconomic status - When (or time): Time of day, week, month, season, year, decades; incubation period - Where (or place): Country, state, county, street, urban or rural, domestic or foreign, institutional or non-institutional
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Epidemic curve:
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a graphic display of the cases of a disease according to the time or date of onset
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Point source epidemic:
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an epidemic curve depicting a distribution of cases which all can be traced to a single source. Includes the incubation period****, which is the period of time between exposure to an infectious agent and the onset of symptoms.
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Propagated epidemic curve:
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an epidemic curve depicting a distribution of cases traceable to multiple sources of exposure
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Case/control study (retrospective):
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one that seeks to compare those diagnosed with a disease with those who do not have the disease for prior exposure to specific risk factors
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Cohort study (prospective study):
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one in which a cohort is classified by exposure to one or more specific risk factors and observed to determine the rates at which disease develops in each group
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AnalyticalStudies:
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Testing of hypotheses about relationships between health problems and possible risk factors
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Where is CDC located?
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Atlanta Georgia
